ABSTRACT Introduction: Population-based studies carried out in Cuba have permitted to evidence the high numbers of dementia diseases (between 6.4% and 10.8%) that increasingly affect the daily lives of many people and their families. Objective: To estimate prevalence and risk factors of dementia syndrome in elderly people. Methods: Observational, analytical and cross-sectional study carried out, in the period 2016-2018, with 249 people aged 65 years or older and their caregivers, who belonged to 27 de Noviembre Polyclinic of Marianao Municipality and selected through intentional sampling. Neuropsychological tests were applied to participants and respondents, as well as a sociodemographic and risk factor survey. The prevalence of dementia was estimated according to the variables studied (age, sex, education level, marital relationship, family history of dementia and active social life) and Poisson regression was used to search for associations between risk factors and dementia syndrome. Results: 12.1% of the study population had dementia syndrome; Alzheimer's dementia was the most frequent, accounting for 70% of the cases. The prevalence was higher in the group aged 80 years and older (23.3%), in females (12.7% vs. 10.6%), as well as in participants without a marital relationship (15.7% vs. 9, 5%), and decreased with the increase in education level (0% in university students and 33.3% in non-university students). Conclusions: The prevalence of dementia was high in the studied population. Older ages, the female sex, a low education level and not having a marital relationship were risk factors associated with the disease.

RESUMEN Introducción: En Cuba se han realizado estudios de base poblacional que resaltan las elevadas cifras de enfermedades demenciales (entre el 6,4 % y el 10,8 %) que afectan cada vez más la vida cotidiana de muchas personas y sus familias. Objetivo: Estimar la prevalencia y los factores de riesgo del síndrome demencial en personas mayores. Métodos: Estudio observacional, analítico de corte transversal, en 249 personas mayores de 65 años o más y sus cuidadores, pertenecientes al policlínico 27 de noviembre del municipio Marianao, en el periodo de 2016-2018, seleccionados a partir de un muestreo intencional. Se aplicaron pruebas neuropsicológicas y encuesta sociodemográfica y de factores de riesgo a participantes e informantes. Se estimó la prevalencia de demencia según variables estudiadas (edad, sexo, escolaridad, vínculo conyugal, historia familiar de demencia y vida social activa) y se utilizó la regresión de Poisson en la búsqueda de asociaciones entre los factores de riesgo y el síndrome demencial. Resultados: De la población en estudio, 12,1 % presentó síndrome demencial, la demencia Alzheimer fue la más frecuente en 70 % de los casos. La prevalencia fue superior en el grupo de 80 años y más (23,3 %), en el sexo femenino (12,7 vs. 10,6 %), en los participantes sin vínculo conyugal (15,7 % vs. 9,5 %) y disminuyó con el aumento del nivel de escolaridad (0 % en universitarios y 33.3 % en iletrados). Conclusiones: La prevalencia de demencia fue elevada en la población estudiada. La mayor edad, el sexo femenino, el bajo nivel de escolaridad y no presentar vínculo conyugal fueron factores de riesgo asociados a esta enfermedad.

ABSTRACT Introduction: Dementia is the disease that contributes the most to disability, dependency and mortality in the elderly. However, the frequency and nature of the problem in the older population of Havana province, Cuba, is unknown. Objectives: To determine the prevalence and risk factors of dementia in people 80 years or older. Methods: A secondary analysis of the database of the study Aging and Alzheimer (10-66) was carried out from June 2003 to December 2007. A descriptive cross-sectional study was carried out in seven selected health areas of Havana province. The universe was made up of 2017 people aged 65 and over. A sample of 480 people aged 80 years or older was taken, who met the inclusion and exclusion criteria. The data were statistically validated using chi square, Student's t, Poisson and Cox regression. Results: The prevalence of dementia in people older than 80 years was 25.8%, being significantly influenced by the presence of comorbidity (OR 7.90; 95% CI 6.27-9.94). A higher educational level was associated with a lower risk of dementia (OR 0.76; 95% CI 0.66-0.88). Conclusions: A high prevalence of dementia was evidenced in people older than 80 years or older. A higher educational level showed a protective effect, an association between comorbidity and the presence of dementia was identified.

