Current Gerontology and Geriatrics Research

Current Gerontology and Geriatrics Research / 2012 / Article

Research Article | Open Access

Volume 2012 |Article ID 175019 |

Genaro G. Ortiz, Elva D. Arias-Merino, María E. Flores-Saiffe, Irma E. Velázquez-Brizuela, Miguel A. Macías-Islas, Fermín P. Pacheco-Moisés, "Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico", Current Gerontology and Geriatrics Research, vol. 2012, Article ID 175019, 6 pages, 2012.

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

Academic Editor: Arnold B. Mitnitski
Received21 Feb 2012
Accepted22 Oct 2012
Published03 Dec 2012


Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged 60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged 60.

1. Introduction

As our society ages, age-related diseases assume increasing prominence as both personal and public health concerns [1]. In Mexico, the annual growth rate of the elderly population was 3.5% in 2000, which if maintained, the current older-adult population (7.6%) would double every 19 years and would amount to 28% of the total Mexican population in 2050 [2]. Late life depression occurring in patients over age 65 is a serious illness and may lead to impaired physical function, increased mortality, and unwarranted use of health care resources. Depression in older adults remains under-diagnosed and under-treated. The prevalence of depression varies depending on the population studied, affecting up to 9% of community dwelling elderly but 25% of institutionalized elderly and those recently hospitalized [13]. Patients with depression often present with cognitive complaints or cognitive deficits. These cognitive changes may occur as a consequence of depression or may indicate a coexisting condition such as Alzheimer’s disease or Parkinson’s disease. Recent research on the prevalence of cognitive impairment in elderly show considerable variability with estimates ranging from 4 to 5% to 40% or more. This variability depends on different diagnostic criteria used, the degree of severity of clinical manifestations, and the age range used in the study, among other factors [46].

In Mexico, little is known about the prevalence of cognitive impairment and depression in older adults. For instance, the few depression prevalence studies carried out have rarely focused on persons 60 years and older, and, consequently, sample sizes have been small to yield precise estimates [710]. That knowledge is important to get items to help plan health services to this population, so the aim of this work is to estimate the prevalence of cognitive impairment and depression among the population 60 years and older who resides in the Guadalajara metropolitan area, Mexico.

2. Methods

This is a cross-sectional, descriptive, and transversal study. The study was conducted in the Guadalajara metropolitan area (GMA). The GMA is the second largest city (Mexico) in demographic terms; it includes the core municipality of Guadalajara and the surrounding municipalities of Zapopan, Tlaquepaque, Tonalá, El Salto, Tlaquepaque, and Zapotlanejo. The six municipalities of GMA are subdivided into 14 urban basic geostatistical areas (UGEA). We used multistage and proportional random sampling to obtain our study sample of adults. The sample size obtained was 1142 adults. Within the 14 UGEAs, we conducted the random selection of blocks. Located the block, we proceed at the southwest corner clockwise until we find an adult 60 years or more. Adults 60 years or more living at least one year at the GAM were invited to participate. Data were collected by means of structured personal interviews conducted by trained interviewers. All participants or family members provided informed consent. Sociodemographic data (age, gender, marital status, education, and occupation) were obtained from the first interview.

The institutional review board of the Instituto Mexicano del Seguro Social approved the study protocol.

Cognitive function was assessed by applying standardized Mini-Mental State Examination (MMSE) of Folstein [11]. MMSE scores range from 0 to 30, with lower scores indicating increasing severity of cognitive impairments in the domains of orientation, memory, attention, and executive functions. Subjects with cognitive impairment had scores between 0 and 18. The sensitivity was 87%, and specificity was 82%.

Depression was assessed with the Geriatric Depression Scale (GDS) [12], a questionnaire specifically developed for screening depressive symptoms in elderly populations. The cutoff for normal range were 10. The sensitivity and specificity was 84% and 95%, respectively.

2.1. Statistics

The data obtained were analyzed with the statistical package for social sciences software (SPSS). Data inconsistencies were corrected, and some data were transformed into dichotomous variables to fit the statistical analysis. The prevalence of cognitive impairment and depression was calculated in percent. Estimated odds ratios (ORs) crude and adjusted and corresponding 95% confidence intervals (CIs) were obtained.

