Allan Gustavo Brigola

Relationship between cognition and frailty in elderly: A systematic review

Objective The aim of this study was to analyze the relationship between cognition and frailty in the elderly. Methods A systematic review on the currently existing literature concerning the subject was carried out. The search strategy included LILACS, SCOPUS, SciELO, PsycINFO, PubMed and Web of Science databases. Results A total of 19 studies were selected for review, from which 10 (52.6%) were cross-sectional and 9 (47.4%) longitudinal, and the majority Brazilian. All of the studies established a link between cognition and frailty. There was a relationship between components of frailty and the cognitive domains. Risk of Mild Cognitive Impairment (MCI), dementia and mortality were all evidenced in the relationship between frailty and cognitive impairment. Conclusion The theory remains limited, but results show the variables that appear to be linked to cognition and frailty in elderly. This data can help in implementing actions to improve the quality of life among elderly.

Subjective memory complaints associated with depression and cognitive impairment in the elderly: A systematic review

The aging process can be accompanied by a slight decline in cognitive functioning, and subjective memory complaints (SMC) appear to be common in the elderly population. Objective To determine whether SMC is associated with cognitive loss or depression and can predict dementia. Methods A systematic review of the literature was conducted. Articles were selected on the following databases, LILACS, SCOPUS, SCiELO, PubMed and Web of Science from August to October 2013. Article selection was based on inclusion and exclusion criteria. Studies published between 2010 and 2013, written in English, Spanish or Portuguese, involving populations 65 years or older, were included. Reviews were excluded. Results After the selection, a summary of the 20 articles retrieved was carried out. Of the total articles retrieved, fifteen were cross-sectional studies and five were longitudinal studies. Most of the cross-sectional studies associated SMC with depression, objective cognitive impairment and anxiety. The emergence of dementia in people with SMC was evidenced in longitudinal studies. Albeit less frequently, SMC were also associated with reduced quality of life, impairment in Activities of Daily Living (ADL), emergence of neuropsychiatric symptoms, lower hippocampal volume, amygdala volume reduction, increased activation of the left temporal, bilateral thalamus, caudate and posterior cingulate, and with the occurrence of ApoE ε4. Conclusion SMC may be associated with changes in mood and/or cognition, and its occurrence appears to increase the likelihood of dementia. In order to further our understanding of the topic, future studies should consider the recruitment of representative samples with control groups and longitudinal designs.

Health profile of family caregivers of the elderly and its association with variables of care: a rural study

Objective: to analyze the profile of a population of caregivers from a city in a rural area of the state of Sao Paulo, Brazil, and identify their health complaints and the characteristics of care provided. Method: a prospective cross-sectional study was performed based on a domicile survey of 99 caregivers and their elderly care recipients. Information about the profile, context of care and health complaints of the caregivers was collected. The caregivers responded to the Zarit Burden Inventory and the Geriatric Depression Scale-15 and the elderly underwent a cognition and functionality assessment. The chi-squared test with odds ratio (OR) was performed to test associations. Result: the majority of the caregivers were women (n=76), elderly (n=83), with a median age 65.8 (±10.4) years and 4.9 (±4.2) years of formal schooling. The most frequent health complaints were pain, systemic hypertension, insomnia, back problems and vision problems. The elderly care recipients were men (n=75), with an average age of 72.0 (±8.2) years. Analysis of associations revealed that caregivers who received emotional support had a lower chance of being highly overburdened (OR=0.37; CI95% 0.15-0.90). Caring for over five years was associated with arthritis (OR=2.50; CI95% 1.0-6.56). Caring of an elderly person with cognitive impairment was strongly associated with peripheral vascular diseases (OR=2.70; CI95% 1.11-6.85) and other diseases (OR=6.94; CI95% 1.43-33.63). Conclusion: A better understanding of the reality of care in rural and remote areas and the identification of factors related to the health care of caregivers provides better care management for the elderly and caregivers, who themselves are aging.Allan Gustavo Brigola1 Resumo Objetivo: analisar o perfil das queixas de saúde de cuidadores e identificar características do cuidado relacionadas em uma população de cuidadores de um município do interior paulista, área rural do Brasil. Método: estudo transversal prospectivo em um inquérito domiciliar com 99 cuidadores e os respectivos idosos receptores de cuidado. Informações do perfil dos cuidadores e dos idosos, do contexto do cuidado e queixas de saúde foram coletadas. O cuidador respondeu ao Inventário de Sobrecarga de Zarit e a Escala de Depressão Geriátrica e o idoso, uma avaliação cognitiva e da funcionalidade. Foi utilizado para verificar associações o teste qui-quadrado com odds ratio (OR). Resultado: os cuidadores foram: maioria de mulheres (n=76), idosas (n=83), com média de 65,8 (±10,4) anos de idade e 4,9 (±4,2) anos de escolaridade. As queixas de saúde mais frequentes foram dor, hipertensão arterial sistêmica, insônia e problemas de coluna e visão. Os idosos receptores de cuidado eram homens (n=75), com média de 72,0 (±8,2) anos de idade. As análises mostraram que os cuidadores que recebiam ajuda emocional ou afetiva apresentavam menor chance de sobrecarga elevada (OR=0,37; CI95% 0,15-0,90). Estar envolvido com o cuidado há mais de cinco anos foi associado ao relato de artrite (OR=2,50; CI95% 1,0-6,56). Cuidar de idoso com alteração cognitiva foi associado às doenças vasculares periféricas (OR=2,70; CI95% 1,11-6,85) e às outras morbidades (OR=6,94; CI95% 1,4333,63). Conclusão: O melhor entendimento da realidade do cuidado e a identificação dos fatores relacionados à saúde dos cuidadores vivendo em áreas rurais e remotas podem fundamentar melhorias na gestão do cuidado do idoso e do próprio cuidador, que também envelhece.

