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Moreira SV, Justi FRDR, Gomes CFDA, Moreira M. Music Therapy Enhances Episodic Memory in Alzheimer's and Mixed Dementia: A Double-Blind Randomized Controlled Trial. Healthcare (Basel) 2023; 11:2912. [PMID: 37998404 PMCID: PMC10671073 DOI: 10.3390/healthcare11222912] [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: 09/22/2023] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Objective: This study aimed to assess whether a music therapy (MT) intervention could improve memory decline in older adults with and without cognitive impairment. A dual-retrieval model of episodic memory was employed to estimate memory processes. Methods: Forty-three older adults with a mean age of 76.49 years (n = 25 with Alzheimer's disease (AD) and mixed dementia, and n = 18 healthy older adults) were randomly selected for the experimental and control groups. The study design was a double-blind randomized controlled clinical trial and a certified music therapist delivered the MT. The primary outcomes were measures of working memory, episodic memory, and autobiographical memory. Results: In the primary outcome measures, MT effects were restricted to episodic memory measures like the Figure Memory Test of the BCSB and the Speech and Sing Memory Test. In both tests, the experimental group improved from pre-test to post-test in delayed recall, but in the Speech and Sing Memory Test, the improvement was restricted to the AD and mixed dementia group. MT had no effects on the secondary outcome measures. Conclusions: These findings suggest that a structured MT intervention can be promising for rehabilitating episodic memory in older adults with dementia.
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Affiliation(s)
- Shirlene Vianna Moreira
- Lato Sensu Postgraduate Program in Psychology, Faculty of Medical and Health Sciences of Juiz de Fora (SUPREMA), Juiz de Fora 36033-003, MG, Brazil;
| | - Francis Ricardo dos Reis Justi
- Department of Psychology, Institute of Human Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (F.R.d.R.J.); (C.F.d.A.G.)
| | - Carlos Falcão de Azevedo Gomes
- Department of Psychology, Institute of Human Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (F.R.d.R.J.); (C.F.d.A.G.)
| | - Marcos Moreira
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil
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Monteiro AM, Borges MK. Association of frailty with cognitive impairment and functional disability in older adults with affective disorders: a brief research report. Front Psychiatry 2023; 14:1181997. [PMID: 37496684 PMCID: PMC10366589 DOI: 10.3389/fpsyt.2023.1181997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction The Clinical-Functional Vulnerability Index (IVCF-20) is a validated multidimensional instrument that has been used in Brazil to evaluate functional disability in frail older adults. The main aim of this study was to assess frailty using this novel screening tool. In addition, to investigate whether frailty was associated with cognitive impairment and functional disability in older adults with affective disorders. Methods Participants included were over 60 years old, with affective disorders (depressive or anxiety disorders), from two specialized outpatient clinics. The sample was comprised of 46 patients (30% of a total from 153). The following instruments were applied: Clock Drawing Test (CDT), Mini Mental State Examination (MMSE); Verbal Fluency Test (VFT); Pfeffer Questionnaire or Functional Assessment Questionnaire (FAQ); Katz Index; Geriatric Depression Scale (GDS-15); Geriatric Anxiety Inventory (GAI), and IVCF-20 as well as sociodemographic and clinical questionnaires. The association between the variables of interest was estimated using Spearman correlation. Results This study found a negative correlation between frailty and cognitive decline (MMSE; rs = -0.58; p < 0.001); (VFT; rs = -0.60; p < 0.001); (CDT; rs = -0.47; p = 0.001) and a positive correlation between frailty and depressive symptoms (GDS-15; rs = 0.34; p = 0.019) as well as disability for IADLs (FAQ; rs = 0.69; p < 0.001). However, there was no statistical difference in the association between frailty and anxiety symptoms (GAI; rs = 0.24; p = 0.103) or disability for BADLs (Katz; rs = -0.02; p = 0.895). Discussion Our data support that the associations between frailty, cognitive and functional disability are prevalent issues in Psychogeriatrics. Assessing frailty in a multidimensional context is essential using a rapid assessment frailty tool in clinical practice.
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Affiliation(s)
- Ariane M. Monteiro
- Department of Internal Medicine, Post-Graduate Program of Internal Medicine and Health Sciences (PPGMICS), Complexo do Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| | - Marcus K. Borges
- Department of Internal Medicine and Psychiatry (Geriatric Psychiatry), Post-Graduate Program of Internal Medicine and Health Sciences (PPGMICS), Complexo do Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
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Baptista MAT, Lacerda IB, Belfort T, Nogueira MML, de Oliveira Silva F, Dourado MCN. Awareness of Disease and Its Domains in Young-onset and Late-onset Dementia: The Role of Executive Function. Alzheimer Dis Assoc Disord 2023; 37:200-206. [PMID: 37561987 DOI: 10.1097/wad.0000000000000561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/23/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Executive function (EF) involves a general cognitive process linked to strategic organization and control of complex goal-oriented tasks. In young-onset dementia (YOD), especially Alzheimer's disease, the symptoms that stand out in the initial stage are deficits in attention, visual-spatial function, praxis, and language. The present study aims to investigate what components of EF differ in young and late-onset dementia (LOD) and its impact on awareness and its domains. METHODS Using a cross-sectional design, we included 44 people with YOD and 70 with LOD. We assessed awareness and its domains, cognition, dementia severity, EF, functionality, and neuropsychiatric symptoms. RESULTS The YOD group was more impaired in general cognition ( P =0.017) and had a worse performance in Wechsler Digit Span Backward (DSB) ( P =0.007) and Phonemic fluency task (FAS) ( P =0.046) tests. In the LOD group, deficits in EF had a greater impact on awareness and on most domains (awareness total score, cognitive functioning and health condition, functional activity impairments and social function). CONCLUSIONS Our study findings support the heterogeneity of awareness, not only with regard to the difference between the domains and the measures of EF, but also to the groups studied.
