scholarly journals Prevalence of Alzheimer's disease according to anticholinesterase drug usage from 2012 to 2017 in the state of Paraná, Brazil

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 641
Author(s):  
Dayanna Hartmann Cambruzzi Mendes ◽  
Glaucia Renee Hilgemberg ◽  
Flavio Silva Posseti ◽  
Jéssica Wouk ◽  
Emerson Carraro

Introduction: Alzheimer's disease (AD) is a public health problem in Brazil due to the growing number of older adults in this population. Knowing the prevalence of AD in the Paraná state is essential to improve patients’ quality of life. The objective of the study was to estimate AD prevalence in the state of Paraná, based on the prescription of anticholinesterases, from 2012 to 2017. Methods: Patients diagnosed with AD, aged 60 years or over, who used Brazil’s Unified Public Health System (SUS) and received AD medication from the Department of Pharmaceutical Assistance of the state of Paraná, from 2012 to 2017, were the target population of the present study. The medication data were collected from the Computerized system management and Monitoring of Exceptional Drugs (SISMEDEX), and the population’s data were collected from the Brazilian Institute of Geography and Statistics (IBGE). Results: The sample consisted of 52,687 patients, and the median prevalence of AD in the established period for the state was 642.6/100,000 inhabitants (0.64%). In all ages and macro-regions, women showed the highest prevalence rates. The median prevalence for women in the established period was 755.4/100,000 inhabitants (0.75%). Among men, the median prevalence was 510.2/100,000 inhabitants (0.51%). In the temporal analysis of prevalence, between 2012 and 2017, a reduction of 23% was found in the state rate. The prevalence rate of Paraná for AD is nine times lower than the Brazilian average. Conclusions: Paraná’s prevalence rate for AD is lower than the rates of Brazil and the world, suggesting that AD is underdiagnosed in most municipalities of this state.

Author(s):  
A.P. Porsteinsson ◽  
E.D. Clark

Alzheimer’s disease (AD) remains one of our greatest unmet medical needs, without any approved disease-modifying therapies. The emotional and financial burden of AD is enormous and predicted to grow exponentially with increasing median population age, posing a major public health problem. The potential to prevent or improve cognitive decline due to AD has important implications. There are medications currently approved for symptomatic treatment of AD, but they have limited clinical benefits and do not change the ultimate trajectory of the disease. The need to find effective treatments for AD that can prevent, slow, arrest, or even reverse the disease is ever more urgent and interventions that delay the symptomatic onset of AD would have a major public health impact (1).


OCL ◽  
2018 ◽  
Vol 25 (4) ◽  
pp. D402 ◽  
Author(s):  
Jean-François Dartigues

Alzheimer’s disease was described in 1906, but it was only in 1987 that it was recognized as a public health problem with the actions of patient family associations. Despite successive Alzheimer plans, it remains a neglected and under-diagnosed disease. The lack of curative treatment and a clash of views between general practitioners and specialists explain these findings. Paradoxically, despite this neglect, Alzheimer’s disease is receding in the city. This is the proof that prevention is possible.


Author(s):  
Rafael Brito-Aguilar

Dementia has become a major public health concern around the world. Dementia risk factors are significantly different among countries. The number of new cases of dementia anticipated each year worldwide is almost 7.7 million, one new case every four seconds. There are 3.6 million (46%) new cases per year in Asia, 2.3 million (31%) in Europe, 1.2 million (16%) in the Americas, and 0.5 million (7%) in Africa. Latin American and Caribbean low and middle-income countries are at high risk. Air pollution is an important risk modifiable factor for dementia across the world, and the recent report of the Alzheimer’s disease continuum in children and young adults residing in Metropolitan Mexico City along with the presence of cognitive impairment in 55% of the young adult population residing in Mexican cities with fine particulate matter concentrations above the current USEPA annual standard of 12 μg/m3 makes this a severe public health problem in progress. It is imperative to keep generating epidemiological data on dementia worldwide and their relationship with air pollutants to improve the strategies to face all the challenges associated with dementia and Alzheimer’s disease in particular. Alzheimer’s disease is a fatal disease, we have no cure, and we ought to invest in protecting our citizens by intervening in modifiable environmental factors.


CNS Spectrums ◽  
2009 ◽  
Vol 14 (S7) ◽  
pp. 4-7 ◽  
Author(s):  
Stephen Salloway

There are currently >5 million people in the United States who have been diagnosed with Alzheimer's disease. That prevalence rate is expected to triple as the population ages. The health and economic burden due to Alzheimer's disease is a worldwide problem, with some of the greatest burden coming from the developing world as people live longer in those societies. Throughout the world, the projected growth of Alzheimer's disease is dramatic. This is a worldwide public health problem of the highest order, and there is a compelling need to develop new treatments and methods of earlier diagnosis need to slow the progression of the disease and lessen its impact.


