Every three seconds, a new case of dementia emerges in the world, and by 2050 there will be at least 150 million persons with dementia. The World Health Organization declared dementia for a public ...health priority of the 21st century before the emergence of the SARS-CoV-2/COVID 19, which affected the elderly population the most. Dementia is a disease that affects the individual, caregivers and wider society. Due to increasing dependence from others, dementia causes a health, economic, emotional, psychological and physical burden for the person with dementia and his caregivers. There is still a great stigma associated with dementia. Less than half of people with dementia are diagnosed and treated, although we have drugs available that can slow the course of the disease. In the multi-author's monograph Monitoring of Dementia in Slovenia: Epidemiological and other aspects, we addressed the problem of dementia, especially in relation to COVID-19. The publication also highlights the estimates on the prevalence of dementia in Slovenia, which were made on Slovenian data and the population of Slovenia. The publication is distinguished by a multidisciplinary treatment of the topics and is intended for both the lay and the professional public.
Dementias present a global health challenge and give rise to significant economic costs. This study aims to evaluate the economic impact of one-year outpatient healthcare, nursing home, and formal ...and informal home help costs for all patients referred to the Centre for Cognitive Impairments at the Department of Neurology, Ljubljana University Medical Centre, Slovenia.
Data was acquired retrospectively from physicians' records and the costs for 2015 were calculated. Total costs were estimated by means of a bottom-up calculation of outpatient visits, diagnostic examinations and anti-dementia medication. In a subgroup of 120 patients with dementia, the Resource Utilization in Dementia questionnaire was used to estimate formal and informal care costs.
A total of 720 patients visited the memory clinic in 2015. Diagnosis at first visit was subjective cognitive or mild cognitive impairment (SCI/ MCI) for 322 patients, dementia for 258 patients, and psychiatric or other disorders for 140 patients. The average annual cost per patient was EUR 578. It was highest for patients with dementia (EUR 751), EUR 550 for patients with SCI/MCI, and lowest for patients with psychiatric and other disorders (EUR 324). Monthly informal and social care costs were between EUR 1,037 and EUR 3,369, depending on the methodology used.
The cost of diagnosing a cognitive disorder depends on how extensive the diagnosis is. With an estimated prevalence of 34,137 persons with dementia in Slovenia, basic diagnostic investigations incur costs of approximately EUR 7 million. Direct medical costs represent a smaller portion of total dementia costs; this is because annual costs for formal and informal home help are estimated at EUR 265 million and nursing home placements at EUR 105 million.
To help general practitioners (GPs) in early identification of patients with palliative care (PC) needs, this pilot study aimed to determine the potential of the combined original surprise question ...(SQ1) ('Would I be surprised if this patient died within the next 12 months?') and the second surprise question (SQ2) ('Would I be surprised if this patient was still alive after 12 months?'). We hypothesized that answering these SQs would trigger them to make a multidimensional care plan.
26 Slovenian GPs, randomized into 4 groups, were invited to write a care plan for each of the four patients described in case vignettes (2 oncologic, 1 organ failure and 1 frailty case). GPs in group 1 were only asked to write a care plan for each patient. GPs in group 2 answered SQ1 and GPs in groups 3 and 4 answered SQ1 and SQ2 before writing the care plan. The type and number of PC aspects mentioned in the respective care plans were quantified into a numeric RADboud ANTicipatory (RADIANT) score.
Mean RADIANT scores in groups 1-4 were 2.2, 3.6, 2.5 and 3.1, respectively. When comparing the different vignettes, vignette B (terminal oncologic patient) scored best (3.6). Mean RADIANT scores in groups 3 and 4 were slightly higher for GPs who would be surprised compared to GPs who would not be surprised if the patient was still alive in 12 months.
The combined SQs were considered helpful in the early identification of patients in need of PC in Slovenian general practice.
Introducción: las demencias son enfermedades degenerativas que afectan a 35.6 millones de personas en el mundo y a más de 100 000 en Cuba; constituyen un acontecimiento vital estresante y hacen al ...anciano muy dependiente de otros y, por tanto, presa fácil de violencia. Objetivo: caracterizar los pacientes con demencia, según grupos de edades, sexo y nivel educacional, manifestaciones clínicas e identificar las conductas violentas, ejercidas sobre ellos, en la consulta de demencia y de terreno durante marzo a agosto de 2010. Material y Método: se realizó un estudio descriptivo desde el 1ero de marzo al 31 de agosto de 2010, en la consulta de demencia y/o en terreno pertenecientes al Policlínico Cristóbal Labra. La información se obtuvo mediante la aplicación de los siguientes instrumentos: Miniexamen del estado mental del anciano, criterios del DSM-IV, la escala de Zarit, Yasavage y la aplicación de una encuesta creada por la autora. Se utilizaron variables cuantitativas y cualitativas; los datos se recogieron en una planilla previamente diseñada y se procesaron de forma automatizada. Los resultados se mostraron en tablas y/o gráficos, y se calcularon medidas de resumen (frecuencias absolutas y porcentajes). Resultados: la demencia se relacionó con aumento de la edad, sexo femenino y menor grado de escolaridad. Los principales síntomas que generaron violencia fueron la pérdida de memoria e insomnio, predominó la Violencia Psicológica; las hijas fueron las principales maltratadoras. Conclusión: la demencia en adultos mayores constituyó un factor estresante generador de violencia en los cuidadores.
Le vieillissement démographique de la population augmente le risque de certaines pathologies en rapport avec l’âge dont les démences vasculaires.
Évaluer les aspects épidémiologiques, cliniques, ...paracliniques et thérapeutiques des démences vasculaires au service de l’hôpital national Ignace Deen de Conakry.
Nous avons mené une étude rétrospective de type descriptif d’une durée de 5 ans, allant du 1er janvier 2016 au 31 décembre 2020. L’étude a porté sur les dossiers des patients chez lesquels le diagnostic de démences vasculaires a été retenu selon les critères du DSM-IV. Nos variables ont été qualitatives et quantitatives.
Sur un total 1750 dossiers nous avons colligé 99 cas de démences vasculaires soit 5,6 %. L’âge moyen était de 69±10 ans. Le sex-ratio H/F de 2,41. Les troubles de la mémoire représentaient 89,9 % des motifs de consultation et la principale comorbidité était l’hypertension artérielle soit 77,8 %. Les scores MMSE et MoCA était modérés chez la majorité des patients(respectivement 61,6 % et 54,5 %).
La fréquence relativement faible des démences vasculaires dans notre contexte est sans doute liée aux considérations socioculturelles, car les démences sont considérées comme une fatalité du sujet âgé, d’une part, et d’autre part, le refus de consultation des patients et la recherche systématique des troubles mnésiques. À l’évaluation de score Moca, l’atteinte neurocognitive était modérée chez 54,5 %.
En Guinée, les démences en particulier les démences vasculaires, constituent une cause importante de comorbidité, de mortalité et de handicap cognitif.
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