ABSTRACT
INTRODUCTION: Mild cognitive impairment (MCI) is a cognitive disturbance in which intensity is not enough to be classified as dementia and does not affect significantly the functioning or activities of daily living. The MCI has a progression rate to Alzheimer-type dementia (ATD) related to different factors. AIM: To evaluate the association between the presence of psychological and behavioural symptoms (PBS) with progression to ATD en MCI subjects. PATIENTS AND METHODS: We evaluated 318 patients with MCI assessed in a Dementia Unit of Catalonia between 1998 to 2002 who were followed five years after the MCI diagnosis. We determined the PBS presence, those classified as affective, behavioural and psychotic symptoms. We also assessed sociodemographic aspects and the ApoE genotype. RESULTS: The mean age was 74 +/- 7.87 years-old, 56.7% presented PBS, with affective (53%), behavioural (32.2%) and psychotic symptoms (14.8%). In the study, 32.1% progressed to ATD. We found association between the presence of PBS and the progression to ATD (OR = 2.77; 95% CI = 1.66-4.63), specifically with behavioural and psychotic symptoms. The ApoE epsilon4 allele showed association with the progression to ATD (OR = 1.81; 95% CI = 1.11-2.94). The logistic regression model showed a significant association between the PBS and the epsilon4 allele with the progression to ATD. CONCLUSIONS: The PBS presence in MCI patients is associated with ATD progression with or without ApoE epsilon4 allele.
Subject(s)
Alzheimer Disease/physiopathology , Behavioral Symptoms/physiopathology , Cognition Disorders/physiopathology , Disease Progression , Adult , Aged , Aged, 80 and over , Alzheimer Disease/genetics , Apolipoprotein E4/genetics , Behavioral Symptoms/genetics , Cognition Disorders/genetics , Female , Humans , Male , Middle AgedABSTRACT
Introducción. El deterioro cognitivo leve (DCL) es una alteración cognitiva cuya intensidad no es suficiente para ser catalogada como demencia, ya que no interfiere significativamente en la autonomía funcional en las actividades de la vida diaria. El DCL presenta una tasa de progresión a demencia tipo Alzheimer (DTA) relacionada con diferentes factores. Objetivo. Evaluar la asociación entre la presencia de síntomas psicológicos y conductuales (SPC) con la progresión a DTA en sujetos con DCL. Pacientes y métodos. Evaluamos 318 pacientes con DCL valorados por una unidad de demencias de Cataluña de 1998 a 2002, con seguimiento los cinco años siguientes al diagnóstico de DCL. Se determinó la presencia de SPC clasificados en síntomas afectivos, psicóticos y conductuales. También se evaluaron otras variables sociodemográficas y el genotipo ApoE. Resultados. La edad promedio fue de 74 ± 7,87 años, y el 56,7% presentó SPC con síntomas afectivos (53%), conductuales (32,2%) y psicóticos (14,8%). El 32,1% progresó a DTA. Se encontró asociación estadística entre la presencia de SPC con la progresión a DTA (OR = 2,77; IC 95% = 1,66-4,63), concretamente con alteraciones conductuales y síntomas psicóticos. El alelo épsilon 4 del gen ApoE mostró asociación con la progresión a DTA (OR = 1,81; IC 95% = 1,11-2,94). El modelo de regresión logística mostró asociación significativa entre los SPC y el alelo épsilon 4 con la progresión a DTA. Conclusiones. La presencia de SPC en el DCL se asocia con la progresión a DTA, tanto en presencia como en ausencia del alelo épsilon 4 del gen ApoE (AU)