RESUMEN Introducción: La demencia es el padecimiento que más contribuye a la discapacidad, dependencia y mortalidad en las personas mayores.(1) Sin embargo, se desconoce la frecuencia y naturaleza del problema en la población más envejecida de la provincia La Habana, Cuba. Objetivos: Determinar la prevalencia y factores de riesgo de demencia en personas de 80 años o más. Métodos: Se realizó un análisis secundario de la base de datos del estudio Envejecimiento y Alzheimer (10-66) en el período comprendido entre junio 2003 y diciembre 2007. Se realizó un estudio descriptivo de corte transversal en siete áreas de salud seleccionadas de la provincia La Habana. El universo estuvo constituido por 2017 personas de 65 años o más. Se tomó una muestra de 480 personas de 80 años o más, los cuales cumplieron con los criterios de inclusión y exclusión. Los datos fueron validados estadísticamente mediante el chi cuadrado, t de student, la regresión de Poisson y de Cox. Resultados: La prevalencia de demencia en personas de 80 años o más fue de 25,8 %, encontrándose, significativamente, influenciada por la presencia de comorbilidad (OR 7, 90; IC 95 % 6,27- 9,94). Un mayor nivel educacional se asoció con menor riesgo de demencia (OR 0,76; IC 95 % 0,66-0,88). Conclusiones: Se evidenció una alta prevalencia de demencia en personas mayores de 80 años o más. Un mayor nivel educacional mostró efecto protector, se identificó una asociación entre comorbilidad y presencia de demencia.

ABSTRACT Introduction: The existence of the SARS-CoV-2 coronavirus (COVID-19) represents an unprecedented health problem around the world, including people with dementia, their families and caregivers. Objectives: To study the characteristics of caregivers and care recipients as well as the burden among caregivers of people with dementia during the COVID-19 pandemic. Material and Methods: Prospective observational study. The universe comprised 3000 people aged 65 years who were selected by simple random sampling without replacement from the population based study of Aging and Alzheimer's Disease. Of them, 160 participants from Havana were evaluated at two different moments: in 2016 - 2018 and from October 1 to November 30, 2020. Results: The caregivers who were evaluated during the pandemic presented higher levels of stress or higher Zarit burden Interview scores (p=0,017) as well as a greater morbidity as measured by the General Health Questionnaire (p<0,0001) in relation to the study conducted in 2016-2018. Stress among caregivers was associated with the presence and severity of behavioral and psychological symptoms, OR = 1,02 (95 % CI 1.00-1.03); stages of dementia, OR = 1,61 (95 % CI, 1.45-1.76); greater care needs, OR = 1,56 (95 % CI, 1.14-2.77); fear of getting sick from COVID-19, OR = 1,52 (95 % CI, 1.11-4.12); insecurity about the future, OR = 1,26 (95 % CI, 1.04 -2.53) and job abandonment due to care, OR = 1,19 (95 % CI, 1.01-2.12). Conclusions: Our findings confirm that there is greater stress and burden among caregivers of people living with dementia during the COVID-19 pandemic and that there is a need to achieve coordinated actions in the national health system strategies aimed at supporting people with dementia and caregivers.

