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Behavioural disturbances in patients with diagnosis of neurocognitive disorder in Bogotá (Colombia)
Alteraciones del comportamiento de pacientes con diagnóstico de trastorno neurocognoscitivo en Bogotá (Colombia)
Claudia Chimbí-Ariasa,b,1, José Manuel Santacruz-Escuderob,c,d,
,1
, Diego Andrés Chavarro-Carvajala,e, Rafael Samper-Ternentf, Hernando Santamaría-Garcíab,d,g
a Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
b Centro de Memoria y cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
c Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
d Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
e Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
f Departamento de Medicina Interna, División de Geriatría, Sealy Center on Aging, University of Texas Medical Branch, Houston, Texas, United States
g Departamento de Fisiología, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In 2015&#44; major neurocognitive disorder &#40;MaND&#41; affected 47 million people in the world&#44; 60&#37; of whom lived in low- and medium-income countries&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is estimated that&#44; in 2030&#44; more than 75 million people will have some sign of MaND&#46; This figure is projected to have tripled by 2050&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In general&#44; neurocognitive disorder &#40;ND&#41; is divided into mild neurocognitive disorder &#40;MiND&#41; or major neurocognitive disorder &#40;MaND&#41;&#44; and has replaced the term &#34;dementia&#34; used in previous decades due to the new criteria and diagnostic categories proposed by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders&#44; Fifth Edition &#40;DSM-5&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In addition to cognitive and functional signs characteristic of NDs&#44; there are behavioural disturbances &#40;BD&#41;&#44; which also affect patient functioning and may appear at any point in the course of the disease with a highly variable grouping pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> BD are defined as a heterogeneous group of symptoms that impact various domains of an individual&#39;s psychic functioning&#44; such as affect&#44; thinking and behaviour&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> BD are common in patients with a diagnosis of ND&#44; whether it is MiND or MaND&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#8211;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">BD negatively impact the patient and his or her carers to a far greater extent than cognitive decline symptoms themselves&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> BD are associated with risk behaviours<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#44; a higher percentage of institutionalisation&#44; more hospitalisations on mental health units<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and greater use and higher costs of health services&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite the importance of BD in the course and follow-up of NDs&#44; the different studies that have examined their prevalence have reported disparate&#44; inconclusive data in the various samples analysed&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#8211;7</span></a> Some studies have indicated that BD may be found in any type of ND and in any stage of the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a> The studies have shown major differences in reporting the prevalence of BD in NDs&#46; Some have found that 59&#37; of patients with MiND may present BD<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#59; others have indicated that 50-80&#37; of patients with ND have BD in the course of their disease&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Although these reports provide important information on BD in NDs&#44; the prevalence of BD in the different types of ND &#8212; including MiND and MaND &#8212; has yet to be determined&#46; Regardless of prevalence&#44; the impact of BD on quality of life and care for people with ND renders BD a very important subject in the study of the population with this condition&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The objective of this study was to determine BD frequency and type in a group of patients with a diagnosis of ND &#40;making a distinction between MiND and MaND&#41; assessed at the Intellectus Memory and Cognition Centre at Hospital Universitario San Ignacio &#91;San Ignacio University Hospital&#93; in 2015&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Design</span><p id="par0030" class="elsevierStylePara elsevierViewall">This was a retrospective&#44; descriptive&#44; observational study&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Population</span><p id="par0035" class="elsevierStylePara elsevierViewall">A review of 859 medical histories yielded 507 patients with a diagnosis of ND &#40;either MaND or MiND&#41; evaluated at the Intellectus Memory and Cognition Centre at Hospital Universitario San Ignacio in Bogot&#225;&#44; Colombia&#44; between 1 January and 31 December 2015&#46; An interdisciplinary assessment was performed as described below&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Evaluation