Physicians with specialty in geriatrics, psychiatry and neurology have not received training about the differential diagnosis of dementia, particularly regarding fronto-temporal dementia (FTD). Objective: To assess the level of knowledge of physicians about FTD. Material and Method: The survey was carried out during symposiums and scientific congresses from January 2016 to July 2017. Inclusion criteria: being a general practitioner or specialist in Geriatrics, Neurology and psychiatry whose training process as a physician and specialist has been carried out in Peruvian universities. We analyzed 217 surveys of which 13 were eliminated. The survey was divided into three parts, the first about general data of doctors, the second part was about the diagnosis of dementia; and the third on specific data of FTD. STATA version 12 was used for the statistical analysis. Results: 90% of the doctors surveyed were specialists in: Psychiatry (41.3%), Geriatrics (31.3%) and Neurology (15.4%). The 98.5% of physicians surveyed claimed to diagnose dementia. The medical specialists performed better when identifying the tests used. 72.1% of the doctors surveyed could not recognize any type of FTD, while 27.9% recognized at least 1 type of FTD. 43.8% of physicians surveyed identified 5 or more of the symptoms presented in FTD. Conclusions: The level of knowledge among medical specialists surveyed about the diagnosis of dementia is acceptable, however it is deficient when it is specifically about the diagnosis of FTD.

Resumen Médicos especialistas en geriatría, psiquiatría y neurología no han recibido entrenamiento respecto al diagnóstico diferencial de demencia, en particular acerca de demencia frontotemporal (DFT). Objetivo: Evaluar el nivel de conocimiento de los médicos sobre DFT. Material y Método: La encuesta se llevó a cabo durante simposios y congresos científicos desde enero de 2016 hasta julio de 2017. Los criterios de inclusión fueron: ser médico general o especialista en Geriatría, Neurología y Psiquiatría cuyo proceso de formación como médico y especialista haya sido realizado en universidades peruanas. Se analizaron 217 encuestas de las cuales 13 fueron eliminadas. La encuesta estuvo dividida en tres partes: la primera sobre datos generales de los médicos, la segunda parte fue acerca del diagnóstico de demencia y la tercera sobre datos específicos de DFT. Para el análisis estadístico se utilizó STATA versión 12. Resultados: El 90% de los médicos encuestados fueron médicos especialistas en: Psiquiatría (41,3%), Geriatría (31,3%) y Neurología (15,4%). El 98,5% de médicos encuestados afirmó diagnosticar demencia. Los médicos especialistas tuvieron un mejor desempeño al momento de identificar las pruebas empleadas. El 72,1% de médicos encuestados no pudo reconocer ningún tipo de DFT, mientras que el 27,9% reconoció al menos 1 tipo de DFT. El 43,8% de médicos encuestados identificó correctamente 5 o más de los síntomas presentados en DFT. Conclusiones: El nivel de conocimientos entre médicos especialistas encuestados acerca del diagnóstico de demencia es aceptable, sin embargo es deficiente cuando se trata específicamente acerca del diagnóstico de DFT.

Alzheimer's disease and epilepsy not only share advanced age as a risk factor, also mechanisms underlying in their etiology. The seizures usually occur in late stages of Alzheimer's disease; however patients with familial Alzheimer's disease have even greater risk for seizures, which have been found in patients with mutations in PSEN1, PSEN2 or APP developing seizures even in early stages of the disease. Furthermore temporal lobe epilepsy per se could generate memory impairment and hippocampal sclerosis generatere organization of excitatory and inhibitory neural networks that would result in seizure activity. Is important to recognize patients with Alzheimer's disease and epilepsy for initiate early treatment and prevent further cognitive impairment and improve the quality of life of these patients.

