Clinical Manifestations.

Area of Science:

• Neurology
• Public Health
• Geriatrics

Background:

• Dementia is a progressive cognitive decline syndrome, often linked to aging and neurodegenerative conditions.
• It disproportionately affects low- and middle-income countries, where two-thirds of the global dementia population resides.
• Primary care plays a crucial role in identifying and referring patients for specialized dementia services.

Purpose of the Study:

• To evaluate the sociodemographic and clinical profile of patients referred from primary care to specialized dementia services in Porto Alegre.
• To assess the impact of the COVID-19 pandemic on the dementia patient referral process.

Main Methods:

• A cross-sectional study analyzing first-time consultations in dementia outpatient clinics between 2019 and 2022.
• Inclusion criteria: first consultations from the public primary care network at two tertiary hospitals in Porto Alegre.
• Data collected included sociodemographic information, clinical profiles, and diagnoses based on the last consultation.

Main Results:

• Analysis of 251 patients (119 in 2019, 132 in 2022) showed a significant increase in median patient age (70 to 73 years) and symptom onset age (66 to 69 years).
• Median symptom duration doubled from 1 to 2 years between 2019 and 2022.
• The Mini Mental State Examination (MMSE) median score remained 18, with a notable prevalence of psychiatric diagnoses (23.5% in 2019, 16.7% in 2022).

Conclusions:

• The findings suggest a delay in dementia diagnosis and access to specialized care within the public health system, particularly post-COVID-19 pandemic.
• A high prevalence of psychiatric diagnoses indicates potential misreferrals from primary care settings.
• Improvements in primary care dementia screening and referral pathways are warranted.