RESUMEN Introducción: La existencia del SARS-CoV-2 coronavirus (COVID-19) representa un problema de salud sin precedentes en todo el mundo, incluidas las personas con demencia, sus familias y cuidadores. Objetivo: Estudiar las características del cuidado y el grado de sobrecarga en cuidadores de personas con demencia durante la pandemia causada por la COVID-19. Material y Métodos: Estudio observacional prospectivo. El universo comprendió 3000 personas de 65 años seleccionadas por un muestreo aleatorio simple sin reposición procedentes del estudio poblacional Envejecimiento y Alzheimer, de ellas 160 participantes, residentes en La Habana fueron evaluados en dos momentos diferentes; 2016 - 2018 y del 1 de octubre al 30 de noviembre de 2020. Resultados: Los cuidadores evaluados durante la pandemia presentaron mayor estrés o sobrecarga según la escala de Zarit (p=0,017) y mayor morbilidad según el cuestionario general de salud (p<0,0001) en relación con el estudio realizado en 2016-2018. El estrés en los cuidadores se asoció con la presencia y severidad de los síntomas psicológicos y conductuales, OR=1.02 (IC 95 % 1,00-1,03), el estadio de la demencia OR= 1,61 (IC 95 %, 1,45-1,76), mayores necesidades de cuidados OR=1.56 (IC 95 %, 1.14-2.77), temor a enfermar por la COVID-19 OR= 1.52 (IC 95 %, 1.11-4.12), inseguridad en el futuro OR= 1,26 (IC 95 %, 1,04-2,53) y el abandono del trabajo por el cuidado OR= 1,19 (IC 95 %, 1,01-2,12). Conclusiones: Nuestros hallazgos confirman mayor estrés y sobrecarga en cuidadores de personas que viven con demencia durante la pandemia y la necesidad de una acción coordinada en las estrategias del sistema nacional de salud, dirigida a las personas con demencias y los cuidadores.

ABSTRACT Introduction: In Cuba, the prevalence of dementia diseases (10.2%) it is a reality the National Health System is facing nowadays. Dementia affects not only the person who suffers from it, but also to the family and especially the health of the caregiver, who undergoes physical and emotional changes that compromise their quality of life. Objectives: Identify the risk factors for physical and psychological morbidity in a group of caregivers of older adults with dementia. Methods: Secondary analysis of the database of the study named "Aging and Alzheimer": a population study in people aged 65 and over conducted in Havana and Matanzas provinces, Cuba, in the period from 2003 to 2007. Primary caregivers of older adults with dementia were selected. A sociodemographic and risk factor interview, Zarit's scale of overload and the overall health questionnaire were applied. Results: The level of overload (OR-4.88; 95% CI 2.16-11.02) was a risk factor for physical and psychological morbidity in caregivers, while the high level of education was a protective factor (OR-0.5; CI 95% 0.36-0.82). Conclusions: Providing care to a demented patient is a source of chronic stress that can lead to serious health consequences for the main caregiver and in which various risk factors are associated with an increased overload. Studying these risk factors allow to explore care in other contexts and to involve dimensions, relationships and links that become challenges in the face of the design, execution and assessment of support interventions in response to identified needs, to address the conflicts, fears, and challenges experienced by key caregivers.

RESUMEN Introducción: En Cuba, la prevalencia de las enfermedades demenciales (10,2 %) constituye una realidad a la que se enfrenta hoy día el Sistema Nacional de Salud. La demencia repercute no solo en la persona que la padece, sino en su familia y sobre todo en la salud del cuidador, quien es sometido a cambios físicos y emocionales que comprometen su calidad de vida. Objetivos: Identificar los factores de riesgo de morbilidad física y psicológica en un grupo de cuidadores de adultos mayores con demencia. Métodos: Análisis secundario de la base de datos del estudio “Envejecimiento y Alzheimer”, un estudio poblacional en personas de 65 años de edad y más, realizado en La Habana y Matanzas, Cuba, en el periodo de 2003 a 2007. Se seleccionaron cuidadores principales de adultos mayores demenciados. Se aplicó una entrevista sociodemográfica y de factores de riesgo, la escala de sobrecarga de Zarit y el cuestionario general de salud. Resultados: El nivel de sobrecarga (OR = 4,88; IC 95 % 2,16-11,02) constituyó un factor de riesgo de morbilidad física y psicológica en los cuidadores, mientras que el alto nivel educacional se comportó como un factor protector (OR= 0,5; CI 95% 0,36-0,82). Conclusiones: La prestación de cuidados a un enfermo demente conforma una fuente de estrés crónico que puede conllevar a serias consecuencias para la salud del cuidador principal, y en la que diversos factores de riesgo se relacionan con una mayor sobrecarga. Estudiar estos factores de riesgo permite explorar el cuidado en otros contextos e involucrar dimensiones, relaciones y vínculos que se convierten en retos frente al diseño, ejecución y evaluación de intervenciones de apoyo como respuesta a las necesidades identificadas, para afrontar los conflictos, miedos, desafíos que experimentan los cuidadores principales.

