Biomedical subjects

Félix Bermejo-Pareja

Publications and source records attributed to Félix Bermejo-Pareja.

7 recordsLinked to original sources

PubMed2006

Stroke prevalence among the Spanish elderly: an analysis based on screening surveys.

BACKGROUND: This study sought to describe stroke prevalence in Spanish elderly populations and compare it against that of other European countries. METHODS: We identified screening surveys--both published and unpublished--in Spanish populations, which fulfilled specific quality requirements and targeted prevalence of stroke in populations aged 70 years and over. Surveys covering seven geographically different populations with prevalence years in the period 1991-2002 were selected, and the respective authors were then asked to provide descriptions of the methodology and raw age-specific data by completing a questionnaire. In addition, five reported screening surveys in European populations furnished useful data for comparison purposes. Prevalence data were combined, using direct adjustment and logistic regression. RESULTS: The overall study population, resident in central and north-eastern Spain, totalled 10,647 persons and yielded 715 cases. Age-adjusted prevalences, using the European standard population, were 7.3% for men, 5.6% for women, and 6.4% for both sexes. Prevalence was significantly lower in women, OR 0.79 95% CI 0.68-0.93, increased with age, particularly among women, and displayed a threefold spatial variation with statistically significant differences. Prevalences were highest, 8.7%, in suburban, and lowest, 3.8%, in rural populations. Compared to pooled Spanish populations, statistically significant differences were seen in eight Italian populations, OR 1.39 95% CI (1.18-1.64), and in Kungsholmen, Sweden, OR 0.40 95% CI (0.27-0.58). CONCLUSION: Prevalence in central and north-eastern Spain is higher in males and in suburban areas, and displays a threefold geographic variation, with women constituting the majority of elderly stroke sufferers. Compared to reported European data, stroke prevalence in Spain can be said to be medium and presents similar age- and sex-specific traits.

Age Distribution↗

PubMed2006

Elderly-onset essential tremor is associated with dementia.

OBJECTIVE: To determine whether essential tremor (ET) is associated with prevalent dementia. METHODS: The authors identified all persons with dementia and ET in a population-based study in central Spain (the Neurological Disorders in Central Spain [NEDICES] Study). Dementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria. RESULTS: Thirty-one (11.4%) of 273 ET cases had dementia vs 204 (6.0%) of 3,382 non-ET subjects (controls) (odds ratio [OR] = 2.00, 95% CI = 1.34 to 2.98, p = 0.001). In a model that adjusted for age, stroke, and educational level, OR = 1.35, 95% CI = 0.87 to 2.18, and p = 0.17. In an adjusted model, ET cases with tremor onset after age 65 were 70% more likely to be demented than were controls (OR = 1.70, 95% CI = 1.04 to 2.76, p = 0.03), whereas ET cases with tremor onset at age < or = 65 and controls were equally likely to be demented (OR = 0.38, 95% CI = 0.09 to 1.73, p = 0.21). CONCLUSIONS: Older-onset essential tremor (ET) was associated with dementia. Prospective studies are required to elucidate the association between ET and dementia.

Age of Onset↗

PubMed2006

Population-based case-control study of cognitive function in essential tremor.

OBJECTIVES: To determine whether patients with essential tremor (ET) have cognitive deficits when compared with controls and whether the types of cognitive deficits reported previously are also found in this large sampling of patients with ET. METHODS: A total of 232 patients with ET and 696 matched controls age 65 years or older (median 75 years) living in central Spain (the Neurologic Diseases in Central Spain study) underwent a neuropsychological assessment, including tests of global cognitive performance, frontal executive function, verbal fluency, and memory. Subjects also were asked whether they had forgetfulness. RESULTS: Fifty-six patients with ET were previously undiagnosed; only 14 (6%) were taking medication for tremor. Adjusted for age, gender, education, premorbid intelligence, medications, and depressive symptoms, cases performed less well on most neuropsychological tests and especially tests of global cognitive performance (37-item Mini-Mental State Examination = 27.0 +/- 6.7 in cases vs 28.9 +/- 5.9 in controls, p < 0.001) and frontal executive function (Trail Making Test number of errors = 8.7 +/- 11.0 in cases vs 3.8 +/- 7.6 in controls, p < 0.001). Forgetfulness was reported in 117 (50.4%) patients with ET vs 300 (43.1%) controls (p = 0.05). CONCLUSIONS: In a population-based sample of largely untreated patients with essential tremor, cases performed more poorly on formal neuropsychological testing than did their counterparts without tremor. A complaint of forgetfulness was also marginally more common in patients with essential tremor.

Age Factors↗

PubMed2005

Incidence of essential tremor in three elderly populations of central Spain.