3. Results

1142 adults of both genders (413 men and 729 women) aged 60 to 110 years (mean age years) were evaluated. The average age for male and female was essentially the same ( ). Regarding marital status, 49.0% were married or living with a partner, and 51.0% were single; significant differences by gender were found ( ) as more women were not married (60.1%), and more men were married (70.5%). The schooling range was 0 to 23 years, and the average was 4.42 years (4.15 for women and 4.89 for men). No significant differences were observed in education years by gender ( ). It is noteworthy that 23.2% of the adults had no formal educational instruction. 73.9% of the sample did not have the benefit of retirement or have a pension, while 26.1% are retirees and pensioners (18.5% women; 39.5% men). Differences in the benefit of retirement or pension between men and women were found (see Table 1).

(%) (%) (%)

Sex729 (63.8)413 (36.2)1141(100.0)
 60–69362 (49.7)179 (43.3)541 (47.4) 0.123
 70–79234 (32.1)155 (37.6)389 (34.0)
133 (18.2)79 (19.1)212 (18.6)
Marital status
 Married291 (39.9)291 (70.5)560 (49.0)0.000
 Not married438 (60.1)122 (29.5)582 (51.0)
Education (years)
 0177 (24.3)88 (21.3)265 (23.2)0.090
 1–4258 (35.4)144 (34.9)402 (35.2)
 5–8185 (25.4)104 (25.2)289 (25.3)
 9–1280 (11.0)45 (10.9)125 (10.9)
 ≥1329 (4.0)32 (7.7)61 (5.3)
Retired or pensioned
 Yes135 (18.5)163 (39.5)398 (26.1)0.000
 No594 (81.5)250 (60.5)844 (73.9)

As shown in Table 2, the overall prevalence of cognitive impairment in this sample was 13.8% (CI 95%; 11.9–16.0). Women showed a higher proportion of cognitive impairment (14.5%, CI 95%; 12.1–17.4) than men (12.6%, CI 95%; 9.6–16.3), although no significant differences by gender were found ( ). The overall prevalence of depression was 29.1%. Women showed a higher proportion of depression (33.6%) than men (21.1%).

Cognitive impairmentDepression
CI 95% Absence
CI 95%Absence

Female116 (14.5)(12.1–17.4)623 (85.5)245 (33.6)(30.2–37.2)484 (66.4)
Male52 (12.6)( 9.6–16.3)361 (87.4)87 (21.1)(17.3–25.4)326 (78.9)

Total158 (13.8)(11.9–16.0)984 (86.2)332 (29.1)(26.5–31.8)810 (70.9)

Data analysis of odds ratio showed in Table 3 suggests that the prevalence of cognitive impairment is associated with being older than 75 years ( CI 95%; 3.43–7.06), being not married ( CI 95%; 2.39–5.08), low educational level ( CI 95%; 5.16–4.60), and depression ( CI 95%; 2.31–4.60). Likewise, exhibited in Table 3, demographic variables (being older than 75 years, being not married, and low educational level) and depression were associated with cognitive impairment in adjusted odd rate.

VariablesWith cognitive impairment
Without cognitive impairment
OR crudeCI 95%OR adjusted*CI 95%

 Female106 (14.5)623 (85.5)1.180.87–1.680.79 0.51–1.22
 Male 52 (12.6)361 (87.4)1
 ≥75107 (26.7)294 (73.3)4.923.43–7.063.492.37–5.14
 ≤7451 (6.9)690 (93.1)1
Marital status
 Not married117 (20.9)443 (79.1)3.482.39–5.082.731.77–4.19
 Married 41 (7.0)541 (93.0)1
Retired or pensioner
 No126 (14.9)718 (85.1)1.450.96––1.99
 Yes 32 (10.7)266 (89.3)1
 0–4144 (21.6)523 (78.4)9.065.16––10.9
 5–2314 (2.9)461 (97.1)1
 Yes83 (25.0)249 (75.0)3.262.31–4.602.291.57–3.36
 No75 (9.3)735 (90.7)1

OR: odd ratio.
*OR adjusted by gender, age, marital status, pensioner, education, and depression.