ABSTRACT In Cuba, 10 % of people aged 65 years and over are living with dementia, mainly Alzheimer's disease. The aim of this review is to provide information about the impact of COVID 19 on one of the most vulnerable groups in the population, people with dementia, and to provide useful recommendations to healthcare professionals, families and caregivers. The search was run in august 2020 of the literature on the subject published between January 10 and July 30, 2020, which included the databases (PubMed / MEDLINE, EMBASE, Lilacs, SciELO and Cochrane CENTRAL, using the terms “Alzheimer”, OR “ dementia ”, OR “aging” AND “COVID-19”, AND “Coronavirus” and pandemia”.

RESUMEN En el mundo 50 millones de personas viven con demencia. El 10 % de las personas de 65 años y más, aproximadamente, 170 000 personas, que representan el 1,3 % de la población cubana, viven con demencia, fundamentalmente enfermedad de Alzheimer. El objetivo de la presente revisión es ofrecer información acerca del impacto de la COVID-19 en uno de los grupos más vulnerables de la población, las personas con demencias y ofrecer recomendaciones útiles a los profesionales de la salud, las familias y los cuidadores. Con este propósito se realizó una revisión de la literatura sobre el tema publicada entre el 10 de enero y el 30 de julio del 2020, que incluyó las bases de datos (PubMed/MEDLINE, EMBASE Lilacs, Scielo, y Cochrane Central, utilizando los términos “Alzheimer”, OR “demencia”, OR “envejecimiento” AND “COVID-19”, AND “coronavirus” and pandemia”.

ABSTRACT INTRODUCTION Age-related cognitive disorders, including Alzheimer disease, are among the main causes of disability and dependence in older adults worldwide. High blood homocysteine levels (hyperhomocysteinemia) are a risk factor for diseases whose metabolism involves different B vitamins. Antioxidant vitamins provide a protective effect by mitigating oxidative stress generated by these diseases. Epidemiological studies have presented varying results on the relationships between blood levels of these vitamins and such cognitive disorders. OBJECTIVE Evaluate the association of vitamin and homocysteine levels with mild cognitive impairment and Alzheimer disease in a group of Cuban older adults. METHODS A cross-sectional study was conducted in Havana, Cuba, of 424 persons aged ≥65 years: 43 with Alzheimer disease, 131 with mild cognitive impairment, and 250 with no signs of cognitive impairment. Dementia was diagnosed using criteria of the International 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and mild cognitive impairment was diagnosed using Petersen’s criteria. Blood levels of vitamins (thiamine, B-2, folate, B-12, C and A) and homocysteine were measured by standard procedures. Analysis of variance for continuous variables and percentage comparison tests for dichotomous variables were used to compare groups. RESULTS Persons with Alzheimer disease presented significantly lower levels of vitamins B-2, C and A than healthy participants (p <0.05). Homocysteine levels were significantly higher in those with Alzheimer disease and mild cognitive impairment than in participants with no cognitive impairment (p <0.05). Statistically, levels of thiamine, folic acid, and vitamin B-12 were not significantly different across groups. Compared with those without cognitive impairment, prevalence rates (PR) in the Alzheimer group were significantly higher for hyperhomocysteinemia (PR = 3.26; 1.84–5.80) and deficiency of all B vitamins: thiamine (PR = 1.89; 1.04–3.43), B-2 (PR = 2.85; 1.54–5.26), folate (PR = 3.02; 1.53–5.95), B-12 (PR = 2.21; 1.17–4.19), vitamin C (PR = 3.88; 2.12–7.10) and A (PR = 5.47; 3.26–9.17). In mild cognitive impairment, prevalence rates were significantly higher for hyperhomocysteinemia (PR = 1.42; 1.08–1.87), vitamin B-2 deficiency (PR = 1.70; 1.24–2.32) and vitamin A deficiency (PR =1.88; 1.05–3.38). CONCLUSIONS Hyperhomocysteinemia and various vitamin deficiencies are related to Alzheimer disease and mild cognitive impairment. Longitudinal studies are needed to further elucidate the relationship between different nutritional biomarkers and dementia. A better understanding of this relationship could provide a basis for therapeutic and preventive strategies.