Author(s):  
Albert Dayor Piersson ◽  
Wiam Elshami ◽  
Alberta Naa Afia Adjei ◽  
Klenam Dzefi-Tettey ◽  
Philip N. Gorleku

Falls are an important clinical, socioeconomic, and public health problem in the older adult population. Advancing age is a major risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD). The preclinical phase of AD, which is regarded as an important window for early therapeutic intervention before the onset of MCI and subsequently AD, can serve as a critical period to reduce or prevent falls among elderly people at risk of AD. In this chapter, first, a discussion is provided on the degrees of fall-related injuries, pain, and severity of falls in elderly people at risk of AD. Secondly, a discussion is provided on the clinical, socioeconomic, and public health implications of falls. Studies that integrated neuroimaging techniques were also reviewed to identify brain biomarkers that can be targeted for the prevention of falls among the elderly. It is anticipated that the outcome of this chapter may have a critical role in the prevention of falls among elderly people at risk or suffering from AD.


Author(s):  
David Vaquero-Puyuelo ◽  
Concepción De-la-Cámara ◽  
Beatriz Olaya ◽  
Patricia Gracia-García ◽  
Antonio Lobo ◽  
...  

(1) Introduction: Dementia is a major public health problem, and Alzheimer’s disease (AD) is the most frequent subtype. Clarifying the potential risk factors is necessary in order to improve dementia-prevention strategies and quality of life. Here, our purpose was to investigate the role of the absence of hedonic tone; anhedonia, understood as the reduction on previous enjoyable daily activities, which occasionally is underdetected and underdiagnosed; and the risk of developing AD in a cognitively unimpaired and non-depressed population sample. (2) Method: We used data from the Zaragoza Dementia and Depression (ZARADEMP) project, a longitudinal epidemiological study on dementia and depression. After excluding subjects with dementia, a sample of 2830 dwellers aged ≥65 years was followed for 4.5 years. The geriatric mental state examination was used to identify cases of anhedonia. AD was diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. A multivariate survival analysis and Cox proportional hazards regression model were performed, and the analysis was controlled by an analysis for the presence of clinically significant depression. (3) Results: We found a significant association between anhedonia cases and AD risk in the univariate analysis (hazard ratio (HR): 2.37; 95% CI: 1.04–5.40). This association persisted more strongly in the fully adjusted model. (4) Conclusions: Identifying cognitively intact individuals with anhedonia is a priority to implement preventive strategies that could delay the progression of cognitive and functional impairment in subjects at risk of AD.


2020 ◽  
Vol 11 ◽  
Author(s):  
Tânia Regina Ferreira ◽  
Luciane Cruz Lopes ◽  
Cristiane de Càssia Bergamaschi

Background: There is lack of national studies that assess the risks associated with the drugs provided under the Brazilian public health system for treating Alzheimer’s disease. Then, this study determined the prevalence and severity of self-reported adverse drug reactions (ADRs) prescribed to patients with Alzheimer’s disease in the Brazilian public health system.Methods: A cross-sectional study was carried out based on public data from the MEDEX system (information on dispensing data, known as exceptional dispensing medications) and interviews with patients and/or caregivers who get access to Alzheimer’s drugs at a public pharmacy in a large Brazilian city, between July and September 2017, inquiring about ADRs and serious adverse events (SAEs).Results: The subjects were asked about ADRs and SAEs related to the use of donepezil, galantamine, rivastigmine and memantine. Out of 285 patients enrolled on the database, 250 participated in the study (87.7%). Among the participants, approximately 63.0% were female, 70.3% aged ≥75 years and 70.3% had comorbidities. Overall, 209 patients (83.6%) reported at least one ADR (total 1,149 ADRs) and rivastigmine was associated with the largest number of ADRs per patient (7.9 ADRs/patient). The predominant adverse effects were psychiatric disorders with common frequency (57.1%) and mild severity (89.0%). Six patients (2.4%) had SAEs that required hospitalization. The use of antipsychotics was the variable associated with ADR (OR = 4.95; 95% CI: 1.45–16.93; p = 0.011).Conclusion: There was a large number of reported ADRs and most of them were of common frequency and mild severity, being mainly related to psychiatric disorders. Considering the fragility of these patients, it is important to improve safety-related care in the use of drugs for treating this disease.


2021 ◽  
Vol 21 (4) ◽  
pp. 797-803
Author(s):  
Andres Joaquin Guarnizo Chávez ◽  
Nathaly Alejandra Romero Heredia

Introduction: Adolescent suicide is a public health problem that has been neglected due to the pandemic and confinement. Objective: To describe the characteristics of adolescent suicide, during the period of confinement due to pandemic in the year 2020 in Ecuador. Method: An observational, descriptive, cross-sectional, retrospective study was carried out, with the information from the database of violent deaths of the Ministry of Government, from March 17 to September 13, which lasted through the state of emergency. The analysis was carried out by province, sex, age, suicide method and frequency in days after the event occurred. The suicide mortality rate (per 100,000 inhabitants) was estimated for each province. Results: During confinement due to a state of emergency in 2020 in Ecuador, 97 suicides were registered among adolescents between 10 and 19 years of age. The highest number was estimated in males between 15 and 19 years of age, with the most frequent age being 19. The most frequent day of removal of corpses was on Mondays, and the preferred mode of suicide was by hanging with 81 reported cases. followed by intoxication and poisoning. Conclusions: No increases were found in the suicide mortality rate during the state of emergency in 2020. However, it must be considered that the context of COVID-19 has increased the burden of psychological suffering, which may lead adolescents to think about suicide.


