Cynthia Arcoverde

Role of physical activity on the maintenance of cognition and activities of daily living in elderly with Alzheimer's disease

BACKGROUND The practice of physical activities has proved to be an efficient strategy in the improvement of independency and cognitive functions in the elderly with Alzheimers disease (AD). OBJECTIVE To evaluate the relation between the practice of physical activity, cognition and activities of daily living (ADL) of patients with AD. METHOD The cognitive and physical aspects and ADL were evaluated of 37 elders (19 normal controls, 11 sedentary with AD and 7 active with AD). RESULTS The variable that best predicts the cognitive state (MMSE) is the duration of disease for the AD sedentary group and Lawtons Scale for the AD active group. We observed a correlation between MMSE score and duration of disease in the sedentary group and between MMSE and ADL in the active group. CONCLUSION Our study showed that physical and cognitive stimulation in patients with AD can contribute to decrease cognitive and functional decline.FUNDAMENTO: A pratica de atividade fisica tem se mostrado uma estrategia eficaz na melhora da independencia e das funcoes cognitivas em idosos com doenca de Alzheimer (DA). OBJETIVO: Avaliar a relacao entre a pratica de atividade fisica, a cognicao e as atividades de vida diaria (AVD) em pacientes com DA. METODO: Foram avaliados os aspectos cognitivos, fisicos e as AVD de 37 idosos (19 controles normais, 11 com DA sedentarios e 7 com DA ativos). RESULTADOS: A variavel que melhor prediz o estado cognitivo (MEEM) foi o tempo de doenca para o grupo DA sedentarios e a Escala de Lawton para o grupo DA ativo. Observou-se correlacao entre MEEM e tempo de doenca no grupo sedentario e MEEM e AVD no grupo ativo. CONCLUSAO: O nosso estudo mostrou que a estimulacao fisica e cognitiva em pacientes com DA pode contribuir na diminuicao do declinio cognitivo e funcional.

Treadmill training as an augmentation treatment for Alzheimer?s disease: a pilot randomized controlled study

OBJECTIVE To assess the effect of aerobic exercise on the cognition and functional capacity in Alzheimers disease (AD) patients. METHOD Elderly (n=20) with mild dementia (NINCDS-ADRDA/CDR1) were randomly assigned to an exercise group (EG) on a treadmill (30 minutes, twice a week and moderate intensity of 60% VO₂max) and control group (GC) 10 patients. The primary outcome measure was the cognitive function using Cambridge Cognitive Examination (CAMCOG). Specifics instruments were also applied to evaluate executive function, memory, attention and concentration, cognitive flexibility, inhibitory control and functional capacity. RESULTS After 16 weeks, the EG showed improvement in cognition CAMCOG whereas the CG declined. Compared to the CG, the EG presented significant improvement on the functional capacity. The analysis of the effect size has shown a favorable response to the physical exercise in all dependent variables. CONCLUSION Walking on treadmill may be recommended as an augmentation treatment for patients with AD.

Consciência da doença na doença de Alzheimer: resultados preliminares de um estudo longitudinal

CONTEXTO: A presenca de deficits cognitivos e dos sintomas psicologicos e do comportamento nas demencias torna o fenomeno da consciencia da doenca um objeto de estudo bastante complexo. Esse fenomeno tem sido mais investigado em estudos de corte transversal do que em estudos de corte longitudinal. OBJETIVO: Comparar o comprometimento da consciencia da doenca na doenca de Alzheimer (DA) ao longo de seis meses. METODO: Ao longo de seis meses, 18 pacientes com DA leve foram avaliados por meio da Escala de Avaliacao do Impacto Psicossocial da Demencia (AIPD), do Miniexame do Estado Mental (MEEM), do Estadiamento Clinico da Demencia (CDR), da Escala Cornell para Depressao na Demencia (Cornell), da Escala Qualidade de Vida na Doenca de Alzheimer (QdV-DA) - versao paciente e do Questionario de Atividades Funcionais (Pfeffer). Os cuidadores foram avaliados com a Escala Zarit Burden Interview (Zarit) e a QdV-DA - versao cuidador. RESULTADOS: Ao final de seis meses, houve declinio no grau de consciencia da doenca (p = 0,02), no estado cognitivo (p < 0,01), nas atividades funcionais (p < 0,01) e no estadiamento clinico da doenca (p < 0,01) e aumento dos sintomas depressivos (p < 0,01). CONCLUSAO: Ha comprometimento da consciencia da doenca e deficits cognitivos e funcionais a medida que a gravidade da demencia aumenta.

Impaired cognition in depression and Alzheimer (AD): a gradient from depression to depression in AD

OBJECTIVE To assess cognition in major depressed (MD), Alzheimers disease (AD), and depression in AD elderly. METHOD Subjects were evaluated by Mini Mental, Rey Auditory Verbal Learning Test, Rey Complex Figure, Digit Span, Similarities, Trail Making A/B, Verbal Fluency and Stroop. One-way ANOVA and multivariate models were used to compare the performance of each group on neuropsychological tests. RESULTS We evaluated 212 subjects. Compared to MD, attention, working memory, processing speed and recall showed significantly better in controls. Controls showed significantly higher performance in all cognitive measures, except in attention compared to AD. Verbal fluency, memory, processing speed and abstract reasoning in MD was significantly higher compared to AD. AD was significantly better in general cognitive state than depression in AD. All other cognitive domains were similar. CONCLUSION A decreasing gradient in cognition appeared from the control to depression in AD, with MD and AD in an intermediate position.

Effects of motor and cognitive dual-task performance in depressive elderly, healthy older adults, and healthy young individuals

Impairments in dual-task performance can be observed in healthy older adults when motor and cognitive assignments are applied simultaneously. According to the hypofrontality hypothesis, there may be a reduction in frontal cognitive function during exercise. Objective The aim of the present study was to compare the performance changes on cognitive tests of depressive elderly (n=10), healthy older adults (n=10), and healthy young individuals (n=10) during cycle ergometer exercise. Methods The groups were submitted to a working memory test, a short memory test and a semantic memory test, before and during a 20-minute cycle ergometer exercise at 80% of their age-predicted maximal heart rate. Results Significant differences (p=0.04) were observed in scores on the digit backward test during exercise when young individuals were compared to healthy older adults. This result indicates that young subjects, as expected, had better performance than elderly. No significant differences were found among the groups for the digit forward subtest (p=0.40) or the vocabulary test (p=0.69). Conclusion Data from this study showed that healthy older adults had impaired performance on higher cognitive tasks when these assignments were applied together with motor tasks.