1. Investigación

Community pharmacists and general practitioners have daily contact with patients with Alzheimer’s disease (AD) but the number of positive cases constantly increases every day. Thus, the aim of this research is to describe the level of AD knowledge among community pharmacists and general practitioners in Spain, in order to see where the biggest gaps in the knowledge are. Therefore, a cross-sectional study has been carried out, using the Alzheimer’s disease knowledge survey (ADKS), among members of the Spanish Society of Primary Care Physicians and the Spanish Society of Family and Community Pharmacy to report the differences in AD knowledge in both professional collectives. The ADKS has been responded by 578 community pharmacists and 104 general practitioners and consists of a battery of 30 questions, whose possible answers are true or false. It assesses the AD knowledge in seven areas (impact on the disease, risk factors, course of the disease, diagnosis, care, treatment and symptoms). Results indicate that Spanish pharmacists and general practitioners have a high personal knowledge of AD, nevertheless, it is not associated with greater awareness. Both scored above 80% at the categories: diagnostic, treatment and symptoms. However, lower knowledge level (60% of correct answers) was found in those related to risk factors, such as the ignorance about hypercholesterolemia or hypertension as risk factors for the disease. Community pharmacists are already acting to control cardiovascular risk factors, but a wider knowledge of the relationship of these factors to AD is needed to act against these silent risk factors. Thus, pharmacists may also be involved in the management of AD that includes recognizing early symptoms for early detection of cognitive impairment. Hence, knowledge about risk factors is very important in developing this expanding role.

Objetivo: desarrollar un programa de cribado de deterioro cognitivo (DC) en mayores de 50 años. Con la finalidad de que el servicio profesional farmacéutico sea más costo-efectivo utilizaremos un árbol de decisión para la selección del paciente. Además, se pretende valorar la importancia de la dieta mediterránea y el consumo de antioxidantes en la prevención del deterioro cognitivo y estudiar marcadores genéticos de riesgo de enfermedad de Alzheimer. Método: para ello se diseña un estudio observacional transversal mediante entrevista personal estructurada en pacientes que muestren indicios de pérdida de memoria. El estudio de captación se realizará en farmacias desde septiembre 2018 hasta septiembre de 2019. Los pacientes con puntuación en los test con posible DC se remitirán a atención primaria, previa presentación del proyecto a coordinación médica. Se perseguirá el resultado del diagnóstico obtenido en atención primaria y/o especializada. Se utilizarán como test de cribado el Memory Impairment Screening (MIS), Short Portable Mental State Questionnaire (SPMSQ) de Pfeiffer, el Fluidez Verbal Semántica (FVS) y siempre que sea posible el Test del Informador (TIN). Se define deterioro cognitivo por MIS ≤4; SPMSQ ≥ 3 (para analfabetos ≥ 4); FVS ≤10 palabras y el valor del TIN >57. A su vez se recogen una muestra de saliva del paciente, para estudio genético, y datos de nutrición para valorar la importancia de la dieta mediterránea y de los alimentos antioxidantes en la prevención del DC. / The aim of this study is to develop a screening program for cognitive impairment (CI) in people older than 50 year old. In order to make the pharmaceutical professional service more cost-effective, we will use a decision tree for patient’s selection. In addition, to assess the importance of the Mediterranean diet and the consumption of antioxidants in the prevention of cognitive deterioration and study genetic markers of risk of Alzheimer’s disease. A cross-sectional observational study is designed by a structured personal interview in patients showing signs of cognitive impairment. The recruitment study will be conducted in pharmacies from September 2018 to September 2019. Patients with a score on the tests with possible CI will be referred to primary care previous presentation of the project to the medical coordination. The result of the diagnosis obtained in primary and / or specialized care will be pursued. The Memory Impairment Test (MIS), the Short Portable Mental State Questionnaire (SPMSQ) of Pfeiffer, the Semantic Verbal Fluency (FVS) and, whenever possible, the Informer Test (TIN) will be used as screening tests. Cognitive impairment is defined by MIS ≤4; SPMSQ ≥ 3 (for illiterates ≥ 4); FVS ≤10 words. The value of TIN> 57. In turn, a sample of the patient’s saliva, for genetic study, and nutrition data are collected through a survey to assess the importance of the Mediterranean diet and antioxidant foods in CI prevention.