Author(s):  
Vanessa Silva Lins ◽  
Marcia Queiroz de Carvalho Gomes

A demência é uma das principais causas de incapacidade entre a população idosa, sua prevalência vem crescendo com o aumento da longevidade e vem se tornando um problema de saúde pública. O idoso acometido por demência tem as ocupações e o desempenho ocupacional bastante comprometido, necessitando da assistência do terapeuta ocupacional. O objetivo do presente estudo é analisar as contribuições da Terapia Ocupacional na atenção ao idoso com demência, descritas nas produções científicas publicadas em periódicos na área de saúde. Trata-se de uma revisão sistemática, do tipo integrativa, realizada na plataforma BIREME, nas bases de dados da LILACS, SciELO e MEDLINE, usando os descritores “Demência AND Terapia Ocupacional” e “Doença de Alzheimer AND Terapia Ocupacional”, nos idiomas português e espanhol. Foram encontrados 33 artigos, desse total foram selecionados para análise 07 artigos, que estavam dentro dos critérios de inclusão. Esta revisão permitiu constatar que, apesar da tímida produção de publicações de terapeutas ocupacionais acerca da demência, nos dois idiomas pesquisados, a Terapia Ocupacional vem ampliando seu escopo de ação, para além das tradicionais abordagens cognitivas e centradas apenas no idoso, avançou na promoção de práticas preventivas e no manejo de sintomas psicológicos e comportamentais, que envolvem tanto o ambiente físico quanto o ambiente social do idoso. A Terapia Ocupacional tem desenvolvido e utilizado instrumentos próprios da profissão, tais como a DADL-Br e a COPM, fortalecendo sua identidade e especificidade. Vem contribuindo para a qualidade de vida e bem-estar do idoso com Demência e seus cuidadores/familiares, promovendo uma atenção integral e contextualizada. Abstract Dementia is one of the leading causes of disability among the elderly population. Its prevalence has increased with longevity growth and it has become a public health problem. The older adults person affected by dementia has his/her occupations and occupational performance quite compromised, requiring Occupational Therapy assistance. The objective of the present study is to analyze Occupational Therapy assistance contributions to the elderly with dementia, described in the scientific productions published in health journals. It is a review of the integrative type, performed in BIREME platform, in the databases of LILACS, SciELO and MEDLINE, using the descriptors "Dementia AND Occupational Therapy" and "Alzheimer's Disease AND Occupational Therapy", in Portuguese and Spanish.We have found 33 articles, from which 7 articles were selected for analysis, according to the inclusion criteria.This review showed that, in spite of the small number of publications about the performance of dementia in both languages, Occupational Therapy has expanded its scope of action. Beyond cognitive approaches focused on the older adults, it has been making progress on preventing and managing psychological and behavioral symptoms, involving both the physical and social environment of the older adults. Occupational Therapy has developed and used its own tests and evaluations, such as DADL-Br and COPM, strengthening its identity and specificity. It contributes to the quality of life and well-being of the elderly with Dementia and their caregivers / family, promoting integrated and contextualized care.Keywords: Dementia, Alzheimer's Disease, Elderly; Occupational Therapy.


2020 ◽  
Vol 10 (2) ◽  
pp. 84 ◽  
Author(s):  
Atif Mehmood ◽  
Muazzam Maqsood ◽  
Muzaffar Bashir ◽  
Yang Shuyuan

Alzheimer’s disease (AD) may cause damage to the memory cells permanently, which results in the form of dementia. The diagnosis of Alzheimer’s disease at an early stage is a problematic task for researchers. For this, machine learning and deep convolutional neural network (CNN) based approaches are readily available to solve various problems related to brain image data analysis. In clinical research, magnetic resonance imaging (MRI) is used to diagnose AD. For accurate classification of dementia stages, we need highly discriminative features obtained from MRI images. Recently advanced deep CNN-based models successfully proved their accuracy. However, due to a smaller number of image samples available in the datasets, there exist problems of over-fitting hindering the performance of deep learning approaches. In this research, we developed a Siamese convolutional neural network (SCNN) model inspired by VGG-16 (also called Oxford Net) to classify dementia stages. In our approach, we extend the insufficient and imbalanced data by using augmentation approaches. Experiments are performed on a publicly available dataset open access series of imaging studies (OASIS), by using the proposed approach, an excellent test accuracy of 99.05% is achieved for the classification of dementia stages. We compared our model with the state-of-the-art models and discovered that the proposed model outperformed the state-of-the-art models in terms of performance, efficiency, and accuracy.


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