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Biomedical subjects

S López-Pousa

Publications and source records attributed to S López-Pousa.

At least 37 records · Page 2Linked to original sources
PubMed1979

CT for the follow-up of cranial trauma.

The author's experience in diagnosing lesions of cerebral trauma with the CT scanner are outlined. The study is divided into acute and chronic lesions. Special attention is drawn to the morphology of subdural and intracerebral haematomas, which is dependent upon their duration.

Brain Edema↗
PubMedDate not supplied

Evolution of depressive symptoms in Alzheimer disease: one-year follow-up.

The current longitudinal study analyzes the natural course of depressive symptoms in patients with Alzheimer disease (AD). The goals were to identify the clinical and sociodemographic variables related to depressive symptoms, to assess the effect of depressive symptoms on the course of cognitive and functional impairment and on associated neuropsychiatric disorders, and to identify which factors are associated with remission, persistence, and emergence of depressive symptoms at 12 months. A sample of 150 patients with mild or moderate severity was assessed at baseline and at 12 months using the neuropsychologic battery Cambridge Cognitive Examination. The Neuropsychiatric Inventory and Rapid Disability Rating Scale were administered to the caregiver. Prevalence, persistence, and emergence of depressive symptoms at baseline were 51%, 55%, and 20%, respectively. Remission of depressive symptoms at 12 months leads to a decreased frequency of other noncognitive disorders and to a slight improvement in the assessment of global function. The presence of depressive symptoms does not affect the course of cognitive impairment at 12 months, and a psychiatric history of the patient and the number of depressive symptoms at baseline are risk factors for the emergence and persistence of depressive symptoms at 12 months.

Aged↗
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.

Adult↗
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.

Aged↗
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.

Aged↗
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.

Aged↗
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.

Age Distribution↗
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.

Aged↗
PubMedDate not supplied

[CAMDEX-R in the clinical evaluation of dementias].

CAMDEX has been very useful both for clinical use as epidemiological enquiries about dementia. However, the knowledge evolution about means that nowadays this schedule shows several shortcoming. A new version, CAMDEX-R, has adapted and introduced enough items to satisfy the actual requirements. The present article describes the changes and new contributions accomplished on the schedule.

Dementia↗
PubMedDate not supplied

[Burden and quality of life in carers of patients with Alzheimer type dementia].

OBJECTIVE: To analyze the factors which affect the burden and quality of life in carers of patients with Alzheimer's disease. MATERIAL AND METHODS: From a sample of 234 carers of patients in the Unit for Assessment of Memory and Dementia with a diagnosis of probable Alzheimer's disease, according to the scale of National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCS-ADRDA), and of minimal or slight severity, according to the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) criteria, we obtained sociodemographic variables and administered the following questionnaires: Neuropsychiatric Inventory (NPI), Rapid Disability Rating Scale (RDRS-2), Quality of Life Questionnaire (QLQ) and Burden Interview (BI). RESULTS: The sex of the carers, the hours of attention to the basic activities of daily life (BADL) and the Cambridge Cognitive Examination (CAMCOQ), Minimental State Examination (MMSE), QLQ, NPI and RDRS-2 scores were related to the BI score. Multiple regression accepted the scoring for NPI, RDRS-2 and QLQ in the model. The QLQ score was associated with male sex of the patient, the age of the carer, employment status, whether or not he lived with the patient, with the family relationship, the hours of attention to the BADL and the scores on CAMCOG, MMSE, RDRS-2, NPI and BI. The multiple regression model included the age of the carer, the BI score and the hours of attention to the BADL. CONCLUSION: The non-cognitive symptoms, functional disability and poor perception of quality of life are factors affecting the burden and age of the carer, the hours of attention to the BADL and the burden affecting quality of life.

Aged↗
PubMedDate not supplied

[Effectiveness of donepezil at six months in the treatment of cognition deterioration in patients with Alzheimer-type dementia].

INTRODUCTION: We compared two groups of patients with cognitive deterioration secondary to Alzheimer's disease (AD) of minimal and slight degree (CAMDEX criteria), one treated with donepezil and the other without this drug (a case history sample) over a period of six months. PATIENTS AND METHODS: Both groups received the CAMCOG battery of neuropsychological tests at basal (pretreatment) time and six months later. RESULTS: Those in the study sample who received donepezil (5-10 mg/day) were 91 patients (average age: 75.25, standard deviation = 6.01) of whom 28.6% were men. The control group, who did not receive anticholinesterase drugs (case history sample) consisted of 84 persons (average age: 75.98, standard deviation = 5.01) with 29.8% men. There were no significant differences with regard to age, sex, basal CAMCOG score or period of time between the two CAMCOG determinations. The averages of the differences between the basal CAMCOG scores and those six months later in the two groups was statistically significant (-1.5275 +/- 7.8458 against -6.7143 +/- 6.1234; p < 0.001). Multivariate analysis of repeat measurements corroborates these findings since significant differences were found between the two groups (p < 0.001) in the results of CAMCOG after six months. CONCLUSION: Donepezil was seen to be effective in that it delayed cognitive deterioration after six months in patients with minimal and slight degrees of AD.

Aged↗
PubMedDate not supplied

[The clinical incidence of frontal dementia].

INTRODUCTION AND OBJECTIVES: Although the neuropathology of Pick s disease and the frontal lobe dementias has been well defined, the complexity of the clinical diagnosis makes epidemiological studies difficult. The objective of this study was to determine the annual clinical incidence of fronto temporal dementia. PATIENTS AND METHODS: A retrospective observational study was made of the diagnoses of all persons attended in UVAMID during the period 1999 2000. Clinical evaluation was standardized following a protocol of the UVAMID. This included a clinical history obtained by interviewing the patient and a reliable informant, general medical and neurological examination, neuropsychological examination and a battery of complementary tests. RESULTS: In clinical practice the incidence of the different types of dementia varies between 93/100,000 in Alzheimer type dementia and 14/100,000 in DFT f. When age groups are considered, there is a progressive increase in the incidence of DFT f with 12/100,000 in the age group 46 69 years and 57/100,000 in the group of 75 79 years. CONCLUSIONS: The results of this study show that cases of DFT f form 2.7% of the new cases occurring annually. The main limitation of this study is that since these patients were referred for consultation from primary care centres, they form a non representative clinically biased sample which limits extrapolation of the results.

Adolescent↗