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Prevalence study of mild cognitive impairment and dementia in Tremembé, State of São Paulo

Grant number: 12/04815-6
Support Opportunities:Regular Research Grants
Duration: November 01, 2012 - October 31, 2014
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Ricardo Nitrini
Grantee:Ricardo Nitrini
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Dementia is one of the major health problems due to the rapidly growing population of elderly, with a prevalence that has been around 7% in individuals aged 65 years or more in Brazilian studies. Mild cognitive impairment (MCI) is a clinical condition between normal aging and dementia with an insufficiently determined prevalence in population studies, particularly in Brazil. Epidemiological studies that identify these conditions, particularly the MCI, are still rare. Objectives: To determine the prevalence of MCI and dementia in the Tremembé community, São Paulo, and evaluate the influence of socio-demographic variables. Start cohort studies of elderly patients for further investigation of the incidence, risk and protective factors. Methods: In the preliminary stage of the study was to evaluate the prevalence of MCI and dementia in nursing home population. This preliminary step was also used to test the applicability of the instruments (questionnaires and neuropsychological evaluations). The study population will be conducted in single phase, with the elderly (more than 60 years) living in the community. Households in the city of Tremembé will be chosen at random, corresponding to 20% of elderly in region of the town. Clinical and neurological evaluation, interviews with the informants and neuropsychological tests will be applied to all participants. As questionnaires will be used: the IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly) and Functional Activity Questionnaire Pfeffer. As neuropsychological tests are applied: a Battery of Brief Cognitive Screening and Mini Mental State Examination (MMSE). Psychiatric evaluation will be done through two scales: the scale of the Cornell questionnaire and Primary Care Evaluation of Mental Disorders (PRIME-MD). The diagnosis of dementia and MCI will be established in a consensus meeting between the researcher and two neurologists with expertise in cognitive neurology based on the set of data. A derivative of the AD8 questionnaire with 22 items, Addenbrooke's Cognitive Examination Revised (ACE-R) and the Montreal Cognitive Assessment (MoCA) will be applied in order for the validation for population study. . Patients diagnosed with dementia and MCI will undergo further examination which should include brain MRI and blood tests to confirm the etiology, and exclude potentially reversible causes. Results of the pilot project: In the public nursing home there were, at the time, with 32 people institutionalized, and other private nursing home with 6 seniors. Thirty-seven of them were women with a mean age of 81.11 and mean schooling years of 3.74. Alzheimer's disease (AD) is the most common, present in 17 cases, followed by 5 patients with Cognitive Impairment, 4 dementias of unknown causes, 3 had Vascular Dementia, 1 patient had AD with cerebrovascular disease, 1 Frontotemporal Dementia, 1 with cognitive impairment by multiple causes and 1 with schizophrenia. Only 5 individuals examined had no cognitive impairment. Preliminary results: In the community population have been examined, 82 individuals with a mean age of 69.9 (± 7.84), mean schooling years of 4.29 and 44 were women, accounting for 53.66%. The prevalence of dementia was 20.73% and Cognitive Impairment without Dementia (CCSD), a definition that contains the concept of MCI cases, was 18.29%. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
KAROLINA G. CESAR; MÔNICA S. YASSUDA; FABIO H. G. PORTO; SONIA M. D. BRUCKI; RICARDO NITRINI. Teste MoCA: dados normativos e de acurácia diagnóstica para idosos com níveis educacionais heterogêneos no Brasil. Arquivos de Neuro-Psiquiatria, v. 77, n. 11, p. 775-781, . (12/04815-6)
CESAR, KAROLINA G.; BRUCKI, SONIA M. D.; TAKADA, LEONEL T.; NASCIMENTO, LUIZ F. C.; GOMES, CAMILA M. S.; ALMEIDA, MILENA C. S.; OLIVEIRA, MAIRA O.; PORTO, FABIO H. G.; SENAHA, MIRNA L. H.; BAHIA, VALERIA S.; et al. Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembe, Brazil. Alzheimer Disease & Associated Disorders, v. 30, n. 3, p. 264-271, . (12/04815-6)
CESAR, KAROLINA G.; YASSUDA, MONICA S.; PORTO, FABIO H. G.; BRUCKI, SONIA M. D.; NITRINI, RICARDO. Addenbrooke's cognitive examination-revised: normative and accuracy data for seniors with heterogeneous educational level in Brazil. INTERNATIONAL PSYCHOGERIATRICS, v. 29, n. 8, p. 1345-1353, . (12/04815-6)
KAROLINA G. CÉSAR; SONIA M.D. BRUCKI; LEONEL T. TAKADA; LUIZ FERNANDO C. NASCIMENTO; CAMILA M.S. GOMES; MILENA C.S. ALMEIDA; MAIRA O. OLIVEIRA; FÁBIO H.G. PORTO; MIRNA L.H. SENAHA; VALÉRIA S. BAHIA; et al. Desempenho na Escala Analógica Visual de Felicidade e na Escala Cornell de Depressão em Demência no estudo epidemiológico de Tremembé, Brasil. Dement. Neuropsychol., v. 8, n. 4, p. 389-393, . (12/04815-6)

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