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UWI Author(s)
Barnaby, L.; Sewell, Clayton A.; Lipps, Garth E. .
Clinical presentations of patients attending a dementia clinic in Kingston, Jamaica
Journal Title
Alzheimer’s and Dementia
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Background: The clinical presentations of patients attending the new Dementia Clinic, University Hospital (UHWI), over the period 2001- 2005 were examined. Methods: Medical records were perused to identify Axis 3, Axis1 conditions and socio-demographic factors in patient and family,along with disturbing behaviors which had necessitated referral. Routine and special investigations, including CT scans were checked. Diagnosis utilized DSM-1V TR criteria and progress assessed via Folsteins’s Mini Mental State Exam MMSE and Functional Activities questionnaire The Statistical Package for Social Sciences (SPSS) was used in data analysis. Results: Seventy-five persons, 51% male (N¼ 38) and 49% women (N¼37) aged 54-94 yrs (mean 74yrs þ/ 9.53, mode 77yrs) were seen. Hypertension þ/ Parkinson’s) 54% (N¼41), Hypertension plus Diabetes 12% (N¼9) and Diabetes alone 4% (N¼3) were the most common illnesses noted. Other illnesses, including Parkinson’s, Cancer, and Alcoholism, comprised 18.4%, while 44% had arthritis. Sensory deficits were present in 9.6% of persons. 17% had hip replacement, gastro-intestinal, genitor-urinary, thyroid, eye, brain, and heart surgery. In patients, Alzheimer was diagnosed in 46.5% (33), Dementia NOS in 19.7% (N¼14) Vascular in 9.9 %(N¼7) and mixed in 2.2% (N¼2). In families, hypertension occurred in 11.5% (N¼6), diabetes plus hypertension 5.8% (N¼3), diabetes alone 7.7% (N¼4) and CVA plus asthma in 5.8%. Vascular dementia was 83.6% (N¼51), Alzheimer 8.2% (N¼5) and mixed 3.3% (N¼2). Past psychiatric illness was reported in patients (15.2%) and families (17.7%). c2 revealed associations between Axis 1 diagnosis and age (p<0.005), and educational level (p<0.01); social class and educational level (p<0.000), gender and marital status (p<0.001); family history of dementia and type of Dementia (p<0.005). No association was found between the dementia type in the family and the dementia diagnosis in the patients (p > 0.05). Requested CT scanning was completed by only 53.3%. c2 of Social class and CT was significant (p¼ 0.001), as was analysis of variance (p<0.004). Conclusions: Diabetes and hypertension were the commonest Axis 3 diagnoses in family and patients. Whereas vascular dementia predominated in the family, in patients, Alzheimer, then Dementia NOS, vascular and mixed dementias were most common. Possible reasons for this are discussed.....
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