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de Almeida MA, Barbosa MT, Resende EDPF, Carvalho VA, Santos APB, Machado JCB, Lara VP, Gomes KB, Machado TH, Caramelli P. Association of Alcohol Consumption with Cognition and Functionality in Older Adults Aged 75+ Years: The Pietà Study. Can J Aging 2024:1-11. [PMID: 38467581 DOI: 10.1017/s0714980824000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
The relationship between alcohol consumption and cognition is still controversial. This is a cross-sectional population-based study conducted in Caeté (MG), Brazil, where 602 individuals aged 75+ years, 63.6% female, and with a mean education of 2.68 years, were submitted to thorough clinical assessments and categorized according to the number of alcoholic beverages consumed weekly. The prevalence rates of previous and current alcohol consumption were 34.6% and 12.3%, respectively. No association emerged between cognitive diagnoses and current/previous alcohol consumption categories. Considering current alcohol intake as a dichotomous variable, the absence of alcohol consumption was associated with dementia (OR = 2.34; 95%CI: 1.39-3.90) and worse functionality (p = 0.001). Previous consumption of cachaça (sugar cane liquor) increased the risk of dementia by 2.52 (95%CI: 1.25-5.04). The association between the consumption of cachaça and dementia diagnosis has not been described before.
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Affiliation(s)
- Mariana Alves de Almeida
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Elisa de Paula França Resende
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
- Hospital das Clínicas da Universidade Federal de Minas Gerais/EBSERH, Belo Horizonte, MG, Brazil
| | - Viviane Amaral Carvalho
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Paula Borges Santos
- Hospital das Clínicas da Universidade Federal de Minas Gerais/EBSERH, Belo Horizonte, MG, Brazil
| | | | - Vivian Proença Lara
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Karina Braga Gomes
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thais Helena Machado
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Vale TC, Cardoso FEC, da Silva DJ, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Caramelli P, Barbosa MT. Clinical and functional correlates of parkinsonism in a population-based sample of individuals aged 75 + : the Pietà study. BMC Neurol 2023; 23:276. [PMID: 37479964 PMCID: PMC10360246 DOI: 10.1186/s12883-023-03290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/16/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Parkinsonism is strongly associated with ageing, and many studies have suggested that parkinsonian signs may affect up to half of older adults and is associated with a wide range of adverse health outcomes. We compared clinical and functional characteristics of oldest-old community-dwelling individuals with parkinsonism (parkinsonian group [PG]) to individuals without parkinsonism (non-parkinsonian group [NPG]. METHODS The Pietà study is a population-based study conducted in Caeté, southeast Brazil, involving 607 individuals aged 75 + years submitted to an extensive clinical evaluation. A subset of 65 PG individuals (61.5% women, median age of 82 years) was compared to 542 NPG individuals (64.8% women, median age of 80 years). RESULTS PG individuals had significantly more functional impairment, clinical comorbidities (including number of falls, loss of bladder control and dysphagia) and major depression. Multivariate analysis revealed that older age, higher UPDRSm scores, lower category fluency test (animals/minute) and delayed recall memory scores were associated with PG. This group was also more cognitively impaired, with lower performance than NPG individuals in the Mini-Mental State Examination, category fluency test (animals/minute), clock drawing and in delayed recall (p < 0.001 for all tests). UPDRSm scores were the most contributing factor to cognition that independently explained variability in functionality of the entire sample. CONCLUSION Individuals aged 75 + years with parkinsonism were significantly more clinically and functionally impaired in this population-based sample. Cognitive dysfunction explained most of the loss of functionality in these patients. UPDRS-m scores contributed independently to explain variability in functionality in the whole sample.
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Affiliation(s)
- Thiago Cardoso Vale
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
- Movement Disorders Unit, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
| | - Francisco Eduardo Costa Cardoso
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danilo Jorge da Silva
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Elisa de Paula Franca Resende
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Antônio Lúcio Teixeira
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
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Gomes KB, Pereira RG, Braga AA, Guimarães HC, Resende EDPF, Teixeira AL, Barbosa MT, Junior WM, Carvalho MDG, Caramelli P. Machine Learning-Based Routine Laboratory Tests Predict One-Year Cognitive and Functional Decline in a Population Aged 75+ Years. Brain Sci 2023; 13:brainsci13040690. [PMID: 37190655 DOI: 10.3390/brainsci13040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cognitive and functional decline are common problems in older adults, especially in those 75+ years old. Currently, there is no specific plasma biomarker able to predict this decline in healthy old-age people. Machine learning (ML) is a subarea of artificial intelligence (AI), which can be used to predict outcomes Aim: This study aimed to evaluate routine laboratory variables able to predict cognitive and functional impairment, using ML algorithms, in a cohort aged 75+ years, in a one-year follow-up study. METHOD One hundred and thirty-two older adults aged 75+ years were selected through a community-health public program or from long-term-care institutions. Their functional and cognitive performances were evaluated at baseline and one year later using a functional activities questionnaire, Mini-Mental State Examination, and the Brief Cognitive Screening Battery. Routine laboratory tests were performed at baseline. ML algorithms-random forest, support vector machine (SVM), and XGBoost-were applied in order to describe the best model able to predict cognitive and functional decline using routine tests as features. RESULTS The random forest model showed better accuracy than other algorithms and included triglycerides, glucose, hematocrit, red cell distribution width (RDW), albumin, hemoglobin, globulin, high-density lipoprotein cholesterol (HDL-c), thyroid-stimulating hormone (TSH), creatinine, lymphocyte, erythrocyte, platelet/leucocyte (PLR), and neutrophil/leucocyte (NLR) ratios, and alanine transaminase (ALT), leukocyte, low-density lipoprotein cholesterol (LDL-c), cortisol, gamma-glutamyl transferase (GGT), and eosinophil as features to predict cognitive decline (accuracy = 0.79). For functional decline, the most important features were platelet, PLR and NLR, hemoglobin, globulin, cortisol, RDW, glucose, basophil, B12 vitamin, creatinine, GGT, ALT, aspartate transferase (AST), eosinophil, hematocrit, erythrocyte, triglycerides, HDL-c, and monocyte (accuracy = 0.92). CONCLUSIONS Routine laboratory variables could be applied to predict cognitive and functional decline in oldest-old populations using ML algorithms.
