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S López-Pousa

Publications and source records attributed to S López-Pousa.

44 records · Page 3Linked to original sources
PubMedDate not supplied

[Carer's burden and depressive symptoms in patients with Alzheimer s disease. State after twelve months].

OBJECTIVE: The objective of this study is to determine the effect of depressive symptoms of patients in the burden perceived by the carer, evaluate the course of this burden in relation to the disappearance, persistence or appearance of depressive symptoms after twelve months and find which factors are associated with a rise or fall in the carer s load after twelve months. PATIENTS AND METHODS: A prospective observational study for 12 months of a sample of 150 patients with the clinical diagnosis of probable Alzheimer s disease on the criteria of NINDCS ADDRA: The sociodemographic data of their carers were collected and tested on the following scales: CAMDEX, CAMCOG, NPI, RDRS 2 and Burden Interview (BI) initially and twelve months later. RESULTS: The existence of depression initially was associated with an increased burden (score of BI of 22.76 compared with 15.79), increased non cognitive symptoms (NPI score of 16.23 compared with 5.94) and greater functional disability (RDRS 2 score of 27.89 compared with 25.53). The burden increased in the group of patients whose depressive symptoms persisted and in those in whom they appeared after twelve months. CONCLUSION: The data suggest that depressive symptoms increase functional disability and are associated with an increase in non cognitive symptoms. At the same time the functional disability and non cognitive symptoms increase the carer's burden.

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[Tolerance and adverse events of treatment with acetylcholinesterase inhibitors in a clinical sample of patients with very slight and mild Alzheimer s disease over a six-month period].

INTRODUCTION: At present acetylcholinesterase inhibitors (AChEI) are used in the treatment of the cognitive deterioration associated with Alzheimer s disease (AD). The side effects of these drugs are linked with the increase in acetylcholine, which limits their effectiveness, and must be adjusted to the patient close to the maximum tolerated dose. PATIENTS AND METHODS: We conducted a comparative retrospective study of the tolerance and the adverse events (AE) of two AChEI in a group of patients with very slight and mild probable AD over a 6 month period. RESULTS: The sample was made up of 175 patients, of which 134 began therapy with 5 10 mg/day of donepezil and 41 with 6 12 mg/day of rivastigmine. 20% of the patients presented AE and 8% abandoned the treatment. Gastrointestinal disorders (GID) were the main AE observed (57.1%). Only 6% of the patients treated with donepezil abandoned the therapy because of the AE as opposed to 14.6% of the patients treated with rivastigmine. Patients treated with rivastigmine displayed a higher incidence of GID and the relative risk of presenting GID was 4.4 times higher than in the patients treated with donepezil. CONCLUSIONS: The GID associated to therapy with AChEI are the main reason for abandoning treatment and occur more frequently in patients treated with rivastigmine.

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PubMedDate not supplied

[Clinical incidence of dementia with Lewy bodies].

INTRODUCTION AND AIMS: Dementia with Lewy bodies (DLB) has only relatively recently been acknowledged as an independent neurodegenerative entity. Until now few epidemiological prevalence studies have been carried out that include DLB and there are no studies about its incidence. The aim of this study is to determine the annual clinical incidence of DLB. PATIENTS AND METHODS: We performed an observational retrospective study of the diagnosis of all the individuals who were attended at the UVAMID (Memory and Dementia Assessment Unit) between 1999 and 2001. The clinical assessment was performed in a standardised manner following the UVAMID protocol, which includes the medical history, obtained by interviewing the patient and a reliable informant, a general medical and neurological check up, neuropsychological exploration and a set of complementary tests. RESULTS: The incidence of DLB in clinical practice was found to be 26/100,000 cases per year. By age groups, a progressive increase in incidence was seen until the 80 84 year old bracket and 63% of the cases of DLB were males. CONCLUSIONS: The results of this study show that cases of DLB made up 2% of the total number of new annual cases. The main limitation of this study lies in the fact that, because patients were referred to clinic from primary health care centres, they do not constitute a representative sample that is clinically unbiased, and this imposes restraints on the extrapolation of results.

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[A proposal for a clinical registry of dementias].

AIMS: We outline a proposal for the structural and functional features needed to develop a registry of dementias which can be used to collect standardised information that is both reliable and valid concerning cases of dementia in the specialised health care centres within a particular geographical area. DEVELOPMENT: Due to the shortage of information about aspects concerning the impact of dementias on the health care system (in terms of the usage of resources and patterns of detection, referral, diagnosis and treatment in usual clinical practice in primary and secondary care), a sequential implementation of the registry is proposed so that it can be adapted to each health district or region. The first step is to identify the cases and sources of information; second, a system for collecting data must be developed that allows information to be gathered in a standardised manner while at the same time making it possible to work in close collaboration with the specialists who diagnose dementia; and, third, it must be set up with the logistics and staff needed to centralise all the functions and activities of the registry. CONCLUSIONS: Epidemiological surveillance is an essential instrument for planning, managing and distributing community health resources, for following up the natural history of chronic diseases and for assessing the impact of programmes of prevention. In this respect, and from a functional point of view, the proposed registry of dementias meets all the basic requirements of epidemiological surveillance.

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PubMedDate not supplied

[Incidence of cerebrovascular disease in Spain: a study in a rural area of Girona].

In Spain in recent years several studies have been carried out into the incidence of acute stroke among the population at large. The average figure for incidence in these studies was 227 cases per 100,000 inhabitants, ranging from a low of 163 to a high of 323 cases. In the study made among the rural population of Girona the incidence rate was 257 cases per 100,000 inhabitants which was reduced to 134 cases when adjustment was made with world population. The overall incidence rate for stroke was 193 cases per 100,000 inhabitants, with that for first stroke being 174 cases per 100,000 inhabitants. The incidence of Transient Ischaemic Attacks (TIA) was 64 cases per 100,000 inhabitants. Acute stroke incidence was greater in men (364 per 100,000) than in women (149 per 100,000). The fatality rate for acute stroke in the first month was 38 cases per 100,000 inhabitants. Significant risk factors in acute stroke were alcohol abuse, hypertension, valvulopathy, earlier episodes of stroke and TIA and emboligenous source of cardiac origin.

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PubMedDate not supplied

[Prevalence of cerebrovascular disease in Spain: a study in a rural area of Girona].

In Spain in recent years two studies have been carried out into the prevalence of stroke. In the study made in Girona of the rural population over 64 years of age, the prevalence for stroke was 4,012 cases per 100,000 inhabitants. The figure was higher for women- 5,072 -than for men 2,675 cases. Transient Ischaemic Attacks (TIA) had a prevalence rate of 679 cases per 100,000 population of those aged over sixty-nine, being higher for men (1,161 cases) than for women (371 cases). The results from Girona differ from the findings in other Spanish regions in that the former are lower but at the same time are similar to those obtained in other western countries. The greatest risk factors for those over 69 years old were arterial hypertension, earlier episodes of TIA, diabetes, auricular fibrillation, congestive cardiac insufficiency, chronic bronchitis, myocardial infarction peripheral vascular-diseases, arteriosclerosis, heart disease with embolization and alcohol abuse.

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