Salud Mental

What diseases affect elderly Mexican population? Clinical and socialdemographic characteristics of patients of the psychogeriatric clinic of the National Institute of Psychiatry

##plugins.themes.bootstrap3.article.main##

Luis Fernando Collazos Marin
Guillermo Velázquez Lopez
Ismael Aguilar Salas

Abstract

Introduction. The demographic and epidemiological transition, as well as the aging population has changed how older adults are treated in our healthcare system.

Objective. To establish the sociodemographic and clinical characteristics of the patients from the Psychogeriatric Clinic (PC) of the Ramón de la Fuente Muñiz National Institute of Psychiatry (INPRFM) seen between January 1, 2011, and December 31, 2020.

Method. Descriptive, observational, cross-sectional, retrospective study. A database was created with the information from digital clinical records. No additional scales were used. Statistical analysis performed in SPSS 20.0.

Results. 2056 records were found, 1247 met the inclusion criteria. The mean age was 74.28 years, women 73.46% (n = 916), primary school 46.62% (n = 427), married 35.70% (n = 327), urban area 93.99% (n = 1172), home-based 78.28% (n = 717), low socioeconomic level 59.99% (n = 522). The most common psychiatric pathology was depressive disorders 62.07% (n = 774) and neurocognitive disorders 37.52% (n = 468) due to Alzheimer’s disease 17.08% (n = 213), with Mini-Mental State Examination of 18.88 points (± 6.68). They had comorbidities such as arterial hypertension 52.85% (n = 659), diabetes mellitus 23.34% (n = 291) and had a geriatric syndrome in 64.42% (n = 218).

Discussion and conclusion. Aging in Mexico affects the female population the most. The analysis report from the prevalence for psychogeriatric pathologies of the PC it’s for of its kind. The main goal is promoting research on dementias and highlighting the magnitude of the problem for Latin American governments. The results are not intended to be extrapolated to the general population.
Keywords:
Elderly, sociodemographic factors, cognitive impairment, dementia, geriatric psychiatry

References

Aguilar-Navarro, S. G., Mimenza-Alvarado, A. J., Palacios-García, A. A., Samudio-Cruz, A., Gutiérrez-Gutiérrez, L. A., & Ávila-Funes, J. A. (2018). Validez y confiabilidad del MoCA (Montreal Cognitive Assessment) para el tamizaje del deterioro cognoscitivo en México. Revista Colombiana de Psiquiatría, 47(4), 237-243. doi: 10.1016/j.rcp.2017.05.003

Alexopoulos, G. (2019). Mechanisms and treatment of late-life depression. Translational Psychiatry, 9(1), 188. doi: 10.1038/s41398-019-0514-6

Alvarado García, A. M., & Salazar Maya, Á. M. (2014). Análisis del concepto de envejecimiento. Gerokomos, 25(2), 57-62. doi: 10.4321/S1134-928X2014000200002

Andreescu, C., & Lee, S. (2020). Anxiety disorders in the elderly. Advances in Experimental Medicine and Biology, 1191, 561-576. doi: 10.1007/978-981-32-9705-0_28

Arias-Merino, E. D., Mendoza-Ruvalcaba, N. M., Arias-Merino, M. J., Cueva-Contreras, J., & Vázquez Arias, C. (2012). Prevalence of successful aging in the elderly in Western Mexico. Current Gerontoly and Geriatrics Research, 2012, 460249. doi: 10.1155/2012/460249

Baker, F. M., & Espino, D. V. (1997). A Spanish version of the geriatric depression scale in Mexican-American elders. International Journal of Geriatric Psychiatry, 12(1), 21-25. doi: 10.1002/(sici)1099-1166(199701)12:13.0.co;2-2

Beaman, S. R. de, Beaman, P. E., Garcia-Peña, C., Villa, M. A., Heres, J., Córdova, A., & Jagger, C. (2004). Validation of a Modified Version of the Mini-Mental State Examination (MMSE) in Spanish. Aging, Neuropsychology, and Cognition, 11(1), 1-11. doi: 10.1076/anec.11.1.1.29366