Data analysis between sociodemographic variables exhibited as depression is associated with being female ( CI 95%; 1.43–2.51), being older than 75 years ( CI 95%; 1.03–1.76), being not married ( CI 95%; 1.46–2), low educational level ( CI 95%; 2.07–3.65), and cognitive impairment ( CI 95%; 2.31–4.60). Similarly we exhibited in Table 3, demographic variables that being woman, being not married, low educational level, and cognitive impairment were associated with depression in adjusted odd rate (Table 4).

VariablesWith depression
Without depression
OR crudeCI 95%OR adjustedCI 95%

 Female245 (33.6)484 (66.4)1.891.43–2.511.69(1.24–2.32)
 Male 87 (21.1)326 (78.9)1
 ≥75133 (33.2)268 (66.8)1.35(1.03–1.76)0.95(0.68–1.23)
 ≤74199 (26.9)542 (73.1)1
Marital status
 Not married200 (35.7)360 (64.3)1.89(1.46–2.45)1.42(1.06–1.91)
 Married132 (22.7)450 (77.3)1
Retired or pensioner
 No126 (14.9)718 (85.1)1.45(0.96–2.20)1.01(0.72–1.41)
 Yes32 (10.7)266 (89.3)1
 0–4248 (37.2)419 (62.8)2.75(2.07–3.65)2.31(1.70–3.13)
 5–2384 (17.7)391 (82.3)1
Cognitive impairment
 Yes83 (52.5)75 (47.5)3.26(2.31–4.60)2.33(1.60–3.40)
 No249 (25.3)735 (74.7)1

OR: odd ratio.
*OR adjusted by gender, age, marital status, pensioner, education, and cognitive impairment.

4. Discussion

The data obtained in this work shows that the overall prevalence of cognitive impairment in a representative sample of older adults of the GMA was 13.8%. This result is higher than the obtained previously in the whole Mexican population that was 7.7% [10]. This difference with the data from the present work could be explained by the allocation of subjects, variety of instruments (self-report scale and interviewer’s rating scale), staff (psychiatric and nonpsychiatric), type of sample, and other factors which are specific characteristics of the population of the GAM. Interestingly, risk factors for cognitive impairment detected in this work were being older than 75 years, being woman, single, retired, or pensioned, and low scholarship.

The overall prevalence of depression found in this work was 29.1%. This data was lower than the previously reported [13], which found a prevalence of 36.2%. That discrepancy may be due to the number and characteristics of the sample. Prevalence studies in Europe, the United States, and Canada reveal relatively consistent findings. For instance, 22.2% of individuals in the United States of age 71 years or older have cognitive impairment without dementia [14], and Canadian samples aged 65 and over report prevalence rates for cognitive impairment without dementia of 16.8% [15]. In contrast, the prevalence of depression in elderly New Mexico Hispanic population was 13.2% (6.4% in men and 16.9% in women) [16].

In consonance with the previously reported data [17], the prevalence of depression increases with the age. The elderly may have chronic-degenerative or neurological illness more often than other age groups as suggested by Katon and Sullivan [18] In addition, social characteristics were important factors that affect depression such as retirement, loss of a partner, or loss of friends.

The prevalence of depression was higher in women than in men and is correlated with the sociodemographic data analyzed (age, being married, low scholarship, and being not retired or pensionated). These differences of gender have too many depression-related phenomena. Therefore, it is not well understood but probably related to a combination of biological and genetic factors including hormonal changes as well as from the stress from working life, family responsibility, and social roles [19].

For both conditions (cognitive impairment and depression), the probability is higher in women and increases with age, being married, a low scholarship, and subjects without pension or not retired. According to the present data, most epidemiological studies have shown an association between low education and cognitive impairment [20]. In this work, 74% of older adults do not have retirement or pensions, and most of these are lacking a family, and institutional or social support. This may create a situation of loneliness and isolation affectively and loss of roles that can lead to depression, which plays an important role for cognitive impairment.