La enfermedad de Alzheimer y la epilepsia no solo comparten la edad avanzada como un factor de riesgo, si no también compartirían mecanismos subyacentes en su etiología. Las crisis epilépticas generalmente fueron reportadas en estadios tardíos de la enfermedad de Alzheimer; sin embargo los pacientes con enfermedad de Alzheimer familiar con mutaciones en la PSEN1, PSEN2 y proteína precursora del amiloide tienen mayor riesgo de desarrollar crisis epilépticas aún en estadios tempranos de la enfermedad. Por otro lado la epilepsia del lóbulo temporal podría generar per sé compromiso de memoria y la esclerosis hipocampal generar reorganización de redes neuronales excitatorias e inhibitorias que daría como resultado una actividad epiléptica. Es importante reconocer e iniciar tratamiento temprano en pacientes con Enfermedad de Alzheimer y epilepsia para evitar mayor deterioro cognitivo y mejorar la calidad de vida de estos pacientes.

OBJETIVO: Avaliar a sobrecarga do cuidador baseada na entrevista de Zarit (ZBI). MÉTODOS: Nós incluímos cuidadores com 18 anos ou mais de idade, língua espanhola como nativa, alfabetizados. Foram avaliadas características demográficas: idade, gênero, educação, relação com o paciente com demência, extensão do cuidado, outras fontes de ajuda para os cuidados, impacto na economia doméstica, suporte familiar e percepção do comprometimento de saúde; e dados clínicos de saúde dos pacientes: tipo de demência, tempo desde o diagnóstico, tratamento e escala de deterioração global (GDS); ZBI e BDI-II. RESULTADOS: Avaliamos 92 cuidadores informais. Os pacientes tinham 69 anos ou mais, 75% tinha pelo menos um ano do diagnóstico, 73,9% com doença de Alzheimer, 84,8% recebia algum tratamento, 75% tiveram GDS de 5 ou mais. Quanto aos cuidadores: 75% tinham 55 anos ou mais, mulheres (81,5%), casados (83,7%), cônjuge (60,9%), com pelo menos 10 anos de educação (75%) e um ano de cuidado (75%), tempo reduzido de entretenimento (90,2%) e autopercepção de comprometimento da saúde (83,7%). A mediana da ZBI foi 38 (mínimo: 3 e máximo: 74). O coeficiente de BDI foi 1,38 (p<0,001). CONCLUSÃO: Nossa amostra de cuidadores informais peruanos mostram valores consideráveis na ZBI. A autopercepção de piora de saúde, repercussão na economia familiar e tempo de cuidado foram os principais determinantes da ZBI, embora somente a BDI foi um preditor consistente de ZBI.

OBJECTIVE: The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). METHODS: Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. RESULTS: A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer's disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). CONCLUSION: This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI.

Depression and dementia, in particular Alzheimer´s disease (AD) are critically important issues in the mental health of old age. Both conditions apparently reduce quality of life and increase the impairment of activities of daily living for elderly persons. AD usually shows poor prognosis owing to progressive neuronal degeneration, while depression is basically reversible. Longitudinal follow-up and case-control studies reported a strong association between late-onset depression and dementia, and therefore increased risk was observed in 2-5 times to develop dementia in patients with late-onset depression. Furthermore, early-onset depression have also consistenly demonstrated to be a risk factor for dementia and unlikely to be prodromal to dementia. The nature of this association (if depression is a prodrome or consequence of, or risk factor for dementia) remains unclear. Regardless of this, treatment strategies for depression could alter the risk of dementia

Depresión y demencia, sobre todo enfermedad de Alzheimer (EA) son entidades críticas en la salud mental de la tercera edad. Ambas condiciones disminuyen la calidad de vida e incrementan el deterioro de actividades de vida diaria de individuos de la tercera edad. EA tiene pobre pronóstico al ser una enfermedad neurodegenerativa; mientras que la depresión es básicamente reversible. Los estudios de seguimiento longitudinal y de caso-control reportan una estrecha asociación entre depresión de inicio tardío y deterioro cognitivo progresivo, pues se ha demostrado riesgo de incremento en 2 a 5 veces para desarrollar demencia en pacientes con depresión de inicio tardío. Por otro lado, la depresión de inicio precoz ha demostrado en forma consistente ser también un factor de riesgo para demencia, y escasas probabilidades de ser pródromo de demencia.La naturaleza de la asociación (si depresión es un pródromo o consecuencia de demencia, o un factor de riesgo para desarrollar demencia) permanece aún sin ser esclarecida. Independiente de ello, las estrategias para tratar depresión podrían alterar el riesgo de desarrollar demencia.