Memory clinic experience under a social security health system in Costa Rica

Abstract

Dementia and mild cognitive impairment (MCI) are an increasingly prevalent clinical entity in our field, showing an increasing incidence with age.ObjectiveThe purpose of this study was to identify the main types of dementia and MCI treated in a memory disorders unit in Costa Rica.MethodsA consecutive and standardized register of patients diagnosed with dementia and MCI at the memory disorders unit of the National Geriatrics and Gerontology Hospital (NGGH) was analyzed.ResultsDementia was diagnosed in 63.5% of the 3572 cases, whereas 10.6% met criteria for MCI. The most frequent type of dementia was Alzheimer's disease (47.1%), followed by vascular pathology (28.9%), mixed forms (17.2%) and other types (6.8%). In MCI, 69.5% were of amnestic multiple domain type and 14.3% were non-amnestic multiple domain, while 41.3% were of vascular and 35.8% of neurodegenerative etiology. Mean age was 79.6±6.7 years and 64.7% were women in dementia cases whereas mean age was 76.4±6.9 years and 62.1% were women in MCI. Mean years of schooling was 4.95±4.09 years and 6.87±4.71, while mean time between onset of symptoms and clinical diagnosis was 3.2±2.6 years and 2.67±2.69 years, in dementia and MCI, respectively.ConclusionThe determination of the main types of dementia and MCI in Costa Rica and their main features has allowed the registration of comprehensive, hitherto unavailable information that will be useful for the management and strategic planning of public health care.

Diagnostic diversity among patients with cognitive complaints: A 3‐year follow‐up study in a memory clinic

“…AD was the most common subtype of pure type dementia in our study, followed by VaD. This finding was consistent with previous memory clinic reports . Unlike reports from Japan, Hong Kong, and Costa Rica, the proportion of DLB was lower than PDD in our study .…”

“…The distribution of different types of dementia in memory clinics has been described in previous studies, in which Alzheimer disease (AD) is the most common pure type dementia (35%‐48%), followed by vascular dementia (VaD). Mixed type dementia, when included in the diagnostic category, is also reported to be common (8%‐30%) . However, the diagnostic classification in these studies was rather limited, whereas the frequencies of other degenerative dementias such as dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), frontotemporal dementia (FTD), or secondary causes of dementia were not adequately reported.…”

“…Memory clinics are established to facilitate timely diagnosis and appropriate intervention for patients with cognitive impairment or dementia . The distribution of different types of dementia in memory clinics has been described in previous studies, in which Alzheimer disease (AD) is the most common pure type dementia (35%‐48%), followed by vascular dementia (VaD). Mixed type dementia, when included in the diagnostic category, is also reported to be common (8%‐30%) .…”

“…Diagnoses other than degenerative dementia are also seen in memory clinics . The data from the UK Croydon Memory Service Model showed that 34% of the referrals were subjective cognitive impairment or other nondementia neurologic disorders .…”

“…In the Netherlands, the proportion of dementia diagnoses among patients seen in memory clinics decreased from 85% to 59% during 1998 to 2009, and over one‐third of memory clinic patients received diagnoses other than dementia . However, few studies reported the details of nondegenerative conditions of cognitive complaints . The distribution of other causes of cognitive complaints might be informative for clinicians to have a better grasp of differential diagnoses in practice.…”