We found similar prevalence of depression compared with the study made in Dublin [21]. It is worthy to note that as reported in the Mexico-American population, there is a link between depression and symptoms associated with cognitive impairment [22, 23], and this study found (CI 95% 2.63–5.34). The reported prevalence of cognitive impairment in Cuba varies from 4.2% to 19.6% this increases to more age [24], and similar data was obtained in our study. Other authors also confirm that depressive symptoms are associated with cognitive impairment [25], but by itself, mild depression does not lead to a severe cognitive impairment [26], but the most severe cases of chronic depression did so significantly [25]. Indeed, mild cognitive impairment among elderly population, which is determined by multiple etiologies, signifies and amplifies the occurrence of depression symptoms but not vice versa.

Cognitive disorders and depression have become a health problem, as there is an association of both transversely in the elderly, and early diagnosis could reduce other health problems, such as isolation, loneliness, and dependency. Depression often coexists with physical harm and social problems. It is essential to investigate the risk factors of cognitive impairment in our population with the goal of that older adults with cognitive impairment have a personalized and effective treatment to prevent the development of dementia. Patients with dementia have a poor prognosis, have an increased risk of institutionalization and are a major cause of stress on caregivers. For this reason, early detection of cognitive impairment may be beneficial for the patient, his family and the health sector.

The elderly population suffers a high incidence of disorders associated with cognitive impairment and depressive symptoms. For example, the incidence of depression secondary to Parkinson’s disease has been estimated at around 40%, the prevalence of poststroke depressive syndrome between 30% and 50%, and the incidence of depression secondary to Alzheimer’s disease from 10% to 20% [27].

Health personnel should also know that cognitive impairment has a high prevalence in settings as general hospitals. However, clinical experience suggests that these disorders often go unnoticed by medical nursing staff.

According to Delphi consensus study, in the United States and Canada, the incidence for dementia syndrome in people over 60 years was 6.4%. In Western Europe, a prevalence of 5.4% was reported. This consensus dementia prevalence was slightly higher than in Latin America with a 4.6% [28].

On the other hand, in the United States, depression alone represents a forty three billion dollar annual expense. Although the prevalence of depression may vary depending on the population studied and the methodology applied, its range is between 10% and 27% [29]. The prevalence of depression in the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) was slightly lower than that reported in the US and comparable to Pan-European estimates [30].

The study of prevalence of cognitive impairment is essential because it constitutes an important risk factor for developing dementia syndrome. Although rates of progression are widely different across studies and populations, it has been found that the rate at which patients with cognitive impairment progress to dementia is about 70% over a period of 5 years, that is, 10%–15% per year as opposed to 1%-2% of control subjects [31]. Thus, its early detection is of great importance to develop preventive and early rehabilitation.

Inferring causality in the relation between depression and cognitive impairment in old age has been hampered by the fact that most studies have examined only one direction of this relation. Some studies found that depression is a risk factor for the development of cognitive decline, whereas others could not confirm this finding. The relationship between depression and cognitive impairment shows that depression in old age is a concomitant phenomenon of already existing cognitive impairment rather than an independent risk factor. Our findings, based on various measures of cognitive function instead of a dichotomous end point, are in line with those from a large population-based study in people aged 65 and older showing that depression is an early manifestation rather than a predictor of Alzheimer’s disease. Thus, in elderly people, the presence of depressive symptoms does not mean that they are at increased risk of cognitive decline.

5. Conclusions

Cognitive impairment and depression are highly correlated in adults aged 55 and more. Cognitive disorders and depression have become a health problem in developing countries.


This work was supported by Grant no. 1419-5 from Fondo Sectorial en Salud/CONACyT, Mexico.