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Affiliation(s)
- Karina Braga Gomes
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Ramon Gonçalves Pereira
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Alexandre Alberto Braga
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | | | | | - Maira Tonidandel Barbosa
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Wagner Meira Junior
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | - Paulo Caramelli
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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Carmona KC, Resende EDPF, Guimarães HC, Machado TH, Amaral-Carvalho V, Santos ELD, Barbosa MT, Caramelli P. High performance older adults in a population-based sample with low education: Pietà study. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:112-118. [PMID: 36948197 PMCID: PMC10033194 DOI: 10.1055/s-0042-1759760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Healthy brain aging can be defined as aging without neurological or psychiatric disorders, sustaining functional independence. In addition to the absence of disease and preserved functionality, there are individuals who stand out for their superior performance to that considered normal for their age in cognitive tests. These individuals are called "high-performance older adults" (HPOA). OBJECTIVES To investigate the presence of HPOA in an oldest-old population with low education, and if present, to investigate associations with sociodemographic, clinical, and lifestyle variables. METHODS We evaluated 132 cognitively healthy individuals from the Pietà Study, a population-based investigation with 639 participants. We used the delayed recall from the Rey Auditory-Verbal Learning Test to verify the existence of HPOA and to classify participants based on their performance. Sociodemographic, clinical, and lifestyle variables associated with HPOA were investigated. RESULTS We identified 18 individuals fulfilling HPOA criteria (age: 77.4 ± 2.6 years old; 14 women; education: 4.6 ± 3.4 years). The other participants, 114 total (age: 79.8 ± 4.5 years old; 69 women; education: 3.0 ± 2.7 years) were classified as "standard performance older adults" (SPOA). In multivariate analysis, younger age (odds ratio [OR] = 0.672; 95% confidence interval [CI]: 0.462-0.979; p = 0.037) and lower scores on the Geriatric Depression Scale (OR = 0.831; 95%CI: 0.688-0.989; p = 0.038) were associated with HPOA. CONCLUSIONS The present study identifies for the first time HPOA with low educational level, thereby reinforcing the existence of biological substrates related to this condition. Furthermore, the data suggest an association between younger age and less depressive symptoms with HPOA.
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Affiliation(s)
- Karoline Carvalho Carmona
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Elisa de Paula França Resende
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Henrique Cerqueira Guimarães
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Thais Helena Machado
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
| | - Viviane Amaral-Carvalho
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
| | - Etelvina Lucas Dos Santos
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
| | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
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Ribeiro F, Teixeira-Santos AC, Caramelli P, Leist AK. Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants. Ageing Res Rev 2022; 81:101703. [PMID: 35931410 PMCID: PMC9582196 DOI: 10.1016/j.arr.2022.101703] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Studies have shown that the prevalence of dementia in Latin America and the Caribbean (LAC) may be higher than in high-income countries. Thus, we sought to systematically analyse the prevalence of dementia and explore possible drivers that lead to this disparity in LAC countries. METHOD We searched Pubmed, Web of Knowledge, Scopus, Lilacs, and SciELO for studies on dementia in LAC countries published in English, Spanish, and Portuguese. Random-effects model was applied. RESULTS Thirty-one studies from 17 LAC countries were included. Pooled prevalence of all-cause dementia was 10.66%. Further analyses with studies providing raw prevalence by sex, area, and educational level showed a higher prevalence for women (8.97%) than for men (7.26%). Also, dementia prevalence was higher for rural than urban residents (7.71% vs 8.68%, respectively). Participants without formal education presented more than double the prevalence of dementia (21.37%) compared to those with at least one year of formal education (9.88%). Studies with more recent data collection showed higher dementia prevalence. CONCLUSION Our findings suggest a high global dementia prevalence in LAC countries and an unequal burden of dementia for women, lower-educated, and rural residents. Secular increases in dementia prevalence call for greater public health efforts for preventative actions.
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Affiliation(s)
- Fabiana Ribeiro
- Department of Social Sciences, University of Luxembourg Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg,Correspondence to: University of Luxembourg, Department of Social Sciences, Esch-sur Alzette, Luxembourg.
| | - Ana C. Teixeira-Santos
- Department of Social Sciences, University of Luxembourg Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190 - sala 246, 30130-100 Belo Horizonte, Minas Gerais, Brazil
| | - Anja K. Leist
- Department of Social Sciences, University of Luxembourg Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
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Diabetes and impaired fasting glucose in a population-based sample of individuals aged 75 + years: associations with cognition, major depressive disorder, functionality and quality of life-the Pietà study. Neurol Sci 2021; 42:3663-3671. [PMID: 33439392 DOI: 10.1007/s10072-020-05008-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To investigate the rates of diabetes mellitus (DM) and impaired fasting glucose (IFG) in a population-based sample of individuals aged 75 + years old and their associations with cognitive performance, depression, functionality, and quality of life (QoL). STUDY DESIGN Overall, 350 people participated in the study. Assessments of cognition, mood, functionality and QoL were performed using the mini-mental state examination (MMSE), clock-drawing, category fluency tests, the Mini-International Neuropsychiatric Interview, Pfeffer's Functional Activities Questionnaire, and the WHO Quality of Life-Old (WHOQOL-OLD). RESULTS IFG (ADA criteria) was identified in 42.1% of the sample, while the DM rate was 24.1%. Lack of knowledge of the DM diagnosis and lack of treatment occurred in 27% and 39% of the sample, respectively. Rates of dementia and depression, MMSE, category fluency scores, and previous cardiovascular events did not differ between the glycaemic groups. Individuals with DM performed worse on the clock-drawing test, functionality, and WHOQOL-OLD than the other participants. Individuals with IFG presented similar QoL and functionality when compared with the group without DM. CONCLUSIONS IFG and DM were common in this population-based sample aged 75 + years old, as were inadequate diagnoses and treatments of DM. DM individuals presented poor performance in the executive function test, functionality, and QoL. Further studies are recommended to investigate the value of an IFG diagnosis among the most elderly population.
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da Costa Dias FL, Teixeira AL, Guimarães HC, Santos APB, Resende EDPF, Machado JCB, Barbosa MT, Caramelli P. The influence of age, sex and education on the phenomenology of depressive symptoms in a population-based sample aged 75+ years with major depression: the Pietà Study. Aging Ment Health 2021; 25:462-467. [PMID: 31791131 DOI: 10.1080/13607863.2019.1698517] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Late-life depression (LLD) is the most common mental disorder among the elderly, but its clinical features remain unclear, especially among older adults. We sought to investigate if age, sex and education could influence the severity or frequency of LLD symptoms. METHODS We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the Mini International Neuropsychiatric Interview to diagnose major depression according to DSM-IV criteria and the GDS-15 to measure depression severity. RESULTS Excluding 174 individuals diagnosed with dementia, 54 (11.6%) of the remaining 457 individuals were diagnosed with LLD; 77.8% of which were female. On average, these participants were aged 81.0 ± 4.8 years and had 2.7 ± 3.3 years of schooling. Symptom severity was not influenced by sociodemographic variables. Death/suicidal ideation was more frequent among men, while psychomotor disturbance was more present in women (p = 0.04 and p = 0.042). More educated individuals (≥ 4 years) also reported a higher frequency of psychomotor disturbance (p = 0.039). CONCLUSIONS Severity of depressive episode was not influenced by sociodemographic variables. Sex and educational level had a significant impact on symptom profiles.