of the group of cases at the memory clinic</span><p id="par0040" class="elsevierStylePara elsevierViewall">Geriatric medicine&#44; psychiatry&#44; neurology and neuropsychology conducted a standardised interdisciplinary assessment&#46; Geriatric medicine performed a full evaluation of the patient&#39;s baseline condition that included multimorbidity&#44; functioning and social situation&#46; Psychiatry conducted a semi-structured interview to detect BD according to the classification of the International Psychogeriatric Association &#40;IPA&#41;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and the DSM-5&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The interview also ruled out BD that could be attributed to an independent mental illness&#46; The neurology department performed an in-depth examination of the medical history and risk factors for cerebrovascular disease&#44; checked for other nervous system diseases and conducted a neurological examination&#46; The neuropsychology department was responsible for doing a full battery of neuropsychology tests&#44; which included examination of various cognitive domains such as memory&#44; executive function&#44; attention&#44; visuoconstructional function&#44; language and social cognition&#46; Following the assessments mentioned&#44; an interdisciplinary decision-making board was convened to arrive at a diagnosis and consensus recommendations&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Study conduct</span><p id="par0045" class="elsevierStylePara elsevierViewall">All medical histories for patients assessed at the Intellectus Memory and Cognition Centre at Hospital Universitario San Ignacio during the period mentioned were taken&#46; Patients with a diagnosis of ND according to the criteria of the DSM-5&#44; which divides NDs into major and mild forms depending on the functional decline caused by the cognitive deficit&#44; were enrolled&#46; The manual includes as part of the diagnosis the presence of BD&#44; which depends on whether the cognitive disorder is accompanied by clinically significant BD&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Patients who had any concomitant chronic mental illness with a diagnosis of neurocognitive disorder and patients with disorders related to the use of psychoactive substances were excluded&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Instruments</span><p id="par0050" class="elsevierStylePara elsevierViewall">Functioning in basic activities of daily living was measured using the Barthel Index&#44; which was initially developed to evaluate the capacity for self-care of people with neuromuscular abnormalities and is now used to screen for dependency in basic activities of daily living&#46; This scale is easy to apply and useful for longitudinal patient follow-up&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The Mini-Mental State Examination &#40;MMSE&#41; was used as a general measure of cognition&#46; This test has shown high sensitivity in tracking cognitive functioning in general and is widely supported for initial follow-up of abnormalities in domains such as memory&#44; language&#44; executive function and visuoconstructional capacity in people with NDs&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The Yesavage scale was used to screen for depression&#46; This scale has high internal and external reliability and validity in detecting depression in older adults&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> As the patients in question had a diagnosis of ND&#44; the Cornell Scale for Depression in Dementia was also used&#46; This 19-item instrument administered to both patients and carers has high sensitivity&#44; internal validity and inter-observer reliability&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The standardised battery of neuropsychological tests consisted of specific tests for each cognitive domain&#46; Language was evaluated using tests of phonological and semantic fluency&#44; naming and complex verbal comprehension&#46; Attention was assessed using the Symbol Digit Modalities Test&#46; The visuoconstructional domain was evaluated with the Rey Complex Figure Test&#46; Executive function was assessed using interpretation of sayings&#44; graphomotor series and the Institute of Cognitive Neurology &#40;INECO&#41; screening test&#46; Finally&#44; memory was evaluated using the Grober test&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">An initial univariate analysis examined outliers and sample distribution&#46; This enabled the variables to be adjusted and categorised&#46; Categorical variables were expressed in terms of frequencies and percentages&#59; means&#8239;&#177;&#8239;standard deviation were used to present continuous variables&#46; The data were subsequently analysed with bivariate models to determine the association between dependent and independent variables&#59;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> tests were used for categorical variables and Student&#39;s t-test was used for continuous variables&#46; The level of statistical significance was set at p&#8239;&#60;&#8239;0&#46;05&#46; Data analysis was performed using the program STATA &#40;version 12&#41; for