  1. B. D. Lebowitz, J. L. Pearson, L. S. Schneider et al., “Diagnosis and treatment of depression in late life: consensus statement update,” Journal of the American Medical Association, vol. 278, no. 14, pp. 1186–1190, 1997. View at: Google Scholar
  2. Consejo Nacional de Población, Estimaciones y Proyecciones del Consejo Nacional de Población, CONAPO, Mexico City, Mexico, 2002.
  3. J. Teresi, R. Abrams, D. Holmes, M. Ramirez, and J. Eimicke, “Prevalence of depression and depression recognition in nursing homes,” Social Psychiatry and Psychiatric Epidemiology, vol. 36, no. 12, pp. 613–620, 2001. View at: Publisher Site | Google Scholar
  4. R. C. Petersen, “Mild cognitive impairment or questionable dementia?” Archives of Neurology, vol. 57, no. 5, pp. 643–644, 2000. View at: Google Scholar
  5. O. L. López, R. L. Hamilton, J. T. Becker, S. Wisniewski, D. I. Kaufer, and S. T. Dekosky, “Severity of cognitive impairment and the clinical diagnosis of Alzheimer dementia with Lewy bodies,” Neurology, vol. 54, no. 9, pp. 1780–1787, 2000. View at: Google Scholar
  6. P. Casanova-Carrillo, “Estudio clínico de las principales causas de trastornos cognoscitivos en la atención primaria,” Revista Cubana de Medicina General Integral, vol. 17, no. 4, pp. 309–315, 2001. View at: Google Scholar
  7. L. M. Gutiérrez, F. Ostrosky-Solis, and S. Sanchez, “Prevalence of dementia and mild cognitive impairment in subjects 65 years older in México city: an epidemiological survey,” Gerontology, vol. 47, p. 145, 2000. View at: Google Scholar
  8. S. Mejia, L. M. Gutiérrez, A. R. Villa, and F. Ostrosky-Solís, “Cognition, functional status, education, and the diagnosis of dementia and mild cognitive impairment in Spanish-speaking elderly,” Applied Neuropsychology, vol. 11, no. 4, pp. 196–203, 2004. View at: Google Scholar
  9. G. Ocegueda-Azpeitia and A. Pichardo-Fuster, “Prevalencia de la depresión en ancianos mexicanos,” Arch Geriátrico, vol. 6, pp. 78–81, 2003. View at: Google Scholar
  10. S. Mejía-Arango, A. Miguel-Jaimes, A. Villa, L. Ruiz-Arregui, and L. M. Gutiérrez-Robledo, “Deterioro cognoscitivo y factores asociados en adultos mayores en México,” Salud Publica de Mexico, vol. 49, supplement 4, pp. S475–S481, 2007. View at: Google Scholar
  11. M. F. Folstein, S. E. Folstein, and P. R. Mchugh, “‘Mini mental state’: a practical method for grading the cognitive state of patients for the clinician,” Journal of Psychiatric Research, vol. 12, no. 3, pp. 189–198, 1975. View at: Publisher Site | Google Scholar
  12. J. A. Yesavage, T. L. Brink, and T. L. Rose, “Development and validation of a geriatric depression screening scale: a preliminary report,” Journal of Psychiatric Research, vol. 17, no. 1, pp. 37–49, 1983. View at: Publisher Site | Google Scholar
  13. M. Pando Moreno, C. Aranda Beltrán, N. Alfaro, and P. Mendoza, “Prevalencia de la depresión en adultos mayores en una población urbana,” Revista Española de Geriatría y Gerontología, vol. 36, no. 3, pp. 140–144, 2001. View at: Google Scholar
  14. B. L. Plassman, K. M. Langa, G. G. Fisher et al., “Prevalence of cognitive impairment without dementia in the United States,” Annals of Internal Medicine, vol. 148, no. 6, pp. 427–434, 2008. View at: Google Scholar
  15. J. E. Graham, K. Rockwood, B. L. Beattie et al., “Prevalence and severity of cognitive impairment with and without dementia in an elderly population,” The Lancet, vol. 349, no. 9068, pp. 1793–1796, 1997. View at: Publisher Site | Google Scholar
  16. L. J. Romero, I. E. Ortiz, M. R. Finley, S. Wayne, and R. D. Lindeman, “Prevalence of depressive symptoms in new mexico hispanic and non-hispanic white elderly,” Ethnicity and Disease, vol. 15, no. 4, pp. 691–697, 2005. View at: Google Scholar