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Affiliation(s)
- Filipi Leles da Costa Dias
- Post-Graduate Program in Adult Health, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.,Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.,Medical Sciences Faculty of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Antônio Lúcio Teixeira
- Post-Graduate Program in Adult Health, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.,Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Henrique Cerqueira Guimarães
- Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Ana Paula Borges Santos
- Post-Graduate Program in Adult Health, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.,Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Elisa de Paula França Resende
- Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil
| | | | - Maira Tonidandel Barbosa
- Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Paulo Caramelli
- Post-Graduate Program in Adult Health, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.,Cognitive and Behavioral Neurology Research Group, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil
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Vale TC, Barbosa MT, França Resende EDP, Silva LC, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Caramelli P, Cardoso F. No Correlation Between White Matter Changes and Mild Parkinsonian Signs in Individuals Aged Older Than 75 Years. Mov Disord 2020; 35:1489-1491. [PMID: 32491221 DOI: 10.1002/mds.28120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/06/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Thiago Cardoso Vale
- Internal Medicine Department, The Federal University of Juiz de Fora Medical School, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil.,Faculty of Medical Sciences of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Elisa de Paula França Resende
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil
| | - Luciana Costa Silva
- Radiology Service of the Hermes Pardini Institute, Belo Horizonte (MG), Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Internal Medicine Department, The Federal University of Minas Gerais, Medical School, Brazil
| | | | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil
| | | | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil
| | - Francisco Cardoso
- Movement Disorders Unit, Internal Medicine Department, The Federal University of Minas Gerais, Medical School, Brazil
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White Matter Microstructure in Illiterate and Low-Literate Elderly Brazilians: Preliminary Findings. Cogn Behav Neurol 2019; 31:193-200. [PMID: 30562228 DOI: 10.1097/wnn.0000000000000173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate differences in white matter microstructure between illiterate and low-literate elderly Brazilians. BACKGROUND High literacy levels are believed to partially counteract the negative effects of neurodegenerative diseases. Investigating the impact of low literacy versus illiteracy on brain structure can contribute knowledge about cognitive reserve in elderly populations with low educational attainment. Fractional anisotropy is a measure derived from diffusion tensor imaging sequences that positively correlate with the integrity of the brain's white matter microstructure. METHODS Older adults who participated in an epidemiological study to investigate brain aging in Brazil and had magnetic resonance scans with the diffusion tensor imaging acquisition were selected (n=31). Participants were divided into two groups: (a) low-literate (n=21), with 3.4 (1.4) years of education, 79.8 (3.8) years of age, 17 cognitively healthy and four with cognitive impairment-no dementia; and (b) illiterate (n=10) with no formal schooling, 80.7 (4.1) years of age, six cognitively healthy and four with cognitive impairment-no dementia. We contrasted the two groups' white matter microstructure measures using whole-brain and region of interest approaches. RESULTS The low-literate participants had significantly higher fractional anisotropy values in the right superior longitudinal fasciculus than did the illiterate ones. CONCLUSIONS Although our results are preliminary because of the sample size, they suggest that low literacy, versus illiteracy, is associated with higher fractional anisotropy values, which are indirect measurements of white matter microstructure. This finding provides insight into a possible mechanism by which literacy, even at low levels, may contribute to cognitive reserve.
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Prevalence of late-life depression and its correlates in a community-dwelling low-educated population aged 75+ years: The Pietà study. J Affect Disord 2019; 242:173-179. [PMID: 30189354 DOI: 10.1016/j.jad.2018.08.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/03/2018] [Accepted: 08/07/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The number of individuals with advanced age is growing worldwide, especially in developing countries. Depression is the most common mental disorder in the elderly. The aim of this study was to evaluate the prevalence rates and the correlates of late-life depression (LLD) and clinically significant depressive symptoms (CSDS) in a population aged 75+ years. METHODS We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil, and used the MINI to diagnose LLD according to DSM-IV criteria and the GDS-15 to identify CSDS. Quality of life was assessed by the WHOQOL-OLD scale. RESULTS Overall, 639 individuals (64% female, with a mean age of 81.1 ± 5.2 and 2.6 ± 2.8 years of schooling) were evaluated; 70 (11.1%) were diagnosed with LLD and 146 (25.6%) with CSDS. Depressed subjects (both with LLD and CSDS) had poorer measures of quality of life. Logistic regression analyses showed that LLD was independently associated to a history of falls/fracture, a diagnosis of cognitive impairment-no dementia, the number of regular drugs used, lack of reading habit and, inversely, to systolic blood pressure. LIMITATIONS The use of MINI which has not been validated in the elderly. No information was available on the number of previous depressive episodes or on the age of first episode. CONCLUSION Both dimensional and categorical diagnoses of depression were prevalent among community-dwelling oldest-old individuals. Different clinical and personal variables were associated with depression, which negatively influenced the quality of life of the affected individuals.
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Vale TC, Barbosa MT, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Cardoso F, Caramelli P. Parkinsonism in a population-based study of individuals aged 75+ years: The Pietà study. Parkinsonism Relat Disord 2018; 56:76-81. [PMID: 29934195 DOI: 10.1016/j.parkreldis.2018.06.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Parkinsonism is one of the most prevalent neurological syndromes in the elderly. There are only a few epidemiological studies focusing on parkinsonism in oldest-old individuals, particularly in Latin America. This study aims to investigate the prevalence and characteristics of parkinsonism in subjects aged 75 + years living in the community. METHODS The Pietà study is a population-based investigation on brain aging conducted in Caeté, southeast Brazil. A sample composed of 610 community-dwelling individuals aged 75 + years (48.7% of the total population within this age range) underwent clinical, neurological, cognitive and functional assessments. RESULTS The sample comprised mostly women (61.5%), with mean age of 83.3 years and mean schooling of 2.5 years. Parkinsonism was identified in 65 subjects (crude prevalence = 10.7%). Parkinson's disease, Parkinsonism + dementia syndrome, drug-induced parkinsonism, vascular parkinsonism and Lewy-body dementia were identified in, respectively, 19 (29.2%), 19 (29.2%), 8 (12.3%), 4 (6.1%) and 1 (1.5%) subjects. In 14 individuals (21.5%), the etiology of parkinsonism could not be determined. The most important vascular risk factor was hypertension (64.6%). Cognitive evaluation disclosed dementia in 37 (56.9%) subjects. Mean Pfeffer's functional activities questionnaire score was 12.2 points and 22 (33.8%) subjects were impaired in basic activities of daily living. CONCLUSION Parkinsonism was common in this oldest-old population, being associated with dementia and vascular risk factors, particularly hypertension. Different confounders, such as concomitant dementia and exposure to anti-dopaminergic drugs, were present in this population, challenging the definition of causes of parkinsonism.
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Affiliation(s)
- Thiago Cardoso Vale
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Juiz de Fora (MG), Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Elisa de Paula França Resende
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Mauro César Quintão Cunningham
- Movement Disorders Unit, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | | | - Antônio Lucio Teixeira
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Francisco Cardoso
- Movement Disorders Unit, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil.