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Affiliation(s)
- Maria Alice Tourinho Baptista
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Esteves CDS, Oliveira CRD, Lima MP, Gonzatti V, Irigary TQ. Teste do Desenho do Relógio: Dados Normativos Para Idosos. PSICO-USF 2022. [DOI: 10.1590/1413-82712027270306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumo Trata-se de um estudo quantitativo, retrospectivo, correlacional e de corte transversal, com objetivo de fornecer dados normativos do TDR para idosos, levando em consideração diferentes faixas etárias e níveis de escolaridade. Duzentos e trinta e cinco foram entrevistados individualmente, distribuídos em cinco grupos etários e quatro níveis de escolaridade. Os instrumentos foram Ficha de Dados Sociodemográficos, Miniexame do Estado Mental (MEEM), Escala de Depressão Geriátrica, versão reduzida (GDS-15), Tarefa de Fluência Verbal Semântica (TFVS) e o TDR. Utilizou-se estatísticas descritivas, correlação de Pearson e análise univariada (one-way ANOVA) com post hoc Scheffe. Os escores do TDR apresentaram associações significativas com os anos de idade, anos de escolaridade, MEEM, TFVS e GDS-15. Houve diferença de desempenho no TDR ao considerarem os grupos por idade. O estudo fornece valores normativos para o TDR em uma amostra de idosos do sul do Brasil que foram influenciados pela idade, escolaridade, sintomatologia depressiva e fluência verbal.
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Advinha AM, Nunes C, de Barros CT, Lopes MJ, de Oliveira-Martins S. Key factors of the functional ability of older people to self-manage medications. Sci Rep 2021; 11:22196. [PMID: 34772959 PMCID: PMC8590057 DOI: 10.1038/s41598-021-01434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Daily medication use can be affected by the gradual loss of functional ability. Thus, elderly patients are at risk for nonadherence due to functional decline, namely, decreases in cognitive skills and visual and manual dexterity. The main objective was to assess the ability of older people to self-manage their medication and to identify the main predictors for unintentional nonadherence. A cross-sectional study was conducted (2014-2017) in community centers and pharmacies. Functional assessment was performed with the Portuguese versions of the Drug Regimen Unassisted Grading Scale (DRUGS-PT) and the Self-Medication Assessment Tool (SMAT-PT). A purposive sample including 207 elderly patients was obtained. To identify the main predictors, binary logistic regression was performed. The average DRUGS-PT score was slightly lower than that in other studies. On the SMAT-PT, the greatest challenge for patients was identifying medications by reading labels/prescriptions. The main difficulties identified were medication memorization and correct schedule identification. The scores were higher with the real regimen than with the simulated regimen, underlining the difficulties for patients in receiving new information. Regarding the predictors of an older individual's ability to self-manage medications, two explanatory models were obtained, with very high areas under the curve (> 90%). The main predictors identified were cognitive ability, level of schooling and daily medication consumption.
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Affiliation(s)
- Ana Margarida Advinha
- CHRC - Comprehensive Health Research Centre, Lisbon, Portugal.
- Universidade de Évora, Évora, Portugal.
| | - Carla Nunes
- CHRC - Comprehensive Health Research Centre, Lisbon, Portugal
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Manuel José Lopes
- CHRC - Comprehensive Health Research Centre, Lisbon, Portugal
- Universidade de Évora, Évora, Portugal
| | - Sofia de Oliveira-Martins
- CHRC - Comprehensive Health Research Centre, Lisbon, Portugal
- Faculdade de Farmácia, Universidade de Lisboa, Lisbon, Portugal
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Cezar NODC, Ansai JH, de Oliveira MPB, da Silva DCP, Vale FAC, Takahashi ACDM, de Andrade LP. Changes in executive function and gait in people with mild cognitive impairment and Alzheimer disease. Dement Neuropsychol 2021; 15:60-68. [PMID: 33907598 PMCID: PMC8049569 DOI: 10.1590/1980-57642021dn15-010006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Changes in executive function and motor aspects can compromise the prognosis of older adults with mild cognitive impairment (MCI) and favor the evolution to dementia. Objectives The aim of this study was to investigate the changes in executive function and gait and to determine the association between changes in these variables. Methods A 32-month longitudinal study was conducted with 40 volunteers: 19 with preserved cognition (PrC), 15 with MCI and 6 with Alzheimer disease (AD). Executive function and gait speed were assessed using the Frontal Assessment Battery, the Clock-Drawing test and the 10-meter walk test. For data analysis, the Pearson product-moment correlation, two-way repeated-measures ANOVA, and chi-square were conducted. Results After 32 months, an improvement in the executive function was found in all groups (p=0.003). At baseline, gait speed was slower in individuals with MCI and AD compared to those with PrC (p=0.044), that was maintained after the follow-up (p=0.001). There was significant increase in number of steps in all groups (p=0.001). No significant association was found between changes in gait speed and executive function. Conclusions It should be taken into account that gait deteriorates prior to executive function to plan interventions and health strategies for this population.
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Affiliation(s)
| | - Juliana Hotta Ansai
- Graduate Program in Movement Sciences, Universidade Federal de Mato Grosso do Sul - Campo Grande, MS, Brazil
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Dias KM, Herdman TH, Ferretti-Rebustini REDL, Lopes CT, Santos ERD. Relationships between nursing diagnoses and the level of dependence in activities of daily living of elderly residents. EINSTEIN-SAO PAULO 2020; 18:eAO5445. [PMID: 33174968 PMCID: PMC7607918 DOI: 10.31744/einstein_journal/2020ao5445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/14/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To identify and validate nursing diagnoses of elderly residents, and determine their relationship with the level of dependence in activities of daily living. METHODS One hundred thirty-five older adults were assessed using medical history and physical examination. Twelve validated gerontological instruments were administered to assess delirium, nutritional status, risk for falls, risk for pressure injury, dementia, cognitive losses, depression, and level of dependence in daily living and instrumental activities of daily living. Nursing diagnoses were identified and validated by experienced, doctorally-prepared nurses. The association between the presence of a nursing diagnosis and the level of dependence was assessed by a test for trend in proportions. The Kruskal-Wallis hypothesis test was used to investigate the association between the number of nursing diagnoses and the level of dependence of the elderly. RESULTS Most older adults were at risk for malnutrition, at high risk for falls, cognitively impaired, totally dependent for daily living and activities of daily living. In addition, they had very mild dementia and most did not have risk for pressure injuries. Depression was noted among those with dementia, but was absent in those without dementia. A total of 52 nursing diagnoses were validated. Of these, 11 were associated with the level of dependence in daily living. CONCLUSION These results can be reproduced in other skilled nursing facilities for older adults, and these may allow the planning of interventions to alleviate etiologies and signs/symptoms of nursing diagnoses, rather than simply directing care toward a general category of dependence. Therefore, guaranteeing individualized nursing care to meet the specific needs of each resident.
