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.

痴呆（Dementia）与轻度认知障碍（Mild Cognitive Impairment, MCI）是本学科领域内日益高发的临床病症，其发病率随年龄增长逐步升高。
研究目的：本研究旨在明确哥斯达黎加某记忆障碍门诊收治的痴呆与MCI患者的主要类型。
研究方法：本研究对国家老年病与老年医学医院（National Geriatrics and Gerontology Hospital, NGGH）记忆障碍门诊收录的确诊痴呆及MCI患者的连续标准化登记数据进行了回顾性分析。
研究结果：在3572例病例中，63.5%被确诊为痴呆，10.6%符合MCI诊断标准。痴呆患者中最常见的类型为阿尔茨海默病（Alzheimer's disease，47.1%），其次为血管性痴呆（28.9%）、混合性痴呆（17.2%）及其他类型痴呆（6.8%）。在MCI患者中，69.5%为遗忘型多域MCI，14.3%为非遗忘型多域MCI；按病因学分型，41.3%为血管源性MCI，35.8%为神经变性源性MCI。痴呆患者的平均年龄为79.6±6.7岁，女性占比64.7%；MCI患者的平均年龄为76.4±6.9岁，女性占比62.1%。痴呆患者的平均受教育年限为4.95±4.09年，MCI患者为6.87±4.71年；两组患者从症状发作至临床确诊的平均间隔时间分别为3.2±2.6年与2.67±2.69年。
研究结论：明确哥斯达黎加地区痴呆与MCI的主要类型及其临床特征后，本研究获取了此前未被系统记录的全面数据，此类信息将为公共卫生医疗的管理与战略规划提供关键参考依据。