PREVALENCE OF DEMENTIA AND INTEGRATION OF THE FAMILY HEALTH MODEL IN PRIMARY CARE: A COMMUNITY-BASED STUDY IN LLAY-LLAY, CHILE.
Authors
-
Sebastián Ibañez Villalobos
https://orcid.org/0009-0008-5214-9401
-
Scarlett Venegas Salas
Universidad de Valparaíso
https://orcid.org/0009-0002-2446-6748
-
Cristina Osorio Gallegos
Universidad de Valparaíso
https://orcid.org/0009-0006-7893-4382
-
Gabriela Collado Lagos
Universidad de Valparaíso
https://orcid.org/0009-0007-9462-2298
Download
Abstract
Introduction: major neurocognitive disorder is one of the leading causes of dependency in old age. In Chile, its management is integrated into the Regime of Explicit Health Guarantees and the National Dementia Plan, recognizing Primary Health Care as the fundamental axis for detection and follow-up. Objectives: to estimate the prevalence of major neurocognitive disorder in individuals ≥ 60 years of age and to describe the clinical and follow-up characteristics of confirmed cases within the Explicit Health Guarantees program for major neurocognitive disorder at the Family Health Center in the commune of Llay Llay during 2024. Method: a descriptive and cross-sectional study based on the Explicit Health Guarantees program. 101 patients with a confirmed diagnosis according to the Global Deterioration Scale were included. Absolute and relative frequencies of the disease were calculated, and the communal prevalence was estimated. Results: a communal prevalence of 2.0% was identified in individuals ≥ 60 years of age. 52.5% were men and 47.5% were women. The most frequent age group was 80–89 years. The predominant clinical stages were GDS 5 and 6. 98% of cases had active interdisciplinary follow-up, supported by the Family Health Model. Conclusions: the communal prevalence of the disease is consistent with what has been described for Chilean Primary Health Care. The findings reinforce the importance of strengthening early screening, timely diagnosis, and comprehensive interdisciplinary care at the primary level.
Keywords:
Major neurocognitive disorder , Primary Health Care , Prevalence , Older adult , Health Programs.References
Instituto Nacional de Estadísticas. Envejecimiento en Chile: Evolución, características de las personas mayores y desafíos demográficos para la población. Santiago: INE; 2022. Disponible en: https://www.ine.gob.cl/inicio/documentos-de-trabajo/documento/envejecimiento-en-chile-evoluci%C3%B3n-caracter%C3%ADsticas-de-las-personas-mayores-y-desaf%C3%ADos-demogr%C3%A1ficos-para-la-poblaci%C3%B3n.
World Health Organization. Global status report on the public health response to dementia. Geneva: WHO; 2021. Disponible en: https://www.who.int/publications/i/item/9789240033245.
Ministerio de Salud de Chile. Encuesta Nacional de Salud 2016–2017: primeros resultados. Santiago: MINSAL; 2017. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://redsalud.ssmso.cl/wp-content/uploads/2018/02/ENS-2016-17_PRIMEROS-RESULTADOS-ilovepdf-compressed.pdf.
Ministerio de Salud de Chile. Orientaciones técnicas para la implementación de GES Nº 85 de Alzheimer y otras demencias. Santiago: MINSAL; 2022. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://diprece.minsal.cl/wp-content/uploads/2023/10/2023.07.21-OOTT-GES-Alzheimer-y-otras-Demencias-RV2.pdf.
Gauthier S, Webster C, Servaes S, Morais JA, Rosa-Neto P. World Alzheimer Report 2022. London: ADI; 2022. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.alzint.org/u/World-Alzheimer-Report-2022.pdf.
Long S, Benoist C, Weidner W. World Alzheimer Report 2023. Londres: ADI; 2023. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.alzint.org/u/World-Alzheimer-Report-2023_Spanish.pdf.
Alzheimer’s Disease International. World Alzheimer Report 2024: Global changes in attitudes to dementia. London: ADI; 2024. Disponible en: https://www.alzint.org/resource/world-alzheimer-report-2024/.
Madrid López R, et al. Abordaje de la sobrecarga del cuidador principal de pacientes con demencia: prevalencia, factores de protección y de riesgo. Eur J Health Res. 2023;9(1):1–18. DOI: https://doi.org/10.32457/ejhr.v9i1.2232.
Rodríguez Rodríguez, C. Las familias y los cuidados a las personas mayores dependientes: entre la reciprocidad y la ambivalencia. Cuadernos de Trabajo Social. (2013); 26(2): 349-358. DOI: https://doi.org/10.5209/rev_CUTS.2013.v26.n2.42291 .
Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry. 2012 Sep;169(9):946-53. DOI: 10.1176/appi.ajp.2012.11101529.
Slachevsky A, et al. The CUIDEME Study: determinants of burden in chilean primary caregivers of patients with dementia. J Alzheimers Dis. 2013;35(2):297-306. DOI: 10.3233/JAD-122086.
