Prevalencia y factores de riesgo del trastorno de la memoria asociado a la edad en un área de salud / Prevalence and risk factors of age-related memory disorder in a health district

Introducción. El envejecimiento normal se caracterizapor la alteración de las funciones cognitivas. En 1958 Kral defineel ‘olvido benigno de la senescencia’ para designar un trastornomnésico diferente del envejecimiento normal. En 1986 un grupo deinvestigadores del National Institute of Mental Health y otros centrospropone una nueva entidad neuropsicológica denominada trastornode la memoria asociado a la edad. Actualmente constituye unreto para la comunidad científica establecer la prevalencia, la evolucióny los factores de riesgo de esta entidad. Objetivos. Establecerla prevalencia y precisar algunos factores de riesgo en el trastornode la memoria asociado a la edad. Sujetos y métodos. Eluniverso estuvo constituido por todos los pacientes mayores de 50años de edad de un área de salud (234 individuos), a los que se lesaplicaron los criterios diagnósticos. Además de a los pacientes, seseleccionó un grupo control para establecer correlación con factoresde riesgo seleccionados. Resultados y conclusiones. La prevalenciaobtenida fue del 39,7%; de ellos, el 38,7% correspondía alsexo masculino y el 40,4% al femenino. También se observó que amayor edad del paciente y años de evolución, hay mayor deteriorode la memoria. Con relación a los factores de riesgo, se comprobóque el hábito de fumar y las características psicosociales constituyeronfactores predisponentes, no así la hipertensión arterial, el antecedentede demencia y la satisfacción de las necesidades básicas

Introduction. Normal aging is characterised by alterations affecting the cognitive functions. In 1958 Kral coinedthe term ‘benign senescent forgetfulness’ to designate a memory disorder that is different from those that occur during normalaging. In 1986, a group of researchers at the National Institute of Mental Health and other centres proposed a novel neuropsychologicalentity called age-related memory disorder. The determination of the prevalence, progression and risk factors ofthis condition currently represents an important challenge for the scientific community. Aims. To establish the rate of prevalenceand to identify some of the risk factors involved in age-related memory disorders. Subjects and methods. The universeconsisted of all the patients over 50 years of age from a health district (234 individuals); the diagnostic criteria were appliedto the whole sample. In addition to the patients, a control group was also chosen in order to be able to establish a correlationwith selected risk factors. Results and conclusions. The prevalence rate was found to be 39.7%, of which 38.7% were malesand 40.4% were females. It was also observed that the impairment was greater as the patient’s age and the length of thedisease history increased. As far as risk factors are concerned, it was observed that smoking and psychosocial characteristicsconstitute predisposing factors, while this was not the case for arterial hypertension, a history of dementia and the satisfactionof basic needs

Prevalencia y factores de riesgo del trastorno de la memoria asociado a la edad en un área de salud

El envejecimiento normal se caracteriza por la alteración de las funciones cognitivas. En 1958 Kral define el ‘olvido benigno de la senescencia para designar un trastorno mnésico diferente del envejecimiento normal. En 1986 un grupo de investigadores del National Institute of Mental Health y otros centros propone una nueva entidad neuropsicológica denominada trastorno de la memoria asociado a la edad...(AU)

Normal aging is characterised by alterations affecting the cognitive functions. In 1958 Kral coined the term 'benign senescent forgetfulness' to designate a memory disorder that is different from those that occur during normal aging. In 1986, a group of researchers at the National Institute of Mental Health and other centres proposed a novel neuropsychological entity called age-related memory disorder...(AU)

[Prevalence and risk factors of age-related memory disorder in a health district]. / Prevalencia y factores de riesgo del trastorno de la memoria asociado a la edad en un area de salud.

