Influencia del inicio precoz del tratamiento conservador en la evolución del paciente pediátrico con vejiga neuropática / Influence in the outcome of neuropathic pediatric patients after early treatment

IntroducciónEl cateterismo limpio intermitente (CI) y el tratamiento anticolinérgico son la base del tratamiento conservador de la vejiga neuropática (VN); sin embargo, todavía no hay acuerdo sobre la edad a la que debería iniciarse dicha terapia.ObjetivoEl objetivo de nuestro estudio fue analizar la influencia del inicio precoz (primer año de vida) del tratamiento anticolinérgico y el CI en la evolución a largo plazo de la función renal y vesical. Nuestra hipótesis es que los niños que iniciaron el tratamiento conservador en el primer año de vida tienen mejor pronóstico en términos de función renal y vesical, así como menos necesidad de tratamiento quirúrgico que aquellos que iniciaron el tratamiento a edades más avanzadas.Pacientes y métodosEstudio retrospectivo de los pacientes con VN tratados en nuestro servicio (1995- 2005) dividiéndolos para su comparación en dos grupos: grupo 1 incluye a aquellos que iniciaron el tratamiento conservador en el primera año de vida, y grupo 2, a aquellos que lo iniciaron entre el primer y el quinto año. Se revisaron las historias clínicas recogiendo datos sobre: edad de inicio del CI y tratamiento anticolinérgico, presencia de reflujo vésico-ureteral (RVU) o ureterohidronefrosis (UHN), función renal, presencia de cicatrices renales, infección del tracto urinario (UTI), presencia de cicatrices renales, comportamiento vesical, necesidad de intervención quirúrgica y continencia urinaria.ResultadosSe incluyeron 61 pacientes: 25 en el grupo 1 y 36 en el grupo 2. Al inicio del estudio, la presencia de RVU e hiperactividad vesical eran más frecuentes en el grupo 2. En el grupo 1, un paciente con vejiga hiperactiva cambió a vejiga de baja acomodación, y en el grupo 2 un paciente con vejiga de acomodación normal y 4 con vejigas hiperactivas cambiaron a vejigas de baja

Background Clean intermittent catheterization (CIC) and anticholinergic drugs are the mainstay treatment for neuropathic bladder (NB). However, there is not consensus about the time therapy should be started in pediatric patients.AimTo analyze the impact of early start (first year of life) of CIC and anticholinergic treatment on long-term renal and bladder function. Our hypothesis is that those children who start conservative treatment in the first year of life have better outcome in terms of bladder and renal function and less need of surgical procedures, compared to those who started treatment later in life.Patients and methodRetrospective study of pediatric patients with NB treated in our hospital (1995-2005) dividing them for comparison in two groups: group 1 started treatment in the first year of life and group 2 between 1 and 5 years old. Collected data included: date of CIC and anticholinergic initiation, presence of VUR or UHN, renal function, UTIs, renal scars, bladder behavior, surgery and urinary continence.ResultsSixty-one patients were included, 25 in group 1 and 36 in group 2. Initially vesico-ureteral reflux (VUR) and overactive bladders were more frequent in group 2. In group 1 one overactive bladder changed to low compliant and in group 2, one normal bladder and 4 overactive bladders changed. At the end of follow-up there were 11 low compliant bladders in group 1 and 17 in group 2. However, in group 1, only 2 patients required bladder augmentation (BA) while in group 2, 12 patients needed it. At the end of the study only 2 patients in group 2 had slight renal insufficiency.ConclusionsPatients who started conservative treatment in the first year of life have better long-term outcome in terms of UTI, renal scars and surgical procedures. Even if they initially had low compliant bladders, these patients require less BA

Influence in the outcome of neuropathic pediatric patients after early treatment.