iOS&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">Initially&#44; 859 medical histories for patients assessed by a memory clinic in 2015 were reviewed&#46; Applying the inclusion and exclusion criteria yielded a total of 507 medical histories with MiND and MaND &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The mean age of the people with MiND at diagnosis was 71&#46;04 years&#44; and that of those with MaND was 75&#46;32 years &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#46; There were more women than men with a diagnosis of ND &#40;318 women and 189 men&#41;&#46; This difference persisted when the sample was stratified by severity &#40;MiND versus MaND&#41;&#59; however&#44; it was not statistically significant &#40;p&#8239;&#61;&#8239;0&#46;249&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Among aetiologies of ND&#44; Alzheimer&#39;s disease was the most common&#44; followed by behavioural variant frontotemporal lobar degeneration &#40;BvFTD&#41;&#44; and finally disorders of multiple aetiologies and those of vascular aetiology &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">The analyses showed a higher frequency of BD in patients with MaND than in patients with MiND &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; When the group with MaND was analysed&#44; the highest frequency of BD corresponded to BvFTD&#44; followed by Alzheimer&#39;s disease&#44; vascular aetiologies and multiple aetiologies &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Apathy&#44; irritability&#44; aggression and emotional lability were the most common types of BD&#44; but differences by severity were seen&#46; Subjects with MiND presented more irritability&#44; apathy and aggression&#59; those with MaND presented more apathy&#44; irritability and emotional lability&#46; When BD was analysed by aetiology in subjects with MaND&#44; the following were seen &#40;in order of frequency&#41;&#58; in Alzheimer&#39;s disease&#44; irritability&#44; apathy&#44; emotional lability&#44; paranoia and aggression&#59; in BvFTD&#44; apathy&#44; irritability and aggression&#46; In subjects with MaND of vascular aetiology&#44; apathy&#44; irritability and emotional lability were most common&#59; and in ND due to multiple aetiologies&#44; apathy&#44; irritability and aggression were most common &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">This study examined BD in patients diagnosed with ND &#40;MiND or MaND&#41; in 2015 at a centre specialising in cognition in Bogot&#225;&#46; It found that the most common types of BD were apathy&#44; irritability&#44; aggression and emotional lability and that the least common types were hallucinations&#44; psychosis and sadness&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A high frequency of BD was found in the different aetiologies of ND&#46; This might have been explained by the fact that the interdisciplinary group conducted a systematic evaluation of BD&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">At our centre&#44; the highest frequency of BD was seen in subjects with BvFTD&#44; followed by those with Alzheimer&#39;s disease&#44; those with disorders of vascular aetiology and&#44; finally&#44; those with disorders due to multiple aetiologies&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In addition&#44; a rate of BD as high as 13&#46;92&#37; was seen in MiND&#44; indicating that BD was significant regardless of ND severity or aetiology&#46; When this study was compared to prior studies&#44; similar prevalences were found&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Previous studies on BD prevalence in patients diagnosed with MaND have reported depression&#47;dysphoria&#44; apathy&#44; delirium and anxiety&#47;aggression as the most common types of BD in the population&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Other studies in institutionalised patients diagnosed with MaND have shown a prevalence of BD of up to 92&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> with the most commonly seen types of BD being apathy&#44; irritability&#44; aberrant motor behaviour and agitation&#47;aggression&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> In our study&#44; in general&#44; the prevalence of BD was similar to that in prior publications&#44; but differed in that emotional lability was more prevalent in our population&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">When BD prevalences were compared&#44; studies that had only determined the presence or absence of dementia reported apathy&#44; irritability&#44; persecution and depression&#59; in others&#44; aberrant motor behaviour and aggression were also prevalent&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Moreover&#44; articles that examined BD by aetiology of ND have found a prevalence in Alzheimer&#39;s disease of 66&#8211;100&#37;&#59; the most commonly reported types of BD were apathy&#44; irritability and depression&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Others found a prevalence of BD of up to 39&#37;&#44; particularly in the form of aggression&#44; alteration of activity and psychosis&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> In this study&#44; in general&#44; the