Screening Younger Individuals in a Primary Care Setting Flags Putative Dementia Cases and Correlates Gastrointestinal Diseases with Poor Cognitive Performance

Dement Geriatr Cogn Disord. 2017;43(1-2):15-28. doi: 10.1159/000452485. Epub 2016 Dec 2.

Abstract

Background/aims: Diagnosing dementia is challenging in many primary care settings, given the limited human resources and the lack of current diagnostic tools. With this in mind, a primary care-based cohort was established in the Aveiro district of Portugal.

Methods: A total of 568 participants were evaluated using cognitive tests and APOE genotyping.

Results: The findings revealed a dementia prevalence of 12%. A strong correlation between increasing Clinical Dementia Rating (CDR) scores and education was clearly evident. Other highly relevant risk factors were activities of daily living (ADL), instrumental ADL, aging, depression, gender, the APOE ε4 allele, and comorbidities (depression as well as gastrointestinal, osteoarticular, and neurodegenerative diseases). A hitherto unreported, significant correlation between gastrointestinal disease and high CDR score was clearly observable.

Conclusions: This study shows the merit of carrying out a dementia screening on younger subjects. Significantly, 71 subjects in the age group of 50-65 years were flagged for follow-up studies; furthermore, these cases with a potentially early onset of dementia were identified in a primary care setting.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aging / psychology
  • Apolipoproteins E / genetics
  • Cognition Disorders / psychology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Dementia / diagnosis*
  • Dementia / psychology*
  • Female
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / psychology*
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Portugal
  • Prevalence
  • Primary Health Care
  • Psychomotor Performance
  • Risk Factors
  • Socioeconomic Factors

Substances

  • Apolipoproteins E