Lessons from the epidemiology of neuropsychiatric disorders in older people

Abstract

lessons from the epidemiology of neuropsychiatric disorders in older peopleLições da epidemiologia dos transtornos neuropsiquiátricos em idosos Cássio Machado de Campos Bottino D emographic changes that have occurred in Brazil have been widely publicized in recent years, showing the aging process of the Brazilian population. This is a worldwide phenomenon, which has occurred since the 20 th century, and it is unparalleled in human history, affecting countries globally, due to the persistent increase in absolute and relative number of older people, with profound impact on the economic and social spheres of human life. Aging is a long-lasting phenomenon, with the proportion of older people rising from 8%, in 1950, to 10%, in 2000, and an estimated 21%, in 2050 1 .The United Nations (UN) estimates for 2005, pointed to Brazil as belonging to the group of ten countries with the largest population of people aged 60 years or more, and estimates indicate that Brazil, in 2050, will be one of the six countries that have more than 10 million over 80 years-old. Among developing nations, Brazil has the highest percentage increase of the elderly population worldwide, with the group above 60 years-old increasing by about 23 times from 1950 to 2050, while its population as a whole is expected to grow about 4.5 times during this period 1 .Therefore, we can imagine the impact that these demographic changes can have on our health care system. The neuropsychiatric disorders are among the most severe and disabling conditions affecting older people, and some articles published in recent years started to provide a bigger picture regarding the most prevalent diseases in this age range.One of the first of these papers described that the prevalence of dementia in the population over 65 years-old, living in Catanduva, in the state of São Paulo, was 7.1% 2 . The estimated prevalence of dementia found in another study carried out in São Paulo city, was 12.9% in the population over 60 years 3 , figures equal to or higher than the prevalence rates of dementia found in developed countries 4 . Assessing the factors associated with dementia, the authors reported that age, especially above 70 years-old, lack of formal education, history of stroke, head trauma, diabetes, and epilepsy were associated with increased Odds Ratio of dementia and while the history of tumor/cancer, arthritis, current work and frequent reading of books were associated with reduced Odds Ratio of dementia in Brazilian studies 4 .We can conclude from these data that the prevalence of dementia is similar or even higher in our country, and that Alzheimer's disease and vascular dementia are the most frequent causes of dementia. It is also well-known that dementia has a profound effect upon the patients' families and in this number of this journal, Camargos et al. 5 showed the results of interviews performed in Brasilia, with 311 caregivers of people with or without dementia. The authors pointed out that the use of psychotropic drugs (benzodiazepines or antidepressants) was more ...

Comunicação e cuidados paliativos em demência: revisão de 5 anos

“…It is caused mainly by Alzheimer's disease (AD) and Vascular Dementia (VaD) with many intersections between both (known as Mixed Dementia) 2 . Its prevalence is very high worldwide, between 5% and 7 1 , similar to the data obtained in Brazilian studies 3 . It was estimated that 35.6 million people lived with dementia in 2010, and it is expected to almost double every 20 years (65.7 in 2030 and 115.4 in 2050) 1 .…”

“…It was estimated that 35.6 million people lived with dementia in 2010, and it is expected to almost double every 20 years (65.7 in 2030 and 115.4 in 2050) 1 . This high prevalence, together with the high costs demanded by these patients' care, makes dementia a health priority to governments of all countries 3 . In spite of huge investments on research, the pathophysiology of Alzheimer, the most common cause of dementia, is not completely known 4 .…”

“…The most important known factor, however, is increasing age. Prevalence of dementia increased exponentially with age in every country, doubling with every 5.5-year increment in age in individuals from North and Latin America 1,3 . Symptoms of dementia may vary widely, from mild memory impairment until complete loss of contact with the environment 6 .…”

Cognitive Rehabilitation of Dementia in Adults with Down Syndrome: A Review of Non-Pharmacological Interventions

“…Neuropsychiatric disorders are among the most severe and disabling age-related diseases [ 1 ]. Dementia is a neuropsychiatric disorder that affects cognition and function, having multiple aetiologies.…”

Balance and Gait

“…Therefore, the premorbid cognitive deficit and the variable degree of intellectual disability compound the challenges of the differential diagnosis. In addition, 7 most test batteries commonly used in the general population are of limited use in individuals with DS, many of whom are unable to achieve the minimum score on the proposed cognitive tasks, because of a premorbid cognitive deficit. 6 Recent studies indicate association between gait abnormalities and cognitive decline among euploid seniors.…”