  17. T. Gabryelewicz, M. Styczynska, A. Pfeffer et al., “Prevalence of major and minor depression in elderly persons with mild cognitive impairment—MADRS factor analysis,” International Journal of Geriatric Psychiatry, vol. 19, no. 12, pp. 1168–1172, 2004. View at: Publisher Site | Google Scholar
  18. W. Katon and M. D. Sullivan, “Depression and chronic medical illness,” Journal of Clinical Psychiatry, vol. 51, no. 6, pp. 3–11, 1990. View at: Google Scholar
  19. S. H. Kennedy, Treating Depression Effectively Applying Clinical Guidelines, Taylor and Francis group, London, UK, 2004.
  20. L. A. Simons, J. Simons, J. Mccallum, and Y. Friedlander, “Lifestyle factors and risk of dementia: dubbo study of the elderly,” Medical Journal of Australia, vol. 184, no. 2, pp. 68–70, 2006. View at: Google Scholar
  21. A. Denihan, M. Kirby, I. Bruce, C. Cunningham, D. Coakley, and B. A. Lawlor, “Three-year prognosis of depression in the community-dwelling elderly,” British Journal of Psychiatry, vol. 176, pp. 453–457, 2000. View at: Publisher Site | Google Scholar
  22. M. A. Raji, C. A. Reyes-Ortiz, Y. F. Kuo, K. S. Markides, and K. J. Ottenbacher, “Depressive symptoms and cognitive change in older Mexican Americans,” Journal of Geriatric Psychiatry and Neurology, vol. 20, no. 3, pp. 145–152, 2007. View at: Publisher Site | Google Scholar
  23. C. A. Reyes-Ortiz, I. M. Berges, M. A. Raji, H. G. Koenig, Y. F. Kuo, and K. S. Markides, “Church attendance mediates the association between depressive symptoms and cognitive functioning among older Mexican Americans,” Journals of Gerontology, vol. 63, no. 5, pp. 480–486, 2008. View at: Google Scholar
  24. S. P. Casanova, “Deterioro cognitivo en la tercera edad,” Revista cubana de Medicina General Integral, vol. 20, no. 5-6, 2004. View at: Google Scholar
  25. R. Chen, Z. Hu, L. Wei, X. Qin, C. Mccracken, and J. R. Copeland, “Severity of depression and risk for subsequent dementia: cohort studies in China and the UK,” British Journal of Psychiatry, vol. 193, no. 5, pp. 373–377, 2008. View at: Publisher Site | Google Scholar
  26. R. S. Wilson, S. E. Arnold, T. L. Beck, J. L. Bienias, and D. A. Bennett, “Change in depressive symptoms during the prodromal phase of Alzheimer disease,” Archives of General Psychiatry, vol. 65, no. 4, pp. 439–446, 2008. View at: Publisher Site | Google Scholar
  27. B. H. Mulsant, B. G. Pollock, R. D. Nebes, C. C. Hoch, and C. H. F. Reynolds, “Depresión en la enfermedad de Alzheimer,” in Avances en la Enfermedad de Alzheimer y Estados Similares, L. L. Heston, Ed., pp. 161–175, J&C Ediciones Médicas, Barcelona, Spain, 1998. View at: Google Scholar
  28. C. P. Ferri, M. Prince, C. Brayne et al., “Global prevalence of dementia: a delphi consensus study,” The Lancet, vol. 366, no. 9503, pp. 2112–2117, 2005. View at: Publisher Site | Google Scholar
  29. S. Aguilar-Navarro and J. A. Ávila-Funes, “Depression: clinical features and consequences among the elderly,” Gaceta Medica de Mexico, vol. 143, no. 2, pp. 141–148, 2007. View at: Google Scholar
  30. S. Satyanarayana, M. W. Enns, B. J. Cox, and J. Sareen, “Prevalence and correlates of chronic depression in the canadian community health survey: mental health and well-being,” Canadian Journal of Psychiatry, vol. 54, no. 6, pp. 389–398, 2009. View at: Google Scholar
  31. F. E. Taragano, R. F. Allegri, and C. Lyketsos, “Mild behavioral impairment. A prodromal stage of dementia,” Dementia e Neuropsychologia, vol. 2, no. 4, pp. 256–260, 2008. View at: Google Scholar

Copyright © 2012 Genaro G. Ortiz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More related articles

 PDF Download Citation Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles