Estefani Serafim Rossetti

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.

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.

FRAGILIDADE, SINTOMAS DEPRESSIVOS E SOBRECARGA DE IDOSOS CUIDADORES EM CONTEXTO DE ALTA VULNERABILIDADE SOCIAL

Objective: to analyze the relationship between frailty, depressive symptoms and overload of elderly caregivers in a context of high social vulnerability. Method: correlational, cross-sectional study, with quantitative approach, carried out with 73 elderly primary caregivers of other elderly people enrolled in Family Health Units inserted in contexts of high social vulnerability of a city in the interior of Sao Paulo (Brazil). The data were collected through an individual interview, using a questionnaire for sociodemographic characterization, the Zarit Overload Inventory, Geriatric Depression Scale and Frailty Assessment, according to the Fried Phenotype. Results: the majority of the elderly caregivers were between 60 and 69 years old; they were female and had one to four years of schooling. Regarding the frailty, 37% were frail, 54.8% pre-frail and 8.2% non-frail. The elderly caregivers presented, in the majority, small overload (68.5%) and absence of indications of depressive symptoms (67.1%). There was a positive correlation and moderate magnitude (r=0.460, p=0.000) between frailty and depressive symptoms, that is, as the levels of frailty increase, the depressive symptoms become more prevalent. Conclusion: there was a correlation between frailty and depressive symptoms. Therefore, it is necessary to approach the health professionals in order to identify early the frailty and depressive symptoms of elderly caregivers in order to avoid late interventions. Special attention should be given to caregivers inserted in contexts of high social vulnerability

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

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.

Elderly caregivers living in urban, rural and high social vulnerability contexts

OBJECTIVE Comparing the differences in the sociodemographic, care and health profiles of elderly caregivers of the elderly living in urban, rural, and high social vulnerability contexts. METHOD A cross-sectional study developed with elderly caregivers enrolled in the Family Health Units of a municipality in the interior of São Paulo. Household interviews and evaluations were conducted on: Activities of Daily Living (ADL), self-reported pain, frailty, cognition, life satisfaction, family functionality, burden, stress and hope. RESULTS A total of 343 elderly caregivers of elderly individuals participated in the study, of which 55.1% lived in an urban context, 23.6% in rural areas, and 21.3% in a context of high social vulnerability. The majority of elderly caregivers were women across the three contexts, with a median age of 67 years and caring for their spouse. Caregivers from regions of high social vulnerability had lower education level, received less emotional and material help to care, were less satisfied with life, more fragile, in more cognitive decline, had worse family functionality and a lower level of hope when compared to caregivers of urban and rural contexts (p≤0.05). However, caregivers from areas of high vulnerability were more independent for ADL. CONCLUSION Professionals working in Primary Care should consider these differences when planning interventions aimed at the specific group of caregivers.

Elderly who take care of elderly: a study on the Frailty Syndrome

Objective Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services.

ASSOCIATION BETWEEN FAMILIAR FUNCTIONALITY, PSYCHOLOGICAL VARIABLES AND HEALTH PERCEPTION IN ELDERLY CARERS OF DEPENDENT ELDERLY IN A REGION OF HIGH SOCIAL VULNERABILITY

P3-582 CAN INCREASING THE DIFFICULTY OFA NEUROGENESIS-SENSITIVE TASK ENHANCE ITS SENSITIVITY TO DETECTING AGE-RELATED DECLINES IN VOLUNTEERS AGED 50 TO 96? KeithWesnes, Helen Brooker, Anne Corbett, Clive Ballard, Wesnes Cognition Ltd, Reading, United Kingdom; University of Exeter Medical School, Exeter, United Kingdom; King’s College London, London, United Kingdom. Contact e-mail: keith@wesnes.com