ABSTRACT Introduction: The World Health Organization (WHO) approved the Plan of Action to tackle dementia in its 70th World Meeting held on May 29th, 2017 in Geneva, Switzerland. Dementia affects 50 million people in the world, and if there is not an effective intervention, this figure will nearly triple by the year 2050. This disease can become the most expensive one that the health services will face and one of those of greatest impact in the family and society worldwide. Objective: To present the actions carried out in Cuba for the implementation of the world goals suggested in the global plan of action for dementia approved by the WHO. Material and methods: The global plan of action for the attention to dementia approved by the World Health Organization in 2017 was reviewed, and the fulfillment of the implementation of the seven world goals in our country was verified. The sources of information reviewed were the Annual Health Statistics Report 2017, the work reports presented by the Elderly Department, Social Care Services, and Mental Health, 2017. Development: Cuba developed the National Strategy for Alzheimer disease and dementia syndromes in 2014 taking into account the Global Plan of Action as a response of public health to dementia 2017-2025. This Cuban strategy was brought up to date in 2017 with the following concepts: 1) gender equality, 2) improvement of the information systems regarding the disease, 3) update of the indicators according to the plan approved by the WHO 4) creation of friendly environments for people with dementia. There is at least a specialized center in each province for the early diagnosis of the disease from the Primary Health Care. Conclusions: Cuba has taken the first steps in the implementation of the global plan of action for the response of public health to dementia from 2017 to 2025, and the advance on this respect will depend on the commitment of the health care personnel and all social sectors.

RESUMEN Introducción: La OMS en su 70a Asamblea Mundial de la Salud realizada el 29 de mayo del 2017 en Ginebra, Suiza, aprobó el Plan de Acción Mundial para enfrentar las demencias. La demencia afecta a 50 millones de personas en el mundo, si no se logra una intervención eficaz esta cifra casi se triplicará para el año 2050. Esta enfermedad puede llegar a ser la más cara que enfrentarán los servicios de salud y una de las de mayor impacto en la familia y la sociedad a escala mundial. Objetivo: mostrar las acciones realizadas en Cuba en la implementación de las metas mundiales propuestas en el Plan de acción global sobre la respuesta de salud pública a la demencia 2017-2025 aprobado por la OMS. Material y métodos: Se revisó el Plan de acción global para la atención a la demencia aprobado por la OMS en el año 2017 y se verificó el cumplimiento de las siete metas mundiales en Cuba. Las fuentes de información fueron el Anuario Estadístico de Salud 2017 y los informes de trabajo del Departamento de adulto mayor, Asistencia Social y Salud Mental de 2017. Desarrollo: Cuba elaboró la Estrategia nacional para la enfermedad de Alzheimer y los síndromes demenciales en el año 2014 y la actualizó en el año 2017 con los siguientes conceptos atendiendo al Plan de acción global sobre la respuesta de salud pública a la demencia 2017-2025: 1) igualdad de género, 2) perfeccionar los sistemas de información en relación con la demencia, 3) actualizar sus indicadores acordes con el plan de la OMS 4) crear ambientes y ciudades amigables para las personas con síndrome demencial. Existe al menos un centro especializado en cada provincia para el diagnóstico temprano de la enfermedad, a partir del nivel de Atención Primaria de Salud. Conclusiones: Cuba ha dado los primeros pasos en la implementación del Plan de acción global sobre la respuesta de salud pública a la demencia 2017-2025, continuar avanzando dependerá del empeño, la motivación y el compromiso del personal de la salud y todos los sectores sociales.