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Affiliation(s)
- Karina Mello Dias
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | | | - Camila Takao Lopes
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Eduarda Ribeiro Dos Santos
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Stein AM, da Silva TMV, Coelho FGDM, Rueda AV, Camarini R, Galduróz RFS. Acute exercise increases circulating IGF-1 in Alzheimer's disease patients, but not in older adults without dementia. Behav Brain Res 2020; 396:112903. [PMID: 32937170 DOI: 10.1016/j.bbr.2020.112903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/20/2020] [Accepted: 09/05/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Increased Insulin-like growth factor I (IGF-1) has been associated with improvement of cognitive function in response to exercise. Evidences indicate a role for IGF-1 in beta-amyloid clearance and reducing hyperphosphorylation tau in Alzheimer's disease (AD). There is a need to investigate the IGF-1 response to exercise in AD patients due to well-known potential effects of exercise on IGF-1. The aim of this study was to examine circulating IGF-1 levels in AD patients and older adults without dementia after acute exercise and to verify the associations among cardiorespiratory fitness, cognition and IGF-1 levels. METHOD Seventy-four older adults (40 older adults without dementia and 34 AD patients) participated in this study. The outcomes included IGF-1 plasma levels and performance in the submaximal exercise stress test. Secondary outcomes included cognitive functions, depressive symptoms, level of physical activity, insulin-resistance, and cholesterol. All participants performed the incremental test on a treadmill and IGF-1 was collected before and after the exercise. RESULTS A tendency to the difference of baseline IGF-1 plasma levels between the groups was found. After the acute exercise AD patients also presented higher levels of circulating IGF-1 compared to the Older adults without dementia. Correlations among cardiorespiratory fitness and cognitive functions were found. CONCLUSION The findings suggest that AD patients and older adults respond differently to acute exercise in terms of circulating IGF-1 levels. This response seems to indicate either an IGF-1 resistance or a compensatory exercise-induced to lower IGF-1 levels in AD patients. Cardiorespiratory fitness is associated with global cognition, executive function, attention and information processing speed.
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Affiliation(s)
- Angelica Miki Stein
- Instituto de Biociências, Universidade Estadual Paulista (UNESP), Campus Rio Claro, Brazil; UTFPR, Federal University of Technology - Paraná (UTFPR), Campus Curitiba, Brazil.
| | - Thays Martins Vital da Silva
- Instituto de Biociências, Universidade Estadual Paulista (UNESP), Campus Rio Claro, Brazil; Instituto Federal Goiano, Campus Avançado Hidrolândia, Brazil
| | - Flávia Gomes de Melo Coelho
- Instituto de Biociências, Universidade Estadual Paulista (UNESP), Campus Rio Claro, Brazil; Postgraduate Program in Physical Education, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - André Veloso Rueda
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Campus São Paulo, Brazil
| | - Rosana Camarini
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Campus São Paulo, Brazil
| | - Ruth Ferreira Santos Galduróz
- Instituto de Biociências, Universidade Estadual Paulista (UNESP), Campus Rio Claro, Brazil; Center of Mathematics, Computing and Cognition, University Federal of ABC (UFABC), Campus São Bernardo, Brazil
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Ortega LDFV, Aprahamian I, Borges MK, Cação JDC, Yassuda MS. Screening for Alzheimer's disease in low-educated or illiterate older adults in Brazil: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 77:279-288. [PMID: 31090809 DOI: 10.1590/0004-282x20190024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Cognitive screening instruments are influenced by education and/or culture. In Brazil, as illiteracy and low education rates are high, it is necessary to identify the screening tools with the highest diagnostic accuracy for Alzheimer's disease (AD). OBJECTIVE To identify the cognitive screening instruments applied in the Brazilian population with greater accuracy, to detect AD in individuals with a low educational level or who are illiterate. METHODS Systematic search in SciELO, PubMed and LILACS databases of studies that used cognitive screening tests to detect AD in older Brazilian adults with low or no education. RESULTS We found 328 articles and nine met the inclusion criteria. The identified instruments showed adequate or high diagnostic accuracy. CONCLUSION For valid cognitive screening it is important to consider sociocultural and educational factors in the interpretation of results. The construction of specific instruments for the low educated or illiterate elderly should better reflect the difficulties of the Brazilian elderly in different regions of the country.
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Affiliation(s)
- Luciane de Fátima Viola Ortega
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brasil
| | - Ivan Aprahamian
- Faculdade de Medicina de Jundiaí, Grupo de Investigação em Multimorbidades e Saúde Mental em Idosos, Disciplina de Geriatria e Gerontologia, Jundiaí SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Psiquiatria, São Paulo SP, Brasil
| | - Marcus Kiiti Borges
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Psiquiatria, São Paulo SP, Brasil
| | - João de Castilho Cação
- Faculdade de Medicina de São José do Rio Preto, Unidade de Geriatria, São José do Rio Preto SP, Brasil
| | - Mônica Sanches Yassuda
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brasil.,Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brasil
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Coelho AR, Perobelli JLL, Sonobe LS, Moraes R, Barros CGDC, Abreu DCCD. Severe Dizziness Related to Postural Instability, Changes in Gait and Cognitive Skills in Patients with Chronic Peripheral Vestibulopathy. Int Arch Otorhinolaryngol 2020; 24:e99-e106. [PMID: 31892965 PMCID: PMC6828563 DOI: 10.1055/s-0039-1695025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/18/2019] [Indexed: 01/09/2023] Open
Abstract
Introduction Peripheral vestibular disorders can lead to cognitive deficits and are more common in elderly patients. Objective To evaluate and correlate cognitive, balance and gait aspects in elderly women with chronic peripheral vestibular dizziness, and to compare them with elderly women without vestibular disorders. Methods Twenty-two women presenting peripheral vestibular dizziness episodes for at least six months participated in the study. The individuals were categorized by dizziness severity level: moderate ( n = 11) or severe ( n = 11). The control group ( n = 11) included women showing no vestibulopathy, light-headedness or dizziness. Cognitive assessments and semi-static and dynamic balance assessments were performed with the Balance Master (Neurocom International, Inc., Clackamas, OR), while the Dizziness Handicap Inventory provided a score for the severity of the symptoms. The groups were submitted to statistics of inference and correlation between cognitive, balance and stability variables. Results The group with severe dizziness showed higher sway speed of the center of pressure in the anteroposterior direction, smaller step length, and slower gait than the control group. Regarding the cognitive variables, the group with severe dizziness symptoms presented significant correlations with stability and gait variables. Conclusion The relationship between cognitive aspects, balance and gait was stronger in women with severe dizziness than in those with no vestibulopathy.