BACKGROUND: Clean intermittent catheterization (CIC) and anticholinergic drugs are the mainstay treatment for neuropathic bladder (NB). However, there is not consensus about the time therapy should be started in pediatric patients. AIM: To analyze the impact of early start (first year of life) of CIC and anticholinergic treatment on long-term renal and bladder function. Our hypothesis is that those children who start conservative treatment in the first year of life have better outcome in terms of bladder and renal function and less need of surgical procedures, compared to those who started treatment later in life. PATIENTS AND METHOD: Retrospective study of pediatric patients with NB treated in our hospital (1995-2005) dividing them for comparison in two groups: group 1 started treatment in the first year of life and group 2 between 1 and 5 years old. Collected data included: date of CIC and anticholinergic initiation, presence of VUR or UHN, renal function, UTIs, renal scars, bladder behavior, surgery and urinary continence. RESULTS: Sixty-one patients were included, 25 in group 1 and 36 in group 2. Initially vesico-ureteral reflux (VUR) and overactive bladders were more frequent in group 2. In group 1 one overactive bladder changed to low compliant and in group 2, one normal bladder and 4 overactive bladders changed. At the end of follow-up there were 11 low compliant bladders in group 1 and 17 in group 2. However, in group 1, only 2 patients required bladder augmentation (BA) while in group 2, 12 patients needed it. At the end of the study only 2 patients in group 2 had slight renal insufficiency. CONCLUSIONS: Patients who started conservative treatment in the first year of life have better long-term outcome in terms of UTI, renal scars and surgical procedures. Even if they initially had low compliant bladders, these patients require less BA.

Influence in the outcome of neuropathic pediatric patients after early treatment. / Influencia del inicio precoz del tratamiento conservador en la evolución del paciente pediátrico con vejiga neuropática.

BACKGROUND: Clean intermittent catheterization (CIC) and anticholinergic drugs are the mainstay treatment for neuropathic bladder (NB). However, there is not consensus about the time therapy should be started in pediatric patients. AIM: To analyze the impact of early start (first year of life) of CIC and anticholinergic treatment on long-term renal and bladder function. Our hypothesis is that those children who start conservative treatment in the first year of life have better outcome in terms of bladder and renal function and less need of surgical procedures, compared to those who started treatment later in life. PATIENTS AND METHOD: Retrospective study of pediatric patients with NB treated in our hospital (1995-2005) dividing them for comparison in two groups: group 1 started treatment in the first year of life and group 2 between 1 and 5 years old. Collected data included: date of CIC and anticholinergic initiation, presence of VUR or UHN, renal function, UTIs, renal scars, bladder behavior, surgery and urinary continence. RESULTS: Sixty-one patients were included, 25 in group 1 and 36 in group 2. Initially vesico-ureteral reflux (VUR) and overactive bladders were more frequent in group 2. In group 1 one overactive bladder changed to low compliant and in group 2, one normal bladder and 4 overactive bladders changed. At the end of follow-up there were 11 low compliant bladders in group 1 and 17 in group 2. However, in group 1, only 2 patients required bladder augmentation (BA) while in group 2, 12 patients needed it. At the end of the study only 2 patients in group 2 had slight renal insufficiency. CONCLUSIONS: Patients who started conservative treatment in the first year of life have better long-term outcome in terms of UTI, renal scars and surgical procedures. Even if they initially had low compliant bladders, these patients require less BA.

Sluggish Cognitive Tempo: Sociodemographic, Behavioral, and Clinical Characteristics in a Population of Catalan School Children.

OBJECTIVE: The aims of the present study were to examine the presence of sluggish cognitive tempo (SCT) symptoms in children; associations of the symptoms with sociodemographic characteristics of the children; and relationships between SCT symptoms and symptoms of ADHD, dyslexia, academic performance, and behavioral problems. METHOD: We evaluated Catalan schoolchildren aged 7 to 10 years in Barcelona, 2012-2013. Parents filled out the SCT-Child Behavior Checklist (SCT-CBCL), the Strengths and Difficulties Questionnaire (SDQ), and a questionnaire concerning sociodemographic characteristics. Teachers completed the ADHD criteria of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) (ADHD- DSM-IV), a list of dyslexia symptoms, and evaluated the children's academic performance. SCT symptoms were studied as a continuous and dichotomous variable. RESULTS: In all, 11% of the children in our sample scored above the clinical cut-off on the SCT-CBCL scale. We observed a higher rate of SCT symptoms in boys, children whose father was unemployed, those whose maternal educational level was lower, children with a high socioeconomic vulnerability index at home, those who reported maternal smoking during pregnancy and current second-hand smoke exposure at home, and children with an ADHD diagnosis. More SCT symptoms were associated with inattention symptoms, symptoms of dyslexia, academic problems, and emotional and peer relationship problems. CONCLUSION: We observed a higher prevalence of SCT symptoms in our sample than expected in the general population. While girls are less prone to SCT symptoms, some socioeconomic indicators, dyslexia, and inattention symptoms as well as exposure to smoking at home increase the risk of SCT and must be taken into account during assessments.

