Cecilia M. Serrano

Economic impact of dementia in developing countries: an evaluation of costs of Alzheimer-type dementia in Argentina

BACKGROUND There is no previous information about economic costs of Alzheimers disease (AD) in South America. The objective of this study was to evaluate the costs of AD in Argentina. METHODS Eighty community-dwelling patients, 20 institutionalized AD patients and their respective primary caregivers, and 25 healthy elderly subjects participated in this study. The cognitive and neuropsychiatric impairments and severity of dementia were assessed with the Mini-mental State Examination, Neuropsychiatric Inventory and Clinical Dementia Rating, respectively. A structured interview about health and health-care resources used during the past 3 months was administered to family caregivers. The time devoted by carers to looking after the patients and the caregiver burden (Zarits Burden Interview) were recorded. RESULTS The annual direct costs of the disease increased with cognitive deterioration from US

Cognitive, functional and behavioral factors associated with the burden of caring for geriatric patients with cognitive impairment or depression: evidence from a South American sample

3420.40 in mild to US

Behavioral symptoms related to cognitive impairment.

9657.60 in severe AD, and with institutionalization (US

Late- versus early-onset geriatric depression in a memory research center.

3189.20 outpatient vs. US

Clinical and economic characteristics associated with direct costs of Alzheimer's, frontotemporal and vascular dementia in Argentina.

14,447.68 institutionalized). Most direct costs were paid for by the family. CONCLUSIONS With the projected increase in the number of persons at risk for developing AD in emerging countries, the family cost of the disease will be significant. Dementia costs should be a matter of analysis when health policies are being designed in developing countries.

Validity and Reliability of the SF-36 Administered to Caregivers of Patients with Alzheimer’s Disease: Evidence from a South American Sample

To examine behavioral, cognitive and functional factors associated with psychosocial burden in caregivers of geriatric patients.

Role of cognitive reserve in progression from mild cognitive impairment to dementia

Neuropsychiatric symptoms (NPS) are core features of Alzheimer’s disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI) can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI) in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct ‘MBI’ and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI) and dementia stages of Alzheimer’s disease and frontotemporal lobar degeneration.

Perfis Diferenciais de Perda de Memória entre a Demência Frontotemporal e a do Tipo Alzheimer

OBJECTIVE To contrast early-onset (<60 years) and late-onset (>60 years) depression in geriatric patients by evaluating differences in cognition, vascular comorbidity and sociological risk factors. Both patient groups were compared with normal subjects. MATERIALS AND METHODS We recruited 76 patients with depressive symptoms (37 late onset and 39 early onset) and 17 normal controls matched by age and educational level. All subjects were assessed using a semistructured neuropsychiatric interview and an extensive neuropsychological battery. Vascular and sociological risk factors were also evaluated. RESULTS We found a significant variation in performance between depressive patients and normal controls in most cognitive functions, especially memory (P < 0.0001), semantic fluency (P < 0.0001), verbal fluency, and digit-symbol (P < 0.0001). Late-onset depression patients scored lower and exhibited more severe impairment in memory domains than early-onset depression patients (P < 0.05). Cholesterol levels and marital status were significantly (P < 0.05) different between the depressive groups. Both depressed groups (early- and late-onset) were more inactive than controls (P < 0.05; odds ratio: 6.02). CONCLUSION Geriatric depression may be a manifestation of brain degeneration, and the initial symptom of a dementia. It is important to consider this in the treatment of patients that exhibit late-onset depressive symptoms.

Onset Age and Clinical Heterogeneity of Dementias: A Diagnostic and Therapeutic Approach

BACKGROUND The economic cost of dementia is high and can be predicted by cognitive and neuropsychiatric profiles. The differential costs of the various subtypes of dementia are unknown in Argentina, and this study therefore aimed to compare these costs. METHODS Patients with a diagnosis of dementia of Alzheimer-type (DAT), frontotemporal dementia (FTD) and vascular dementia (VaD), and their primary caregivers, were evaluated between 2002 and 2008. RESULTS 104 patients with dementia (DAT = 44, FTD = 34, VaD = 26) were screened and matched by age and educational level with 29 healthy subjects. Demographic variables showed no significant differences among dementia patients. The annual direct costs were US

Características clínicas y económicas asociadas con los costes directos en demencia tipo Alzheimer, frontotemporal y vascular

4625 for DAT, US