frequency of BD in MaND due to Alzheimer&#39;s disease was similar and only differed in that emotional lability was also common in the population studied&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">A study with 60 patients&#44; divided into those with multi-infarct dementia and those with subcortical ischaemic vascular disease&#44; reported a BD prevalence of 95&#37;&#59; types of BD included apathy&#44; abnormal eating behaviour and irritability&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> These results did not differ from our own&#44; which found BD to be present in more than 50&#37; of cases of ND of vascular aetiology in the form of apathy&#44; irritability or emotional lability&#44; although abnormal eating behaviour did not appear&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">BD in patients with a diagnosis of MaND contributes to early institutionalisation&#44; a decline in quality of life for both patients and carers&#44; carer overload&#44; increased disability<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and the costs involved in care for patients with dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">BD appear to play a role in the diagnosis and follow-up of patients with ND&#46; A group of prior studies indicated that BD in cognitively normal patients may predict cognitive decline&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28</span></a> Thus&#44; criteria for mild behavioural impairment have been proposed as a way to identify early incipient changes associated with neurodegenerative diseases of any aetiology&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">BD in NDs seems to lie at the core of a group of neuropsychiatric disturbances that include changes in cognitive&#44; affective and social interaction processes&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Furthermore&#44; some types of BD would seem to arise from the decline in the processes described&#46; For example&#44; disinhibited behaviour could be tied to changes in inhibitory control and other executive functions&#44; considering emotional regulation processes&#46; Similarly&#44; affective&#44; cognitive and social changes could be described in symptoms such as apathy and irritability&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Interactions between these cognitive&#44; affective and social abnormalities&#44; added to BD&#44; are associated with changes in the course of MaNDs&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Therefore&#44; considering that BD are associated with the adverse outcomes reported&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;26</span></a> investigation of these abnormalities in NDs opens up an opportunity to investigate how better behaviour management may impact treatment response&#44; follow-up and disease prognosis&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Further studies should evaluate the presence of BD using other standardised instruments&#46; Demographic and cognitive factors associated with changes in BD prevalence in different types of ND must also be examined&#46; Finally&#44; subsequent studies must analyse the extent to which better management of BD could alter the progressive course of the disease&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Limitations of this study include its cross-sectional methodology&#44; which impeded causal inference&#44; and the fact that it was conducted at a leading national specialised centre for the diagnosis and treatment of patients with suspected ND&#44; as it precluded evaluation of BD prevalence in the general population&#46; Another limitation is the way in which BD were evaluated&#44; i&#46;e&#46; by clinical consensus rather than a scale&#46; However&#44; some publications have stated that one source of information on the presence of BD is direct observation by a medical team&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;30</span></a></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions</span><p id="par0170" class="elsevierStylePara elsevierViewall">This study sought to determine the frequency of BD in a group of patients with a diagnosis of ND in the target population&#46; Following evaluation of reports of interdisciplinary assessments by a memory clinic&#44; it can be affirmed that BD is a common manifestation in patients with ND in general&#44; and is prevalent in MiND and in the different aetiologies of MaND according to other studies&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Although BD essentially appears in MaND&#44; it does also present in MiND&#46; This is significant as BD has been proposed as a way to identify early changes associated with neurodegenerative diseases&#46; Identification of BD in our population has valuable implications for developing and implementing specific treatment strategies to decrease its impact on the patient&#44; carer and health system&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The main aim of this study is to determine the prevalence of behavioural disturbances &#40;BD&#41; in a group of patients with diagnosis of neurocognitive disorders assessed by a memory clinic in a referral assessment centre in Bogot&#225;&#44; Colombia&#44; in 