Idiane Rosset

(Pre)diabetes, brain aging, and cognition.

Cognitive dysfunction and dementia have recently been proven to be common (and underrecognized) complications of diabetes mellitus (DM). In fact, several studies have evidenced that phenotypes associated with obesity and/or alterations on insulin homeostasis are at increased risk for developing cognitive decline and dementia, including not only vascular dementia, but also Alzheimers disease (AD). These phenotypes include prediabetes, diabetes, and the metabolic syndrome. Both types 1 and 2 diabetes are also important risk factors for decreased performance in several neuropsychological functions. Chronic hyperglycemia and hyperinsulinemia primarily stimulates the formation of Advanced Glucose Endproducts (AGEs), which leads to an overproduction of Reactive Oxygen Species (ROS). Protein glycation and increased oxidative stress are the two main mechanisms involved in biological aging, both being also probably related to the etiopathogeny of AD. AD patients were found to have lower than normal cerebrospinal fluid levels of insulin. Besides its traditional glucoregulatory importance, insulin has significant neurothrophic properties in the brain. How can clinical hyperinsulinism be a risk factor for AD whereas lab experiments evidence insulin to be an important neurothrophic factor? These two apparent paradoxal findings may be reconciliated by evoking the concept of insulin resistance. Whereas insulin is clearly neurothrophic at moderate concentrations, too much insulin in the brain may be associated with reduced amyloid-beta (Abeta) clearance due to competition for their common and main depurative mechanism - the Insulin-Degrading Enzyme (IDE). Since IDE is much more selective for insulin than for Abeta, brain hyperinsulinism may deprive Abeta of its main clearance mechanism. Hyperglycemia and hyperinsulinemia seems to accelerate brain aging also by inducing tau hyperphosphorylation and amyloid oligomerization, as well as by leading to widespread brain microangiopathy. In fact, diabetes subjects are more prone to develop extense and earlier-than-usual leukoaraiosis (White Matter High-Intensity Lesions - WMHL). WMHL are usually present at different degrees in brain scans of elderly people. People with more advanced WMHL are at increased risk for executive dysfunction, cognitive impairment and dementia. Clinical phenotypes associated with insulin resistance possibly represent true clinical models for brain and systemic aging.

Diferenciais socioeconômicos e de saúde entre duas comunidades de idosos longevos

OBJETIVO: Identificar diferencias demograficas y socioeconomicas relacionadas con el estado de salud de ancianos mas viejos residentes en dos ciudades de diferentes regiones de Brasil. METODOS: Estudio epidemiologico transversal y comparativo de ancianos mas viejos (>80 anos) residentes en Ribeirao Preto (RP - Sureste de Brasil) y Caxias do Sul (Sur), con muestra probabilistica de 117 sujetos en CS y 155 en RP, realizados entre 2007 y 2008. El instrumento de colecta incluyo datos demograficos y socioeconomicos mini-examen del estado mental, Medida de Independencia Funcional, numero de comorbilidades autoreferidas y Escala de Depresion Geriatrica. RESULTADOS: La edad promedio fue similar, con predominancia de mujeres (~70%) y viudos (~60%) en ambos municipios. La escolaridad promedio no difirio estadisticamente, pero la renta promedio del anciano fue mayor en RP que en CS (p=0,05). RP presento mayor concentracion de individuos en los extremos de escolaridad y renta que CS. El escore promedio del mini-examen del estado mental fue similar entre los dos grupos y mayor para individuos del sexo masculino, con edad entre 80 y 84 anos, casados y con mayor escolaridad. Se observo mejor desempeno funcional entre ancianos de 80 a 84 anos en ambos municipios, entre los de mayor escolaridad en RP; y entre los de sexo masculino y los casados en CS. Ancianos de CS presentaron mayor numero de comorbilidades que los de RP (p<0,001). Ancianos del sexo masculino, casados, y con mayor renta presentaron menos sintomas depresivos en ambos grupos; y los de RP presentaron mayor escores en la Escala de Depresion Geriatrica que los de CS (p<0,001). CONCLUSIONES: Aunque los ancianos de CS presenten menor desigualdad socioeconomica y menos sintomas depresivos, poseen tambien mayor numero promedio de comorbilidades y menor nivel de independencia funcional, al compararlos con los de RP.OBJECTIVE To identify demographic and socioeconomic differentials associated with the health status of oldest-old individuals living in two cities of different Brazilian regions. METHODS A comparative and cross-sectional epidemiological study was conducted with the oldest-old (> 80 years), living in the cities of Ribeirão Preto (RP, Southeastern Brazil) and Caxias do Sul (CS, Southern). The probabilistic sample included 117 individuals in CS and 155 in RP, and data were collected between 2007 and 2008. The instrument included demographic and socioeconomic data, Mini-Mental State Examination, Functional Independence Measure, number of self-reported comorbidities and Geriatric Depression Scale. RESULTS Mean age was similar, with predominance of women (~70%) and widowed individuals (~60%) in both cities. Mean level of education did no differ statistically, although mean income was higher in RP than in CS (p = 0.05). RP showed a higher concentration of individuals in the extreme levels of education and income than that of CS. Mean score of the Mini-Mental State Examination was similar in both groups and higher among men, individuals aged between 80 and 84 years, married and with a higher level of education. Better functional performance was observed in elderly individuals aged between 80 and 84 years in both cities, in those with higher level of education in RP; and in males and married individuals in CS. Elderly individuals in CS showed higher number of comorbidities than those in RP (p < 0.001). Male elderly individuals, married and with -higher income level showed fewer depressive symptoms in both groups; and those in RP showed higher Geriatric Depression Scale score than the others in CS (p < 0.001). CONCLUSIONS Although the oldest old in CS showed lower socioeconomic inequality and fewer depressive symptoms, they also had a higher mean number of comorbidities and lower level of functional independence, when compared to those in RP.

