Characteristics of Patients with Dementia Attended in a Tertiary Outpatient
Clinic in Eastern Region, Saudi Arabia
Mostafa Amr
1*
, Abdel-Hady El-Gilany
2
, Khaid Sallam
3
and Tarek Shams
4
1
Professor of psychiatry, College of Medicine, Mansoura University, Egypt
2
Professor of Public Health, Faculty of Medicine, Mansoura University, Egypt
3
Assistant professor of Neurology, College of Medicine, Banha University, Egypt
4
Professor of anesthesia and ICU, College of Medicine, Mansoura University, Egypt
*
Corresponding author: Dr Mostafaamr, Mansoura University, Mansoura, Egypt, Tel: 00201012444197; E-mail: mostafapsy@yahoo.com
Received Date: January 24, 2014, Accepted Date: September 15, 2014, Published Date: September 22, 2014
Copyright: © 2014, Mostafa Amr et al., This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Increasing longevity and a growing older population is associated with a higher prevalence of
dementia. However; research on dementia in the Gulf region is relatively scanty compared to the western world.
Objects: This is a cross sectional study to evaluate the clinical and demographic profile among 53 patients with
dementia seen at the outpatient clinics of a tertiary care hospital (King Fahd Hospital), in Saudi Arabia between June
2007 and May 2011.
Method: Evaluation of patients consisted of medical history, cognitive testing, assessment of functional status
(Activities of Daily Living Scale - ADL; Instrumental Activities Daily Living - IADL) and application of the
Neuropsychiatry Inventory (NPI) for behavioral symptoms. Severity of dementia was evaluated based on the Clinical
Dementia Rating Scale (CDR).
Results: Of the whole sample, 73.6% were males. Age was 71 ± 5.8 years (mean ± SD). The types of dementia
were: Alzheimer's disease (56.6%), vascular dementia (24.5%), mixed cases of Alzheimer and vascular dementia
(18.9%). At least one neuropsychiatric symptom was diagnosed in 98.1% of the sample. There were significant
differences on some NPI symptoms such as delusions, hallucinations, apathy and aberrant motor activity.
Conclusions: Dementia is expected to be a growing problem in Saudi Arabia and the overall prevalence of
neuropsychiatric symptoms has been found to be high. These findings suggest that a screening program focused on
identifying symptoms of early cognitive impairment and neuropsychiatric symptoms should be included amongst the
tools employed by physicians for diagnosing dementia.
Keywords: Dementia; Alzheimers disease; Vascular dementia;
Mixed dementia; Neuropsychiatric symptoms; Saudi Arabia
Introduction
The phenomenon of population aging (defined as an increase in the
median age of the population) [1] is already a major social and health
problem in developing countries. By the year 2025, the world will host
1.2 billion people aged 60 and over, rising to 1.9 billion in 2050 [2].
The same trend is predicted in the Eastern Mediterranean Region
(EMR) including Saudi Arabia; while the proportion of the elderly
population to total population was 4.8 % in 2000 it expected to reach
7.9 % by year 2025 and 12.9 % by 2050 [3].
The increase in the aged population has been attributed to a decline
in fertility and a twenty years increase in the average life span during
the second half of the 20th century, [4] as a result of the rapid socio-
economic growth and increased provision of health and other social
services. Among the major consequences of this growth is an increase
in the prevalence of dementia, particularly Alzheimers disease [5]. In
the United States, approximately 10% of the population older than 65
years of age suffers from dementia, with Alzheimer Disease accounting
for about 2/3 of the cases [6]. In European countries, the prevalence of
dementia is 6.4% and it increases with increasing age [7].
Dementia is characterized by cognitive, functional and behavioral
symptoms. However, the current diagnosis of dementia focuses
principally on, with neuropsychiatric symptoms considered to be
secondary, descriptive symptoms [8]. Several studies have examined
the prevalence of these symptoms. Depending on the population type
studied and the methods used, prevalence can range from 61 to 97%
[8,9]. Neuropsychiatric symptoms can induce a marked disability in
patients with dementia and increase caregiver stress[10]. Furthermore,
they have been found to increase rates of institutionalization and
overall financial cost [11].
In the Gulf region, there is a paucity of epidemiological data on
dementia in general, and Alzheimers in particular [12-16]. Moreover,
the study of dementia in our region has focused on the impairment of
memory and other cognitive functions. To our knowledge, there has
been no population-based estimate of the prevalence of
neuropsychiatric symptoms in Saudi Arabia.
The present work is a hospital based study conducted between June
2007 and May 2011 aimed at investigation of the socio-demographic
Journal of Psychiatry
Amr et al., J Psychiatry 2014, 17:6
http://dx.doi.org/10.4172/1994-8220.1000143
Research Article Open Access
J Psychiatry
ISSN:1994-8220 Journal of Psychiatry, an open access
Volume 17 • Issue 6 • Psychiatry-13-13