Introduction. Mild cognitive impairment (MCI) is a cognitive disturbance in which intensity is not enough to be classified as dementia and does not affect significantly the functioning or activities of daily living. The MCI has a progression rate to Alzheimer-type dementia (ATD) related to different factors. Aim. To evaluate the association between the presence of psychological and behavioural symptoms (PBS) with progression to ATD en MCI subjects. Patients and methods. We evaluated 318 patients with MCI assessed in a Dementia Unit of Catalonia between 1998 to 2002 who were followed five years after the MCI diagnosis. We determined the PBS presence, those classified as affective, behavioural and psychotic symptoms. We also assessed sociodemographic aspects and the ApoE genotype. Results. The mean age was 74 ± 7.87 years-old, 56.7% presented PBS, with affective (53%), behavioural (32.2%) and psychotic symptoms (14.8%). In the study, 32.1% progressed to ATD. We found association between the presence of PBS and the progression to ATD (OR = 2.77; 95% CI = 1.66-4.63), specifically with behavioural and psychotic symptoms. The ApoE epsilon4 allele showed association with the progression to ATD (OR = 1.81; 95% CI = 1.11-2.94). The logistic regression model showed a significant association between the PBS and the epsilon4 allele with the progression to ATD. Conclusions. The PBS presence in MCI patients is associated with ATD progression with or without ApoE epsilon4 allele (AU)
Subject(s)
Humans , Alzheimer Disease/psychology , Cognition Disorders/diagnosis , Mental Disorders/diagnosis , Disease Progression , Psychotic Disorders/diagnosis , Apolipoproteins E/analysis , Genetic MarkersABSTRACT
Objetivos: Determinar la prevalencia de psicopatología en los candidatos a cirugía bariátrica en la Clínica Reina Sofía, entre octubre y noviembre de 2007, e identificar algunos potenciales factores de riesgo para su aparición. Método: Se realizó un estudio descriptivo con corte transversal comparativo, en el cual participaron 50 candidatos a cirugía bariátrica, a quienes después de firmar el consentimiento informado se les aplicó la Structured Clinical Interview (SCID), para el DSM-IV, y preguntas estructuradas para la exploración sistemática de las variables estudiadas. Resultados: La muestra de 50 pacientes se conformó en un 62% (n=31) por mujeres. La edad promedio de los participantes fue de 45,2 (DE=12,94) y el promedio en el índice de masa corporal (IMC) fue de 38,92 Kg/m² (DE=3,53). La prevalencia de psicopatología fue del 38% (n=19), clasificada como trastornos del estado del ánimo: 24% (n=12); trastornos adaptativos: 8% (n=4), y trastornos de ansiedad: 6% (n=3). Al comparar los sujetos de acuerdo con la presencia de psicopatología, se encontró una asociación estadísticamente significativa entre el antecedente de abuso sexual infantil y la presencia de psicopatología (OR=10,71; IC 95%: 1,14-100,52). No hubo relación con variables sociodemográficas, grado de obesidad o problemas psicosociales. Conclusiones: El estudio mostró una asociación estadísticamente significativa entre la presencia de psicopatología y el antecedente de abuso sexual infantil...
Objectives: To determine the prevalence of psychopathology among bariatric surgery candidates at the Reina Sofía Clinic during October-November 2007, and to identify some factors associated to psychopathology in this population. Method: This is a descriptive study with a comparative transversal analysis. 50 bariatric surgery candidates were considered into study, who accepted to participate in the study and signed written informed consent. These patients were then assessed with Structured Clinical Interview (SCID), for DSM-IV, and structured questions for the systematic variables exploration. Results: In the study group (n=50), 62% (n=31) were women, the mean age was 45.2 years (SD=12.94) and the mean body mass index (BMI) of the group was 38.92 Kg/m² (SD=3.53). The psychopathology prevalence was 38% (n=19), with mood disorders: 24% (n=12); adaptative disorders; 8% (n=4), and anxiety disorders: 6% (n=3). The comparative analysis by the psychopathology presence showed a signifi cant correlation with history of sexual abuse and psychopathology (OR=10.71; 95% C.I.: 1.14-100.52). The analysis did not show significant relation among demographic characteristics, obesity grade or social problems and the risk of psychopathology. Conclusions: the study shows a significant correlation between child sexual abuse history and psychopathology...
