Dados do Trabalho

Título

Evaluation of MEEM and CDR in elderly with and without dementia followed at a Homeopathy service in Rio Branco, Acre

Resumo

INTRODUCTION: Dementia is a clinical condition in which there is a significant cognitive decline in relation to a previous level, causing difficulties in occupational, social and domestic life. The Mini Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR) are useful tools that can be applied to patients with dementia for screening and staging purposes, respectively. OBJECTIVE: Evaluation and comparation of the results of the MMSE and CDR in elderly patients with and without dementia, undergoing complementary homeopathic treatment. METHODOLOGY: Study participants were 43 elderly under follow-up for cognitive or motor complaints, with and without dementia, at Hospital do Idoso – Fundação Hospitalar do Acre. Dementia diagnoses were made according to well-defined etiological criteria. Participants were interviewed with individual and socioeconomic questionnaires, cognitive assessment by the MMSE and assessment of dementia severity using the CDR. Data were entered and analyzed using the SPSS 20 program. RESULTS: The most frequent diagnoses of dementia were frontotemporal dementia, Alzheimer's dementia and vascular dementia. The results of the CDR were in agreement with those of the MMSE in 24 patients with dementia and 3 patients without dementia. Of 16 patients classified as "questionable dementia" by the CDR, 10 were classified as "dementia" by the MMSE and 6 were classified as "no dementia" by the MMSE. If we consider as having dementia confirmed by the CDR only scores from 1 to 3, the agreement rate between the CDR and the MMSE is 76.74%. DISCUSSION: The MMSE result worsens as the CDR staging levels increase, which is in agreement with other studies. The data also point to a strong influence of the level of education on the MMSE, an association that is already well described in the literature. In addition, in the direct comparison of the MMSE with the degrees of the CDR, there is interference, even in patients without dementia, in attention, calculation and visuospatial ability, suggesting that these domains can be affected early even in patients with complaints that are limited to deficits in memory. CONCLUSION: The results of the present study suggest that the mean MMSE scores follow a pattern of agreement in relation to the staging degrees recommended by the CDR and tend to remain regular in returns, with some exceptions that can be explained by the progression of the disease, by the effect of medications and by external factors.

Palavras Chave

Dementia. CDR. Mini Mental State Examination. MMSE. Clinical Dementia Rating.