Dados do Trabalho

Título

Causes of rapidly progressive dementia: a multicentric study in tertiary medical centers of Santa Catarina

Resumo

Introduction: rapidly progressive dementia (RPD) is characterized by accelerated cognitive decline leading to functional impairment. There is no clear accepted definition of RPD, with most studies using a time frame of 1 to 2 years from symptom onset to dementia. There are many causes of RPD, but few studies have examined the epidemiology of different RPD etiologies.
Objectives: this study aimed to identify the relative frequency of different causes of RPD among inpatients from four tertiary medical centers in Florianópolis, Santa Catarina, Southern Brazil. This is an ongoing study and we report its preliminary results.
Methods: this is a cross-sectional retrospective study. Medical records of patients admitted from 2001 to 2020 and registered under ICD-10 codes potentially linked to RPD were identified and searched for RPD cases. RPD was defined as any disorder fulfilling the National Institute on Aging – Alzheimer’s Association criteria for dementia whose course from symptom onset to dementia was less than or equal to 2 years. Patients diagnosed with a primary psychiatric disorder or delirium were excluded. The etiological RPD diagnoses registered at hospitalization were reported. Each medical record was reviewed and the authors reclassified the RPD etiology according to established diagnostic criteria.
Results: 4714 medical records were identified. As for May 2022, 2502 medical records have been analyzed, and 68 RPD patients were found, 46 (67.6%) of which were male. Mean age of onset was 65.5 years (SD=15.3), and mean time from onset to functional impairment was 222.3 days (SD=210.1). At hospitalization, the RPD diagnoses were: mixed dementia (MD; n=16; 23.5%), vascular dementia (VD; n=15; 22.1%), nonprion neurodegenerative disorders (NPND; n=9; 13.2%), autoimmune encephalopathies (AIE; n=5; 7.4%), neoplasms (NEO; n=4; 5.9%), prion diseases (PRD; n=3; 4.4%), carential diseases (CD; n=3; 4.4%), infectious diseases (ID; n=3; 4.4%), toxic-metabolic dementia (TMD; n=1; 1.5%) and genetic diseases (GD; n=1; 1.5%). No cause was registered in 8 cases (11.8%). The revised diagnoses were: NPND (n=17; 25.0%), VD (n=17; 25.0%), MD (n=8; 11.8%), AIE (n=6; 8.8%), TMD (n=4; 5.9%), NEO (n=4; 5.9%), ID (n=4; 5.9%), PRD (n=2; 2.9%), post-traumatic dementia (n=2; 2.9%), CD (n=2; 2.9%), GD (n=1; 1.5%) and normal pressure hydrocephalus (n=1; 1.5%).
Conclusion: the etiologies of RPD are many and tertiary center studies may help clarify their epidemiology and clinical profile.