Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

adulto mayor

 

Depression in adult day care centers in Ecuador: Prevalence and associated variables. Depresión en adultos que asisten a los centros de día en Ecuador: Prevalencia y variables asociadas.

Objectives: The present study aims to identify the prevalence and factors associated with depression in older adults attending day care centers in Quito, Ecuador.

Methods: This study is a correlational study with a non-experimental cross-sectional design. The study was applied in the 8 “Centros de Experiencia del Adulto Mayor” in the city of Quito, Ecuador. A total of 463 older adults with a mean age of 70.15 years were evaluated. All participants were administered a sociodemographic and health questionnaire, cognitive functioning, levels of depression, autonomy, and physical activity were measured.

Results: Using linear regressions, direct relationships were identified between depression scores with marital status (B=0.276, p=0.04) and renal impairment (B=1.257, p=0.007); and inverse relationships with educational level (B=-0. 537, p=0.002), sleep hours (B=-0.342, p<0.001), fish consumption (B=-0.318, p=0.021), physical activity (B=-0.454, p=0.002) and cognitive impairment (B=-0.091, p<0.001).

Conclusions: The results reflect the importance of considering a holistic approach in addressing depression in the older adult, including health, functional status and cognitive status together to prevent and or address depression in older adults. This study contributes to the implementation of public health policies related to the variables associated with depression in adults.

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Evaluación de la función cognitiva diaria del adulto y adulto mayor mediante el uso del ECog (everyday cognition). Evaluation of the daily cognitive function of adults and elderly adults through the use of ECog (everyday cognition).

Introduction: Older adulthood is the stage of life where significant biological changes occur, such as a decrease in cognitive function. The ECog is a valuable tool for detecting early changes in declining cognitive function and subjective cognitive impairment. It can be answered by an informant (relative) without needing the patient to be present. It can be applied to patients with a low educational level or some disability without this limitation.

Objective: To know the changes in the daily cognitive function of adults and older adults for decades. (50-59, 60-69, >70 years) using the ECog.

Methods: Descriptive, cross-sectional, randomized, survey-type study. Patients over 50 who attended a Family Medicine consultation for any reason other than dementia were included, patients who did not wish to participate were excluded, and incomplete surveys were eliminated. The n was 180 patients, 60 for each age group (group 1=50-59 years, group 2=60-69 years, and group 3=>70 years). The ECog was applied to the patients (answered by an informant). The means were calculated by age group, the variation between each group was calculated using a means comparison formula, the prevalence of Subjective Cognitive Impairment (cut-off point in ECog>1.36) was calculated by age group, and the most affected domains.

Results: The decrease in cognitive function measured by the ECog increased significantly with age in each group (Anova p value less than 0.001) and the prevalence of cases with Subjective Cognitive Impairment. The most affected functions were memory, attention and organization. The least affected domain was language.

Conclusion: A significant decline in cognitive function was observed with advancing age. The ECog is an excellent tool, easy
and straightforward to use for the Primary Care physician.

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Psicosis orgánica, tipo trastorno esquizofreniforme, posterior a hemorragia subaracnoidea. Organic psychosis, schizophreniform disorder type, after subarachnoid hemorrhage

Organic psychosis refers to a group of diseases currently classified as “mental disorders due to a medical illness”, unlike the absence of specific organic causality that exists in primary disorders. These are secondary to long-term processes , which is necessary to re-evaluate frequently due to the association between age-related deterioration, comorbidity and the evolution of psychosis itself. We present the case of a patient with subarachnoid hemorrhage secondary to a ruptured arteriovenous malformation, who suffered from a slight change in behavior and decreased cognitive functions with subsequent evolution to dissociative symptoms, episodes of hypersomnia and disconnection from the environment, through assessment joint of specialties was reached the diagnosis of organic psychosis type schizophreniform disorder.

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Relación entre la depresión y la demencia. Relationship between depression and dementia

The high association of depression and dementia in the elderly has motivated to investigate the type of relationship that exists between them. The objective of this narrative review was to describe the relationship between depression and dementia, for which the Medline, Science Direct, Dialnet, Redalyc databases were reviewed between 2000 and 2021, with the verbal descriptors “dementia” AND “depression” AND “relationship” AND “older adult” OUT “caregiver depression” to locate the candidate documents and then select the final sample made up of 60 published articles, which were reviewed by three judges for selection. Seven explanations of the relationship between dementia and depression were identified in which depression is considered a risk factor for dementia, a prodrome, a consequence, among others. Likewise, there was evidence that, although all the hypotheses have scientific support, there are also indications of their refutability. The types of relationship with the greatest scientific support were “depression as a risk factor” and “as a prodrome of dementia”, although the limitations in the studies prevent clarifying the relationship between these entities. Longitudinal studies that review the history of depression are suggested as a useful methodology to determine the relationship between them.

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Desempeño en Funciones Ejecutivas de Adultos Mayores: Relación Con su Autonomía y Calidad de Vida. Executive Functions Performance In Old Adults: Relationship With Autonomy And Quality Of Life

Throughout the life cycle, the human being is able to consciously control his thoughts, emotions and behavior in a way that adjusts to the demands of the environment, which is lost with old age, affecting the independent and autonomous life of people, negatively impacting their quality of life. The purpose of this review is to determine the executive functions that are most impaired over the years. The narrative review method was used to collect articles that addressed the relationship between executive functions and quality of life in older adults without severe cognitive impairment. The results show that the executive functions that are most affected over the years are attention, working memory and verbal fluency, involved in the search and updating of information; cognitive flexibility, responsible for generating modifications in behavior, thinking and reasoning, fundamental in efficient cognitive functioning. In addition, a slowdown in reasoning, inhibitory deficit, transmission deficit and sensory-perceptive is reported. It is concluded that executive functions are sensitive to the aging process and progressively affect the autonomy and quality of life of older adults. It is considered relevant to generate a maintenance program for these cognitive functions, as a way to promote successful aging.

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