全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Demographic and Clinical Characteristics of Patients with Dementia in Greece

DOI: 10.1155/2014/636151

Full-Text   Cite this paper   Add to My Lib

Abstract:

Introduction. Dementia’s prevalence increases due to population aging. The purpose of this study was to determine the demographic profile of Greek patients with dementia and the differences in management between the urban and rural population. Methods. A cross sectional study was carried out including 161 randomly selected specialists from different regions in Greece who filled in a structured questionnaire relating to patients with dementia, regarding various sociodemographic and clinical characteristics. Results. A total of 4580 patients (52% males) with dementia were recorded. Mean age was 73.6 years and 31% lived in rural areas. The Mini Mental Status Examination (MMSE) was used in 87% of cases. In the urban areas the diagnosis of dementia was made in an earlier stage of the disease in comparison to the rural areas . Higher comorbidity and a higher percentage of low education were evident in rural residents , while higher medication usage was observed in urban patients . Conclusions. The results implicate the need for improvement in health care delivery in Greek rural areas and health care professionals’ training to achieve a proper treatment of dementias and increase the quality of life among the elderly habitants of remote areas. 1. Introduction Old age seems to be the main risk factor for dementia [1, 2]. Higher prevalence rates are observed in people over 65 years old showing steadily increasing rates in each following five-year age group. About 14% of people aged 71 and older are affected by dementia, with women demonstrating higher rates in prevalence, but not in incidence [3]. Socioeconomic features [1], low educational level [3–6], cardiovascular comorbidity, and coexistence of other medical conditions increase the prevalence [2, 7] and the mortality of dementia [7] while the quality of life of patients decreases. Moreover, mental disorders often affect patients with dementia [8] and their caregivers [9, 10] influencing even more their diminished quality of life and need for institutionalization. Therefore, neuropsychiatric symptoms and mental disorders of patients with dementia need to be assessed and treated independently [11]. Given the persistent prolongation of life expectancy, the impact of dementia on healthcare systems [1], on families and caregivers [12, 13], and the mortality directly linked to Alzheimer’s disease (AD) and other dementias [1], it is imperative for current epidemiological data to be available to primary and secondary health care systems. A report of Turner et al. showed that general practitioners’ lack of knowledge

