The demographic characteristics and the risk factors of dementia in an elderly population in Saudi Arabia at tertiary care hospital

---

Muneerah Albugami, Najeeb Qadi, Abdelazeim Elamin, Mumin Siddiquee, Usamah El Alem, Fahed Almokbal, Alaa Mohammed, Alawi Alattas and Yasmin AlTwaijri

King Faisal Specialist Hospital and Research Centre, Saudi Arabia

: Int J Ment Health Psychiatry

Abstract

---

Background: Dementia is characterized by the impairment of memory and learning and at least one other cognitive domain (i.e., aphasia, apraxia, agnosia or executive function), representing a highly severe functional deterioration that interferes with the patient’s daily functional abilities and independence. Itis caused by different etiologies and it has a substantial social and economic impact. There is a little information about dementia in Saudis. The objective is to describe the demographic characteristics and the risk factors of dementia, the prevalence of different types of dementia, and the current clinical practice of dementia in Saudi Arabia at tertiary care hospital.

Methods: This is a retrospective chart review study of fifteen years span from 1995 -2010 of patients with dementia who received regular care at King Faisal Specialist Hospital and Research Centre (KFSH&RC). Exclusion criteria included depression without dementia and delirium due to acute illness or medications.

Results: The basic characteristics and clinical presentation of patients are shown in table 1& figure 1. Comorbidities in demented patients’ are shown in figure 2. Types of dementia are shown in figure 3. Nearly half of the patients were treated for dementia. Among them, 71 patients were put on a cholinesterase inhibitor only, 23 patients received only memantine while 134 patients were put on a combination treatment. More than half of patients required feeding tubes during their illness, 44.1 % of these patients requiring gastrostomy tube. The cause of frequent admission to hospital was sepsis in 40% of patients with aspiration pneumonia and urinary tract infection & one third of patients had frequent admission due to heart failure. Half of the patients had their family members take care of them, while around 12 % stayed at hospital for long nursing care. 74.09% of the patients died with the mean age at death 77.4 years, 66.87 % of them were male. The commonest cause of death was sepsis 36.98% (pneumonia 68%, UTI 20%, bed sores 6.4%); cardiac causes 16.09 % (heart failure 24.56%, MI15.78%& other cardiac causes 59.65%), stroke 12.72%, malignancy 5.62%, pulmonary embolism 1.77%, and cardiac pulmonary arrest 26.04%.

Conclusion: (1) Mixed dementia is the most common type of dementia in Saudis due to high prevalence of cardiovascular diseases risk factors. Preventing and controlling these risk factors may help to prevent mixed dementia. (2) High prevalence of depression among demented Saudi patients. It requires early recognition and treatment. (3) Despite lack of evidence that feeding tubes benefit patients with dementia; the use of feeding tubes is expected to increase. (4) Demented patients have frequent admissions and long stay in hospital which makes the economic cost very high. There is an urgent need to have national strategies to open nursing home in Saudi Arabia. (5) Mortality rate among demented patients is high. No matter what care is offered, the outcome of dementia is expected to be poor. The underlying message of this study is to increase awareness of the public and health system about the impact of dementia in Saudis and the need for prevention strategies, trained physicians and more research.

Biography

---

Muneerah Mohammed Albugami is currently a consultant Internal Medicine and Women’ Health at King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh as well as the adjunct associate professor at the College of Medicine- Alfaisal University.

E-mail: mbugami@kfshrc.edu.sa