Biomedical subjects

J Llinàs-Reglà

Publications and source records attributed to J Llinàs-Reglà.

8 recordsLinked to original sources

PubMed1998

[Prevalence of depressive disorders in dementia].

OBJECTIVE: To find the prevalence of depressive illness associated with dementia in our geriatric population. MATERIAL AND METHODS: A study was made of the entire population aged over 69 years in eight rural districts of the province of Girona (Spain). Diagnosis was made using CAMDEX criteria. RESULTS: The prevalence of depression (depressive disorders plus pseudo dementia) was 9.1% (IC = 7.6-10.5%). In the group of patients with dementia, the frequency of depression was 28.15% whilst in the group with no dementia it was 5.4% (p = 0.0000). No differences were seen in the prevalence of depression between patients with Alzheimer type dementia (ATD) and those with vascular dementia (VD). The gravity of dementia, sex and age did not influence the frequency of depression. CONCLUSIONS: Depression in patients with dementia was very frequent in our geriatric population. Dementia was seen to be a risk factor with regard to depression.

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PubMed1998

[Non-cognitive aspects of dementia].

OBJECTIVE: To observe the frequency of various psychiatric disorders (depressive disorders, anxiety state and paraphrenic-paranoid disorders). PATIENTS AND METHODS: This study includes the 'cases' of dementia detected in an epidemiological field study done door-to-door, double phased and including non-institutionalized persons aged over 69 years in a rural area. All diagnoses were done by CAMDEX and on these criteria. RESULTS: Depressive disorder was diagnosed in 26.5% studied, paraphrenic or paranoid disorder in 14% and anxiety state in 6.5%. Depression and paraphrenic-paranoid disorder were not associated with the severity of the dementia, whilst anxiety state was more commonly seen in mild dementia. Paraphrenic-paranoid disorders were commoner in women than in men. CONCLUSION: The considerable prevalence of other psychiatric diagnoses in persons with dementia shows that non-cognitive symptoms are common in these patients.

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PubMedDate not supplied

[The Neuropsychiatric Inventory. Psychometric properties of its adaptation into Spanish].

OBJECTIVE: The purpose of this study was to examine the reliability and validity of the Spanish (Spain) version of the Neuropsychiatric Inventory. PATIENTS AND METHODS: The Neuropsychiatric Inventory was administered to the caregivers of 63 subjects from the Dementia Unit, Hospital Santa Caterina, Girona. All patients had detailed neuropsychological assessment, and their non-cognitive symptoms were also examined with the CAMDEX. RESULTS: There was a high level of internal consistency reliability. The Neuropsychiatric Inventory subscores correlated with those of the CAMDEX, indicating an acceptable level of validity. The most frequent symptom was apathy (56%), followed by irritability (38%), depression/dysphoria (35%), aberrant motor behavior (30%), agitation/aggression (29%), anxiety (27%), disinhibition (24%), delusions (19%), hallucinations (14%) and euphoria (3%). CONCLUSIONS: This study showed that the Spanish version of the Neuropsychiatric Inventory is a reliable instrument, which can briefly assess non-cognitive symptoms in demented patients. The Neuropsychiatric Inventory is a useful instrument for research and clinical practice in different culture around the world.

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PubMedDate not supplied

[Depression and dementia: case-control study].

OBJECTIVE: To know the prevalence and risk factors for depression in demented patients. PATIENTS AND METHODS: From a field epidemiological study, in a double phase, door to door, in which 1,460 subjects older than 69 from a rural area participated, three groups were established: group A made up of 200 dementia diagnosed subjects; group B made up of 119 subjects without dementia but with punctuation on the screening instrument (MEC) under the cut off point; the 283 subjects on the group C were not catalogued as demented, and the MEC punctuation was over the cut off point. Both the diagnoses of dementia and depression were made in basis of CAMDEX criteria. RESULTS: The frequency of depression in groups A, B and C was 26.5%, 11.76% and 4.94%, respectively. The dementia is a risk factor for depression (OR: 4.81; CI: 2.93-7.91). There are no differences in the frequency of depression according to dementia subtypes. Sex, age, marital status and severity of dementia do not have an influence on the prevalence of depression. The presence of psychiatric history is a risk factor for depression on groups A and B, but not for C. CONCLUSION: Depressions are more common on subjects with cognitive impairment.