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Mourão AM, Vicente LCC, Abreu MNS, Chaves TS, Sant'Anna RV, Braga MAF, Meira FCAD, de Souza LC, Miranda ASD, Rachid MA, Teixeira AL. Association between executive and food functions in the acute phase after stroke. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:158-162. [PMID: 29809234 DOI: 10.1590/0004-282x20180005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 11/28/2017] [Indexed: 11/22/2022]
Abstract
Purpose To investigate potential associations among executive, physical and food functions in the acute phase after stroke. Methods This is a cross-sectional study that evaluated 63 patients admitted to the stroke unit of a public hospital. The exclusion criteria were other neurological and/or psychiatric diagnoses. The tools for evaluation were: Mini-Mental State Examination and Frontal Assessment Battery for cognitive functions; Alberta Stroke Program Early CT Score for quantification of brain injury; National Institutes of Health Stroke Scale for neurological impairment; Modified Rankin Scale for functionality, and the Functional Oral Intake Scale for food function. Results The sample comprised 34 men (54%) and 29 women with a mean age of 63.6 years. The Frontal Assessment Battery was significantly associated with the other scales. In multivariate analysis, executive function was independently associated with the Functional Oral Intake Scale. Conclusion Most patients exhibited executive dysfunction that significantly compromised oral intake.
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Affiliation(s)
- Aline Mansueto Mourão
- Setor da Unidade de Acidente Vascular Cerebral, Hospital Risoleta Tolentino Neves, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Mery Natali Silva Abreu
- Departamento de Enfermagem Aplicada, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Tatiana Simões Chaves
- Setor da Unidade de Acidente Vascular Cerebral, Hospital Risoleta Tolentino Neves, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Romeu Vale Sant'Anna
- Departamento de Neurologia, Unidade de Acidente Vascular Encefálico, Hospital Risoleta Tolentino Neves, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marcela Aline Fernandes Braga
- Setor da Unidade de Acidente Vascular Cerebral, Hospital Risoleta Tolentino Neves, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Fidel Castro Alves de Meira
- Departamento de Neurologia, Unidade de Acidente Vascular Encefálico, Hospital Risoleta Tolentino Neves, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Leonardo Cruz de Souza
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Aline Silva de Miranda
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Milene Alvarenga Rachid
- Departamento de Patologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Antônio Lucio Teixeira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Resende EDPF, Tovar-Moll FF, Ferreira FM, Bramati I, de Souza LC, Carmona KC, Guimarães HC, Carvalho VA, Barbosa MT, Caramelli P. Integrity of white matter structure is related to episodic memory performance in the low-educated elderly. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 75:778-784. [PMID: 29236820 DOI: 10.1590/0004-282x20170158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
The low-educated elderly are a vulnerable population in whom studying the role of white matter integrity on memory may provide insights for understanding how memory declines with aging and disease. METHODS Thirty-one participants (22 women), 23 cognitively healthy and eight with cognitive impairment-no dementia, aged 80.4 ± 3.8 years, with 2.2 ± 1.9 years of education, underwent an MRI scan with diffusion tensor imaging (DTI) acquisition. We verified if there were correlations between the performance on the Brief Cognitive Screening Battery (BCSB) and the Rey Auditory Verbal Learning Test (RAVLT) with DTI parameters. RESULTS The BCSB delayed recall task correlated with frontotemporoparietal connection bundles, with the hippocampal part of the cingulum bilaterally and with the right superior longitudinal fasciculus. The RAVLT learning and delayed recall scores also correlated with the hippocampal part of the cingulum bilaterally. CONCLUSIONS Although preliminary, our study suggests that the integrity of white matter frontotemporoparietal fasciculi seems to play a role in episodic memory performance in the low-educated elderly. This finding opens opportunities to study potential targets for memory decline prevention in vulnerable populations.
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Affiliation(s)
- Elisa de Paula França Resende
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | | | | | - Ivanei Bramati
- IDOR - Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro RJ, Brasil
| | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Karoline Carvalho Carmona
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Henrique Cerqueira Guimarães
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Viviane Amaral Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
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Fraga VG, Guimarães HC, Teixeira AL, Barbosa MT, Carvalho MG, Caramelli P, Gomes KB. Polymorphisms in cytokine genes influence cognitive and functional performance in a population aged 75 years and above. Int J Geriatr Psychiatry 2017; 32:1401-1410. [PMID: 27891653 DOI: 10.1002/gps.4627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the frequency of the cytokine single nucleotide polymorphisms (SNPs) tumor necrosis factor (TNF)-α -308G > A, tumor growth factor (TGF)-β1 codon +10C > T, TGF-β1 codon +25G > C, interleukin (IL)-10 -1082A > G, IL-10 -819C > T, IL-10 -592C > A, IL-6 -174G > C, and IFN-γ +874T > A in a sample of healthy and cognitively impaired elderlies and to verify the probable association between these SNPs and cognitive and functional performance of subjects aged 75 years and above. METHODS 259 Brazilian subjects were included, comprising 81 with cognitive impairment no dementia (CIND) and 54 demented seniors (together made up the cognitively impaired group, CI) and 124 age-matched and gender-matched cognitively healthy controls (CHS). The genotyping was performed by multiplex polymerase chain reaction. The cognitive performance was evaluated by Mini-Mental State Examination Brief Cognitive Screening Battery. The functional performance was accessed by Functional Activities Questionnaire. RESULTS The CClower genotype of TGF-β1 codon +25G > C was frequent in both patient groups. The TThigher genotype of INF-γ +874T > A was less frequent in the dementia group. IL-10 haplotypes of lower expression were more frequent among CIND and demented patients. In CI, individuals with genetic variants that produce higher expression of TGF-β1, INF-γ, and IL-10 showed better normalized cognitive performance. Additionally, the Alower allele of INF-γ +874T > A was related to worse functional performance in CI, while the Alower allele of TNF-α -308G > A was associated with better cognitive and functional scores in the CIND group. CONCLUSIONS Our findings suggest a potential role for certain cytokine SNPs in the development of CIND and dementia, which may influence the functional and cognitive performance of these patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Vanessa G Fraga
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Henrique C Guimarães
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antônio L Teixeira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maira T Barbosa
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria G Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Karina B Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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15
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Dias FLDC, Teixeira AL, Guimarães HC, Barbosa MT, Resende EDPF, Beato RG, Carmona KC, Caramelli P. Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:276-279. [DOI: 10.1590/2237-6089-2017-0046] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/19/2017] [Indexed: 11/21/2022]
Abstract
Abstract Introduction Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. Objectives To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. Methods We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Results Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). Conclusion GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.