INTRODUCTION: Normal aging is characterised by alterations affecting the cognitive functions. In 1958 Kral coined the term 'benign senescent forgetfulness' to designate a memory disorder that is different from those that occur during normal aging. In 1986, a group of researchers at the National Institute of Mental Health and other centres proposed a novel neuropsychological entity called age-related memory disorder. The determination of the prevalence, progression and risk factors of this condition currently represents an important challenge for the scientific community. AIMS: To establish the rate of prevalence and to identify some of the risk factors involved in age-related memory disorders. SUBJECTS AND METHODS: The universe consisted of all the patients over 50 years of age from a health district (234 individuals); the diagnostic criteria were applied to the whole sample. In addition to the patients, a control group was also chosen in order to be able to establish a correlation with selected risk factors. RESULTS AND CONCLUSIONS: The prevalence rate was found to be 39.7%, of which 38.7% were males and 40.4% were females. It was also observed that the impairment was greater as the patient's age and the length of the disease history increased. As far as risk factors are concerned, it was observed that smoking and psychosocial characteristics constitute predisposing factors, while this was not the case for arterial hypertension, a history of dementia and the satisfaction of basic needs.

[Frontal dysfunction in idiopathic Parkinson's disease]. / Disfunción frontal en la enfermedad de Parkinson idiopática.

INTRODUCTION: In his description of the disease in his original work, James Parkinson claimed that the 'senses remained intact', but later reports began to identify cognitive impairment that ranged from dementia to barely identifiable subclinical deteriorations. Research carried out in recent decades has revealed that cognitive disorders form part of the clinical symptoms of Parkinson's disease (PD) and point to the frontal lobes as being the most affected areas; a great deal of controversy, however, still surrounds their definition, epidemiology and pathology. AIM: To determine and classify the frontal deficits associated to this disease and to relate this cognitive performance with certain characteristics of the disease. SUBJECTS AND METHODS: The sample utilised in the study was made up of 222 subjects divided into two groups according to their diagnosis: 111 subjects with idiopathic PD and 111 control subjects. The neuropsychological examination was performed using the Frontal Assessment Battery, the copy of the Rey-Osterrieth complex figure and the digit test for determining frontal functioning. RESULTS AND CONCLUSIONS: We prove the existence of a frontal dysfunction that is characterised by impaired working memory, with visuospatial and executive dysfunction, which suggests greater involvement of the dorsolateral prefrontal cortex and cingulate. According to our findings, because working memory and visuospatial functioning are correlated to the motor status and the time elapsed since the onset of the disease, they could share the same underlying neuroanatomical foundations--the nigrostriatal denervation. This is not the case of executive function, which was not found to be related to the characteristics of the disease under study.

Disfunción frontal en la enfermedad de Parkinson idiopática / Frontal dysfunction in idiopathic Parkinson’s disease

Introducción. Al describir la enfermedad, James Parkinson planteó en su obra original que los sentidos permanecían indemnes, pero descripciones posteriores comenzaron a identificar el deterioro cognitivo, que abarcaba desde una demencia hasta deterioros subclínicos apenas identificables. Las investigaciones realizadas en las últimas décadas han revelado que los trastornos cognitivos forman parte de la sintomatología clínica de la enfermedad de Parkinson (EP) y señalan a los lóbulos frontales como los más afectados; pero todavía es controvertida su definición, epidemiología y patología. Objetivo. Determinar y caracterizar los déficit frontales asociados a esta enfermedad y relacionar este rendimiento cognitivo con algunas características de la enfermedad. Sujetos y métodos. La muestra utilizada estaba compuesta por 222sujetos, divididos en dos grupos en función de su diagnóstico: 111 sujetos con EP idiopática y 111 sujetos controles. La exploración neuropsicológica se constituyó por la batería de evaluación frontal(FAB), la copia de la figura compleja del Rey-Osterrieth y el test de dígitos para determinar la función frontal. Resultados y conclusiones. Se demuestra una disfunción frontal que se caracteriza por disminución de la memoria de trabajo, disfunción visuoespacial y ejecutiva, lo que sugiere una mayor afectación de la corteza prefrontaldorsolateral y cingulada. Según nuestros resultados, la memoria de trabajo y la función visuoespacial, al correlacionarse con el estado motor y el tiempo de evolución de la enfermedad, podrían compartir un mismo sustrato neuroanatómico, la denervación nigroestriatal. No así la función ejecutiva, que no se relacionó con las características de la enfermedad estudiada (AU)