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Affiliation(s)
- Almir Resende Coelho
- Department of Health Sciences, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
- Department of Physiotherapy, Universidade de Franca, Franca, SP, Brazil
| | | | - Lilian Shizuka Sonobe
- Department of Health Sciences, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Renato Moraes
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Nepal GM, Shrestha A, Acharya R. Translation and cross-cultural adaptation of the Nepali version of the Rowland universal dementia assessment scale (RUDAS). J Patient Rep Outcomes 2019; 3:38. [PMID: 31321572 PMCID: PMC6639471 DOI: 10.1186/s41687-019-0132-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/19/2019] [Indexed: 11/12/2022] Open
Abstract
Background Mild Cognitive Impairment (MCI) is a transitional state between normal cognition and dementia during ageing process. Early screening of elderly for MCI can help for early prevention and treatment of dementia. Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive assessment tool with excellent psychometric properties and is particularly useful in culturally and linguistically diverse (CALD) populations. The purpose of this study was to translate RUDAS into Nepali and to evaluate internal consistency of Nepali version of RUDAS. Methods RUDAS was translated to Nepali following recommended guidelines for translation and cross-cultural adaptation of patient reported measures. The pre-final Nepali version of RUDAS was tested on 30 elderly and appropriate changes were made by expert committee. The final Nepali version of RUDAS was developed and was administered on 100 elderly populations (mean age 67.70) to assess internal consistency. Results The rating of the participants upon their understanding of each 6 items of Nepali version of RUDAS on a 10-point Likert scale received a good score of more than 8 except ‘cube drawing’ which only received a mean score of 5.5. Additionally, only 8(27%) elderly have responded to the item ‘cube drawing’. The preference test was done and cube drawing was replaced by stick design test. Nepali version of RUDAS showed acceptable internal consistency with Cronbach’s alpha 0.7. Conclusion The results of our study presents translated and cross-culturally adapted Nepali version of RUDAS that has been proved to be an appropriate assessment tool for screening cognitive impairment among elderly. Electronic supplementary material The online version of this article (10.1186/s41687-019-0132-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Govinda Mani Nepal
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
| | | | - Ranjeeta Acharya
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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Lebrão ML, Duarte YADO, Santos JLF, Silva NND. 10 Years of SABE Study: background, methodology and organization of the study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 21Suppl 02:e180002. [PMID: 30726347 DOI: 10.1590/1980-549720180002.supl.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022] Open
Abstract
The Health, Wellbeing and Aging Study (SABE) began in 2000 under the coordination of the Pan American Health Organization as a multicenter study developed in seven urban centers of Latin America and the Caribbean, to determine the health and living conditions of elderly in this region. In Brazil, the study was developed in the city of São Paulo, where 2,143 individuals (cohort A) aged 60 years or older were selected through probabilistic sampling. In 2006, 1,115 of these individuals were interviewed a second time, and a new probabilistic cohort of individuals aged 60 to 64 years was added (cohort B; n=298). Thus the SABE Study - Brazil was transformed into a multi-cohort longitudinal study, with the objective of identifying changes that occur in the aging process among different generations. In 2010, a longitudinal follow-up was developed with cohorts A and B, with the addition of a new cohort of individuals aged 60 to 64 years (cohort C; n=355). Thethree surveys (2000, 2006 and 2010) involved the application of a questionnaire, anthropometric evaluation and functional tests, with the subsequent inclusion of blood collection for the evaluation of biochemical, immunological and genetic variables, as well as an accelerometer for the measuring of caloric expenditure.
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Affiliation(s)
- Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Jair Lício Ferreira Santos
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | - Nilza Nunes da Silva
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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Cunha DDA, Camargos S, Passos VMDA, Mello CDM, Vaz LS, Lima LRSD. Heterotopic Ossification After Stroke: Clinical Profile and Severity of Ossification. J Stroke Cerebrovasc Dis 2019; 28:513-520. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 09/11/2018] [Accepted: 10/26/2018] [Indexed: 10/27/2022] Open
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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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Wong CEI, Branco LD, Cotrena C, Joanette Y, Fonseca RP. Attentional impairments following right hemisphere damage with and without hemispatial neglect: A comparative study. APPLIED NEUROPSYCHOLOGY. ADULT 2018; 25:274-282. [PMID: 28272901 DOI: 10.1080/23279095.2017.1296839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study aimed to evaluate the performance of patients with right hemisphere damage (RHD) with or without hemispatial neglect (HN) on a cancellation task. The study involved 31 control participants and 31 patients with RHD, matched by age, education, and frequency of reading and writing habits. The numbers of omission and random errors as well as the mean time to task completion were compared between adults with and without RHD, as well as between patients with and without HN. The latter made more left-sided omission errors, and more overall omission errors, than patients with RHD and no HN. The location of the first target canceled differed between subjects with RHD and control participants, as well as between patients with and without hemineglect. The use of organized vs. disorganized search strategies did not differ between groups. Further studies are required to investigate the performance of patients with HN of different levels of severity.
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Affiliation(s)
| | - Laura Damiani Branco
- b Department of Psychology , Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , Brazil
| | - Charles Cotrena
- b Department of Psychology , Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , Brazil
| | - Yves Joanette
- c Department of Medicine , University of Montreal , Montreal , Canada
| | - Rochele Paz Fonseca
- b Department of Psychology , Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , Brazil
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de Noronha ÍFC, Barreto SDS, Ortiz KZ. The influence of education on performance of adults on the Clock Drawing Test. Dement Neuropsychol 2018; 12:61-67. [PMID: 29682235 PMCID: PMC5901251 DOI: 10.1590/1980-57642018dn12-010009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment.
