Irani Iracema de Lima Argimon

Habilidades cognitivas em indivíduos muito idosos: um estudo longitudinal

Estudos longitudinais com idosos com mais de oitenta anos sao escassos na literatura. A pesquisa foi delineada com o objetivo de analisar as modificacoes no perfil de algumas habilidades cognitivas em individuos muito idosos, em dois momentos, com um intervalo de tres anos. Pesquisa do tipo quantitativo, com delineamento longitudinal e prospectivo. A amostra, randomica, foi constituida por 66 individuos de 80 a 95 anos de idade na etapa I e, tres anos apos, na etapa II, por 46 idosos. Os instrumentos usados foram: Escala de Depressao Geriatrica, Questionario de Percepcao Subjetiva de Queixas de Memoria, Mini-Exame do Estado Mental, Span de Numeros, Teste de Lembrancas Livres e com Pistas de Buschke, Teste de Fluencia Verbal - Categoria Animal. Houve uma pequena tendencia de decrescimo no desempenho cognitivo em um periodo de tres anos. Maior numero de atividades de lazer e mais anos de escolaridade foram fatores preditivos de menor variacao no desempenho cognitivo. Apesar da idade avancada, os idosos apresentaram um desempenho de habilidades cognitivas cujo declinio foi de intensidade leve, nao sendo suficiente para acarretar mudancas significativas no seu padrao cognitivo.Estudos longitudinais com idosos com mais de oitenta anos sao escassos na literatura. A pesquisa foi delineada com o objetivo de analisar as modificacoes no perfil de algumas habilidades cognitivas em individuos muito idosos, em dois momentos, com um intervalo de tres anos. Pesquisa do tipo quantitativo, com delineamento longitudinal e prospectivo. A amostra, randomica, foi constituida por 66 individuos de 80 a 95 anos de idade na etapa I e, tres anos apos, na etapa II, por 46 idosos. Os instrumentos usados foram: Escala de Depressao Geriatrica, Questionario de Percepcao Subjetiva de Queixas de Memoria, Mini-Exame do Estado Mental, Span de Numeros, Teste de Lembrancas Livres e com Pistas de Buschke, Teste de Fluencia Verbal - Categoria Animal. Houve uma pequena tendencia de decrescimo no desempenho cognitivo em um periodo de tres anos. Maior numero de atividades de lazer e mais anos de escolaridade foram fatores preditivos de menor variacao no desempenho cognitivo. Apesar da idade avancada, os idosos apresentaram um desempenho de habilidades cognitivas cujo declinio foi de intensidade leve, nao sendo suficiente para acarretar mudancas significativas no seu padrao cognitivo.

Neuroendocrine and Immunological Correlates of Chronic Stress in ‘Strictly Healthy’ Populations

Background: Chronic stress has been associated with detrimental or maladaptive neuroendocrine and immunological changes. Objectives: We assessed the neuroendocrine and immunological correlates of a realistic chronic stress experienced by strictly healthy caregivers of Alzheimer’s disease patients and age-matched controls. Methods: We screened 330 caregivers and 206 non-caregivers according to the ‘strictly healthy’ conditions established by the SENIEUR protocol. Forty-one strictly healthy caregivers (60.56 ± 16.56 years) and 33 non-stressed controls (60.27 ± 14.11 years) were selected for this study. Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were assessed at multiple points by radioimmunoassay. Peripheral T cell proliferation and cellular sensitivity to glucocorticoids (corticosterone and dexamethasone, DEX) were evaluated by colorimetric assays. We also examined the hypothalamic-pituitary-adrenal (HPA) axis response to the administration of a low-dose DEX in vivo. Results: The caregivers were significantly more stressed, anxious and depressed than non-caregivers (all p < 0.0001), in contrast to similar cortisol levels. Caregivers had reduced DHEAS levels (–32%, p < 0.0001), an increased cortisol/DHEAS ratio (39.7%, p < 0.0001) and impaired HPA axis response to DEX intake. Caregivers had a higher T cell proliferation (p < 0.0001) and increased sensitivity to glucocorticoids in vitro (p < 0.01) as compared to non-stressed controls. Conclusions: Our results suggest that the maintenance of health in chronically stressed populations may be associated with both protective and detrimental neuroendocrine and immunological changes.