Rabdomiólisis por múltiples picaduras de avispa asiática (Vespa velutina) / Asian black hornet (Vespa velutina) multiple stings and secondary rhabdomyolysis

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Técnica neuromuscular de la vaina rectal abdominal / No disponible

La Técnica Neuromuscular (TNM) permite simultanear exploración, diagnóstico y tratamiento, y tiene como objetivo normalizar el tejido muscular y conjuntivo. La técnica permite localizar las induraciones y/o dificultades del deslizamiento dentro de tejido conjuntivo, que se interpretan como una disminución de las propiedades viscoelásticas de dicho tejido, lo que limita la doble función de filtro iónico y difusión de nutrientes. Consta de una serie de trazos realizados con el pulgar, de forma lenta, que permiten centrar la atención tanto en la sensación palpatoria como en la respuesta del paciente. La técnica abdominal básica trata las zonas abdominales y consta de varias partes. Debe prestarse especial atención a la línea alba y la vaina rectal abdominal, por su gran variedad de factores funcionales y estructurales, y su repercusión tanto a nivel local como sobre la salud en su conjunto (AU)

No disponible

Increased myo-inositol in parietal white and gray matter as a biomarker of poor prognosis in neuropsychiatric lupus: a case report.

Neuropsychiatric manifestations can be a serious complication of systemic lupus erythematosus, affecting nearly 56% of these patients. Frequently, acceptable clinical outcome is observed in neurolupus with immunosuppressive therapy. Different metabolites identified with MR spectroscopy may be associated with modifications in the natural history of this disease, specifically in the central nervous system. We report a case of neurolupus with progressive neurologic impairment despite aggressive immunosuppressive treatment. We describe clinical features, laboratory and MRI results, as well as characteristic findings on MR spectroscopy. Serial MRI identified atrophy of the left temporal lobe. MR spectroscopy showed an increase of myo-inositol/creatine ratio intensity, accompanied by a decrease of N-acetylaspartate/creatine ratio in both parietal white and gray matter. During follow-up, the patient developed progressive cognitive deficiency despite the intensification of therapy. Neurolupus manifestations are common and immunosuppressive treatment often avoids severe complications. Characteristic findings on MR spectroscopy may be useful for clinicians to determine poor prognosis and resistance to therapy.

Dopaminergic dysregulation, artistic expressiveness, and Parkinson's disease.

BACKGROUND: The most frequent behavioral manifestations in Parkinson's disease (PD) are attributed to the dopaminergic dysregulation syndrome (DDS), which is considered to be secondary to the iatrogenic effects of the drugs that replace dopamine. Over the past few years some cases of patients improving their creative abilities after starting treatment with dopaminergic pharmaceuticals have been reported. These effects have not been clearly associated to DDS, but a relationship has been pointed out. METHODS: Case study of a patient with PD. The evolution of her paintings along medication changes and disease advance has been analyzed. RESULTS: The patient showed a compulsive increase of pictorial production after the diagnosis of PD was made. She made her best paintings when treated with cabergolide, and while painting, she reported a feeling of well-being, with loss of awareness of the disease and reduction of physical limitations. CONCLUSIONS: Dopaminergic antagonists (DA) trigger a dopaminergic dysfunction that alters artistic creativity in patients having a predisposition for it. The development of these skills might be due to the dopaminergic overstimulation due to the therapy with DA, which causes a neurophysiological alteration that globally determines DDS.

[Increased risk of obesity and central obesity in sedentary postmenopausal women]. / Mayor riesgo de obesidad y obesidad central en mujeres post-menopáusicas sedentarias.

AIMS: To establish the influence of a sedentary behavior (sit time) on body composition in elderly women from Aragón. METHODS: A total of 457 women participated in the study. Hours of walking were used to define the active behavior (> 1 vs. < 1 h/day) and hours of sitting were used to establish the sedentary behavior (> 4 vs. < 4 h/day). Anthropometric evaluation was conducted following the ISAK recommendations. Fat mass was estimated through electrical bio-impedance. Differences between groups were analyzed by ANOVA and logistic regression analysis was used to study the association between active and sedentary behaviors with body composition. RESULTS: The sedentary group had higher weight, BMI, waist circumference and fat mass than the non-sedentary group (all p < 0.05). In addition, those women who sat more than 4 h/day had 1.7, 2.7 and 1.7-fold higher odds ratio for having overweight, obesity and central obesity, respectively, regardless of the hours of walking (95% IC [1.006-2.739]; [1.518-4.491] y [1.154-2.565]). When activity and sedentary levels were studied together, active and sedentary women were 2.0 times more likely to be overweight (95% CI [0.995-3.961]), 4.4 to be obese (95% CI [2.101-9.264]) and 2.3 for having central obesity (95% CI [1.329-3.939]) than women with an active and non-sedentary behavior. CONCLUSION: Being sitting more than 4 hours a day increases the risk of overweight, obesity and central obesity, regardless of the hours of walking in postmenopausal women.