Dependência funcional de idosos e a sobrecarga do cuidador

A finalidade deste estudo foi identificar a dependencia funcional de idosos e a sobrecarga do cuidador. Trata-se de estudo epidemiologico e transversal realizado em 2009 com 574 idosos e 124 cuidadores em Ribeirao Preto-SP, por meio dos instrumentos MIF e Escala de Sobrecarga de Zarit. Entre os idosos, a maioria era do sexo feminino (67,8%), com media de 76,6 anos, baixa escolaridade (54,7%) e renda individual mensal de R

Tendências dos estudos com idosos mais velhos na comunidade : uma revisão sistemática (inter)nacional

942,20. Apenas 15,7% foram identificados como dependentes. Dos cuidadores, 85,6% era do sexo feminino, com media de 56,5 anos e 90,3% eram familiares (filhas ou esposas). A media de sobrecarga dos cuidadores foi de 27,8 (±17,5). A dependencia do idoso foi fator de risco para sobrecarga do cuidador (p<0,05). A abordagem preventiva e a intervencao precoce devem ser prioritarias para essa populacao. Sao necessarias a vigilância de uma equipe multidisciplinar de saude, a aplicacao de instrumentos de avaliacao do comprometimento da funcionalidade e a intervencao para prevencao da sobrecarga dos cuidadores.This study investigated the functional dependency of aged individuals and caregiver burden. This epidemiological and cross-sectional study was conducted in 2009 with 574 aged individuals and 124 caregivers in Ribeirão Preto, SP, Brazil, using the following instruments: Functional Independency Measure (FIM) and Zarit Burden Interview. Among the elderly, most (67.8%) were women with a mean age of 76.6 years, with a low educational level (54.7%) and an average monthly per capita income of R

[Tendencies of studies addressing the eldest individuals of aged population in the community: a (inter)national systematic review].

942.20. Only 15.7% were identified as being dependent. Regarding the caregivers, 85.6% were women with a mean age of 56.5 years; 90.3% were family caregivers (daughters, wives), and the mean burden score was 27.8 (±17.5). The dependency of the aged individuals was a risk factor for caregiver burden (p<0.05). Preventive actions and early intervention should be priority for this population. The following are necessary: surveillance by a multidisciplinary health team, the application of instruments to assess the extent to which functionality is compromised and interventions to prevent caregiver burden.

Functional dependency of older individuals and caregiver burden

The purpose of this study was to identify and analyze the tendencies and types of studies published in Brazil and abroad, involving elders aged>80 years, living in the community. A systematic review of national literature was performed using the LILACS and SciELO databases, and PUBMED and EMBASE for international literature, covering publications of the last two decades. Twelve national and 162 international references were selected. Biological sciences were the prevalent area both at the national (50%) and international (74.1%) levels. All national studies were observational, 91.7% of which were cross-sectional. Of the international studies, 93.3% were observational, 48.1% of which were cross-sectional and 37.6% were cohort studies. The United States were the country responsible for 41.4% of all international publications. Brazil and China were the only developing countries with international publications. Despite the significant number of international scientific publications as of 2005, this fact has not been observed at the national level.The purpose of this study was to identify and analyze the tendencies and types of studies published in Brazil and abroad, involving elders aged >80 years, living in the community. A systematic review of national literature was performed using the LILACS and SciELO databases, and PUBMED and EMBASE for international literature, covering publications of the last two decades. Twelve national and 162 international references were selected. Biological sciences were the prevalent area both at the national (50%) and international (74.1%) levels. All national studies were observational, 91.7% of which were cross-sectional. Of the international studies, 93.3% were observational, 48.1% of which were cross-sectional and 37.6% were cohort studies. The United States were the country responsible for 41.4% of all international publications. Brazil and China were the only developing countries with international publications. Despite the significant number of international scientific publications as of 2005, this fact has not been observed at the national level.