Characterization of cognitive and motor performance during dual-tasking in healthy older adults and patients with Parkinson’s disease

The primary purpose of this study was to investigate the effect of dual-tasking on cognitive performance and gait parameters in patients with idiopathic Parkinson’s disease (PD) without dementia. The impact of cognitive task complexity on cognition and walking was also examined. Eighteen patients with PD (ages 53–88, 10 women; Hoehn and Yahr stage I-II) and 18 older adults (ages 61–84; 10 women) completed two neuropsychological measures of executive function/attention (the Stroop Test and Wisconsin Card Sorting Test). Cognitive performance and gait parameters related to functional mobility of stride were measured under single (cognitive task only) and dual-task (cognitive task during walking) conditions with different levels of difficulty and different types of stimuli. In addition, dual-task cognitive costs were calculated. Although cognitive performance showed no significant difference between controls and PD patients during single or dual-tasking conditions, only the patients had a decrease in cognitive performance during walking. Gait parameters of patients differed significantly from controls at single and dual-task conditions, indicating that patients gave priority to gait while cognitive performance suffered. Dual-task cognitive costs of patients increased with task complexity, reaching significantly higher values then controls in the arithmetic task, which was correlated with scores on executive function/attention (Stroop Color-Word Page). Baseline motor functioning and task executive/attentional load affect the performance of cognitive tasks of PD patients while walking. These findings provide insight into the functional strategies used by PD patients in the initial phases of the disease to manage dual-task interference.

Estratégias de enfrentamento, dificuldades funcionais e fatores associados em idosos institucionalizados

The aim of this study was to analyze the strategies used by elderly people to cope with functional difficulties, and to investigate a possible association between such strategies and variables like depressive symptoms, gender, schooling, marital status, and self-perceived health. 103 institutionalized elderly individuals participated in the study. They required assistance for at least one activity of daily living. The study was cross-sectional and used the following indicators: Personal Data Chart, Activities of Daily Living Scale, Modified Mini International Neuropsychiatric Interview, Mini-Mental Examination, Coping Strategies Inventory, and Geriatric Depression Scale. The most widely used coping strategies in the sample were self-control and problem solving. Significant associations were found between schooling and depression. The findings suggest that assessing coping strategies for stressful events can assist analysis of the situation and appropriate adaptation of the chosen strategies, so as to foster changes within the medical context.

Vinculação da gestante e apego materno fetal

This study verified the association between the type of pregnant womens bonding, symptoms of anxiety, depression and the level of maternal-fetal attachment. The sample was composed of 136 pregnant women between 18 and 42 years of age, from the sixth to the ninth month of pregnancy, with at least the fifth grade. This is a quantitative, transversal and correlational study. The used instruments were: a social-demographic data form, Adult Bonding Scale (EVA), Maternal-Fetal Attachment Scale (MFAS), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Data were analyzed through descriptive statistics, Fishers exact test, Monte Carlo Simulation and Pearsons correlation. Results indicate that there is significant association between the type of pregnant womens bonding, maternal-fetal attachment and depression symptoms. The pregnant women who presented strong bonding showed a high level of maternal-fetal attachment and fewer anxious and depressive symptoms.Este trabalho verificou as relacoes existentes entre o tipo de vinculacao da gestante, sintomas de ansiedade, depressao e nivel de apego materno fetal. Participaram 136 gestantes entre 18 e 42 anos de idade, do 6o ao 9o mes de gestacao com escolaridade minima de 5a serie. Foi realizado um estudo quantitativo, transversal, correlacional. Os instrumentos utilizados foram: Ficha de Dados Sociodemograficos, Escala de Vinculacao do Adulto (EVA), Escala de Apego Materno Fetal (MFAS), Inventario de Depressao de Beck (BDI) e Inventario de Ansiedade de Beck (BAI). A analise dos dados foi realizada por meio de estatistica descritiva, teste exato de Fischer, simulacoes de Monte Carlo e Correlacao de Pearson. Os resultados indicaram que existe associacao significativa entre o tipo de vinculacao da gestante e o apego materno fetal, e sintomas depressivos. As gestantes que apresentaram uma vinculacao segura evidenciaram apego materno fetal alto e sintomas depressivos e ansiosos minimos.