2015&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">This is an observational&#44; retrospective descriptive study of 507 patients with a diagnosis of neurocognitive disorder &#40;according to DSM-5 criteria&#41; evaluated in a referral centre in Bogot&#225;&#44; Colombia&#44; in 2015&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Among the group of patients assessed&#44; analyses reveal mean age for minor neurocognitive disorders of 71&#46;04 years&#44; and 75&#46;32 years for major neurocognitive disorder &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;001&#41;&#46; A total of 62&#46;72&#37; of the sample were female&#46; The most prevalent aetiology of the neurocognitive disorders was Alzheimer&#8217;s disease&#44; followed by behavioural variant frontotemporal dementia and neurocognitive disorders due multiple aetiologies&#46; BD occur more frequently in neurocognitive disorder due to behavioural variant frontotemporal dementia &#40;100&#37;&#41;&#44; Alzheimer&#8217;s disease &#40;77&#46;29&#37;&#41; and vascular disease &#40;76&#46;19&#37;&#41;&#46; The most prevalent BD in the group assessed were apathy &#40;50&#46;75&#37;&#41;&#44; irritability &#40;48&#46;45&#37;&#41;&#44; aggression &#40;16&#46;6&#37;&#41;&#44; and emotional lability &#40;14&#46;76&#37;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">BD occur more frequently in patients with diagnosis of major neurocognitive disorder&#46; BD are more prevalent in behavioural variant frontotemporal dementia than any other group&#46; Apathy&#44; irritability&#44; emotional lability and aggression are the BD that occur with greater prevalence in our sample&#46; We discuss the importance of BD in the clinical progression of neurocognitive disorders&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio es determinar la frecuencia de alteraciones conductuales &#40;AC&#41; en un grupo de pacientes con diagn&#243;stico de trastorno neurocognoscitivo &#40;TN&#41; valorado por cl&#237;nica de memoria en un centro de evaluaci&#243;n en Bogot&#225;&#44; Colombia&#44; durante el a&#241;o 2015&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional descriptivo y de corte retrospectivo de 507 pacientes con diagn&#243;stico de trastorno neurocognoscitivo &#40;seg&#250;n criterios del DSM-5&#41;&#44; valorados en un centro de referencia en Bogot&#225; en 2015&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">La media de edad de los sujetos con trastorno neurocognoscitivo leve en el momento del diagn&#243;stico era 71&#44;04 a&#241;os y la de aquellos con trastorno neurocognoscitivo mayor&#44; 75&#44;32 a&#241;os &#40;p&#8239;&#60;&#8239;0&#44;001&#41;&#46; El 62&#44;72&#37; de la muestra son mujeres&#46; La etiolog&#237;a m&#225;s frecuente del trastorno neurocognoscitivo fue la enfermedad de Alzheimer probable&#44; seguida por la degeneraci&#243;n lobar frontotemporal&#44; variante conductual&#44; y el trastorno neurocognoscitivo debido a m&#250;ltiples etiolog&#237;as&#46; Las AC se presentan con mayor frecuencia en TN debido a degeneraci&#243;n frontotemporal variante conductual &#40;100&#37;&#41;&#44; enfermedad de Alzheimer &#40;77&#44;29&#37;&#41; y vascular &#40;76&#44;19&#37;&#41;&#46; Las AC m&#225;s prevalentes en el grupo evaluado fueron la apat&#237;a &#40;50&#44;75&#37;&#41;&#44; la irritabilidad &#40;48&#44;45&#37;&#41;&#44; la agresividad &#40;16&#44;6&#37;&#41; y la labilidad emocional &#40;14&#44;76&#37;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Las AC suelen aparecer en pacientes con diagn&#243;stico de trastorno neurocognoscitivo mayor&#46; Seg&#250;n la etiolog&#237;a del trastorno neurocognoscitivo mayor&#44; las AC son m&#225;s prevalentes en la degeneraci&#243;n frontotemporal variante conductual&#46; Apat&#237;a&#44; irritabilidad&#44; labilidad emocional y agresividad son las AC m&#225;s comunes en toda la muestra&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:3 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Chimb&#237;-Arias C&#44; Santacruz-Escudero JM&#44; Chavarro-Carvajal DA&#44; Samper-Ternent R&#44; Santamar&#237;a-Garc&#237;a H&#46; Alteraciones del comportamiento de pacientes con diagn&#243;stico de trastorno neurocognoscitivo en Bogot&#225; &#40;Colombia&#41;&#46; Rev Colomb Psiquiat&#46; 2020&#59;49&#58;136&#8211;141&#46;</p>"
      ]
      1 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">The authors Claudia Chimb&#237;-Arias and Jos&#233; Manuel Santacruz-Escudero have contributed equally to this work&#46;</p>"
        "identificador" => "fn0005"
      ]
      2 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study presented at the XII Congreso Colombiano de Gerontolog&#237;a y Geriatr&#237;a &#91;12th Colombian Gerontology and Geriatrics Conference&#93;&#44; Bogot&#225;&#44; Colombia&#44; 21 May 2016&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1003
            "Ancho" => 1496
            "Tamanyo" => 60981
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Aetiology of neurocognitive disorder&#46; BvFTD&#58; behavioural variant frontotemporal degeneration&#59; MiND&#58; mild neurocognitive disorder&#59; LvFTD&#58; language variant frontotemporal degeneration&#46;</p>"
        ]
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        "etiqueta" => "Table 1"