Borges, M. K., Aprahamian, I., Romanini, C. V., Oliveira, F. M., Mingardi, S. V. B., Lima, N. A., … Oude Voshaar, R. C. (2021). Depression as a determinant of frailty in late life. Aging & Mental Health, 25(12), 2279-2285. doi: 10.1080/13607863.2020.1857689

Brito-Aguilar, R. (2019). Dementia Around the World and the Latin America and Mexican Scenarios. Journal of Alzheimerʼs Disease, 71(1), 1-5. doi: 10.3233/JAD-190177

Cahn, D. A., Salmon, D. P., Monsch, A. U., Butters, N., Wiederholt, W. C., Corey-Bloom, J., & Barrett-Connor, E. (1996). Screening for dementia of the Alzheimer type in the community: the utility of the Clock Drawing Test. Archives of Clinical Neuropsychology, 11(6), 529-539.

Calderón, M. D. (2018). Epidemiología de la depresión en el adulto mayor. Revista Médica Herediana, 29(3), 182-191. doi: 10.20453/rmh.v29i3.3408

Calderón-Garcidueñas, L., Mukherjee, P. S., Kulesza, R. J., Torres-Jardón, R., Hernández-Luna, J., Ávila-Cervantes, R., … Villarreal-Ríos, R. Research Universidad del Valle de México UVM Group. (2019). Mild Cognitive Impairment and Dementia Involving Multiple Cognitive Domains in Mexican Urbanites. Journal of Alzheimerʼs Disease, 68(3), 1113-1123. doi: 10.3233/JAD-181208

Canadian Coalition for Senior’s Mental Health, & Canadian Academy of Geriatric Psychiatry. (2021). Guideline Update: Canadian Guidelines on Prevention, Assessment and Treatment of Depression Among Older Adults. Markham, Ontario: Canadian Coalition for Seniors’ Mental Health. Retrieved from https://ccsmh.ca/wp-content/uploads/2021/06/CCSMH_Depression_Guidelines_FINAL_EN.pdf (Access date November 15, 2022)

Cano Gutiérrez, C., Borda, M. G., Samper Ternent, R., Chavarro Carvaja, D. A., Escudero de Santacruz, C., & Arciniegas, A. J. (2018). Iluminando las decisiones e intervenciones públicas para la población adulta mayor: Estudio SABE Bogotá. Medicina, 40(2), 191-207. Retrieved from https://www.revistamedicina.net/index.php/Medicina/article/view/1344 (Access date November 15, 2022)

Casey, D. A. (2017). Depression in Older Adults: A Treatable Medical Condition. Primary Care: Clinics in Office Practice, 44(3), 499-510. doi: 10.1016/j.pop.2017.04.007

Chakrabarty, T., Hadjipavlou, G., & Lam R. W. (2016). Cognitive Dysfunction in Major Depressive Disorder: Assessment, Impact, and Management. Focus (American Psychiatric Publishing), 14(2), 194-206. doi: 10.1176/appi.focus.20150043

Comité de la Academia Nacional de Medicina [ANMM]. (2012). El trastorno de ansiedad generalizada. Boletín de Información Clínica Terapéutica, 21(3), 1-2.

Custodio, N., Wheelock, A., Thumala, D., & Slachevsky, A. (2017). Dementia in Latin America: Epidemiological Evidence and Implications for Public Policy. Frontiers in Aging Neuroscience, 9, 221. doi: 10.3389/fnagi.2017.00221

Dumois-Petersen, S., Gallegos-Arreola, M. P., Magaña-Torres, M. T., Perea-Díaz, F. J., Ringman, J. M., & Figuera, L. E. (2020). Autosomal dominant early onset Alzheimer’s disease in the Mexican state of Jalisco: High frequency of the mutation PSEN1 c.1292C>A and phenotypic profile of patients. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 184(4), 1023-1029. doi: 10.1002/ajmg.c.31865

Espínola Nadurille, M., Dolores Velasco, F., Ramírez-Bermúdez, J., Sosa Ortiz, A. L., & Becerra Pino, M. (2007). Baja frecuencia clínica de la demencia por cuerpos de Lewy en el Instituto de Neurología de México. Revista Española de Geriatría y Gerontología, 42(6), 328-332. doi: 10.1016/S0211-139X(07)73571-0

Gallo, J. J., & Paveza, G. J. (2006). Activities of daily living and instrumental activities of daily living assessment. In J. J. Gallo, H. R. Bogner, T. Fulmer, & G. J. Paveza (Eds.). Handbook of Geriatric Assessment, 4th Ed. (pp. 193-240). MA: Jones and Bartlett Publishers.