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Cognitive performance of community-dwelling oldest-old individuals with major depression: the Pietà study. Int Psychogeriatr 2017; 29:1507-1513. [PMID: 28566108 DOI: 10.1017/s1041610217000850] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determine whether a brief cognitive battery (BCB) could identify cognitive and functional deficits in oldest-old individuals with LLD and a low level of education. METHODS We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the MINI and GDS-15 to diagnose major depression and evaluate its severity, respectively. The cognitive evaluation comprised the Mini-Mental State Examination (MMSE), BCB, clock-drawing test, category fluency test (animals) and Pfeffer's Functional Activities Questionnaire (FAQ). RESULTS Fifty-four (11.6%) of the included individuals were diagnosed with LLD; on average, these participants were aged 81.0 ± 4.8 years and had 3.9 ± 3.4 years of schooling, and 77.8% of the subjects with LLD were female. Depressed individuals scored lower than subjects without dementia/depression on the MMSE overall (p < 0.001) and on several of the MMSE subscales, namely, time (p < 0.001) and spatial orientation (p = 0.021), attention/calculation (p = 0.019), and language (p = 0.004). Individuals with LLD performed worse on the incidental and (p = 0.011) immediate memory (p = 0.046) and learning tasks (p = 0.039) of the BCB. Individuals with LLD also performed worse on the category fluency test (p = 0.006), clock-drawing test (p = 0.011) and FAQ (p < 0.001). Depression severity was negatively correlated with incidental memory (ρ = -0.412; p = 0.003) and positively correlated with FAQ score (ρ = 0.308; p = 0.035). In the multiple regression analysis, only temporal orientation and FAQ score remained independently associated with LLD. CONCLUSION Individuals with depression and a low level of education presented several cognitive and functional deficits. Depression severity was negatively correlated with incidental memory and functionality. Our findings serve as a description of the presence of cognitive dysfunction in individuals with LLD and suggest that these deficits may be identified based on the results of a BCB.
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Cross Talk Between Brain Innate Immunity and Serotonin Signaling Underlies Depressive-Like Behavior Induced by Alzheimer's Amyloid-β Oligomers in Mice. J Neurosci 2017; 36:12106-12116. [PMID: 27903721 DOI: 10.1523/jneurosci.1269-16.2016] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/20/2016] [Accepted: 10/06/2016] [Indexed: 12/12/2022] Open
Abstract
Considerable clinical and epidemiological evidence links Alzheimer's disease (AD) and depression. However, the molecular mechanisms underlying this connection are largely unknown. We reported recently that soluble Aβ oligomers (AβOs), toxins that accumulate in AD brains and are thought to instigate synapse damage and memory loss, induce depressive-like behavior in mice. Here, we report that the mechanism underlying this action involves AβO-induced microglial activation, aberrant TNF-α signaling, and decreased brain serotonin levels. Inactivation or ablation of microglia blocked the increase in brain TNF-α and abolished depressive-like behavior induced by AβOs. Significantly, we identified serotonin as a negative regulator of microglial activation. Finally, AβOs failed to induce depressive-like behavior in Toll-like receptor 4-deficient mice and in mice harboring a nonfunctional TLR4 variant in myeloid cells. Results establish that AβOs trigger depressive-like behavior via a double impact on brain serotonin levels and microglial activation, unveiling a cross talk between brain innate immunity and serotonergic signaling as a key player in mood alterations in AD. SIGNIFICANCE STATEMENT Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the main cause of dementia in the world. Brain accumulation of amyloid-β oligomers (AβOs) is a major feature in the pathogenesis of AD. Although clinical and epidemiological data suggest a strong connection between AD and depression, the underlying mechanisms linking these two disorders remain largely unknown. Here, we report that aberrant activation of the brain innate immunity and decreased serotonergic tonus in the brain are key players in AβO-induced depressive-like behavior in mice. Our findings may open up new possibilities for the development of effective therapeutics for AD and depression aimed at modulating microglial function.
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Chaves ACS, Fraga VG, Guimarães HC, Teixeira AL, Barbosa MT, Carvalho MDG, Mota APL, Silva IDFO, Caramelli P, Gomes KB, Alpoim PN. Estrogen receptor-alpha gene XbaI A > G polymorphism influences short-term cognitive decline in healthy oldest-old individuals. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:172-175. [PMID: 28355325 DOI: 10.1590/0004-282x20170018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 11/21/2016] [Indexed: 11/22/2022]
Abstract
Methods The individuals were categorized in two groups according to the presence or absence of cognitive decline. Cognitive data were related to genetic information. Results The XbaI -351 AA genotype was more common among cognitive decliners, while -351G allele carriers showed cognitive stability or improvement. Conclusion These results suggest that ESR-1 could be associated with one-year cognitive decline in healthy oldest-old individuals, since the estrogen pathway may be involved with neuroprotection, even in healthy brain aging.
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Affiliation(s)
- Amanda Caroline Silva Chaves
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
| | - Vanessa Gomes Fraga
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
| | - Henrique Cerqueira Guimarães
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG,Brasil
| | - Antonio Lucio Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG,Brasil
| | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG,Brasil
| | - Maria das Graças Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
| | - Ana Paula Lucas Mota
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
| | - Ieda de Fátima Oliveira Silva
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG,Brasil
| | - Karina Braga Gomes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
| | - Patrícia Nessralla Alpoim
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte MG, Brasil
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Lima CMB, Alves HVD, Mograbi DC, Pereira FF, Fernandez JL, Charchat-Fichman H. Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil. Dement Neuropsychol 2017; 11:54-61. [PMID: 29213494 PMCID: PMC5619215 DOI: 10.1590/1980-57642016dn11-010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To describe the performance on basic cognitive tasks, instrumental activities
of daily living, and depressive symptoms of a community-based sample of
elderly adults in Rio de Janeiro (Brazil) who participated in multiple
physical, social, and cognitive activities at government-run community
centers. Methods A total of 264 educated older adults (> 60 years of age of both genders)
were evaluated by the Brief Cognitive Screening Battery (BCSB), Lawton's and
Pfeffer's activities of daily living indexes, and the Geriatric Depressive
Scale (GDS). Results The mean age of the sample was 75.7 years. The participants had a mean of 9.3
years of formal education. With the exception of the Clock Drawing Test
(CDT), mean scores on the cognitive tests were consistent with the values in
the literature. Only 6.4% of the sample had some kind of dependence for
activities of daily living. The results of the Geriatric Depression Scale
(GDS-15) indicated mild symptoms of depression in 16.8% of the sample Conclusion This study provided important demographic, cognitive, and functional
characteristics of a specific community-based sample of elderly adults in
Rio de Janeiro, Brazil.
