P0020 - Risk factors in Alzheimer's disease evolution for patients with MCI

Abstract

Background and Aims:

The MCI syndrome is precociously present in over 50% of the patients that develop Alzheimer's Disease (AD) in the following three years. The evolution rhythm can be precipitated by the intervention of some risk factors.

Methods:

Retrospective study with 30 patients with their case histories and current AD diagnosis confirmed by CT and DSM IV, evolution stage medium to serious. The aim was emphasize risk factors:

1. • repeated social psychotraumatic factors;

2. • depressive disorder and prolonged treatment with anticholinergic antidepressants;

3. • cerebral hypoxia, metabolic disfunction;

4. • ischemic cerebral vasculary alterations.

A correlation was made between the observed risk factors with the rapidity in the evolution of the disease in identical treatment conditions (donepezil, rivastigmine).

Results:

The evolution from MCI to AD of the patients in the lot showed three ways :

1. • rapid, under 1 year (6 patients, 20%);

2. • medium, over 2 years (15 patients, 50%);

3. • slow, over 3 years (9 patients, 30%);

For the entire lot the weight of risk factors was :

1. • psychotraumatic (50%);

2. • depression (67%);

3. • prolonged antidepressant treatment (57%);

4. • cerebral hipoxia and metabolic dysfunction (33%);

5. • vascular (63%).

Conclusions:

The rhythm for settlement of cognitive deterioration is proportional with the number of risk factors.

The social impact at family level was significantly important in the forms with rapid evolution.

The rapid evolution automatically associates depression, prolonged antidepressant treatment, hipoxia and vascular component and requires profilactic strategies.