Socioeconomic and health differentials between two community-dwelling oldest-old groups

The purpose of this study was to identify and analyze the tendencies and types of studies published in Brazil and abroad, involving elders aged>80 years, living in the community. A systematic review of national literature was performed using the LILACS and SciELO databases, and PUBMED and EMBASE for international literature, covering publications of the last two decades. Twelve national and 162 international references were selected. Biological sciences were the prevalent area both at the national (50%) and international (74.1%) levels. All national studies were observational, 91.7% of which were cross-sectional. Of the international studies, 93.3% were observational, 48.1% of which were cross-sectional and 37.6% were cohort studies. The United States were the country responsible for 41.4% of all international publications. Brazil and China were the only developing countries with international publications. Despite the significant number of international scientific publications as of 2005, this fact has not been observed at the national level.The purpose of this study was to identify and analyze the tendencies and types of studies published in Brazil and abroad, involving elders aged >80 years, living in the community. A systematic review of national literature was performed using the LILACS and SciELO databases, and PUBMED and EMBASE for international literature, covering publications of the last two decades. Twelve national and 162 international references were selected. Biological sciences were the prevalent area both at the national (50%) and international (74.1%) levels. All national studies were observational, 91.7% of which were cross-sectional. Of the international studies, 93.3% were observational, 48.1% of which were cross-sectional and 37.6% were cohort studies. The United States were the country responsible for 41.4% of all international publications. Brazil and China were the only developing countries with international publications. Despite the significant number of international scientific publications as of 2005, this fact has not been observed at the national level.

Acculturation, Obesity, and Hypertension Among Female Brazilian Indians

A finalidade deste estudo foi identificar a dependencia funcional de idosos e a sobrecarga do cuidador. Trata-se de estudo epidemiologico e transversal realizado em 2009 com 574 idosos e 124 cuidadores em Ribeirao Preto-SP, por meio dos instrumentos MIF e Escala de Sobrecarga de Zarit. Entre os idosos, a maioria era do sexo feminino (67,8%), com media de 76,6 anos, baixa escolaridade (54,7%) e renda individual mensal de R

ON THE BRAZILIAN ELDERLY AMERINDIAN HERITAGE AND THE VERY OLD ITALIAN-BRAZILIAN LONGITUDINAL STUDY ON AGING

942,20. Apenas 15,7% foram identificados como dependentes. Dos cuidadores, 85,6% era do sexo feminino, com media de 56,5 anos e 90,3% eram familiares (filhas ou esposas). A media de sobrecarga dos cuidadores foi de 27,8 (±17,5). A dependencia do idoso foi fator de risco para sobrecarga do cuidador (p<0,05). A abordagem preventiva e a intervencao precoce devem ser prioritarias para essa populacao. Sao necessarias a vigilância de uma equipe multidisciplinar de saude, a aplicacao de instrumentos de avaliacao do comprometimento da funcionalidade e a intervencao para prevencao da sobrecarga dos cuidadores.This study investigated the functional dependency of aged individuals and caregiver burden. This epidemiological and cross-sectional study was conducted in 2009 with 574 aged individuals and 124 caregivers in Ribeirão Preto, SP, Brazil, using the following instruments: Functional Independency Measure (FIM) and Zarit Burden Interview. Among the elderly, most (67.8%) were women with a mean age of 76.6 years, with a low educational level (54.7%) and an average monthly per capita income of R

Dependencia funcional de ancianos y la sobrecarga del cuidador

942.20. Only 15.7% were identified as being dependent. Regarding the caregivers, 85.6% were women with a mean age of 56.5 years; 90.3% were family caregivers (daughters, wives), and the mean burden score was 27.8 (±17.5). The dependency of the aged individuals was a risk factor for caregiver burden (p<0.05). Preventive actions and early intervention should be priority for this population. The following are necessary: surveillance by a multidisciplinary health team, the application of instruments to assess the extent to which functionality is compromised and interventions to prevent caregiver burden.