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        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">BD&#58; behavioural disturbance&#59; MaND&#58; major neurocognitive disorder&#59; MiND&#58; mild neurocognitive disorder&#58; MMSE&#58; Mini-mental State Examination&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Values express n &#40;&#37;&#41; or mean&#8239;&#177;&#8239;standard deviation&#46;</p>"
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                  \t\t\t\t">155 &#40;36&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;249&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n
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                  \t\t\t\t">&#91;0&#44;1&#8211;4&#93;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">&#91;0&#44;1&#8211;4&#93;<span class="elsevierStyleItalic">BD</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">121 &#40;28&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">MMSE</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Yesavage</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9&#8239;&#177;&#8239;8&#44;45&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cornell</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;69&#8239;&#177;&#8239;9&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;55&#8239;&#177;&#8239;9&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2386911.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Description of the population &#40;n&#8239;&#61;&#8239;507&#41;&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">BD&#58; behavioural disturbances&#59; BvFTD&#58; behavioural variant frontotemporal degeneration&#59; MaND&#58; major neurocognitive disorder&#59; MiND&#58; mild neurocognitive disorder&#59; LvFTD&#58; language variant frontotemporal degeneration&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Unless otherwise indicated&#44; values express n &#40;&#37;&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Aetiology of ND&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No BD &#40;n&#8239;&#61;&#8239;182&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BD &#40;n&#8239;&#61;&#8239;325&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence of BD by aetiology&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">MiND</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;35&#44;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;5&#44;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#91;0&#44;1&#8211;4&#93;<span class="elsevierStyleItalic">MaND</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alzheimer&#39;s disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;25&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">160 &#40;49&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BvFTD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;13&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LvFTD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;4&#44;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;1&#44;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;2&#44;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;4&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multiple aetiologies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;10&#44;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;17&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lewy body dementia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#44;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;1&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;5&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Unspecified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#44;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2386909.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Prevalence of behavioural disturbance by aetiology of neurocognitive disorder&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">BD&#58; behavioural disturbances&#59; BvFTD&#58; behavioural variant frontotemporal degeneration&#59; MaND&#58; major neurocognitive disorder&#59; MiND&#58; mild neurocognitive disorder&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Values express n &#40;&#37;&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">MiND &#40;n&#8239;&#61;&#8239;106&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">MaND &#40;n&#8239;&#61;&#8239;401&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Alzheimer&#39;s disease &#40;n&#8239;&#61;&#8239;207&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BvFTD &#40;n&#8239;&#61;&#8239;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Multiple aetiologies &#40;n&#8239;&#61;&#8239;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vascular &#40;n&#8239;&#61;&#8239;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Irritability&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;11&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">145 &#40;36&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;41&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;51&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
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ISSN: 25303120
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