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Affiliation(s)
| | - Heloisa Veiga Dias Alves
- Pontificia Universidade Catolica do Rio de Janeiro - Psicologia, Rio de Janeiro RJ - Brazil.,Bolsista do CNPq
| | - Daniel Correa Mograbi
- Pontificia Universidade Catolica do Rio de Janeiro - Psicologia, Rio de Janeiro RJ - Brazil
| | - Flávia Furtado Pereira
- Secretaria Especial de Envelhecimento e Qualidade de Vida - SESQV, Rio de Janeiro RJ - Brazil
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Resende EDPF, Costa-Silva L, Carmona KC, Machado TH, Machado JCB, Guimarães HC, Barbosa MT, Teixeira AL, de Souza LC, Caramelli P. Ischemic cerebrovascular burden evaluated by magnetic resonance imaging in an elderly Brazilian community: The Pietà study. eNeurologicalSci 2016; 5:30-34. [PMID: 29430555 PMCID: PMC5803083 DOI: 10.1016/j.ensci.2016.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/08/2016] [Accepted: 11/28/2016] [Indexed: 01/18/2023] Open
Abstract
In developing countries, cardiovascular risk factors are poorly controlled, leading to high prevalence of cerebrovascular diseases. The aim of the study was to evaluate the burden of white matter lesions in magnetic resonance through the Fazekas scale in a population aged 75 + years living in the community, and to investigate possible associations between vascular lesions, cardiovascular risk factors and cognitive status. Subjects were selected from a community-based study on brain aging conducted in Caeté (Minas Gerais state), Brazil. Overall, 177 participants (112 cognitively healthy, 36 with cognitive impairment-no dementia and 29 with dementia), being 108 women, aged 79.3 ± 3.8 years, with 3.1 ± 2.9 years of educational level, underwent a 3 Tesla magnetic resonance scanner with fluid attenuated image recovery acquisition. Severity of white matter lesions was assessed through the Fazekas scale. Severe white matter lesions were present in 31.1% of the whole sample and in 25.0% of the cognitively healthy individuals. A significant association was found between severe white matter lesions and cognitive impairment (OR = 2.20, 95% CI 1.17–6.53; p = 0.021), as well as with hypertension (OR = 1.92, 95% CI 1.03–7.39; p = 0.043). In conclusion, a high prevalence of severe white matter lesions was observed in this elderly Brazilian population sample, and white matter lesions were associated with hypertension and cognitive status. Importantly, the prevalence of white matter lesions was also high in cognitively healthy subjects. The ischemic cerebrovascular burden assessed by MRI in an elderly Brazilian community is very high. MRI white matter lesions were associated with cognitive impairment and hypertension. Even in cognitively healthy individuals the prevalence of ischemic cerebrovascular lesions was high.
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Affiliation(s)
- Elisa de Paula França Resende
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Luciana Costa-Silva
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Karoline Carvalho Carmona
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Thais Helena Machado
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - João Carlos Barbosa Machado
- Faculdade de Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, MG 30130-110, Brazil
| | - Henrique Cerqueira Guimarães
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Antônio Lúcio Teixeira
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Leonardo Cruz de Souza
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Paulo Caramelli
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
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Fraga VG, Guimarães HC, Lara VP, Teixeira AL, Barbosa MT, Carvalho MG, Caramelli P, Gomes KB. TGF-β1 Codon 10 T>C Polymorphism Influences Short-Term Functional and Cognitive Decline in Healthy Oldest-Old Individuals: The Pietà Study. J Alzheimers Dis 2015; 48:1077-81. [DOI: 10.3233/jad-150397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Vanessa G. Fraga
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Henrique C. Guimarães
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Vivian P. Lara
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Antônio L. Teixeira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Maira T. Barbosa
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Maria G. Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Karina B. Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
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22
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Fraga VG, Guimarães HC, Teixeira AL, Barbosa MT, Mateo ECC, Carvalho MG, Caramelli P, Gomes KB. Genetic predisposition to higher production of interleukin-6 through -174 G > C polymorphism predicts global cognitive decline in oldest-old with cognitive impairment no dementia. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:899-902. [PMID: 26517210 DOI: 10.1590/0004-282x20150137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 07/29/2015] [Indexed: 11/22/2022]
Abstract
Interleukin 6 (IL-6) is a pro-inflammatory cytokine upregulated in neurodegenerative contexts. The polymorphism IL-6 -174 G > C influences release levels of this cytokine. We aimed to evaluate the influence of IL-6 -174 G > C on global cognitive score of a group with cognitive impairment no dementia in one year of follow-up.Methods The subjects were categorized in two groups: short-term decline in global cognitive score and those with short-term stability or improvement. IL-6 174 G > C information were compared among these groups.Results We observed that individuals with cognitive impairment no dementia with GGlowergenotype were more frequent among global cognitive score non-decliners while carriers of at least one Chigherallele were more frequent in the group with global cognitive score decliners (p = 0.012; RR = 3.095 IC95%= 1.087-8.812).Conclusion These results suggest that the higher expression of IL-6 gene may be an independent risk factor for cognitive decline among individuals with cognitive impairment no dementia.
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Affiliation(s)
- Vanessa G Fraga
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Henrique C Guimarães
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Antônio L Teixeira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira T Barbosa
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Maria G Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Karina B Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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23
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Lara VP, Caramelli P, Teixeira AL, Barbosa MT, Carmona KC, Guimarães HC, Carvalho MG, Fernandes AP, Gomes KB. Cortisol, HDL-c, VLDL-c, and APOE Polymorphisms as Laboratorial Parameters Associated to Cognitive Impairment No Dementia (CIND) and Dementia. J Clin Lab Anal 2015; 30:374-80. [PMID: 26302887 DOI: 10.1002/jcla.21865] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/27/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Population aging is a global phenomenon whose main consequence is the increase of chronic degenerative diseases, including dementia. The aim of this case-control study was to evaluate the laboratorial parameters lipid profile, cortisol, and apolipoprotein E (APOE) gene genotype, comparing cognitively healthy controls and subjects with cognitive impairment no dementia (CIND) and dementia in a group of elderly people. METHODS Three hundred and nine individuals enrolled in the Pietà Study (Brazil) were divided into three groups: control (n = 158), CIND (n = 92), and dementia (n = 59). Participants were interviewed, went through examination, and had blood samples taken. RESULTS Age and APOE showed significant differences among the groups, while sex and lipid profile did not. According to multivariate regression logistic analyses, higher cortisol levels, lower high-density lipoprotein (HDL-c) and very low-density lipoprotein (VLDL-c), presence of ε4 allele of APOE, and aging were associated with CIND and dementia. CONCLUSION These laboratorial parameters are risk factors associated to CIND and dementia in the elderly people and should be investigated in order to develop strategies to prevent or delay the onset of dementia in the oldest-old populations.
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Affiliation(s)
- Vivian P Lara
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antônio L Teixeira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maira T Barbosa
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karoline C Carmona
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Henrique C Guimarães
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria G Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana P Fernandes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karina B Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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24
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Dubois B, Feldman HH, Jacova C, Hampel H, Molinuevo JL, Blennow K, DeKosky ST, Gauthier S, Selkoe D, Bateman R, Cappa S, Crutch S, Engelborghs S, Frisoni GB, Fox NC, Galasko D, Habert MO, Jicha GA, Nordberg A, Pasquier F, Rabinovici G, Robert P, Rowe C, Salloway S, Sarazin M, Epelbaum S, de Souza LC, Vellas B, Visser PJ, Schneider L, Stern Y, Scheltens P, Cummings JL. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurol 2014; 13:614-29. [PMID: 24849862 DOI: 10.1016/s1474-4422(14)70090-0] [Citation(s) in RCA: 2206] [Impact Index Per Article: 220.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD.