References

[1]  Alzheimer's Association, “2010 Alzheimer's disease facts and figures,” Alzheimer's and Dementia, vol. 6, no. 2, pp. 158–194, 2010.
[2]  B. Nunes, R. D. Silva, V. T. Cruz, J. M. Roriz, J. Pais, and M. C. Silva, “Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal,” BMC Neurology, vol. 10, article 42, 2010.
[3]  B. L. Plassman, K. M. Langa, G. G. Fisher et al., “Prevalence of dementia in the United States: the aging, demographics, and memory study,” Neuroepidemiology, vol. 29, no. 1-2, pp. 125–132, 2007.
[4]  Y. Stern, B. Gurland, T. K. Tatemichi, M. X. Tang, D. Wilder, and R. Mayeux, “Influence of education and occupation on the incidence of Alzheimer's disease,” The Journal of the American Medical Association, vol. 271, no. 13, pp. 1004–1010, 1994.
[5]  D. A. Evans, L. E. Hebert, L. A. Beckett et al., “Education and other measures of socioeconomic status and risk of incident Alzheimer disease in a defined population of older persons,” Archives of Neurology, vol. 54, no. 11, pp. 1399–1405, 1997.
[6]  W. A. Kukull, R. Higdon, J. D. Bowen et al., “Dementia and Alzheimer disease incidence: a prospective cohort study,” Archives of Neurology, vol. 59, no. 11, pp. 1737–1746, 2002.
[7]  C. Helmer, P. Joly, L. Letenneur, D. Commenges, and J.-F. Dartigues, “Mortality with dementia: results from a French prospective community-based cohort,” American Journal of Epidemiology, vol. 154, no. 7, pp. 642–648, 2001.
[8]  J. Calleo and M. Stanley, “Anxiety disorders in later life: differentiated diagnosis and treatment strategies,” Psychiatric Times, vol. 25, no. 8, pp. 24–27, 2008.
[9]  K. Yaffe, P. Fox, R. Newcomer, et al., “Patient and caregiver characteristics and nursing home placement in patients with dementia,” The Journal of the American Medical Association, vol. 287, no. 16, pp. 2090–2097, 2002.
[10]  D. H. Taylor Jr., M. Ezell, M. Kuchibhatla, T. ?stbye, and E. C. Clipp, “Identifying trajectories of depressive symptoms for women caring for their husbands with dementia,” Journal of the American Geriatrics Society, vol. 56, no. 2, pp. 322–327, 2008.
[11]  D. Shub and M. E. Kunik, “Psychiatric comorbidity in persons with dementia: assessment and treatment strategies,” Psychiatric Times, vol. 26, no. 4, pp. 32–36, 2009.
[12]  M. Raivio, U. Eloniemi-Sulkava, M.-L. Laakkonen et al., “How do officially organized services meet the needs of elderly caregivers and their spouses with Alzheimer's disease?” American Journal of Alzheimer's Disease and other Dementias, vol. 22, no. 5, pp. 360–368, 2007.
[13]  L. Froelich, N. Andreasen, M. Tsolaki et al., “Long-term treatment of patients with Alzheimer's disease in primary and secondary care: results from an international survey,” Current Medical Research and Opinion, vol. 25, no. 12, pp. 3058–3068, 2009.
[14]  S. Turner, S. Iliffe, M. Downs et al., “General practitioners' knowledge, confidence and attitudes in the diagnosis and management of dementia,” Age and Ageing, vol. 33, no. 5, pp. 461–467, 2004.
[15]  M. Tsolaki, S. Paraskevi, N. Degleris, and S. Karamavrou, “Attitudes and perceptions regarding alzheimer's disease in Greece,” The American Journal of Alzheimer's Disease and other Dementias, vol. 24, no. 1, pp. 21–26, 2009.
[16]  K. N. Fountoulakis, M. Tsolaki, R. C. Mohs, and A. Kazis, “Epidemiological Dementia Index: A screening instrument for Alzheimer's disease and other types of dementia suitable for use in populations with low education level,” Dementia and Geriatric Cognitive Disorders, vol. 9, no. 6, pp. 329–338, 1998.
[17]  S. Argyriadou, H. Melissopoulou, E. Krania, A. Karagiannidou, I. Vlachonicolis, and C. Lionis, “Dementia and depression: two frequent disorders of the aged in primary health care in Greece,” Family Practice, vol. 18, no. 1, pp. 87–91, 2001.
[18]  M. Tsolaki, K. Fountoulakis, E. Chantzi, and A. Kazis, “Risk factors for clinically diagnosed Alzheimer's disease: a case-control study of a Greek population,” International Psychogeriatrics, vol. 9, no. 3, pp. 327–341, 1997.
[19]  M. Tsolaki, C. Fountoulakis, I. Pavlopoulos, E. Chatzi, and A. Kazis, “Prevalence and incidence of Alzheimer's disease and other dementing disorders in Pylea, Greece,” American Journal of Alzheimer's Disease, vol. 14, no. 3, pp. 138–148, 1999.
[20]  R. W. Keefover, E. D. Rankin, P. M. Keyl, J. C. Wells, J. Martin, and J. Shaw, “Dementing illnesses in rural populations: the need for research and challenges confronting investigators,” Journal of Rural Health, vol. 12, no. 3, pp. 178–187, 1996.
[21]  J. Byles, J. Powers, C. Chojenta, and P. Warner-Smith, “Older women in Australia: ageing in urban, rural and remote environments,” Australasian Journal on Ageing, vol. 25, no. 3, pp. 151–157, 2006.
[22]  H. Brodaty, C. Thomson, C. Thompson, and M. Fine, “Why caregivers of people with dementia and memory loss don't use services,” International Journal of Geriatric Psychiatry, vol. 20, no. 6, pp. 537–546, 2005.
[23]  N. Kontodimopoulos, P. Nanos, and D. Niakas, “Balancing efficiency of health services and equity of access in remote areas in Greece,” Health Policy, vol. 76, no. 1, pp. 49–57, 2006.
[24]  Alzheimer's Association, “Alzheimer's disease facts and figures,” Alzheimer's and Dementia, vol. 5, no. 3, pp. 234–270, 2009.
[25]  N. A. Azad, M. Al Bugami, and I. Loy-English, “Gender differences in dementia risk factors,” Gender Medicine, vol. 4, no. 2, pp. 120–129, 2007.
[26]  P. S. Mathuranath, P. J. Cherian, R. Mathew et al., “Dementia in Kerala, South India: prevalence and influence of age, education and gender,” International Journal of Geriatric Psychiatry, vol. 25, no. 3, pp. 290–297, 2010.
[27]  A. Douzenis, I. Michopoulos, R. Gournellis et al., “Cognitive decline and dementia in elderly medical inpatients remain underestimated and underdiagnosed in a recently established university general hospital in Greece,” Archives of Gerontology and Geriatrics, vol. 50, no. 2, pp. 147–150, 2010.
[28]  C. G. Lyketsos, O. Lopez, B. Jones, A. L. Fitzpatrick, J. Breitner, and S. Dekosky, “Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study,” The Journal of the American Medical Association, vol. 288, no. 12, pp. 1475–1483, 2002.
[29]  G. Ravaglia, P. Forti, F. Montesi et al., “Mild cognitive impairment: epidemiology and dementia risk in an elderly Italian population,” Journal of the American Geriatrics Society, vol. 56, no. 1, pp. 51–58, 2008.
[30]  P. Fischer, S. Jungwirth, S. Zehetmayer et al., “Conversion from subtypes of mild cognitive impairment to Alzheimer dementia,” Neurology, vol. 68, no. 4, pp. 288–291, 2007.
[31]  G. Waldemar, K. T. T. Phung, A. Burns et al., “Access to diagnostic evaluation and treatment for dementia in Europe,” International Journal of Geriatric Psychiatry, vol. 22, no. 1, pp. 47–54, 2007.
[32]  Y. Tountas, N. Oikonomou, G. Pallikarona et al., “Sociodemographic and socioeconomic determinants of health services utilization in Greece: the Hellas Health I study,” Health Services Management Research, vol. 24, no. 1, pp. 8–18, 2011.
[33]  M. P. R. DesMeules, C. Lagace, D. Heng, D. Manuel, and R. Pitblado, “How healthy are rural Canadians? An assessment of their health status and health determinants,” in Book How Healthy Are Rural Canadians? An Assessment of Their Health Status and Health Determinants, Canadian Institute for Health Information, Ottawa, Canada, 2006.
[34]  N. Bouzas, “Poverty and social exclusion in rural areas,” in Book Poverty and Social Exclusion in Rural Areas, European Communities, 2008.
[35]  E. Pappa, N. Kontodimopoulos, A. A. Papadopoulos, Y. Tountas, and D. Niakas, “Prescribed-drug utilization and polypharmacy in a general population in Greece: association with sociodemographic, health needs, health-services utilization, and lifestyle factors,” European Journal of Clinical Pharmacology, vol. 67, no. 2, pp. 185–192, 2011.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133