Garre-Olmo, J. (2018). Epidemiología de la enfermedad de Alzheimer y otras demencias. Revista de Neurología, 66(11), 377-386. doi: 10.33588/rn.6611.2017519

González, C. A., & Ham-Chande R. (2007). Funcionalidad y salud: una tipología del envejecimiento en México. Salud Pública de México, 49(4), 448-458.

González, K. D. (2015). Envejecimiento demográfico en México: análisis comparativo entre las entidades federativas. La Situación Demográfica de México 2015 (pp. 113-129). México: Conapo.

Guzmán, J. M. (2002). Envejecimiento y desarrollo en América Latina y el Caribe, Serie Población y Desarrollo, Nº 28 (LC/L.1737-P). Santiago de Chile: Comisión Económica para América Latina y el Caribe (CEPAL). Publicación de las Naciones Unidas, Nº de venta: S.02.II.G, 7-9.

Hernández-Ávila, M., Gutiérrez, J. P., & Reynoso-Noverón, N. (2013). Diabetes mellitus en México: El estado de la epidemia. Salud Pública de México, 55(Supl. 2), s129-s136.

Ismail, Z., Elbayoumi, H., Fischer, C. E., Hogan, D. B., Millikin, C. P., Schweizer, T., … Fiest, K. M. (2017). Prevalence of Depression in Patients With Mild Cognitive Impairment: A Systematic Review and Meta-analysis. JAMA Psychiatry, 74(1), 58-67. doi: 10.1001/jamapsychiatry.2016.3162

Katz, S., Downs, T. D., Cash, H. R., & Grotz, R. C. (1970). Progress in development of the index of ADL. Gerontologist, 10(1), 20-30. doi: 10.1093/geront/10.1_part_1.20

Lee, P. G., Cigolle, C., & Blaum, C. (2009) The co-occurrence of chronic diseases and geriatric syndromes: the health and retirement study. Journal of the American Geriatrics Society, 57(3), 511-5166. doi: 10.1111/j.1532-5415.2008.02150.x

Licht-Strunk, E., Van Marwijk, H. W., Hoekstra, T., Twisk, J. W., De Haan, M., & Beekman, A. T. (2009). Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up. BMJ, 338, a3079. doi: 10.1136/bmj.a3079

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet, 396(10248), 413-446. doi: 10.1016/S0140-6736(20)30367-6

Llibre-Guerra, J. J., Li, Y., Allegri, R. F., Mendez, P. C., Surace, E. I., Llibre-Rodriguez, J. J., … Bateman, R. J. (2021). Dominantly inherited Alzheimer’s disease in Latin America: Genetic heterogeneity and clinical phenotypes. Alzheimer’s Dement, 17(4), 653-664. doi: 10.1002/alz.12227

Long, J. M., & Holtzman, D. M. (2019). Alzheimer Disease: An Update on Pathobiology and Treatment Strategies. Cell, 179(2), 312-339. doi: 10.1016/j.cell.2019.09.001

López Arellano, O. (2015). Carga de la enfermedad en México, 1990-2010: Nuevos resultados y desafíos. Salud Pública de México, 57(3), 288-290. doi: 10.21149/spm.v57i3.7581

Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., … Memish Z. A. (2012). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2095-9128. doi: 10.1016/S0140-6736(12)61728-0

Luppa, M., Sikorski, C., Luck, T., Ehreke, L., Konnopka, A., Wiese, B., … Riedel-Heller, S. G. (2012). Age- and gender-specific prevalence of depression in latest-life - Systematic review and meta-analysis. Journal of Affective Disorders, 136(3), 212-221. doi: 10.1016/j.jad.2010.11.033

Medina-Mora, M. E., Borges, G., Lara Muñoz, C., Benjet, C., Blanco Jaimes, J., Fleiz Bautista, C., … Aguilar-Gaxiola, S. (2003). Prevalencia de trastornos mentales y uso de servicios: Resultados de la Encuesta Nacional de Epidemiología Psiquiátrica en México. Salud Mental, 26(4), 1-16.