Repercusiones de la técnica neuromuscular abdominal sobre el ángulo craneocervical en pacientes con cervicalgia mecánica crónica / Effects of the neuromuscular abdominal technique on the craniocervical angle in patients with chronic mechanical cervicalgia

Introducción: Los músculos abdominales juegan un papel importante en el mantenimiento de la postura. Existen evidencias de que las disfunciones de la pared abdominal tienen gran influencia con los dolores de espalda y en particular con las cervicalgias mecánicas crónicas (CMC). Objetivos: Evaluar la influencia inmediata de la Técnica Neuromuscular (TNM) a nivel de la vaina rectal abdominal, en los trabajadores con posición mantenida más de 4 horas delante del ordenador, en el dolor percibido durante el movimiento cervical, en la movilidad cervical y en la posición de la cabeza. Material y Métodos: Se realizó un ensayo clínico aleatorizado, paralelo de tratamiento experimental frente a tratamiento control, en 34 pacientes (n=34), Grupo Control (GC:n=17) y Grupo Experimental (GE:n=17) . El GC recibió como placebo una técnica de simulación de equilibración funcional a nivel del epigastrio, y en el GE aplicamos la Técnica Neuromuscular a nivel de la vaina rectal abdominal. Resultados: Se encontraron diferencias estadísticamente significativas en el ángulo cráneo-cervical en sedestación (p=0,033) con un 4,93 ± 5,7 % de cambio en el grupo experimental y un 0,6 ± 3,77% en el grupo control. No se encontraron diferencias en el ángulo cráneo-cervical en bipedestación, en el dolor percibido durante el movimiento cervical ni en la amplitud de movilidad del cuello (p>0,05). Conclusiones: La TNM a nivel de la vaina rectal abdominal mejora la posición de la cabeza en sedestación , pero no es útil para equilibrar la posición cefálica en bipedestación, aumentar la movilidad cervical, ni modificar el dolor percibido durante el movimiento cervical (AU)

Introduction: The abdominal muscles play an important role in maintaining the posture. There is evidence that dysfunctions in the abdominal wall have a profound effect on back pain and, in particular, on chronic mechanical cervicalgia (CMC). Objectives: To assess the immediate effect of the Neuromuscular Technique (NMT) at the level of the rectus abdominis sheath in workers maintaining their position for more than 4 hours in front of a computer, for pain noticed during a cervical movement, in cervical mobility and in the head's position. Material and methods: A randomised clinical trial was carried out, in parallel with an experimental treatment compared to a control treatment, in 34 patients (n=34), Control Group (CG:n=17) and Experimental Group (EG:n=17). The control group received a technique simulating a functional balance at the epigastric level, and on the experimental group we applied the Neuromuscular Technique at the level of the rectus abdominis sheath. Results: No statistically significant differences were found in the craniocervical angle in a sitting position (p=0.033) with a 4.3±5.7% change in the experimental group and 0.6±3.77% in the control group. No differences were found in the craniocervical angle in a standing position, in the pain noticed during cervical movement or in the range of neck mobility (p>0.05). Conclusions: NMT at the level of the rectus abdominis sheath improves the head’s position sitting down, but it is not useful to balance the cephalic position when standing, increase the cervical mobility or modify the pain noticed during a cervical movement (AU)

Mayor riesgo de obesidad y obesidad central en mujeres post-menopáusicas sedentarias / Increased risk of obesity and central obesity in sedentary postmenopausal women

