INTRODUCTION: Folstein's Mini Mental State Examination (MMSE) is widely used as screening test for cognitive impairment. OBJECTIVE: To test a Spanish version of the MMSE in a population of high illiteracy rate. MATERIAL AND METHODS: Population-based survey of a stratified random sample of urban and rural residents of five regions of Colombia, followed by neurological and neuropsychological evaluation of suspect cases (phase 2). Dementia was diagnosed using DSM-IV criteria. RESULTS: 1,611 subjects age 50 or older filled out both the WHO Protocol for Epidemiologic Studies of Neurological Disorders and a Spanish version of the MMSE; 55.2% of them had three or less years of schooling; 536 individuals with scores below cutoff points were sent to phase 2. Of the population with satisfactory scores in MMSE 366 (34.0%) were evaluated by neurologists to exclude other neurological conditions. Twelve cases of dementia were diagnosed among individuals with scores below cutoff point and one among subjects with high scores. Age-adjusted prevalence was 8.1 per thousand subjects age 50 or over (95% CI: 3.7-12.5); and 34.2 per thousand for ages 75 or over (95% CI: 12.2-56.2). Sensitivity and specificity were 92.3 and 53.7%; 16 of the 19 questions show significant differences (p < 0.001) according to educational level. A gender gap is significant in low educational levels (p < 0.001) but not in subjects with more than five years of schooling. CONCLUSIONS: MMSE scores correlated closely with level of education. Low specificity leads to many non-demented subjects with low educational status requiring further investigation.

Aged↗

PubMedDate not supplied

[Prevalence of multiple sclerosis in Colombia].

INTRODUCTION: Multiple sclerosis (MS) is the commonest demyelinating condition of the nervous system. It is characterized by numerous demyelinating areas or plaques of demyelination which are found dispersed throughout the nervous system. It has been shown that MS is less frequent in tropical regions than in subtropical regions. In Latin America particularly, there are some studies which show this phenomenon. However, in Colombia no studies of prevalence of MS have been done. OBJECTIVE: To determine the prevalence of multiple sclerosis in five provinces of Colombia (Antioquia, Caldas, Santander, Risaralda and Bolivar). PATIENTS AND METHODS: The capture-recapture method was used for two sources to determine the number of cases defined on the criteria of Poser et al seen between July 1995 and June 2000. RESULTS: The prevalence (cases of MS per 100,000 inhabitants) varied between 1.48 in Antioquia (95% CI 1.12; 1.78) and 4.98 in Risaralda (95% CI 3.52; 6.43). Seventy two percent were women. The regions included in this study represented 25% of the population of Colombia. CONCLUSIONS: There is a low prevalence of MS which is as expected in tropical areas. Persons with MS in these regions may be very useful in the study of other factors involved in the aetiology of MS (genetic). The capture-recapture method is an excellent tool for carrying out prevalence studies since it is cheap and requires little time.

Colombia↗

PubMedDate not supplied

[Neuroepidemiology in the eastern region of Colombia].

OBJECTIVE: To determine the presence of eight neurological disorders (migraine, cerebrovascular disease, disorders of movement, peripheral neuropathy, mental retardation, epilepsy, dementia and the sequelas of head injuries) in the eastern region of Colombia. PATIENTS AND METHODS: Using the neuro epidemiological protocol of the World Health Organization (WHO), modified by our group, together with a questionnaire to determine the sequelas of head injuries and the abbreviated mental test (Mini mental), we interviewed people in the municipalities of Bucaramanga, Piedecuesta and Aratoca. The persons suspected of having neurological disorders, who were over 12 years old, were evaluated by neurologists and those under 12 years old by a neuropaediatrician. RESULTS: In the eastern region, 1,454 persons altogether were interviewed. Neurological conditions were suspected in 454 of these (31.2%), and confirmed in 437 (30.1%). The specific results for these neurological disorders and their respective confidence intervals (in brackets) were: migraine 198.8 (178.7 220.4); peripheral neuropathy: 26.8 (19.4 36.9); epilepsy: 22.7 (15.9 32.1); dementia: 17.9 (11.9 26.5); cerebrovascular disease: 17.2 (11.4 25.7); mental retardation and delayed nervous system development: 15.1 (9.7 23.2); extrapyramidal disorders: 8.3 (4.5 14.8); sequelas of head injuries: 6.9 (3.5 13.1). RESULTS: These results, obtained using a modified version of a WHO protocol, together with dementia and the sequelas of head injuries, will permit the development of health policies and programmes for the control and treatment of neurological disorders prevalent in this region of Colombia

Adult↗

PubMedDate not supplied

Contralateral early blink reflex in multifocal motor neuropathy.

Multifocal motor neuropathy (MMN) is a clinical entity affecting the peripheral nerve system mainly. We present here a Colombian man, 37 year-old, who presented MMN, and interestingly, displayed abnormal responses in the blink reflex after electrical stimulation of the supraorbital nerves. These findings allow us to suggest that the lesion distribution in MMN mostly the subclinical one, seems to be more widespread than usually thought.

Adult↗