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Affiliation(s)
- Bruno Dubois
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France.
| | - Howard H Feldman
- Division of Neurology, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
| | - Claudia Jacova
- UBC Division of Neurology, S152 UBC Hospital, BC, Canada
| | - Harald Hampel
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, IDIBAPS Hospital Clinici Universitari, Barcelona, Spain; BarcelonaBeta Brain Research Centre, Fundació Pasqual Maragall, Barcelona, Spain
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Steven T DeKosky
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Serge Gauthier
- McGill Center for Studies in Aging, Douglas Hospital, Montreal, Quebec, QC, Canada
| | - Dennis Selkoe
- Harvard Medical School Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Randall Bateman
- Washington University School of Medicine, St Louis, Missouri, MO, USA
| | - Stefano Cappa
- Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, Cognitive Neurorehabilitation, Milan, Italy
| | - Sebastian Crutch
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK; Dementia Research Centre, National Hospital, London, UK
| | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA), Middelheim and Hoge Beuken, Antwerp, Belgium; Reference Centre for Biological Markers of Dementia, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Giovanni B Frisoni
- Hopitaux Universitaires et Université de Genève, Geneva, Switzerland; IRCCS Fatebenefratelli, Brescia, Italy; HUG Belle-Idée, bâtiment les Voirons, Chêne-Bourg, France
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK
| | - Douglas Galasko
- Department of Neurosciences, -University of California, San Diego, CA, USA
| | - Marie-Odile Habert
- INSERM UMR, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Nucléaire, Paris, France
| | - Gregory A Jicha
- University of Kentucky Alzheimer's Disease Center, Lexington, KY, USA
| | - Agneta Nordberg
- Karolinska Institutet, Karolinska University Hospital Huddinge, Alzheimer Neurobiology Center, Stockholm, Sweden
| | - Florence Pasquier
- Université Lille Nord de France, Lille, France; CHRU, Clinique Neurologique, Hôpital Roger Salengro, Lille, France
| | - Gil Rabinovici
- UCSF Memory & Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Philippe Robert
- EA CoBTeK and Memory Center, CHU University of Nice, UNSA, Hôpital de Cimiez 4 av Victoria, Nice, France
| | - Christopher Rowe
- FRACP, Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Melbourne, VIC, Australia
| | - Stephen Salloway
- Neurology and the Memory and Aging Program, Butler Hospital, Department of Neurology and Psychiatry, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Paris Cedex, France; Université Paris 5, Paris, France
| | - Stéphane Epelbaum
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Leonardo C de Souza
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France; Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bruno Vellas
- Gerontopole, Pavillon Junod, University Toulouse 3, Toulouse, France
| | - Pieter J Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Neurology and Alzheimer Center, Amsterdam, Netherlands
| | - Lon Schneider
- Department of Psychiatry, Neurology, and Gerontology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division of the Taub Institute, Presbyterian Hospital, New York, NY, USA
| | - Philip Scheltens
- Alzheimer Centrum Vrije Universiteit Medical Center, VU University, Amsterdam, Netherlands
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Guimarães HC, Cascardo JL, Beato RG, Barbosa MT, Machado TH, de Almeida MA, Ritter SRF, Borges KBG, Teixeira AL, Caramelli P. Features associated with cognitive impairment and dementia in a community-based sample of illiterate elderly aged 75+ years: the Pietà study. Dement Neuropsychol 2014; 8:126-131. [PMID: 29213893 PMCID: PMC5619119 DOI: 10.1590/s1980-57642014dn82000007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A higher level of educational attainment constitutes a protective factor against cognitive decline in the elderly. Nevertheless, the elements underpinning this association are yet not fully understood. Objective The primary aim of this study was to compare cognitively impaired illiterate elderly subjects with cognitively preserved counterparts, according to demographics, comorbidities, lifetime habits and APOE genotype. Methods This is a cross-sectional analysis of the illiterate subset of participants (n=174) from the Pietà study, a community-based survey of successful brain aging conducted in Caeté (MG), Brazil. Subjects were categorized into three diagnostic groups: cognitively normal (CN), cognitive impairment no-dementia (CIND) and dementia. The groups were then compared according to selected variables. Results Subjects with dementia were older and had an increased prevalence of reported stroke or transient ischemic attack. The three groups did not differ in relation to demographics, prevalence of comorbidities, socioeconomic level, previous occupation profile and APOE-ε4 allele frequency. Qualitatively evaluated lifetime habits, such as alcohol consumption, smoking and physical activity engagement were also similar across groups. Conclusion No associations were found between cognitive impairment/dementia and the variables evaluated in this community-based sample of illiterate elderly.
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Affiliation(s)
- Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Jorge Luiz Cascardo
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Rogério Gomes Beato
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Thais Helena Machado
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Mariana Alves de Almeida
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Simone Rios Fonseca Ritter
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Karina Braga Gomes Borges
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Antonio Lucio Teixeira
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group , Faculty of Medicine, Federal University of Minas Gerais, MG, Brazil
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Rosanti S, da Silva GE, Santos FH. Longitudinal effects of physical activity on self-efficacy and cognitive processing of active and sedentary elderly women. Dement Neuropsychol 2014; 8:187-193. [PMID: 29213902 PMCID: PMC5619128 DOI: 10.1590/s1980-57642014dn82000016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Previous studies support that regular physical activity in aging contributes as a
protective factor against cognitive decline and improves mood states. However,
there is a lack of longitudinal studies in this area.
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Affiliation(s)
- Sofia Rosanti
- UNESP, Universidade Estadual Paulista, Campus Bauru, SP, Brazil
| | | | - Flávia Heloísa Santos
- UNESP, Universidade Estadual Paulista, Campus Bauru, SP, Brazil.,Universidade do Minho, Braga, Portugal
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Foss MP, de Carvalho VA, Machado TH, Dos Reis GC, Tumas V, Caramelli P, Nitrini R, Porto CS. Mattis dementia rating scale (DRS) normative data for the brazilian middle-age and elderly populations. Dement Neuropsychol 2013; 7:374-379. [PMID: 29213861 PMCID: PMC5619498 DOI: 10.1590/s1980-57642013dn74000004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To expand norms for the Mattis Dementia Rating Scale (DRS) for the Brazilian
middle-age and elderly populations. METHODS The DRS was administered to 502 individuals without cognitive deficits, 312
women and 190 men, aged 50 years or over and with educational level ranging
from 0 to 13 years or more. The sample was composed of subjects who
participated in other studies, from Caeté (Minas Gerais state),
Ribeirão Preto (São Paulo state) and São Paulo
(São Paulo state). Participants were divided into four schooling
groups (illiterate, 1 to 4 years, 5 to 12 years and 13 years or more). The
subjects were divided into four groups according to age (50 to 60, 61 to 70,
71 to 80, and 80 years or over). RESULTS Normative data for DRS scores are expressed as percentile values. The group
with lowest schooling and subjects older than 80 years had the worst
scores. CONCLUSION As expected, age and education were strongly correlated with DRS scores.
