Las demencias en el ámbito de la atención primaria

OBJECTIVE: To study the epidemiological, demographic, social and family, and clinical variables of the population suffering dementia in our health district. DESIGN: A retrospective evaluation of medical records. SETTING: A rural health district. PATIENTS: All those patients with a diagnosis of dementia in 1995. MEASUREMENTS AND RESULTS: The evaluation was based on primary care medical records. The prevalence of dementia in the over-65s ranged, according to the population group, between 1.29 and 5.19 per 100 inhabitants. 90.2% of patients with dementia remained living at home. Their average age was 79.8 (SD, 7.4). 57% had Alzheimer's disease. 40% were in advanced stages of the disease (stage III and IV). Only 26% of the patients were referred to Neurology in 1995. 35% of the patients took no medication for their dementia. 45.6% were included in a home care programme. The main carer was the son or daughter in 47.8% of cases. Expectation of life from when dementia was diagnosed was 5.53 (SD 4.64) years. Patients with dementia died in their own homes in 47% of cases, the main cause of death being infection. CONCLUSIONS: In our rural environment most patients with dementia remained with their families. In most cases the aetiological diagnosis of dementia could be made from primary care.