Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil.
Khronus Saúde e Educação Ltda, Instituto Khronus de Desenvolvimento Humano, Patos de Minas MG, Brazil.
Arq Neuropsiquiatr. 2024 May;82(5):1-9. doi: 10.1055/s-0044-1787138. Epub 2024 Jun 7.
Memory complaints are frequent in older adults and are associated with higher risk of cognitive decline.
To investigate the functional outcome of individuals with memory complaints followed up at primary care centers.
Data were collected between 2016 e 2020 in primary health care centers in Brazil. Patients underwent the Brief Cognitive Screening Battery, and the Functional Activities Questionnaire.
The initial sample (2016) comprised 91 individuals classified into those with subjective cognitive decline (SCD, = 15), mild cognitive impairment (MCI, = 45), or dementia ( = 31). During follow-up, 8 individuals (8.8% of the initial sample) died and 26 (28.5% of the initial sample) were not found. Fifty-seven participants underwent clinical reassessment. Of 15 individuals with SCD, 7 were not found (46.7%), 4 (26.7%) progressed to MCI, and 4 (26.7%) remained stable. Of 45 individuals with MCI, 11 were not found (24.4%), 2 (4.4%) died, 6 (13.4%) progressed to dementia, 12 (26.7%) regressed to SCD, and 14 (31.1%) remained stable. Of 31 individuals with dementia, 8 were not found (25.8%), 6 (19.4%) died, 2 (6.5%) regressed to SCD, 7 (22.6%) regressed to MCI, and 8 remained stable (25.8%). Clinical improvement was due to the treatment of reversible causes, such as B12 hypovitaminosis and mood disorders. Older age, lower Mini-Mental State Examination, and higher scores of memory complaint, but not the use of benzodiazepines and of proton pump inhibitors, were predictors of functional status.
Despite their limits (short sample size, missing data), these results support the idea that adequate screening, follow-up, and treatment of reversible causes of dementia in primary care are essential.
记忆问题在老年人中很常见，并且与认知能力下降的风险增加有关。
调查在初级保健中心接受随访的有记忆问题的个体的功能结局。
数据于 2016 年至 2020 年在巴西的初级保健中心收集。患者接受了简短认知筛查量表和功能活动问卷的评估。
初始样本（2016 年）包括 91 名患者，分为有主观认知下降（SCD，15 例）、轻度认知障碍（MCI，45 例）或痴呆（31 例）的患者。随访期间，8 例患者（初始样本的 8.8%）死亡，26 例患者（初始样本的 28.5%）未找到。57 名参与者接受了临床再评估。15 例 SCD 患者中，有 7 例未找到（46.7%），4 例（26.7%）进展为 MCI，4 例（26.7%）病情稳定。45 例 MCI 患者中，有 11 例未找到（24.4%），2 例（4.4%）死亡，6 例（13.4%）进展为痴呆，12 例（26.7%）回归为 SCD，14 例（31.1%）病情稳定。31 例痴呆患者中，有 8 例未找到（25.8%），6 例（19.4%）死亡，2 例（6.5%）回归为 SCD，7 例（22.6%）回归为 MCI，8 例（25.8%）病情稳定。临床改善归因于治疗可逆病因，如维生素 B12 缺乏症和情绪障碍。年龄较大、简易精神状态检查得分较低、记忆主诉得分较高，但与使用苯二氮䓬类药物和质子泵抑制剂无关，是功能状态的预测因素。
尽管存在局限性（样本量小，数据缺失），但这些结果支持了在初级保健中对痴呆的可逆病因进行充分筛查、随访和治疗的观点。