ABSTRACT Aging and Alzheimer is a prospective, longitudinal cohort study involving 2944 adults aged ≥65 years from selected areas in Cuba’s Havana and Matanzas Provinces. This door-to-door study, which began in 2003, includes periodic assessments of the cohort based on an interview; physical exam; anthropometric measurements; and diagnosis of dementia and its subtypes, other mental disorders, and other chronic non-communicable diseases and their risk factors. Information was gathered on sociodemographic characteristics; disability, dependency and frailty; use of health services; and characteristics of care and caregiver burden. The first assessment also included blood tests: complete blood count, blood glucose, and liver function, lipid profile and ApoE4 genotype (a susceptibility marker). In 2007–2011, the second assessment was done of 2010 study subjects aged ≥65 years who were still alive. The study provides data on prevalence and incidence of dementia and its risk factors, and of related conditions that affect the health of older adults. It also contributes valuable experiences from field work and interactions with older adults and their families. Building on lessons learned, a third assessment to be done in 2016–2018 will incorporate a community intervention strategy to respond to diseases and conditions that predispose to dementia, frailty and dependency in older adults.

Background: cerebrovascular disease is the third cause of death in elder adults of the entire world. Aim: to characterize the epidemiologic, clinical behavior, aspects of the management and the association with atherogenic risk factors of the vascular focal cerebral dysfunction in elder adults. Materials and Methods: we carried out a cross-sectional study, on a “door-to-door” population basis in two directions: one descriptive for determining the prevalence, risk factors, clinical subtypes and management aspects of the Vascular Focal Cerebral Dysfunction (VFCD), and another, cases and controls analytical direction for establishing the risk association in 901 elder people aged 65 years and more who live in a selected area of the Teaching Polyclinic “José Jacinto Milanés” of Matanzas, in the period from January 2003 to November 2006, as part of the international research project 10/66. Outcomes: the obtained prevalence index of vascular focal cerebral dysfunction was 12,9 (116 elder people/43 transitory ischemic stroke and 73 ictus), predominating this affection in women, aged more than 80 years and the clinical subtypes athero- thrombotic ischemic ictus and carotidal transitory ischemic stroke (TIS). Only 29,3 % of the vascular focal cerebral dysfunctions were assessed by a physician during the first 24 hours after the event; in the cardioembolic ictus and hemorrhagic ictus subtypes the percentage increased to 83,3 % and 100 % respectively. The totality of the hemorrhagic ictus, 40, 5 % of the ischemic ictus and only 2,3 % (1 case) of the transitory ischemic seizures were cause of admission. The arterial hypertension (OR-2.56; IC 95 % 1.209-4.815), the associated cardiac disease (OR-2.18; IC 95 % 1.195-4.012), the previous transitory ischemic stroke (OR-50,1; IC 95 % 24,037-104,542) and physical inactivity (OR-2,66; IC 95 % 1,023-6,945) were the main risk factors for the development of an ischemic ictus in the studied group.

Introducción: la enfermedad cerebrovascular constituye la tercera causa de muerte en adultos mayores de todo el mundo. Objetivo: caracterizar el comportamiento clínico, epidemiológico, aspectos del manejo y la asociación con factores de riesgo aterogénicos de la disfunción cerebral focal Vascular en adultos mayores. Materiales y Métodos: se realizó un estudio transversal, de base poblacional “puerta a puerta” en dos vertientes: una descriptiva para determinar la prevalencia, los factores de riesgo, subtipos clínicos y aspectos del manejo de la Disfunción cerebral focal vascular (DCFV) y otra vertiente analítica de casos y controles para establecer la asociación de riesgo en 901 ancianos de 65 años y más que viven en un área seleccionada del Policlínico Universitario “José Jacinto Milanés” de la ciudad de Matanzas, en el periodo comprendido de enero del 2003 a noviembre del 2006, como parte del proyecto de investigación internacional 10/66. Resultados: se obtuvo una tasa de prevalencia de DCFV de 12,9 % (116 ancianos/ 43 ATI y 73 ictus), predominando esta afección en las mujeres, las mayores de 80 años y los subtipos clínicos de ictus isquémico aterotrombótico y ataque transitorio de isquemia (ATI) carotideo. Solo el 29,3 % de las DCFV fueron valoradas por un médico en las primeras 24 h del evento; en los subtipos de ictus cardioembólico e ictus hemorrágico este por ciento se elevó a 83,3 % y 100 % respectivamente. Motivaron ingreso la totalidad de los ictus hemorrágicos, el 40,5 % de los ictus isquemicos y solo el 2,3 % (1 caso) de ATI. La HTA (OR-2.56; IC 95 % 1.209-4.815) la enfermedad cardiaca asociada (OR-2.18; IC 95 % 1.195-4.012), el ATI previo (OR-50,1; IC 95 % 24,037-104,542) y la inactividad física (OR-2,66; IC 95 % 1,023-6,945) constituyeron factores de riesgo para el desarrollo de un ictus isquémico en el grupo estudiado.