Objetivos: Establecer la influencia de un comportamiento sedentario (tiempo sentado) sobre la composición corporal en mujeres mayores de Aragón. Métodos: Participaron un total de 457 mujeres. Las horas de caminar se utilizaron para definir comportamiento activo (> 1 vs. < 1 h/día) y las de estar sentado para establecer comportamiento sedentario (> 4 vs. < 4 h/día). La evaluación antropométrica se llevó a cabo siguiendo las recomendaciones ISAK. La grasa corporal se estimó mediante bio-impedancia eléctrica. Se utilizó ANOVA para analizar diferencias entre grupos y análisis de regresión logística para estudiar la asociación entre los comportamientos activos y sedentarios con la composición corporal.Resultados: El grupo de mujeres sedentarias tenía mayor peso, IMC, perímetro de cintura y masa grasa que las mujeres no sedentarias (todos p < 0,05). Además, aquellas mujeres que permanecían sentadas más de 4 horas al día tenían un riesgo 1,7, 2,7 y 1,7 veces mayor de padecer sobrepeso, obesidad y obesidad central, respectivamente, independientemente de las horas de caminar (95% IC [1,006-2,739]; [1,518-4,491] y [1,154-2,565]). Cuando el nivel de actividad y sedentarismo fueron estudiados de manera conjunta, se observó que las mujeres no activas y sedentarias tenían 2,0 veces más probabilidad de tener sobrepeso (95% IC [0,995-3,961]), 4,4 de padecer obesidad (95% IC [2,101-9,264]) y 2,3 de sufrir obesidad central (95% IC [1,329-3,939]) que las mujeres con un comportamiento activo y no sedentario. Conclusión: Permanecer sentado más de 4 horas al día aumenta el riesgo de padecer sobrepeso, obesidad y obesidad central, independientemente de las horas de caminar en mujeres postmenopáusicas (AU)

Aims: To establish the influence of a sedentary behavior (sit time) on body composition in elderly women from Aragón. Methods: A total of 457 women participated in the study. Hours of walking were used to define the active behavior (> 1 vs. < 1 h/day) and hours of sitting were used to establish the sedentary behavior (> 4 vs. < 4 h/day). Anthropometric evaluation was conducted following the ISAK recommendations. Fat mass was estimated through electrical bio-impedance. Differences between groups were analyzed by ANOVA and logistic regression analysis was used to study the association between active and sedentary behaviors with body composition. Results: The sedentary group had higher weight, BMI, waist circumference and fat mass than the non-sedentary group (all p < 0.05). In addition, those women who sat more than 4 h/day had 1.7, 2.7 and 1.7-fold higher odds ratio for having overweight, obesity and central obesity, respectively, regardless of the hours of walking (95% IC [1.006-2.739]; [1.518-4.491] y [1.154-2.565]). When activity and sedentary levels were studied together, active and sedentary women were 2.0 times more likely to be overweight (95% CI [0.995-3.961]), 4.4 to be obese (95% CI [2.101-9.264]) and 2.3 for having central obesity (95% CI [1.329-3.939]) than women with an active and non-sedentary behavior. Conclusion: Being sitting more than 4 hours a day increases the risk of overweight, obesity and central obesity, regardless of the hours of walking in postmenopausal women (AU)

Female reproductive biology of the bluemouth Helicolenus dactylopterus dactylopterus: spawning and fecundity.

The bluemouth Helicolenus dactylopterus dactylopterus is a zygoparous species that spawns multiple batches of embryos enclosed within a gelatinous matrix. Oocyte development is asynchronous, and the recruitment of secondary growth oocytes occurs continuously during the developing phase, but stops before the start of the first spawning (i.e. fecundity is determinate). The number of developing oocytes can be estimated as a function of the total length of the fish, its ovary mass and its gonado-somatic index. Only at the onset of spawning, when potential fecundity is determined, does condition also have a significant effect. The low levels of atresia detected during most of the spawning season show that this mechanism does not substantially affect the process. There is variability both in the spawning interval (with a mean of 2 days) and in the number of embryos comprising every single batch (up to 37,000). Expected effect of fisheries on the reproductive traits of this deep-sea species is also discussed.

[Drug consumption and cognitive function in non-institutionalized elderly: a population-based study]. / Perfil de consumo farmacológico y función cognoscitiva en edad avanzada: estudio de población general no institucionalizada.