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Affiliation(s)
| | - Simone Dos Santos Barreto
- Adjoined Professor. Department of Specific Training in Speech, Language and Hearing Sciences - Universidade Federal Fluminense, RJ, Brazil
| | - Karin Zazo Ortiz
- Associate Professor. Department of Speech, Language and Hearing Sciences - Universidade Federal de São Paulo
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Santos JID, Rodrigues CJ, Zogheib JB, Malachias MVB, Rezende BA. Assessment of hemodynamic and vascular parameters in Alzheimer's disease, vascular dementia and mild cognitive abnormalities: a pilot study. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.160211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objectives: this pilot study correlated cardiovascular parameters such as atherosclerosis and arterial stiffness in patients with aged-related dementia and sought to identify hemodynamic differences that can help in differential diagnosis. Method: a longitudinal prospective study was performed of 46 patients aged 60 to 80 years in the city of Belo Horizonte, Minas Gerais, Brazil. The patients were classified into three groups: those with Alzheimer’s disease (AD), vascular dementia (VD) or mild cognitive impairment (MCI). The groups were classified by clinical examination and CT or magnetic resonance imaging tests of the encephalon. The arterial stiffness and other hemodynamic parameters of the patients were measured using the Mobil-O-Graph device and carotid artery ultrasound scanning. Data analysis was performed by descriptive statistics, multinomial logistic regression and analysis of variance. Results: 18 patients (39.1%) had MCI, 18 (39.1%) AD and 10 (21.8%) VD. Image exams revealed greater obstructive microangiopathy in the AD group than the MCI group (p<0.05), which in turn exhibited greater normality in such tests than the AD group (p<0.05). There were no significant differences among the groups for the hemodynamic variables. The carotid artery ultrasound examinations identified a greater degree of normality in the MCI group than the AD group (p<0.05). Conclusion: the results do not support the idea of using noninvasive hemodynamic evaluation methods as additional exams in the differential diagnosis of these pathologies.
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Valle Pedroso R, Icassatti Corazza D, De Almeida Andreatto CA, Gomes dos Santos J, Miki Stein A, Gutiérrez Huamaní O, Riani Costa JL, Ferreira Santos-Galduròz R. LOS PREDICTORES MOTORES DE LA DEFICIENCIA DE LAS FUNCIONES EJECUTIVAS EN ANCIANOS CON LA ENFERMEDAD DE ALZHEIMER. UNIVERSITAS PSYCHOLOGICA 2017. [DOI: 10.11144/javeriana.upsy15-5.pmdf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objetivo: Investigar las relaciones entre funciones ejecutivas y capacidad funcional y determinar los predictores motores de la deficiencia de las funciones ejecutivas en ancianos con enfermedad de Alzheimer (EA). Metodología: 24 ancianos con EA fueron evaluados para estimar las funciones ejecutivas y los predictores motores. Se utilizó el análisis estadístico descriptivo, correlación de Pearson y regresión lineal múltiple. Resultados: Las funciones ejecutivas se relacionaron con la flexibilidad (r=0,54), equilibrio (r=0,48), agilidad y movilidad (r =-0,41). El análisis de regresión apuntó equilibrio y flexibilidad como predictores motores de la deficiencia de las funciones ejecutivas. Conclusiones: El prejuicio del equilibrio y la flexibilidad pueden predecir los prejuicios en funciones ejecutivas de ancianos con EA.
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Beckert M, Loureiro F, Menta C, Mello EF, Nogueira EL, von Gunten A, Gomes I. Performance of low-educated elders with depression on Addenbrooke's Cognitive Examination-Revised (ace-r) test. Dement Neuropsychol 2016; 10:19-25. [PMID: 29213426 PMCID: PMC5674909 DOI: 10.1590/s1980-57642016dn10100004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Along with cognitive disorders, depression has been a concern for mental health services due to its highly debilitating effect on the functioning and quality of life of the elderly. However, there is still little understanding of the cognitive alterations resulting from depression or of the difficult differential diagnosis with mild cognitive impairment (MCI). It is known that performance on cognitive tests is strongly influenced by education but few studies have been conducted involving low-educated populations. Objective To evaluate the performance of elders with low education and no dementia on Addenbrooke's Cognitive Examination-Revised (ACE-R) test and its cognitive domains, and compare patients with Current Major Depressive Episode (CMDE) against those without depressive symptoms. Methods A retrospective, cross-sectional analytical study was conducted based on medical files of patients treated at the Cerebral Aging Clinic of the Hospital São Lucas of the PUCRS. The study included 116 individuals with low education (< 8 years of education) aged between 60 and 84 (69.6 ± 6.4) years, with MCDE (N = 41) and controls (N = 75). Results No significant difference was observed between control and MCDE groups in median scores on the ACE-R, Mini-Mental State Examination, and the five cognitive domains. There was also no difference between the groups on separate analyses of results on the clock drawing test, the categorical verbal and phonological fluency test, and the naming test. Conclusion The results of this study showed that depressive symptoms did not influence scores on the ACE-R tests conducted in elders with low education.
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Affiliation(s)
- Michele Beckert
- Psychologist, MD, Department of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Fernanda Loureiro
- Speech Therapist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Caroline Menta
- Psychiatrist, MD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Elisa Fasolin Mello
- Psychiatrist, MD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Eduardo L Nogueira
- Psychiatrist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Armin von Gunten
- Psychiatrist, MD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil, and Old-Age Psychiatric Service, Department of Psychiatry, Lausanne University Hospital, Switzerland
| | - Irênio Gomes
- Neurologist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
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Steibel NM, Olchik MR, Yassuda MS, Finger G, Gomes I. Influence of age and education on the Rivermead Behavioral Memory Test (RBMT) among healthy elderly. Dement Neuropsychol 2016; 10:26-30. [PMID: 29213427 PMCID: PMC5674910 DOI: 10.1590/s1980-57642016dn10100005] [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] [Indexed: 12/28/2022] Open
Abstract
Memory is a cognitive domain extensively evaluated in the neuropsychiatric setting.
Assessment tools with appropriate norms for age and educational level are necessary
for the proper interpretation of results.