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PubMedDate not supplied

[Treatment for non-cognitive symptoms in Alzheimer's disease].

OBJECTIVES: To review the classical treatment for non cognitive symptoms in Alzheimer's disease and to estimate the possible future contributions. DEVELOPMENT: The non cognitive symptoms, with a high frequency in dementia, mean a larger clinical severity, an increment of institutionalization and a larger carer's emotional burden. Several treatment frequently used has been reviewed (antipsychotic, antidepressant, antianxiety, anticonvulsive...) and the response for some of this symptoms is relatively narrow and side effects are frequent and intense. New drugs, as cholinesterase inhibitors and cholinergic agonist, that have demonstrated their efficacy for the cognitive symptoms, seem to be also effective for non cognitive ones. CONCLUSION: The relative low effectivity of classical treatment and the frequency and intensity of side effects open new possibilities to cholinesterase inhibitors in the treatment of non cognitive symptoms in Alzheimer's disease.

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PubMedDate not supplied

[The Cambridge Cognitive Examination as a tool for detection of dementia].

INTRODUCTION: The efficiency of Cambridge Cognitive Examination' (CAMCOG) is analyzed as a tool to detect dementias in epidemiological studies. PATIENTS AND METHODS: The data were obtained from subjects who enrolled the second phase on a door-to-door field epidemiological study. The tool used was the 'Cambridge Mental Disorders of the Elderly Examination' (CAMDEX). RESULTS: From the total sample of 602 subjects, 189 (31%) were men and the remaining 413 (69%) were women. The age average was 77.21 +/- 6.18 for the men group and 78.76 +/- 5.98 for the women group. The cut-off point that obtained best efficacy was 59/60. A multiple regression analysis was made using CAMCOG total scoring as the dependent variable and clinical diagnosis, age, sex and scholarship as independent variables. All the variables intermediate on CAMCOG total scoring with a multiple correlation coefficient (R) of 0.7061 (p < 0.0000). Five of the twelve CAMCOG subareas were efficient with a significance level of p > 0.0000, classifying correctly the 82.56% of the subjects. CONCLUSION: The CAMCOG is a moderate efficient total to discriminate dementia from no dementia on epidemiological studies.

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PubMedDate not supplied

[The prevalence of dementias in a rural area. A study in Girona].

OBJECTIVES: To know the prevalence of dementia and its subtypes in our area. PATIENTS AND METHODS: Epidemiological study, door-to-door, double phase, in which all non-institutionalized subjects from 8 rural villages aged 70 and more were selected. The general physicians and nurses, previously trained, administered the Mini Cognitive Examination (MCE) in the first phase. All subjects to whom cannot been administered MCE due to illness or sensorial deficit, all subjects under the cut-off point and a similar number of subjects randomized among the ones over the cut-off point, get through the second phase in which a clinical psychologist and a neurological trained physician administered the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). All diagnosis were done under CAMDEX criteria. RESULTS: A total of 1,460 subjects participated. The prevalence of dementia was 16.3% (14.4-18.2). The dementia Alzheimer type ratio was 40.76% (34.5-47), the vascular dementia was 38.24% (32.1-44.4), the mixed dementia was 11.7% (7.7-15.8) and the secondary dementia was 9.2% (5.5-12.9%). The logistic regression confirms that age and female sex are dementia risk factor. CONCLUSION: In our geographical area a very high prevalence of dementia is found.

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PubMedDate not supplied

[Integrated program of psychogeriatric care].

INTRODUCTION: At the present time there is considerable controversy over the course to follow in attention to patients with psychogeriatric disorders. Rapid diagnosis and maintaining the patients in their homes are the basic objectives of the policy of sharing responsibility among those involved. DEVELOPMENT: We review the bibliography and suggest a form of attention based on experience acquired in the dementia evaluation unit of the Programme Vida als Anys of the Generalitat de Catalunya. The model described is based on making the diagnosis in the patient's home, giving support to the family and integrating the patient into a follow-up unit, with a person responsible for evaluating and resolving the needs of both patient and family as they arise. In order to carry out this programme, the attention must be given by multidiscliplinary units with the necessary resources.

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