Miranda-Valverde, E., Valerio-Aguilar, D., Jacques Hernández-Gabarain, H., Chaves-Araya, C., Peralta-Azofeifa, M., Corrales-Campos, L. E., … Arias-Salazar, A. (2015). Características clínicas de los casos de demencia diagnosticados en la Clínica de Memoria del Hospital Nacional de Geriatría y Gerontología. Acta Médica Costarricense, 57(3), 130-136.

Moreno Moreno, L. P., Matallana Eslava, D. L., & Cano Gutierrez, C. A. (2015). Current diagnostic challenges from an analysis of social-demographic characteristics of 2453 patients in a Memory and Cognition Hospital. Acta Neurológica Colombiana, 31(1), 27-38. doi: 10.22379/242240225

Moreno-Cervantes, C., Mimenza-Alvarado, A. J., Aguilar-Navarro, S., Alvarado-Ávila, P., Gutiérrez-Gutiérrez, L., Juárez-Arellano, S., & Avila-Funes J. A. (2017). Factores asociados a la demencia mixta en comparación con demencia tipo Alzheimer en adultos mayores mexicanos. Neurología, 32(5), 309-315. doi: 10.1016/j.nrl.2015.12.006

Morimoto, S. S., Kanellopoulos, D., Manning, K. J., & Alexopoulos, G. S. (2015). Diagnosis and treatment of depression and cognitive impairment in late life. Annals of the New York Academy of Sciences, 1345(1), 36-46. doi: 10.1111/nyas.12669

Parra, M. A., Baez, S., Sedeño, L., Gonzalez Campo, C., Santamaría-García, H., Aprahamian, I., … Ibanez, A. (2021). Dementia in Latin America: Paving the way towards a regional action plan. Alzheimer’s Dement, 17(2), 295-313. doi: 10.1002/alz.12202

Prince, M., Acosta, D., Ferri, C. P., Guerra, M., Huang, Y., Jacob, K. S., … Williams, J. D. (2011). The association between common physical impairments and dementia in low and middle income countries, and, among people with dementia, their association with cognitive function and disability. A 10/66 Dementia Research Group population-based study. International Journal of Geriatric Psychiatry, 26(5), 511-519. doi: 10.1002/gps.2558

Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri C. P. (2013). The global prevalence of dementia: A systematic review and metaanalysis. Alzheimer’s Dement, 9(1), 63-75.e2. doi: 10.1016/j.jalz.2012.11.007

Ribeiro, F., Teixeira-Santos, A. C., Caramelli, P., & Leist, A. K. (2022). Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants. Ageing Research Reviews, 81, 101703. doi: 10.1016/j.arr.2022.101703

Rodríguez-Leyva, I., Oliva-Barrios, J. E., Cueli-Barcena, S., Carrizales-Rodríguez J., Chi-Ahumada, E., & Jiménez-Capdeville, M. E. (2018). Demencia frontotemporal: revisión y nuestro punto de vista. Revista Mexicana de Neurociencias, 19(6), 20-31.

Secretaría de Salud. (2010). Diagnóstico y tratamiento de la Enfermedad de Parkinson inicial y avanzada en el tercer nivel de atención. Ciudad de México, México. Retrieved from http://www.facmed.unam.mx/sg/css/GPC/SIDSS-GPC/gpc/docs/SSA-305-10-ER.pdf (Access date November 15, 2022)

Secretaría de Salud. (2017). Diagnóstico y Tratamiento de la Demencia Vascular en el Adulto en los Tres Niveles de Atención: Guía de Práctica Clínica. Ciudad de México, México. Retrieved from http://imss.gob.mx/profesionales-salud/gpc http://www.cenetec.salud.gob.mx/contenidos/gpc/catalogoMaestroGPC.htm (Access date November 15, 2022)