Evaluation of depressive symptoms in older caregivers

Background The number of older caregivers is getting bigger and it is important to know if they experience depressive symptoms because there can be consequences for both caregiver and care recipient. Objective To analyze the recent publications related to the assessment of depressive symptoms in elderly caregivers. Methods Lilacs and PubMed databases were reviewed associating the descriptors “caregivers” AND “aged” AND “depression”. Inclusion criteria were texts including primary data in Portuguese, Spanish or English, published between 2009-2013, also data which evaluated elderly caregivers (≥ 60) and depression or depressive symptoms. There were found n = 1129 texts and after applying the inclusion criteria n = 17 were selected and analyzed. Results Geriatric Depressive Scale (-30 and -15 items) and Center for Epidemiologic Studies Depression scale were the most used scales to evaluate depressive symptoms in older caregivers. Caregivers were in the most of the cases female and cared for a family member with dementia. The majority of the texts that compared older caregivers to older non-caregivers found that caregivers had more depressive symptoms. Discussion Early identification of depressive symptoms can help professionals to minimize damage in caregivers and in care recipient and to plan interventions focusing on improving quality of life of this specific caregiver group.

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

INTRODUCTION Older caregivers living in rural areas may be exposed to three vulnerable conditions, i.e., those related to care, their own aging, and their residence context. OBJECTIVE To analyze the association of burden and frailty with cognition performance in older caregivers in rural communities. METHOD In this cross-sectional survey, 85 older caregivers who cared for dependent elders were included in this study. Global cognition (Addenbrookes Cognitive Examination - Revised; Mini Mental State Examination), burden (Zarit Burden Interview) and frailty (Frieds frailty phenotype) were assessed. All ethical principles were observed. RESULTS Older caregivers were mostly women (76.7%); mean age was 69 years. Cognitive impairment was present in 15.3%, severe burden in 8.2%, frailty in 9.4%, and pre-frailty in 52.9% of the older caregivers. More severely burdened or frail caregivers had worse cognitive performance than those who were not, respectively (ANOVA test). Caregivers presenting a high burden level and some frailty degree (pre-frail or frail) simultaneously were more likely to have a reduced global cognition performance. CONCLUSION A significant number of older caregivers had low cognitive performance. Actions and resources to decrease burden and physical frailty may provide better cognition and well-being, leading to an improved quality of life and quality of the care provided by the caregivers.

