Prevalência de demência e fatores associados ao desempenho cognitivo em idosos clientes de uma operadora de saúde

Abstract

Population aging increases prevalence of degenerative diseases such as dementia, characterized by the presence of decline in memory and other cognitive functions, resulting in the inability of the individual to perform activities of daily living. This study aimed to describe the overall prevalence of dementia and its main subtypes among the elderly, and to examine the association between levels of complexity in lifelong occupations and cognitive performance in later life. The study design was cross-sectional and developed in two stages: cognitive impairment screening and diagnostic evaluation. We used a database of Network FIBRA-RJ, which evaluated elderly (> 65 years) clients of a private health care plan, living in the northern city of Rio de Janeiro. The selection of this sample was done by inverse random sampling in each stratum of sex and age group. To estimate the prevalence of dementia were evaluated 683 elderly. The association of cognitive performance with the occupation included 666 individuals who had responded to the screening instrument and accepted to answer to questionnaires about occupation. The diagnosis of dementia was obtained according to DSMIV; variables such as gender, age, education, income, marital status and occupation were collected by interviews. A total of 115 subjects were diagnosed with dementia, resulting in a prevalence of 16.9% (95% CI=14.4 to 19.8). In the multiple regression, age and education were associated with dementia. For age, the association was stronger among those with 90 years or more (PR = 8.85, 95% CI 2.11 to 37.11) and 85-89 years (PR=6.77, 95% CI=1, 63 to 28.12). Regarding education, the prevalence ratio was 2.77 (95% CI=1.07 to 7.19) for illiterates and 2.63 (95% CI=1.31 to 5.27) for those with 5-8 years of study, compared to the group with higher education. In the work with data, it the group that had performed high complexity work reached cognitive performance score 1.08 higher (p=0.019) than group low complexity. In the work with things, score among complexity intermediate were 0.53 points higher (p=0.044) than low complexity. It was not statistically significant difference in the perfomence cognitive between levels complexity of work with people. We conclude that the prevalence of dementia in this population was higher than those obtained in studies of population basis and that the higher prevalence of dementia was associated with increasing age and lower education. Moreover, it was shown that the complexity of work with data and things were associated with better overall cognitive performance in old age, independent of the age, education, income and occupation time.