[Vascular damage and cognitive-functional performance in a population with mild cognitive impairment]

INTRODUCTION

There is evidence of predemential stages in Vascular Dementia (VD). Alzheimer Disease (AD) and VD share common risk factors and mechanisms. Vascular comorbility may present in 30-60% of patients with AD (mixed dementia). This work seeks to evaluate the impact of the severity of structural vascular damage according to the Fazekas classification (F) on functional cognitive performance in patients with Mild Cognitive Impairment (MCI).

PATIENTS AND METHODS

A cross-sectional study of patients with MCI aged 65 years or older who had brain MRI was carried out. A neurocognitive battery and the EFE (Extended Functional Study) scale were administered to assess complex functionality. The patients were divided according to Fazekas classification: 0-1, 2 and 3. Bivariate analysis and multivariate analysis were performed.

RESULTS

346 patients were included, age: 77.9 (SD 6.1). 66.2% presented F01, 22.8% F2 and 11% F3. Age and MMSE value were statistically significant. Multivariate analysis showed an independent association between vascular damage and complex functional alteration measured by EFE.

CONCLUSIONS

In conclusion, the progression of structural damage to a predominance of white matter would affect global cognitive performance and tasks related to executive function. The most significant finding was the correlation of the degree of vascular damage with the deficit of complex functionality measured with clinical tools that include technological resources. The clinical value of identifying individuals with prodromal DV is highlighted as it could optimize prevention measures.

Prevalence of endoparasitors in rural communities in Central Brazil: a cross-sectional study

Background

Studies show that the magnitude is high in regions lacking basic sanitation, such as rural areas. Despite this, there is little evidence on the prevalence of endoparasitosis in rural communities in developing countries. The aim of this study was to estimate the prevalence of endoparasitosis in residents of rural communities in Central Brazil.

Methods

Cross-sectional study conducted within the scope of the Sanrural Project that aims to assess the health and sanitation conditions of rural communities in 2019. The target population of this study consisted of residents of 17 settlements, 24 quilombola and 7 riverside communities in Central Brazil. By listing the total number of residents of each household in the communities, residents were selected by simple random probability sampling. Then, stool samples were collected in sterile plastic containers and identified. After collection, the samples were transported for analysis by direct examination of the feces. The descriptive analysis was made. The study was approved by the Research Ethics Committee of the Federal University of Goiás.

Results

Data from 680 individuals (children and adults) who had stool samples collected were analyzed. The prevalence's of the endoparasites found were: Entamoeba coli (13.5%; 90%CI: 11.5-15.8%); Giardia lamblia (2.8%; 90%CI: 1.9-4.4); Ascaris lumbricoides (1.5%; 90%CI: 0.9-2.4); Ancyslotoma (0.9%; 90%CI: 0.5-1.7); Enterobius vermicularis (0.7%; 90%CI: 0.4-1.5%); Taenia (0.6%; 90%CI: 0.3-1.3); Hymenolepis nana (0.6%; 90%CI: 0.3-1,3); Itamoeba (0.4; 90%CI: 0.2-1.1); Hymenolepis diminuta (0.3%; 90%CI: 0.1-0.9), Strongiloides (0.0%); Trichuris (0.0%) and, Schistosoma mansoni (0.0%).

Conclusions

An intermediate prevalence for principal endoparasites was observed. This result may suggest the persistence of precarious sanitation conditions. Thus, the implications of the study include the need for systematic action by managers and health professionals in improving sanitation conditions.

Key messages

A current diagnosis will be made on the health and sanitation situation of rural communities in Goiás, based on the analysis of clinical samples and water quality, among other conditions. Based on this diagnosis, together with the community, we will seek solutions for sanitation and health through a Rural Sanitation Security Plan (PSSR).