Living with the elderly is related to a better performance in the recognition of facial expressions of emotion among older individuals

Background: Cohabitation with the elderly may bring benefits to social relationships and exert an influence on the recognition of facial expressions of emotion. Objective: Compare emotion recognition skills between a cohabitation group (CHG) of older adults who live with a dependent elderly individual and a non-cohabitation group (NCHG) of older adults who do not live with an elderly individual. Methods: Interviews were conducted with 62 older adults in the CHG and 56 in the NCHG. The two groups were similar with regard to gender, age, schooling, degree of dependence, cognitive performance, and depressive symptoms. A dynamic task with six emotions (anger, disgust, happiness, surprise, sadness, and fear) and four levels of intensity was administered to evaluate the recognition of facial emotions. Results: The CHG performed better than the NCHG regarding the correct identification of emotions, specifically surprise (60%), disgust (60%, 80%, and 100%), fear (80%), and sadness (80% and 100%). Discussion: Cohabitation with an elderly individual seems to offer benefits to older adults in terms of recognizing facial expressions of emotion. Luchesi BM et al. / Arch Clin Psychiatry. 2018;45(4):82-7

Use of digital game therapy among elderly persons undergoing dialytic treatment: cognitive aspects and depressive symptoms

1 Universidade Federal de São Carlos, Centro de Ciências Biológicas e da Saúde, Departamento de Gerontologia. São Carlos, São Paulo, Brasil. 2 Universidade Federal de São Carlos, Centro de Ciências Biológicas e da Saúde, Programa de Pós-graduação em Enfermagem. São Carlos, São Paulo, Brasil. 3 Universidade Federal de São Carlos, Centro de Ciências Exatas e de Tecnologia, Departamento de Computação. São Carlos, São Paulo, Brasil.

Prevalence of Physical Inactivity and Associated Factors Among Older Caregivers of Older Adults

Objective: The aim of this study is to analyze the prevalence of physical inactivity (PI) and associated factors in older caregivers of older adults. Method: A cross-sectional study was conducted including 312 older caregivers. Sociodemographic, clinical, and care-related characteristics were considered the independent variables for the determination of associated factors with PI in the logistic regression model. Results: The prevalence of PI was 75.3% (95% confidence interval [CI] = [70.1%, 80.0%]). The following factors were associated with PI: being female (odds ratio [OR] = 2.8, 95% CI = [1.3, 5.9]), being older than 75 years of age (OR = 7.1, 95% CI = [2.2, 22.9]), not having a marital life (OR = 4.2, 95% CI = [1.1, 15.8]), being prefrail (OR = 6.2, 95% CI = [1.7, 21.9]), and being frail (OR = 14.8, 95% CI = [3.8, 57.7]). Discussion: The prevalence of PI was high and associated with the female sex, an advanced age, and not being married. Specific public policies considering these results should be created for older caregivers.

Descriptive data in different paper-based cognitive assessments in elderly from the community Stratification by age and education

ABSTRACT Cognitive aging is dynamic and heterogeneous in elderly, thus adequate tools such as paper-based tests are relevant to describe the cognitive profile of this population. Objective: To describe different paper-based cognitive assessments tests in elderly people stratified by age and education. Methods: A cross-sectional study of 667 elderly (≥60 years) living in the community was conducted. Sociodemographic information was collected. Global cognition was assessed by the Addenbrookes Cognitive Examination-Revised (ACE-R), Mini Addenbrooke’s Cognitive Examination (M-ACE) and Mini-Mental State Examination (MMSE). The data were analyzed using descriptive statistics, the t-test and Pearson’s Correlation Coefficient. Results: The findings showed a predominance of women (53.8%), mean age of 71.3 (±7.7) years and 3.6 (±3.5) years of education. The best global cognitive performance and cognitive domain assessment scores were found in the group with higher formal educational level. Each year of education was associated with an increase of up to 10% in scores on the M-ACE and MMSE and up to 11% in ACE-R scores. The mean values of the scores varied according to age, where the 60-69 years group had better scores than other age groups. The correlation matrix between the cognitive tests showed that near perfect correlations (r=1) were frequent in the subgroup with higher education. Conclusion: Younger elderly and those with higher educational level had greater global and domain scores. This study describes the scores of elderly for different strata of education and age. In practice, it is important to choose the most suitable screening instrument, considering the characteristics of the elderly.

On the use of the P300 as a tool for cognitive processing assessment in healthy aging: A review

ABSTRACT Changes in patterns of performance for the cognitive functions of memory, processing speed, and focused attention are expected in old age. Objective: The main goal of this systematic review was to analyze the use of ERP in healthy elderly in studies evaluating the P300 components. Methods: A systematic review was carried out based on recommendations for nursing research on the databases LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. Results: 26 studies involving 940 healthy elderly were identified, most of which sought to identify and determine the influence of age on the P300. Conclusion: Although there is consensus in the literature that P300 latency is significantly longer in elderly with psychiatric disorders compared to healthy elderly, it was not possible to conclude P300 associations with gender, education and other cognitive tests.