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Affiliation(s)
- Nicole Maineri Steibel
- Doutoranda do Programa de Gerontologia Biomédica da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brasil
| | - Maira Rozenfeld Olchik
- Professora Adjunto do Curso de Fonoaudiologia da UFRGS, Departamento de Cirurgia e Ortopedia, Doutora em Educação e Mestre em Fonoaudiologia, Porto Alegre RS, Brasil
| | - Mônica Sanches Yassuda
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo SP, Brasil
| | - Geisa Finger
- Mestranda do Programa de Pós-Graduação em Gerontologia Biomédica - Instituto de Geriatra Gerontologia da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brasil
| | - Irênio Gomes
- Programa de Pós-Graduação em Gerontologia Biomédica do Instituto de Geriatria e Gerontologia da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brasil
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Kerr MDS, Pagliarin KC, Mineiro A, Ferré P, Joanette Y, Fonseca RP. Montreal Communication Evaluation Battery--Portuguese version: age and education effects. Codas 2015; 27:550-6. [PMID: 26691619 DOI: 10.1590/2317-1782/20152015029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 06/11/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To verify age and education effects on communication performance of healthy adults in the Montreal Communication Evaluation Battery, Portuguese version (MAC-PT). METHODS The sample comprised 90 healthy adults from Portugal, European Portuguese speakers, divided into nine groups according to educational level (4-9, 10-13, and > 13 years of formal schooling) and age (19-40, 41-64, and 65-80 years). The influence of age and education was assessed by comparing mean scores between groups, using a two-way analysis of variance followed by Bonferroni post hoc tests (p ≤ 0.05). RESULTS The results showed that participants' performance was influenced by age in pragmatic-inferential, discursive, and prosodic tasks. Education had the greatest influence on the performance in all processes evaluated by the MAC-PT. CONCLUSION Age and education seem to influence the communicative performance and should be considered in the assessment of neurological patients.
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Affiliation(s)
| | | | - Ana Mineiro
- Instituição de Ciências da Saúde, Universidade Católica Portuguesa, Lisboa, Portugal
| | - Perrine Ferré
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Yves Joanette
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Rochele Paz Fonseca
- Faculdade de Psicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Fiorotto SM, Barroso SM. Relato de Experiência em Acompanhamento Cognitivo com um Paciente com Esclerose Múltipla. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2015. [DOI: 10.1590/1982-3703001202014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A Esclerose Múltipla (EM) é uma doença crônica e autoimune, caracterizada por desmielinização, inflamação e neurodegeneração do Sistema Nervoso Central. Entre 30 e 50% dos indivíduos com EM apresentam comprometimento cognitivo. O processo de reabilitação cognitiva visa capacitar o paciente a conviver, reduzir e/ou superar os déficits cognitivos decorrentes da doença. Este trabalho relata a experiência de uma estagiária de Psicologia ao participar de um projeto de extensão universitária de acompanhamento cognitivo a um paciente com EM. Inicialmente o paciente foi submetido à avaliação neuropsicológica, identificando funções cognitivas preservadas e déficits. Foram observados déficits na recordação tardia, compreensão léxica, compreensão aritmética e aprendizagem numérica. Posteriormente, o paciente recebeu acompanhamento cognitivo semanal pelo período de seis meses. Após o período do acompanhamento, foi feita a reavaliação neuropsicológica. Observou-se melhora significativa na capacidade de recordação tardia e na aprendizagem aritmética, que deixaram de consistir em déficits. Além disso, houve abrandamento do déficit na compreensão aritmética. Os demais resultados permaneceram sem alterações. O trabalho mostra o impacto positivo que o acompanhamento cognitivo pode trazer ao paciente com EM e como a experiência de extensão pode auxiliar na formação dos estudantes de Psicologia.
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Mendes-Santos LC, Mograbi D, Spenciere B, Charchat-Fichman H. Specific algorithm method of scoring the Clock Drawing Test applied in cognitively normal elderly. Dement Neuropsychol 2015; 9:128-135. [PMID: 29213954 PMCID: PMC5619351 DOI: 10.1590/1980-57642015dn92000007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The Clock Drawing Test (CDT) is an inexpensive, fast and easily administered measure of cognitive function, especially in the elderly. This instrument is a popular clinical tool widely used in screening for cognitive disorders and dementia. The CDT can be applied in different ways and scoring procedures also vary. Objective The aims of this study were to analyze the performance of elderly on the CDT and evaluate inter-rater reliability of the CDT scored by using a specific algorithm method adapted from Sunderland et al. (1989). Methods We analyzed the CDT of 100 cognitively normal elderly aged 60 years or older. The CDT ("free-drawn") and Mini-Mental State Examination (MMSE) were administered to all participants. Six independent examiners scored the CDT of 30 participants to evaluate inter-rater reliability. Results and Conclusion A score of 5 on the proposed algorithm ("Numbers in reverse order or concentrated"), equivalent to 5 points on the original Sunderland scale, was the most frequent (53.5%). The CDT specific algorithm method used had high inter-rater reliability (p<0.01), and mean score ranged from 5.06 to 5.96. The high frequency of an overall score of 5 points may suggest the need to create more nuanced evaluation criteria, which are sensitive to differences in levels of impairment in visuoconstructive and executive abilities during aging.
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Affiliation(s)
| | - Daniel Mograbi
- PhD, Department of Psychology, Pontifical Catholic University of Rio de Janeiro RJ, Brazil.,Department of Psychology, Institute of Psychiatry, King's College London, UK
| | - Bárbara Spenciere
- BsC, Department of Psychology, Pontifical Catholic University of Rio de Janeiro RJ, Brazil
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Abstract
Cognitive impairment after stroke affects the patient recovery process. Therefore, the identification of factors associated with cognitive outcomes is important since it allows risk profiles of stroke survivors to be determined. Objective To assess cognitive outcome of stroke outpatients and investigate associations among clinical and demographic variables, vascular risk factors, depression symptoms and functional ability; and to describe the neuropsychological profile of these patients. Methods A cross-sectional design study was conducted. Subjects who suffered a first-ever ischaemic stroke 6 to 10 months prior to data collection underwent neuropsychological assessment and screening for depressive symptoms and functional ability. The outcome "cognitive performance" was analyzed considering two groups: "cognitive impairment" and "no cognitive impairment". Results There was a statistically significant association between cognitive impairment and female gender, age, stroke severity and functional ability. Regarding neuropsychological profile, the cognitive impairment group exhibited more generalized deficits in attention, visuospatial organization, verbal functions and verbal memory domains compared to the community control group. Conclusion The occurrence of cognitive impairment among patients was high, especially in women, older participants, individuals with more severe stroke, and greater impairment in functional ability. Multiple cognitive domains are affected and this may hamper recovery and negatively impact independence and quality of life after stroke.