Introduction. In his description of the disease in his original work, James Parkinson claimed that the 'senses remained intact', but later reports began to identify cognitive impairment that ranged from dementia to barely identifiable subclinical deteriorations. Research carried out in recent decades has revealed that cognitive disorders form part of the clinical symptoms of Parkinson’s disease (PD) and point to the frontal lobes as being the most affected areas; a great deal of controversy, however, still surrounds their definition, epidemiology and pathology. Aim. To determine and classify the frontal deficits associated to this disease and to relate this cognitive performance with certain characteristics of the disease. Subjects and methods. The sample utilised in the study was made up of 222 subjects divided into two groups according to their diagnosis: 111 subjects with idiopathic PD and 111 control subjects. The neuropsychological examination was performed using the Frontal Assessment Battery, the copy of the Rey-Osterrieth complex figure and the digit test for determining frontal functioning. Results and conclusions. We prove the existence of a frontal dysfunction that is characterised by impaired working memory, with visuospatial and executive dysfunction, which suggests greater involvement of the dorsolateral prefrontal cortex and cingulate. According to our findings, because working memory and visuospatial functioning are correlated to the motor status and the time elapsed since the onset of the disease, they could share the same underlying neuroanatomical foundations –the nigrostriatal denervation. This is not the case of executive function, which was not found to be related to the characteristics of the disease under study (AU)

Disfunciòn frontal en la enfermedad de Parkinson idiopàtica / Frontal dysfunction in idiopathic Parkinson's disease

In his description of the disease in his original work, James Parkinson claimed that the 'senses remained intact', but later reports began to identify cognitive impairment that ranged from dementia to barely identifiable subclinical deteriorations. Research carried out in recent decades has revealed that cognitive disorders form part of the clinical symptoms of Parkinson's disease (PD) and point to the frontal lobes as being the most affected areas; a great deal of controversy, however, still surrounds their definition, epidemiology and pathology. AIM: To determine and classify the frontal deficits associated to this disease and to relate this cognitive performance with certain characteristics of the disease. The sample utilised in the study was made up of 222 subjects divided into two groups according to their diagnosis: 111 subjects with idiopathic PD and 111 control subjects. The neuropsychological examination was performed using the Frontal Assessment Battery, the copy of the Rey-Osterrieth complex figure and the digit test for determining frontal functioning. We prove the existence of a frontal dysfunction that is characterised by impaired working memory, with visuospatial and executive dysfunction, which suggests greater involvement of the dorsolateral prefrontal cortex and cingulate. According to our findings, because working memory and visuospatial functioning are correlated to the motor status and the time elapsed since the onset of the disease, they could share the same underlying neuroanatomical foundations--the nigrostriatal denervation. This is not the case of executive function, which was not found to be related to the characteristics of the disease under study(AU)

[Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the Centro de Investigaciones Médico Quirúrgicas in Cuba]. / Factores predictivos de las complicaciones neurológicas en el postrasplante hepático inmediato: experiencia en el Centro de Investigaciones Médico Quirúrgicas de Cuba.