Sinoff, G., Ore, L., Zlotogorsky, D., & Tamir, A. (1999). Short Anxiety Screening Test--a brief instrument for detecting anxiety in the elderly. International Journal of Geriatric Psychiatry, 14(12), 1062-1071. doi: 10.1002/(sici)1099-1166(199912)14:123.0.co;2-q

Sosa Ortiz, A. L., Astudillo García, C. I., & Acosta Castillo, G. I. (2017). 2. Situación epidemiológica actual. In L. M. Gutiérrez Robledo, M. d. C. García Peña, P. A. Roa Rojas, & A. Martínez Ruiz, (Eds.). La Enfermedad de Alzheimer y otras demencias como problema nacional de salud, 1st Ed. (pp. 19-33). México DF: Intersistemas S.A. de C.V Publishers.

Soto-Añari, M., Camargo, L., Ramos-Henderson, M., Rivera-Fernández, C., Denegri-Solís, L., Calle, U., … López, N. (2021). Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic. Dementia and Geriatric Cognitive Disorders Extra, 11(3), 213-221. doi: 10.1159/000518922

Taylor, W. D. (2014). Clinical practice. Depression in the elderly. The New England Journal of Medicine, 371(13), 1228-1236. doi: 10.1056/NEJMcp1402180

United Nations [U.N]. (2002). Informe de la Segunda Asamblea Mundial sobre Envejecimiento (pp. 5-9). Madrid: Naciones Unidas. Retrieved from https://undocs.org/es/A/CONF.197/9. (Access date November 15, 2022)

van der Veen, D. C., Gulpers, B., van Zelst, W., Köhler, S., Comijs, H. C., Schoevers, R. A., & Oude Voshaar, R. C. (2021). Anxiety in Late-Life Depression: Determinants of the Course of Anxiety and Complete Remission. American Journal of Geriatric Psychiatry, 29(4), 336-347. doi: 10.1016/j.jagp.2020.12.023

van Rijn, M., Suijker, J. J., Bol, W., Hoff, E., ter Riet, G., de Rooij, S. E., … Buurman, B. M. (2016). Comprehensive geriatric assessment: recognition of identified geriatric conditions by community-dwelling older persons. Age Ageing, 45(6), 894-899. doi: 10.1093/ageing/afw157

Vasquez, D., Castrillón, M. S., Vega, M. G., Henck, C. G., Aguillon, D., Garcia-Cifuentes, E., … Lopera F. (2021). Quality of life in early-onset Alzheimer’s disease due to a PSEN1-E280A mutation. Neurological Sciences, 42(11), 4637-4645. doi: 10.1007/s10072-021-05136-y

Velázquez-Monroy, Ó., Rosas Peralta, M., Lara Esqueda, A., Pastelín Hernández, G., Sánchez Castillo, C., Attie, F., & Tapia Conyer, R. (2003). Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: Resultados finales de la Encuesta Nacional de Salud (ENSA) 2000. Archivos de Cardiología de México, 73(1), 62-77.

World Health Organization [WHO]. (11 June 2021). Fact sheets / Cardiovascular diseases (CVDs). World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (Access date November 15, 2022)

World Health Organization [WHO]. (2017). Depression and other common mental disorders: global health estimates (pp. 7-14). Licence: CC BY-NC-SA 3.0 IGO. Geneva: World Health Organization. Retrieved from https://apps.who.int/iris/handle/10665/254610 (Access date November 15, 2022)

Xiang, Y., Vilmenay, K., Poon, A. N., Ayanian, S., Aitken, C. F., & Chan, K. Y. (2021). Systematic Review Estimating the Burden of Dementia in the Latin America and Caribbean Region: A Bayesian Approach. Frontiers in Neurology, 12, 628520. doi: 10.3389/fneur.2021.628520

Zurique Sánchez, C., Cadena Sanabria, M. O., Zurique Sánchez, M., Camacho López, P. A., Sánchez Sanabria, M., Hernández Hernández, S., ... Ustate Valera, A. (2019). Prevalencia de demencia en adultos mayores de América Latina: revisión sistemática [Prevalence of dementia in the elderly in Latin America: A systematic review]. Revista Española de Geriatría y Gerontología, 54(6), 346-355. doi: 10.1016/j.regg.2018.12.007