Prevalence of dementia and cognitive impairment with no dementia in a primary care setting in southern Brazil

ABSTRACT

Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.

RESUMO

Introdução: Declínio cognitivo é uma condição prevalente, apesar de ainda pouco representada em estudos de países em desenvolvimento. Objetivo: Calcular a prevalência de declínio cognitivo e depressão de uma população de idosos de uma cidade do Sul do Brasil. Métodos: Nós calculamos a prevalência de demência, declínio cognitivo sem demência (DCSD) e sintomas de depressão de uma população idosa de uma cidade assistida pelo sistema público de saúde. Um estudo epidemiológico foi conduzido em Pelotas, Brasil, no contexto de atenção primária incluindo 299 idosos (idade média = 69.75±7.6 anos), apresentando baixo nível educacional (média de anos de educação = 4.16±3.17). Esses indivíduos realizaram teste de rastreio cognitivo, e seus prontuários foram analisados. Resultados: Um total de 142 (47.5%) idosos apresentaram declínio cognitivo, dos quais 104 (34.8%) destes indivíduos atenderam a critérios cognitivos de DCSD e 38 (12.7%) indivíduos atenderam a critérios cognitivos para demência. Dentre todos indivíduos que completaram o rastreio, 141 (48.4%) foram positivos para sintomas de depressão, enquanto 99 (34%) não tinham diagnóstico em seus prontuários. Conclusão: Em suma, nós descrevemos uma prevalência alta de deterioro cognitivo entre idosos em um estudo de atenção primária. Nós também achamos um grande número de idosos com sintomas de depressão sem diagnóstico.

Keywords:

Dementia - Public health - Depression - Cognitive decline - Alzheimer’s disease

Palavras-chave:

Demência - Saúde pública - Depressão - Declínio cognitivo - Doença de Alzheimer

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