El nivell i la variació del risc cardiovascular en la prevenció primària de la demència

Fages, Ester
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Dementia causes progressive cognitive impairment and inability to lead an independent life. Currently, there is no curative treatment for it, and thus primary prevention is essential. Age is the main risk factor for developing dementia and, with the progressive aging of society, it is necessary to have updated data to plan health services. Among the known risk factors, a large part are cardiovascular risk factors. We propose to study them in an integrated way with the cardiovascular risk equations. We have carried out a study to be able to validate dementia diagnoses from a large database that collects data from the primary care clinical history (SIDIAP) and thus, to be able to define the casuistry. We have also analyzed how the association between risk factors and dementia varies according to age and gender, from the age of 65. Finally, we have studied the effect of the level of cardiovascular risk with the REGICOR equation on the incidence of dementia. The results of our study have been satisfactory because they have allowed us extensively validate the dementia diagnoses registered in the SIDIAP database. Likewise, the study of the epidemiology of dementia has reported incidence results of 8.6 per 1,000 person-years (CI95% 8.0-9.3) and prevalence of 5.1% (CI95% 4.5%-5.7%). Both estimates were higher in women and the increase with age was more pronounced in women than in men. The results of study the effect of age and sex on the factors associated with dementia, have shown us that the variables most associated with dementia ranked in: Parkinson's disease, excessive alcohol consumption, depressive disorder, and history of cerebrovascular disease. Both sex and age influence the association between several of these risk factors and dementia. Finally, the results we consider to have the greatest impact have been those provided by the study of the incidence of dementia in relation to the REGICOR risk groups: this incidence increases as the cardiovascular risk increases. The groups with the highest REGICOR risk have an incidence of dementia of 10.19 (CI95% 9.98-10.41), and this is even higher in people with a history of cardiovascular disease, increasing to 12.28 (95% CI 12.05-12.50) ​
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