Clinical aspects of dementia cases diagnosed at the Memory Clinic of the National Geriatric and Gerontology Hospital

Antecedentes: la demencia es una entidad clínica cada vez más prevalente en nuestro medio, cuya incidencia aumenta con la edad. El objetivo del presente estudio es identificar los principales tipos de demencia atendidos en una unidad de trastornos de memoria. Métodos: registro consecutivo y estandarizado de pacientes diagnosticados con demencia en la Unidad de Trastornos de Memoria y Conducta, del Hospital Nacional de Geriatría y Gerontología. Resultados: se evaluó 1659 casos, de los cuales el 65,8% reunió criterios de demencia. El 42,9% correspondió a enfermedad de Alzheimer, el 28,5% a demencia secundaria a patología vascular, el 17,1% a formas mixtas, y el 11,5% a tipos varios. La edad media fue de 79,6 + 6,7 años, y el 66,2% fueron mujeres. La escolaridad promedio fue 4,95 + 4,09 años; el 41,7% estaba casado; el 47,3% tenía un hijo como cuidador; el tiempo promedio entre la aparición de los síntomas y el diagnóstico clínico fue de 3,18 + 2,6 años. La puntuación media del test Minimental fue de 18,35 + 5,9 puntos; en el test de dibujo del reloj fue de 3,4 + 2,5, y el Clinical Dementia Rating fue de 1,7 + 0,7; el 45,2% de los casos correspondió a CDR de 1. El 24% de los casos tenía antecedente familiar de demencia, y el 95,7% presentaba uno o más factores de riesgo cardiovascular, siendo la HTA el más frecuente, en un 70,2%. El 27,1% de los casos fue demencias leves; el 31,9%, moderadas; el 39,3% moderadas-severas, y el 1,7%, severas. El 90% de los casos presentó uno o más trastornos neuroconductuales. Conclusiones: la determinación de los principales tipos de demencia en la población adulta mayor y sus principales características, ha permitido registrar gran cantidad de información que se desconocía y que será de útil para la gestión y planificación de estrategias de atención en salud pública.Background: Dementia is an increasingly prevalent clinical entity in the medical field, whose incidence increases with age. The purpose of this study is to identify the main types of dementia treated in a memory-disorders unit. Methodology: A consecutive and standardized register of patients diagnosed with dementia at the Memory Disorders Unit of the National Geriatrics and Gerontology Hospital. Results: 1659 cases were evaluated, 65.8% met criteria for dementia. 42.9% of the cases were Alzheimer’s disease, 28.5% secondary vascular dementia pathology, mixed forms represented 17.1% and 11.5% were diverse types. The mean age was 79.6 + 6.7 years and 66.2% were women. Average schooling was 4.95+ 4.09 years, 41.7% were married, 47.3% had a child as a caregiver, the average time between onset of symptoms and the clinical diagnosis was 3.18 + 2.6 years. The mean Minimental test score was 18.35 + 5.9 points, in the clock drawing test it was 3.4 + 2.5 and the Clinical Dementia Rating was 1.7 + 0.7; 45.2% of cases were CDR 1. 24% of cases had a family history of dementia and 95.7% had one or more cardiovascular risk factors, with AHT being the most common in 70.2%. 27.1% of dementia cases were mild, 31.9% moderate, 39.3% moderatesevere and 1.7% were severe. 90% of patients had one or more neurobehavioral disorders.Conclusions: The determination of the main types of dementia in the elderly population and their main features has allowed the registry of abundant information that was unknown and that will be useful for the management and strategic planning of public health care.UCR::Vicerrectoría de Docencia::Ciencias Sociales::Facultad de Ciencias Económicas::Escuela de Estadístic

Adapting Agriculture to Climate Change: A Synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across Five Continents

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.info:eu-repo/semantics/publishedVersio

Memory clinic experience under a social security health system in Costa Rica

Dementia and mild cognitive impairment (MCI) are an increasingly prevalent clinical entity in our field, showing an increasing incidence with age. OBJECTIVE: The purpose of this study was to identify the main types of dementia and MCI treated in a memory disorders unit in Costa Rica. METHODS: A consecutive and standardized register of patients diagnosed with dementia and MCI at the memory disorders unit of the National Geriatrics and Gerontology Hospital (NGGH) was analyzed. RESULTS: Dementia was diagnosed in 63.5% of the 3572 cases, whereas 10.6% met criteria for MCI. The most frequent type of dementia was Alzheimer's disease (47.1%), followed by vascular pathology (28.9%), mixed forms (17.2%) and other types (6.8%). In MCI, 69.5% were of amnestic multiple domain type and 14.3% were non-amnestic multiple domain, while 41.3% were of vascular and 35.8% of neurodegenerative etiology. Mean age was 79.6±6.7 years and 64.7% were women in dementia cases whereas mean age was 76.4±6.9 years and 62.1% were women in MCI. Mean years of schooling was 4.95±4.09 years and 6.87±4.71, while mean time between onset of symptoms and clinical diagnosis was 3.2±2.6 years and 2.67±2.69 years, in dementia and MCI, respectively. CONCLUSION: The determination of the main types of dementia and MCI in Costa Rica and their main features has allowed the registration of comprehensive, hitherto unavailable information that will be useful for the management and strategic planning of public health care