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Affiliation(s)
- Maria Gabriela R Ferreira
- Psychologist, Specialist in Neuropsychology, Masters in Health and the Environment from the Regional University of Joinville, Professor at the Departments of Psychology and Medicine of the Regional University of Joinville (UNIVILLE), Joinville SC, Brazil
| | - Carla Heloísa C Moro
- Neurologist, MD, Professor at the Department of Medicine of the Regional University of Joinville (UNIVILLE), Joinville SC, Brazil
| | - Selma C Franco
- Public Health Specialist, MD, Professor at the Department of Medicine of the Regional University of Joinville (Univille), Joinville SC, Brazil. PhD in Child and Adolescent Health from Unicamp and post-doctorate from Rovira i Virgili University, Tarragona, Spain
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Cardoso CDO, Zimmermann N, Paraná CB, Gindri G, de Pereira APA, Fonseca RP. Brazilian adaptation of the Hotel Task: A tool for the ecological assessment of executive functions. Dement Neuropsychol 2015; 9:156-164. [PMID: 29213957 PMCID: PMC5619354 DOI: 10.1590/1980-57642015dn92000010] [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] [Indexed: 11/21/2022] Open
Abstract
Over recent years, neuropsychological research has been increasingly concerned
with the need to develop more ecologically valid instruments for the assessment
of executive functions. The Hotel Task is one of the most widely used ecological
measures of executive functioning, and provides an assessment of planning,
organization, self-monitoring and cognitive flexibility.
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Affiliation(s)
| | - Nicolle Zimmermann
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil
| | | | - Gigiane Gindri
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil
| | | | - Rochele Paz Fonseca
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil
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Ferreira MC, Tozatti J, Fachin SM, Oliveira PPD, Santos RFD, Silva MERD. Redução da mobilidade funcional e da capacidade cognitiva no diabetes melito tipo 2. ACTA ACUST UNITED AC 2014; 58:946-52. [DOI: 10.1590/0004-2730000003097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 11/12/2014] [Indexed: 11/21/2022]
Abstract
Objetivos Avaliar a mobilidade funcional e sua relação com a capacidade cognitiva em pacientes com diabetes tipo 2 (DM2) entre 50 e 65 anos de idade, e com menos de 10 anos de diagnóstico. Materiais e métodos Estudo observacional, analítico e transversal envolvendo indivíduos não diabéticos e pacientes com DM2 com controle glicêmico inadequado, selecionados por amostra de conveniência. Em ambos os grupos, foram aplicados questionário estruturado, avaliação cognitiva com Miniexame do Estado Mental (MEEM) e teste do relógio (TDR), além da avaliação de mobilidade funcional pelo teste Timed Up & GO (TUG). Resultados No TUG os pacientes com DM2 apresentaram tempo médio de 11,27 segundos versus 9,52 segundos nos controles (p = 0,013). A associação entre declínio cognitivo e dismobilidade foi positiva nos indivíduos com DM2 (p = 0,037). No subgrupo que apresentou dismobilidade e declínio cognitivo associados, 18% eram portadores de DM2 e 1,6% era do grupo sem DM2 (p < 0,01). Conclusões Pacientes com DM2 apresentaram pior mobilidade funcional e desempenho cognitivo, favorecendo a hipótese de que o DM2 influencia a mobilidade funcional e capacidade cognitiva antes do aparecimento de complicações vasculares ou neuropáticas. Esses dados sugerem que a hiperglicemia é um fator agravante no desempenho de atividades que exijam funções mentais como atenção, orientação e memória de trabalho. Arq Bras Endocrinol Metab. 2014;58(9):946-52
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Affiliation(s)
| | - Joana Tozatti
- Universidade Comunitária Regional de Chapecó, Brasil
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Teixeira Fabricio A, Aprahamian I, Sanches Yassuda M. Qualitative analysis of the Clock Drawing Test by educational level and cognitive profile. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:289-95. [PMID: 24760093 DOI: 10.1590/0004-282x20140004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 12/17/2013] [Indexed: 11/21/2022]
Abstract
UNLABELLED The use of a qualitative scale for the Clock Drawing Test (CDT) may add information about the pattern of errors committed. OBJECTIVE To translate and adapt the Modified Qualitative Error Analysis of Rouleau into Brazilian Portuguese and to examine the pattern of errors according to educational level and cognitive profile. METHOD 180 adults (47-82 years) completed the CDT. Participants were stratified into age and educational levels and separated between those with and without changes in cognitive screening tests (Mini-Mental State Examination, Verbal Fluency). RESULTS No significant differences were found in CDT scores among age groups. Among participants without cognitive impairment, those with lower education often presented graphic difficulties, conceptual deficits and spatial deficits. Participants with cognitive deficits, demonstrated more frequently conceptual and spatial errors. CONCLUSION The qualitative analysis of the CDT may contribute to the identification of cognitive changes. Education level has to be taken into consideration during the analysis.
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Affiliation(s)
| | - Ivan Aprahamian
- Laboratório de Neurociências LIM-27, Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Mônica Sanches Yassuda
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, Sao Paulo, SP, Brazil
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Mello ALSFD, Zimermann K, Gonçalves LHT. Avaliação da saúde bucal de idosos por enfermeiros: validade e confiabilidade do instrumentO ASBTO. Rev Gaucha Enferm 2012; 33:36-44. [DOI: 10.1590/s1983-14472012000200007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo do estudo foi aplicar o Instrumento "Avaliação da Saúde Bucal para Triagem Odontológica" (ASBTO) em idosos institucionalizados para determinação dos índices de validade e confiabilidade, quando da aplicação por Enfermeiros. Os exames foram executados por um Enfermeiro e por um Cirurgião-Dentista (CD) em 50 idosos de uma instituição de longa permanência. A determinação da consistência interna foi verificada por meio do Coeficiente Alfa de Cronbach e ANOVA. Para determinação da estabilidade e confiabilidade foram considerados os percentuais de concordância e teste Kappa. Não houve diferença estatística significante entre as médias finais obtidas pelo CD e pelo Enfermeiro (p=0,41). Houve maior consistência interna nos exames procedidos pelo CD. Os percentuais de concordância variaram de 60%, na categoria Lábio, até 90%, na categoria "Dentes naturais". O Kappa total do instrumento alcançou 0,46. A utilização do ASBTO é passível por Enfermeiros. Faz-se necessária adequada capacitação e treinamento prático para padronização de critérios.
