Caracterización de multimorbilidad en adultos mayores de 60 años, en un centro de atención interdisciplinario para pacientes con diagnóstico de demencia en la ciudad de Bogotá

Abstract

Estudio observacional retrospectivo, en población de ancianos que ingresaron en los años 2016-2017 al Instituto Nacional de Demencias Emanuel. Se evaluaron: características sociodemográficas y clínicas, antecedentes patológicos, prevalencia de multimorbilidad, polifarmacia y síndromes geriátricos; condiciones contribuyentes al deterioro funcional o cognitivo, y características de la evolución.

Abstract Introduction: It is relevant to describe de situation of the population with dementia en multiple chronic conditions, to offer a model of care that can address their requirements. Objective: Characterization of multimorbidity in elderly population from a interdisciplinary center for patients with diagnosis of Dementia in the city of Bogota. Methods: Retrospective observational study in a population of elders that assisted “Instituto Nacional de Demencias Emanuel” in years 2016-2017. The variables assessed where: sociodemographic and clinical characteristics, history of diseases, conditions contributing to the functional or cognitive deterioration, and follow up. Results: In 177 patients, the average age was 78.23 years, 64.4% were women, 60% had low education and 61% had poor socioeconomic status. Sensorial alterations (79.1%), cardiovascular disease (63.8%) and endocrine diseases (41.2%) were predominant. The most frequent severity of dementia was moderate (44,6%) and the most diagnosed disease was Alzheimer (58,8%). Prevalence of multimorbidity and geriatric syndromes were 92,1% and 95% respectively, and 44% had a contributing condition to deterioration. 55,3% patients assisted to a follow up appointment, 26,5% fulfilled a treatment for contributing conditions, and 17,1% improved in at least one of these. 42,9% of the patients at follow up had only pharmacological treatment for the cognitive symptoms; while 68,4% received antipsychotics/antidepressants.. The subjective functional improvement was documented in 21% of patients, but in the Barthel scale only 8% improved. Conclusion: Elderly with dementia have high complexity and multimorbidity, therefore they require a holistic approach and strategies to guarantee their follow up.