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Introduction: As life expectancy increases, and the prevalence of cognitive impairment and dementia continues to grow, the number of patients with cognitive complaints seen in primary care or specialized out-patient clinics has increased in the last few years. The assessment of these patients requires time, and a step-by-step organization to optimize medical resources., Development: This review presents the most important dementia screening tools with Spanish validation. We focus on those that are brief (less than ten minutes) and easy to use in primary care settings. Two groups of tests can be distinguished: brief cognitive tests and functional activities scales. The first can be considered a part of the mental status examination, and the second an organized history taking. Informant questionnaires and the possibility of self-administered cognitive tests are briefly reviewed., Conclusion: There are no ideal screening tests. The election of the most appropriate will depend on the physiciańs time and knowledge of each test. It is advisable to be familiar with a reduced number of tests, and be aware of their strengths and limitations. Finally, we suggest personal recommendations for the most useful tests in each clinical setting., (2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.)

To evaluate the mortality, thirteen years after the baseline wave (1994), of participants suffering dementia in the Neurological Disorders in Central Spain (NEDICES) Cohort Study, we conducted a population-based cohort study in the elderly (65 years and more) with 5,278 screened participants at baseline. Mortality has been evaluated by means of the National Death Registry of Spain at 1-5-2007, 13 years after enrolment. Cox's proportional hazards regression models were used to evaluate the hazard of death according to dementia severity and type, adjusting for potential covariates (gender, age, level of education, and co-morbidity). Survival was estimated using Kaplan-Meier method. Of the 5,278 participants screened at baseline, 306 had dementia. Mortality at 13 years was: 275 deaths (89.9%) in dementia subjects; and 2,426 (49.0%) in subjects without dementia. Mortality was higher and statistically significant in dementia subjects. The degree of dementia (DSM-III-R) correlated with the risk of mortality, from mild (HR = 2.23; CI: 1.77-2.82) to moderate (HR =3.10; CI: 2.47-3.89) and severe dementia (HR = 4.98; CI: 3.85-6.44). Survival was similar in Alzheimer's disease and vascular dementia. Factors associated with higher mortality in Cox proportional hazard models were older age, male gender, and comorbidity. Using Population Attributable risk (PAR%), dementia was related to 11.3% of all deaths. Dementia intensity increases the mortality risk at ten years in the NEDICES Study as in other cohort studies. Age, gender, and co-morbidity are associated with higher mortality in dementia patients. Almost one third of deaths in persons over 85 years-old could be attributable to dementia.

We present a 86-year-old woman without relevant medical history and two brothers who died by dementia, who started at 55 years with depression and personality changes with ongoing worsening (>30 years) and functional decline. Screening dementia blood test and brain magnetic resonance imaging did not show results that pointed to a secondary cause. The patient met the diagnostic criteria for possible behavioral frontotemporal dementia with a slow progression (bvFTD-SP), suggesting a benign variant. A genetic study confirmed a C9ORF72 hexanucleotide expansion, making this the sixth case mentioned in the literature. We review and discuss the other cases described previously. [ABSTRACT FROM AUTHOR]