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Feldhaus P, Fraga DB, Ghedim FV, De Luca RD, Bruna TD, Heluany M, Matos MP, Ferreira GK, Jeremias IC, Heluany C, Streck EL, Zugno AI. Evaluation of respiratory chain activity in lymphocytes of patients with Alzheimer disease. Metab Brain Dis 2011; 26:229-36. [PMID: 21789567 DOI: 10.1007/s11011-011-9253-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 07/13/2011] [Indexed: 01/02/2023]
Abstract
Alzheimer disease (AD) is a progressive neurodegenerative disease associated with cognitive impairment in multiple domains, such as memory and executive functions. Studies reveal damage in the electron transport chain of patients with AD, suggesting that this mitochondrial dysfunction plays an important role in the pathophysiology of the disease. Blood samples were taken from patients with AD (n = 20) and older subjects without dementia (n = 40) to evaluate the activity of complexes I, II, II-III, and IV of the mitochondrial respiratory chain in isolated lymphocytes. Results from the patient and control groups were compared. The activity of complexes II and IV was increased among patients compared to the control group. No significant difference was observed between controls who were not using psychotropic medication and patients. Our findings point out a mechanism of cellular compensation in which the mitochondrial respiratory chain requires an increase in electron transport to supply the energy needed for cellular functioning. Additional studies are needed to better clarify the mechanisms involved in the mitochondrial dynamics of AD.
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Affiliation(s)
- Pollyana Feldhaus
- Laboratory of Neurociences and Nacional Institute for Translational Medicine (INCT-TM), Postgraduate Program in Health Sciences, Health Sciences Unit University of Sourthern Santa Catarina, 88806-000, Criciúma, SC, Brazil
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Chaves ML, Godinho CC, Porto CS, Mansur L, Carthery-Goulart MT, Yassuda MS, Beato R. Cognitive, functional and behavioral assessment: Alzheimer's disease. Dement Neuropsychol 2011; 5:153-166. [PMID: 29213740 PMCID: PMC5619475 DOI: 10.1590/s1980-57642011dn05030003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Accepted: 06/22/2011] [Indexed: 11/22/2022] Open
Abstract
A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer's disease (AD) is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database) was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The Mini-Mental State Examination has clinical utility as a screening test, as do the multifunctional batteries (CAMCOG-R, ADAS-COG, CERAD and MDRS) for brief evaluations of several cognitive domains. There was sufficient evidence to recommend the CDR scale for clinical and severity assessment of dementia. Tests for Brazilian Portuguese are recommended by cognitive domain based on available data.
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Affiliation(s)
- Márcia L.F. Chaves
- Neurology Service of the Hospital de Clínicas of
Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil
| | - Claudia C. Godinho
- Neurology Service of the Hospital de Clínicas of
Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil
| | - Claudia S. Porto
- Cognitive and Behavioral Neurology Group of the
Department of Neurology of the University of São Paulo School of Medicine,
Hospital das Clínicas of the University of São Paulo School of
Medicine, and Center for Mathematics, Computing and Cognition, Federal University of
ABC, São Paulo SP, Brazil
| | - Leticia Mansur
- Cognitive and Behavioral Neurology Group of the
Department of Neurology of the University of São Paulo School of Medicine,
Hospital das Clínicas of the University of São Paulo School of
Medicine, and Center for Mathematics, Computing and Cognition, Federal University of
ABC, São Paulo SP, Brazil
- Department of Physiotherapy, Speech Therapy and
Occupational Therapy of the University of São Paulo School of Medicine,
São Paulo SP, Brazil
| | - Maria Teresa Carthery-Goulart
- Cognitive and Behavioral Neurology Group of the
Department of Neurology of the University of São Paulo School of Medicine,
Hospital das Clínicas of the University of São Paulo School of
Medicine, and Center for Mathematics, Computing and Cognition, Federal University of
ABC, São Paulo SP, Brazil
| | - Mônica S. Yassuda
- Cognitive and Behavioral Neurology Group of the
Department of Neurology of the University of São Paulo School of Medicine,
Hospital das Clínicas of the University of São Paulo School of
Medicine, and Center for Mathematics, Computing and Cognition, Federal University of
ABC, São Paulo SP, Brazil
- Department of Gerontology, School of Arts, Sciences and
Humanities of the University of São Paulo (EACH-USP East), São Paulo
SP, Brazil
| | - Rogério Beato
- Research Group in Cognitive and Behavioral Neurology,
Department of Internal Medicine, School of Medicine, Federal University of Minas
Gerais (UFMG), Belo Horizonte MG, Brazil
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31
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Paradela EMP, Lopes CDS, Lourenço RA. [Portuguese adaptation of the Cambridge Cognitive Examination-Revised in a public geriatric outpatient clinic]. CAD SAUDE PUBLICA 2010; 25:2562-70. [PMID: 20191148 DOI: 10.1590/s0102-311x2009001200004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 09/08/2009] [Indexed: 11/22/2022] Open
Abstract
This paper presents the results of the first four steps (conceptual, item, semantic, and operational equivalences) of cross-cultural adaptation to Portuguese of the Cambridge Cognitive Examination-Revised (CAMCOG-R). The process was based on the theoretical model proposed by Herdman et al., which includes not only the four steps described above, but also measurement and functional equivalences, not evaluated in the current study. A panel of experts evaluated whether all dimensions that comprise the CAMCOG-R were present in Brazilian reality. Two translations and back-translations were performed, in addition to the 'focus group' technique. The Brazilian Portuguese version of the CAMCOG-R (Br-CAMCOG-R) was developed, maintaining the 69 items from the original instrument, with different levels of difficulty. It was then applied to 196 elders, with the test lasting an average of 43 +/- 9.4 minutes, and an average total score of 67 +/- 14.8 points. The Br-CAMCOG-R can be a useful tool for the cognitive evaluation of elders that tested positive during initial screening.
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