INTRODUCTION: Liver transplant (LT) is today a first choice procedure in a group of hepatic diseases in their acute and chronic terminal stages. It is not, however, a technique that is completely free of complications and those of a neurological nature constitute between 8 47% of those reported. AIMS. The purpose of this study is to present the immediate neurological complications (NC) found in our patients, as well as to determine the predictive factors and their relation to the mortality rate. PATIENTS AND METHODS: From the medical records of 26 patients who received LT at the CIMEQ (July 1999 December 2001), we collected a group of variables related to the donor, the surgical procedure and the post operative period and associated them to the occurrence of NC while these patients were in the ICU. RESULTS: NC were found in 16 patients (61.5%), the most frequent being encephalopathy (30.8%), tremor (26.9%), and convulsions (19.2%). No relation was found between the presence of NC and prior hepatic encephalopathy, the use of a suboptimal donor, nor did it represent a significant increase in the mortality rate. There was a significant relation with LT to recipients rated as grade C on the Child Pugh classification system, the presence of intraoperative hypotension (p= 0.0164) and primary dysfunction of the liver graft (p= 0.041). CONCLUSIONS: NC represented a significant cause of morbidity in the period following a liver transplant in our series, although they had no significant repercussion on the mortality rate. Their presence is related to variables concerning the recipient, the surgical procedure itself and the immediate post operative period.

Factores predictivos de las complicaciones neurológicas en el postrasplante hepático inmediato: experiencia en el Centro de Investigaciones Médico Quirúrgicas de Cuba / Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the centro de investigaciones médico quirúrgicas in cuba

Introducción. El trasplante hepático (TH) es hoy en día un procedimiento de elección en un grupo de enfermedades hepáticas agudas y crónicas en estadio terminal. Sin embargo, no es una técnica exenta de complicaciones; las neurológicas se comunican entre el 8 y el 47 por ciento. Objetivos. Presentar las complicaciones neurológicas (CN) inmediatas encontradas en nuestros pacientes, así como determinar los factores predictivos y su relación con la mortalidad. Pacientes y métodos. De los expedientes clínicos de los 26 pacientes que fueron tributarios de TH en el CIMEQ (julio 1999-diciembre 2001), se recogió un grupo de variables relacionadas con el donante, el acto quirúrgico y el posoperatorio, y se relacionó con la presencia de CN durante su estancia en la UCI. Resultados. Encontramos CN en 16 pacientes (61,5 por ciento); las más frecuentes fueron la encefalopatía (30,8 por ciento), temblores (26,9 por ciento), y convulsiones (19,2 por ciento). No se encontró relación entre la presencia de CN, y encefalopatía hepática previa o con uso de donante subóptimo, ni representó un aumento significativo en la mortalidad. Existió una relación significativa con el TH a receptores grado C de la clasificación de Child-Pugh, la presencia de hipotensión intraoperatoria (p = 0,0164), y de disfunción primaria del injerto hepático (p = 0,041). Conclusiones. En nuestra serie, las CN representaron una morbilidad significativa en el postrasplante hepático, sin repercusión significativa en la mortalidad. Su presencia se relaciona con variables del receptor, del acto operatorio y del posoperatorio inmediato (AU)

Introduction. Liver transplant (LT) is today a first choice procedure in a group of hepatic diseases in their acute and chronic terminal stages. It is not, however, a technique that is completely free of complications and those of a neurological nature constitute between 8-47% of those reported. Aims. The purpose of this study is to present the immediate neurological complications (NC) found in our patients, as well as to determine the predictive factors and their relation to the mortality rate. Patients and methods. From the medical records of 26 patients who received LT at the CIMEQ (July 1999-December 2001), we collected a group of variables related to the donor, the surgical procedure and the post-operative period and associated them to the occurrence of NC while these patients were in the ICU. Results. NC were found in 16 patients (61.5%), the most frequent being encephalopathy (30.8%), tremor (26.9%), and convulsions (19.2%). No relation was found between the presence of NC and prior hepatic encephalopathy, the use of a suboptimal donor, nor did it represent a significant increase in the mortality rate. There was a significant relation with LT to recipients rated as grade C on the Child-Pugh classification system, the presence of intraoperative hypotension (p= 0.0164) and primary dysfunction of the liver graft (p= 0.041). Conclusions. NC represented a significant cause of morbidity in the period following a liver transplant in our series, although they had no significant repercussion on the mortality rate. Their presence is related to variables concerning the recipient, the surgical procedure itself and the immediate post-operative period (AU)