OBJECTIVE: To estimate the incidence of essential tremor (ET) in three populations in central Spain using data from the Neurologic Disorders in Central Spain (NEDICES), a population-based survey of elderly subjects (65 years and older). METHODS: Individuals were evaluated at baseline (1994 to 1995) and at follow-up (a median of 3.3 years later in 1997 to 1998). The evaluation included a screening question for ET and a neurologic examination, when possible. RESULTS: Of 5,278 subjects evaluated at baseline, there were 256 prevalent ET cases. Eighty-three incident ET cases were identified among 3,942 individuals assessed at follow-up. The adjusted annual incidence rate (per 100,000 person-years) in the population aged 65 years and older was 616 (95% CI: 447 to 784). Sixty-four (77.1%) of 83 incident cases had not been diagnosed before our assessment. CONCLUSIONS: The incidence of ET may be higher than previously recognized because a large proportion of patients with ET may never seek medical attention.

Age Factors↗

PubMed2005

Dementia, stroke and Parkinson's disease in Spanish populations: a review of door-to-door prevalence surveys.

We identified 14 door-to-door prevalence surveys on dementia, parkinsonism or stroke in Spanish populations fulfilling specific criteria and combined selected age- and sex-specific data using logistic regression and taking Pamplona as a reference. The prevalence of dementia and of Alzheimer's disease varied significantly with space. However, the largest variation was seen for vascular dementia: odds ratio (OR) and 95% confidence interval (CI) for Gerona were 6.42 (3.23-12.3) in women and 2.30 (1.10-4.79) in men. Stroke was particularly frequent among Arevalo's women, with OR 2.10 and 95% CI 1.26-3.49. The prevalence of Parkinson's disease was twofold higher in Cantalejo. Although differences in methodology make the interpretation of results problematic, the prevalence of stroke and vascular dementia in Spain seems to vary spatially, indicating a space for prevention.

Aged↗

PubMed2003

Prevalence of PD and other types of parkinsonism in three elderly populations of central Spain.

The prevalence of Parkinson's disease (PD) and other types of parkinsonism in three elderly populations of central Spain was investigated using a door-to-door, two-phase approach. This design called for the administration of a brief questionnaire to subjects 65 years of age or older taken from the census of one urban municipality of Greater Madrid (Margaritas, Getafe), one rural site (Arévalo County, Avila), and one urban district of Madrid (Lista) in Spain (N = 5,278). Study neurologists extensively investigated those subjects who screened positively. The diagnoses, based on specified criteria, were reviewed to increase reliability across neurologists. We found 118 subjects with parkinsonism: 81 affected by PD (68.6%), 26 drug-induced parkinsonism (22.0%), 6 parkinsonism in dementia (5.1%), 3 vascular parkinsonism (2.5%), and 2 unspecified parkinsonism (1.7%). The prevalence was 2.2% (95% confidence interval [CI], 1.8-2.6) for all types of parkinsonism and 1.5% (95% CI, 1.2-1.8) for PD. The prevalence estimates of parkinsonism and PD increased with age, declining at 85 years and over. Age prevalence ratios were higher for men. Twenty-three subjects (28.4%) of the subjects with PD were detected through the screening and had not been diagnosed previously. Overall prevalence estimates of PD and other types of parkinsonism in central Spain rank at levels similar to those recently reported for other European and non-European elderly populations. Despite improvement in access to health services, an important proportion of PD patients may never seek neurological attention.

Aged↗

PubMed2003

Prevalence of essential tremor in three elderly populations of central Spain.

Although essential tremor (ET) is considered the most prevalent adult movement disorder, the available information on its prevalence and distribution worldwide is not completely understood. We investigated the prevalence and distribution of ET in three elderly Spanish populations using a door-to-door, two-phase approach. A brief screening instrument was administered on May 1, 1994 to subjects over 64 years old taken from the census of one urban municipality of Greater Madrid (quarter of Margaritas, Getafe), one urban district of Madrid (Lista), and one rural site (Arévalo county, Avila) (N = 5278). Study subjects were limited to those who screened positively (N = 472). To increase reliability, each patient was examined by 3 experienced neurologists, and was classified as having ET only when all 3 neurologists agreed (183 of 472). The present study was part of a large-scale epidemiological survey of neurological diseases, and served as a baseline investigation in a 3-year incidence study. Accordingly, 41 ET patients were identified when evaluating subjects who had screened positively for dementia, stroke, or parkinsonism, despite the fact that they had screened negatively for tremor; furthermore, 32 additional ET prevalent cases were detected when evaluating subjects who had screened positively for tremor in the second cross-sectional study (May 1, 1997), although they had screened negatively for tremor in the first cross-sectional study. We identified 256 persons (152 women, 104 men) with ET; of these, 87 patients (34.0%) reported having an affected relative. Two hundred and four (79.7%) of the subjects with ET were detected through this screening and had not been diagnosed previously. The prevalence of ET was 4.8% (95% CI = 4.2-5.4) for the total population; 4.6% (95% CI = 3.7-5.4) in men and 5.0% (95% CI = 4.2-5.8) in women. Age-specific prevalence increased with advancing age for both men and women. Despite the variability in worldwide data, ET is a frequently encountered disorder in elderly people. Furthermore, as ET may be seen as a relatively benign condition, a large proportion of patients may never seek neurological attention.

Aged↗