Gabrielė Legotaitė, Jurgita Knašienė, Gytė Damulevičienė
Introduction. The prevalence of dementia in Lithuania has risen dramatically in past decades. The ageing population and vascular risk factors may contribute to this rise. The proportions of Alzheimer’s disease (ADD) and vascular dementia (VAD) in older population is not clear. Aim. Our aim was to evaluate the characteristics of cognitive disorders of the older patients, visiting the Memory clinic for the first time and to identify the relationships between cognitive disorders and risk factors, comorbidities. Methods. We used a population-based retrospective cohort study design and extracted data from Memory clinic database. The research involved 202 patients of 60 and over year-old, who visited the Memory clinic in I Consulting Clinic of Kaunas Clinical Hospital, in 2015 for the first time. The statistical analysis of the data was performed using the software SPSS 22.0. The selected statistical significance level was α=0,05. The differences of variables, while comparing several groups of subjects, or relationships between variables were considered as statistically significant when p<α (p<0,05). Chi-square, Student t-test, analysis of variance Anova, Spearmen and Kendall tau-b correlation coefficients, descriptive statistics were used in the data analysis. Results: 202 patient’s (≥ 60 year-old) data were analyzed. 82,7% of patient’s (n=167) had cognitive disorders: 81,4% (n=136) dementia, 18,6% (n=31) mild cognitive impairment (MCI). Dementia, according to severity: severe 15,4%, moderate 72,1%, mild 12,5%. The most common was VAD – in 41,9% of cases (subcortical 64,9 %), mixed dementia – 34,6%, ADD – 15,4 %, other – 4,4%. MCI has relationship with lower education (p<0,001), ischaemic heart disease (IHD) (p=0,030), hypertension (p=0,001). Dementia is associated with older age (p=0,001) and lower education of the patients (p<0,001). VAD is associated with strokes (p<0,001), IHD (p=0,001), hypertension (p=0,01), ischemic lacunar state (p<0,001), urinary incontinence (p=<0,001) and falls (p=0,001). Mixed dementia has relationship with IHD (p=0,026), hypertension (p=0,007), urinary incontinence (p<0,001). Conclusions. The prevalence of cognitive disorders among the older patients visiting the Memory clinic for the first time is high (82,7%) and the most common was VAD. The high prevalence of VAD and mixed dementia is associated with vascular risk factors – strokes, IHD, hypertension, chronic ischemic lacunar state. Community based early interventions controlling vascular risk factors, cognitive function screening and patients referral to Memory clinics have a priority in prevention of cognitive disorders in older population.
Keyword(s): cognitive disorders; mild cognitive impairment; dementia.
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