Queixa amnéstica na atenção primária à saúde: caracterização clínica, neuropsicológica e funcional

• Ano de defesa: 2017
• Autor(a) principal: Marcos Leandro Pereira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Neuropsicologia; Transtornos de memória; Atenção primária à saúde; Transtornos da memória; Neurociências; Cuidados primários de saúde
• Link de acesso: http://hdl.handle.net/1843/BUOS-B3UPK3

Background: Memory complaints are frequent in the elderly. There are different causes of memory impairment, such as age-related cognitive decline, depression, mild cognitive impairment (MCI), or a neurodegenerative disease. Objective: To characterize the memory complaint in primary health care in Patos de Minas (Minas Gerais), in terms of clinical, cognitive and functional profiles Methods: This study was carried out with patients aged 50 years, with memory complaints (spontaneous or inquired). The study was conducted in a primary health center from March to September, 2016. Patients who scored 25 in the Memory Complaint Questionnaire (MAC-Q) or who had spontaneous memory complaints were included. Patients underwent a semistructured interview, Mini Mental State Examination, Figures Test (visual episodic memory test), Clock Test, Semantic Fluency (Animals), the Neuropsychiatric Inventory, and functional assessment (Katz and Pfeffer scales for activities of daily living). Patients were classified into the following categories: subjective cognitive impairment (SCI), amnestic MCI (aMCI), nonamnestic MCI (naMCI) and dementia. Results: 432 patients were initially assessed. 25% of them (n = 108) had memory complaints. The final sample consisted of 91 patients (73.6% were women; mean age 67.6 ±9.76 years; mean educational level of 4 for 8 years). 14.3% had spontaneous complaints and 85.7% had inquired complaints. The most common comorbidities were hypertension (69.2%), diabetes mellitus (36.3%), dyslipidemia (24.2%) hypothyroidism (21.9%), anxiety (17.6%) and depression (12.1%). Low levels of vitamin B12 and hypothyroidism were found in 26.4% e 16.5%, respectively. 13.2% were classified as SCI, 23.5% as naMCI, 29.7% as aMCI and 34.1% as dementia. Patients who presented spontaneous complaints had worse performance in MMSE, 5 'evocation (memory test) and higher score on MAC-Q. There was no correlation between MAC-Q and cognitive tests. Conclusions: MCI and dementia are underdiagnosed. Cardiovascular risk and reversible causes of cognitive decline were frequent in our population, reinforcing the need of appropriate medical screening. Patients with spontaneous memory complaint had worse performance than patients with inquired memory complaint