BACKGROUND: Drug consumption in the general population is concentrated in the elderly. The aim of this study was to assess the pharmacological profile of elderly people 75 years of age and older, to assess the relationship with the cognitive function and the variables associated with drug consumption. METHODS: This is an epidemiological, cross-sectional, door-to-door study among the non-institutionalised population in a rural area. Participants were inhabitants aged 75 and older from the Anglès Primary Healthcare Area (Girona). Drug prescriptions were recorded from participants' medicine chest. Cognitive function was assessed using the Mini-Mental State Examination. RESULTS: A total of 875 individuals took part (82%). Participants with mild and moderate cognitive impairment consumed an average of 4.6 (SD=2.9) and 5.2 (SD=3.2) drugs, participants without cognitive impairment consumed an average of 4 (SD=2.7) drugs (P < 0.005). In the bivariate analysis, taking into account the degree of cognitive impairment, there was a change in drugs acting on the digestive tract and metabolism (P=0.003) and nervous system (P=0.001). Multivariate analysis identified four variables associated with the central nervous system drugs: age, sex, comorbidity and suspicion of depression (P <0.05). CONCLUSIONS: Participants with severe cognitive impairment had a higher frequency of anti-psychotic and antidepressant drug consumption. However, the multivariate analysis shows that advanced age, female sex and suspicion of depression are variables associated with a higher central nervous system drug consumption.

Perfil de consumo farmacológico y función cognoscitiva en edad avanzada: estudio de población general no institucionalizada / Drug consumption and cognitive function in non-institutionalized elderly: A population-based study

Introducción: El consumo de fármacos en la población general se concentra en las personas de edad avanzada. El objetivo del presente estudio fue valorar el perfil farmacológico en ancianos de 75 años y mayores, estimar la relación con la función cognoscitiva y las variables asociadas al consumo farmacológico. Métodos: Estudio epidemiológico transversal y poblacional puerta a puerta de una muestra de población rural no institucionalizada representativa de los habitantes mayores de 74 años del Área Básica de Salud de Anglès (Girona). La prescripción farmacológica se registró a partir de los medicamentos presentes en el domicilio de los participantes. La función cognoscitiva se evaluó mediante el Mini-Mental State Examination. Resultados: Participaron 875 individuos (82%). Los participantes con deterioro cognoscitivo leve y moderado consumían una media de 4,6 (DE=2,9) y 5,2 (DE=3,2) fármacos, superior a los 4 (DE=2,7) fármacos de media consumidos por los que no sufrían deterioro cognoscitivo (p < 0,05). En el análisis bivariante, según el grado de deterioro cognoscitivo existía una variación en el consumo de fármacos del aparato digestivo y metabolismo (p=0,003) y del sistema nervioso (p=0,001). El análisis multivariante identificó cuatro variables asociadas al consumo de fármacos del sistema nervioso: edad, sexo, comorbilidad y sospecha de depresión (p<0,05).Conclusiones: Los participantes con deterioro cognoscitivo grave presentaron una mayor frecuencia de consumo de antipsicóticos y otros antidepresivos. Sin embargo, el análisis multivariante señala que son la edad avanzada, el sexo femenino y la sospecha de depresión las variables asociadas a un mayor consumo de fármacos del sistema nervioso (AU)

Background: Drug consumption in the general population is concentrated in the elderly. The aim of this study was to assess the pharmacological profile of elderly people 75 years of age and older, to assess the relationship with the cognitive function and the variables associated with drug consumption.Methods: This is an epidemiological, cross-sectional, door-to-door study among the non-institutionalised population in a rural area. Participants were inhabitants aged 75 and older from the Anglès Primary Healthcare Area (Girona). Drug prescriptions were recorded from participants’ medicine chest. Cognitive function was assessed using the Mini-Mental State Examination. Results: A total of 875 individuals took part (82%). Participants with mild and moderate cognitive impairment consumed an average of 4.6 (SD=2.9) and 5.2 (SD=3.2) drugs, participants without cognitive impairment consumed an average of 4 (SD=2.7) drugs (P < 0.005). In the bivariate analysis, taking into account the degree of cognitive impairment, there was a change in drugs acting on the digestive tract and metabolism (P=0.003) and nervous system (P=0.001). Multivariate analysis identified four variables associated with the central nervous system drugs: age, sex, comorbidity and suspicion of depression (P <0.05).Conclusions: Participants with severe cognitive impairment had a higher frequency of anti-psychotic and antidepressant drug consumption. However, the multivariate analysis shows that advanced age, female sex and suspicion of depression are variables associated with a higher central nervous system drug consumption (AU)