Dementia is a syndrome that has great repercussions for quality of life of patients and their families, as well as a high social cost. A [2009] systematic review of research evidence and consensus of expert opinions showed that 36 million people live with dementia worldwide, with 4.6 million new cases every year (similar to the global incidence of nonfatal stroke). The prevalence of dementia in older Cubans is high, with rates ranging from 6.4% to 10.2%, or about 130,000 persons (1.1% of the total population). This number is expected to rise to 260,000 by 2030. The age-standardized annual incidence of dementia is also high: 21 per 1000 population, with 28,750 new cases annually. Dementia is the leading cause of disability among older adults and is the main cause of dependency, financial burden and caregiver stress. In this review, we highlight the importance of epidemiological research to obtain greater knowledge of the disease, improve health services, promote actions for prevention and early diagnosis, and implement a national strategy to address dementia in the Cuban population, itself now immersed in two processes: accelerated demographic aging and epidemiologic transition.

Introduction: the mini-mental state examination (MMSE) is a brief, rapid test which may be performed in 5 to 10 minutes and is broadly used to evaluate cognitive decline. Objective: characterize subjects with mild cognitive impairment based on results obtained with the mini-mental state examination. Methods: a descriptive cross-sectional study was conducted with consecutive subjects aged ³ 50, who were evaluated in consultation at the dementia service of "Dr. Carlos J. Finlay" Central Military Hospital. The 46 subjects included were distributed in two groups: 26 with and 20 without mild cognitive impairment. Results: alterations were found in the areas of Registration, Attention and Calculation and Recall. Registration and Recall were only affected in the mild cognitive impairment group. Total MMSE score was significantly lower in patients with mild cognitive impairment versus the group without the condition. Conclusions: the subjects with mild cognitive impairment were basically characterized by total MMSE scores below normal values and the presence of alterations, mainly in the Recall area, but also in Registration.

Introducción: el miniexamen del estado mental es un test breve y rápido, que puede realizarse en 5 o 10 min y es ampliamente usado para evaluar el declive cognitivo. Objetivo: caracterizar a sujetos con deterioro cognitivo leve, según los resultados obtenidos en el miniexamen del estado mental. Métodos: se realizó un estudio descriptivo de corte transversal que incluyó a sujetos con edad ³ 50 años, evaluados por su orden consecutivo en la Consulta de Demencia del Hospital Militar Central "Dr. Carlos J. Finlay". Las 46 personas incluidas, se distribuyeron en dos grupos: 26 con deterioro cognitivo leve y 20 sin esta afección. Resultados: se encontraron alteraciones en el Registro, la Atención y Cálculo y el Recuerdo. El Registro y el Recuerdo, solamente se afectaron en el grupo con deterioro cognitivo leve. El puntaje total del miniexamen del estado mental fue significativamente menor en los pacientes con deterioro cognitivo leve que en el grupo sin esta afección. Conclusiones: los sujetos con deterioro cognitivo leve se caracterizaron en lo fundamental por tener puntajes en el miniexamen del estado mental por debajo de las cifras normales y presencia de alteraciones, sobre todo en el Recuerdo, pero también en el Registro.