Illiterates and older old individuals performed worse than the other groups.
These data might help to improve the accuracy of the diagnosis of cognitive
impairment and dementia in Brazilian middle-age and elderly populations.
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Affiliation(s)
- Maria Paula Foss
- Psicóloga do Setor de Distúrbios do Movimento e Neurologia Comportamental do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP, Doutora em Ciências Médicas (Neurociências) da FMRP-USP, Ribeirão Preto SP, Brazil
| | - Viviane Amaral de Carvalho
- Psicóloga, Neurologia Cognitiva e do Comportamento da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil
| | - Thais Helena Machado
- Fonoaudióloga, Doutora em Linguística pela UFMG, Pesquisadora no Ambulatório de Neurologia Cognitiva e do Comportamento do Hospital das Clínicas da UFMG, Belo Horizonte MG, Brazil
| | - Geraldo Cássio Dos Reis
- Estatístico do Departamento de Neurociências e Ciências do Comportamento da FMRP-USP, Ribeirão Preto SP, Brazil
| | - Vitor Tumas
- Médico, Faculdade de Medicina de Ribeirão Preto - FMRP-USP, Ribeirão Preto SP, Brazil
| | - Paulo Caramelli
- Professor do Departamento de Clínica Médica da Faculdade de Medicina da UFMG; Coordenador do Ambulatório de Neurologia Cognitiva e do Comportamento do Hospital das Clínicas da UFMG, Belo Horizonte MG, Brazil
| | - Ricardo Nitrini
- Diretor da Disciplina de Neurologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil
| | - Cláudia Sellitto Porto
- Psicóloga do Grupo de Neurologia Cognitiva do Comportamento da Clínica Neurológica do Hospital das Clínicas da FMUSP, Doutora em Ciências pela FMUSP, São Paulo SP, Brazil
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Guimarães HC, Caramelli P, Fialho PPA, França EDP, Afonso MPD, Teixeira AL. Serum levels of soluble TNF-α receptors but not BDNF are associated with apathy symptoms in mild Alzheimer's disease and amnestic mild cognitive impairment. Dement Neuropsychol 2013; 7:298-303. [PMID: 29213854 PMCID: PMC5619202 DOI: 10.1590/s1980-57642013dn70300011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/18/2013] [Indexed: 11/24/2022] Open
Abstract
Apathy is intimately associated with dementia. Unfortunately, its pathophysiology remains poorly understood. The motivational impairment that characterizes this disorder might share the same inflammatory mechanisms, as suggested by the sickness behavior theory. OBJECTIVE The primary aim of this study was to investigate the association between apathy symptoms and serum levels of tumor necrosis factor alpha (TNF-α) and its soluble receptors. Brain-derived neurotrophic factor (BDNF) levels were also analyzed since these have been associated with depression, a condition which shares abulic features with apathy. METHODS The sample consisted of 27 subjects with mild Alzheimer's disease or amnestic mild cognitive impairment, who were submitted to specific apathy evaluation using the Apathy Scale (AS) and provided blood samples for biomarker analysis. Participants were categorized into two groups according to median AS scores (17 points). RESULTS Subjects with higher apathy symptoms (n=13) displayed higher levels of TNF-α soluble receptors (type 1: p=0.03; type 2: p=0.04). No other difference was found between groups. CONCLUSION These findings point to the involvement of inflammatory mediators in the genesis of apathy symptoms, as suggested by the sickness behavior theory.
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Affiliation(s)
- Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group,
Department of Internal Medicine, Faculty of Medicine of the Federal University of
Minas Gerais, Belo Horizonte (MG), Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group,
Department of Internal Medicine, Faculty of Medicine of the Federal University of
Minas Gerais, Belo Horizonte (MG), Brazil
| | - Patricia Paes Araujo Fialho
- Behavioral and Cognitive Neurology Research Group,
Department of Internal Medicine, Faculty of Medicine of the Federal University of
Minas Gerais, Belo Horizonte (MG), Brazil
| | - Elisa de Paula França
- Behavioral and Cognitive Neurology Research Group,
Department of Internal Medicine, Faculty of Medicine of the Federal University of
Minas Gerais, Belo Horizonte (MG), Brazil
| | - Marcelo Pelizzaro Dias Afonso
- Behavioral and Cognitive Neurology Research Group,
Department of Internal Medicine, Faculty of Medicine of the Federal University of
Minas Gerais, Belo Horizonte (MG), Brazil
| | - Antonio Lucio Teixeira
- Behavioral and Cognitive Neurology Research Group,
Department of Internal Medicine, Faculty of Medicine of the Federal University of
Minas Gerais, Belo Horizonte (MG), Brazil
- Translational Psychoneuroimmunology Group, Department of
Internal Medicine, Faculty of Medicine of the Federal University of Minas Gerais,
Belo Horizonte (MG), Brazil
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Lara VP, Caramelli P, Teixeira AL, Barbosa MT, Carmona KC, Carvalho MG, Fernandes AP, Gomes KB. High cortisol levels are associated with cognitive impairment no-dementia (CIND) and dementia. Clin Chim Acta 2013; 423:18-22. [PMID: 23611893 DOI: 10.1016/j.cca.2013.04.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/05/2013] [Accepted: 04/08/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND This study aimed to compare serum cortisol concentrations in cognitively healthy elderly and in subjects with cognitive impairment no dementia (CIND) and dementia, besides to evaluate these concentrations according to apolipoprotein E genotype (APOE). METHODS Three-hundred and nine elderly enrolled in the Pietà Study (Brazil) were divided in 3 groups: control (n=158), CIND (n=92) and dementia (n=59) and had concentrations of morning serum cortisol measured. Hormone concentrations were measured by chemiluminescence and APOE genotypes were determined by PCR followed by restriction fragment length polymorphism (RFLP). RESULTS Medians of cortisol concentrations (μg/dl) for the groups were 12.14 (interquartile range - IQR 6.34) for control, 13.65 (IQR 5.88) for CIND and 14.47 (IQR 7.35) for dementia. Significant differences were observed for control vs. CIND (P=0.003), control vs. dementia (P=0.001), but not for CIND vs. dementia (P=0.269). No association was observed between cortisol concentrations and APOE genotype among the groups (P=0.348). CONCLUSIONS The elevation in cortisol concentrations is associated with dementia, independently of APOE genotypes. Further studies are required to understand if elevation of cortisol is an initial event and how hippocampal damage and the loss of hypothalamus-pituitary-adrenal (HPA) axis inhibition may affect its concentrations.
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Affiliation(s)
- Vivian P Lara
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
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