Ministerio de Salud de Chile. Plan Nacional de Demencia. Santiago: MINSAL; 2017. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.alzint.org/u/Chilie-PLAN-DE-DEMENCIA.pdf.
Ministerio de Salud de Chile. Plan Nacional de Salud Integral para Personas Mayores y su plan de acción 2020–2030. Santiago: MINSAL; 2021. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://diprece.minsal.cl/wp-content/uploads/2021/09/Plan-Nacional-de-Salud-Integral-para-Personas-Mayores_v2.pdf.
Connolly A, Gaehl E, Martin H, Morris J, Purandare N. Underdiagnosis of dementia in primary care: Variations in the observed prevalence and comparisons to the expected prevalence. Aging & Mental Health. 2011 Nov;15(8):978–84. DOI: 10.1080/13607863.2011.596805.
Ponjoan A, Garre-Olmo J, Blanch J, Fages E, Alves-Cabratosa L, Martí-Lluch R, et al. Epidemiology of dementia: prevalence and incidence estimates using validated electronic health records from primary care. Clinical Epidemiology. 2019;11:217–28. DOI: 10.2147/CLEP.S186590. DOI: 10.2147/CLEP.S186590.
Alzheimer’s Disease International. World Alzheimer Report 2016 Improving healthcare for people living with dementia. London, 2016. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.alzint.org/u/WorldAlzheimerReport2016.pdf.
World Health Organization. Global action plan on the public health response to dementia 2017–2025. Geneva: WHO; 2017. Disponible en: https://www.who.int/publications/i/item/global-action-plan-on-the-public-health-response-to-dementia-2017---2025.
Organización Panamericana de la Salud. Estrategia y plan de acción sobre demencias en las personas mayores. Washington (DC): OPS; 2015. Disponible en: https://www.paho.org/es/documentos/cd54r11-estrategia-plan-accion-sobre-demencias-personas-mayores-resolucion-2015.
World Health Organization. Integrated care for older people (ICOPE): guidance on person-centred assessment and pathways in primary care. Geneva: WHO; 2019. Disponible en: https://www.who.int/publications/i/item/9789240103726.
Slachevsky A, Olavarría L, Ramos T, et al. Políticas públicas para las demencias en Chile: perspectiva histórica y desafíos. Cuad Méd Soc (Chile). 2025;65(2):11–25. DOI:10.56116/cms.v65.n.2.2025.221.
Slachevsky A. Percepción de conocimiento sobre las demencias en profesionales de la salud de Chile. Rev Med Chile. 2016;144(11):1365–8. Disponible en: https://www.revistamedicadechile.cl/index.php/rmedica/article/view/5051.
León T, Troncoso D, Barría S, Kaczmarska M, Lawlor B, Slachevsky A. Dementia-related primary care training needs: a qualitative study. Arq Neuropsiquiatr. 2025;83(7). DOI:10.1055/s-0045-1809544.
Instituto Nacional de Estadísticas. Censo 2024: resultados comunales preliminares. Santiago: INE; 2025. Disponible en: https://censo2024.ine.gob.cl/resultados/.
Biblioteca del Congreso Nacional de Chile. Llay Llay Reporte Comunal. Santiago: BCN; 2025. Disponible en: https://www.bcn.cl/siit/reportescomunales/comunas_v.html?anno=2025&idcom=5703.
Ministerio de Salud de Chile. Resumen ejecutivo: Guía de práctica clínica de demencia tipo Alzheimer. Santiago: MINSAL; 2021. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://diprece.minsal.cl/wp-content/uploads/2021/12/Resumen-Ejecutivo-GPC-Demencia-tipo-Alzheimer2021-12-09-V2.pdf.
Reisberg B, Ferris S, de Leon M, Crook T. The Global Deterioration Scale for Assessment of Primary Degenerative Dementia. American Journal of Psychiatry. 1982 Sep;139(9):1136–9. DOI: 10.1176/ajp.139.9.1136
Ministerio de Salud de Chile. Norma General Técnica N.º 151 sobre estándares de acreditación de los Comités Ético-Científicos. Resolución Exenta Nº 403. Santiago: MINSAL; 2013. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.ispch.cl/sites/default/files/normativa_anamed/ensayos_clinicos/Resoluci%C3%B3n%20Exenta%20403.pdf.
Pais R, Ruano L, P. Carvalho O, Barros H. Global Cognitive Impairment Prevalence and Incidence in Community Dwelling Older Adults—A Systematic Review. Geriatrics. 2020 Oct 27;5(4):84. DOI: 10.3390/geriatrics5040084.
Saraiva Aguiar R, Salmazo da Silva H. Qualidade da atenção à saúde do idoso atenção primária: uma revisão integrativa. Enfermería Global. 2022 Jan 1;21(1):545–89. DOI: https://doi.org/10.6018/eglobal.444591.
Silva M, Sá L, Marques G. Impacto do Transtorno Neurocognitivo na Família: Scoping Review. Revista Paulista de Enfermagem. 2018;30(1):1–15. DOI:10.33159/25959484.