Systematic review of the prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies

This paper describes the findings of a systematic literature review aimed at providing an overview of the lifetime prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. Databases MEDLINE, ProQuest, Psychnet, and Web of Science were browsed for papers published in English between 1999 and May 2012 using the following search string: bipolar disorders OR bipolar spectrum disorders AND prevalence OR cross-sectional OR epidemiology AND population-based OR non-clinical OR community based. The search yielded a total of 434 papers, but only those published in peer-reviewed journals and with samples aged ≥ 18 years were included, resulting in a final sample of 18 papers. Results revealed rather heterogeneous findings concerning the prevalence of bipolar disorders and bipolar spectrum disorders. Lifetime prevalence of bipolar disorder ranged from 0.1 to 7.5%, whereas lifetime prevalence of bipolar spectrum disorders ranged from 2.4 to 15.1%. Differences in the rates of bipolar disorder and bipolar spectrum disorders may be related to the consideration of subthreshold criteria upon diagnosis. Differences in the prevalence of different subtypes of the disorder are discussed in light of diagnostic criteria and instruments applied.

A resiliência em idosos e sua relação com variáveis sociodemográficas e funções cognitivas

The aim of this article is to study the relationship between older peoples resilience and some sociodemographic variables and cognitive functions. In order to do so, the scores obtained from the Resilience Scale were compared to average scores from two other investigation tools: Subjective Perception of Memory Complaints and the Mini-Mental State Examination. The research sample was composed of 86 old people, of which 67 were women, and 19 were men, whose ages varied from 60 to 90. The results showed that there is no relationship between resilience and sociodemographic variables. On the other hand, they did show that higher numbers of memory subjective complaints directly correspond to lower indices of resilience. The survey also revealed that there is a direct and meaningful correlation between the Resilience Scale and Mini-Mental State Examination, so it is possible to conclude that the higher the resilience scores, the greater are old peoples achievements in cognitive performance scoring.

Contextual recognition memory deficits in major depression are suppressed by cognitive support at encoding.

OBJECTIVES To investigate the effect of cognitive support (an associative orienting instruction at encoding) on contextual memory in depressed patients. METHODS Seventeen patients (age 20-40 years, 14 women) diagnosed with major depressive disorder (MDD) and 22 healthy controls matched for age, gender and education completed a recognition memory task for item (object) and context (location), with or without an incidental binding cue at encoding. In addition, participants completed the vocabulary subtest of the Wechsler Adult Intelligence Scale (WAIS III) and the Wisconsin Card Sorting Test (WCST). Salivary samples were collected at 7 AM, 4 PM and 10 PM on the day of testing for cortisol and DHEA level measurement. RESULTS Depressed patients showed a deficit in contextual memory in the absence of a binding cue but did not differ from healthy controls in item memory or when a binding cue was present. Cortisol and cortisol/DHEA ratios were lower in depressed patients compared to healthy controls and correlated with memory deficits. CONCLUSIONS Contextual memory deficits in MDD patients can be reduced by providing cognitive support at encoding.

Contextual memory and encoding strategies in young and older adults with and without depressive symptoms

Objectives: This study examines the role of depressive symptoms associated with age on contextual memory and how this association could impair the use of strategic instructions during encoding. Method: Young and older controls and older adults with depressive symptoms performed memory recognition tests for item and context. Results: Memory results indicated that mild depressive symptoms did not aggravate the age-related contextual memory pattern, but interfered with the magnitude of the memory enhancement provided by specific encoding instructions when compared with young adults. These between-group differences in the use of memory strategies were eliminated with the inclusion of the performance on Wisconsin Card Sorting Test as a covariate. Conclusion: Mild depressive symptoms were associated with an impaired ability to use incidental memory strategies at encoding, suggesting the need for further investigation on the effects of non-clinical depressive symptomatology on cognitive decline in aging.

Phonemic and semantic verbal fluency tasks: normative data for elderly Brazilians

Este estudo buscou investigar a influencia de caracteristicas sociodemograficas no desempenho de idosos em duas tarefas de fluencia verbal, alem de fornecer dados normativos de referencia nessas tarefas, conforme niveis de educacao, para a populacao brasileira de idosos saudaveis​​. A amostra inicial incluiu 521 idosos com idade a partir 60 anos, participantes do Programa Estrategia Saude na Familia. Foram excluidos os participantes que tinham pontuacoes sugestivas de declinio cognitivo no Mini Exame do Estado Mental, de sintomas depressivos na Escala de Depressao Geriatrica e com autorrelato de doencas neurologicas ou de disturbios psiquiatricos. A amostra final foi composta por 218 participantes que responderam a tarefa de fluencia verbal fonemica (letras F, A e S) e 265 que responderam a tarefa semântica (animais). O desempenho em ambas as tarefas foi associado a idade e aos anos de ensino formal, mas nao ao sexo. Ainda, a variavel escolaridade mostrou ter um impacto maior no desempenho de fluencia verbal do que a idade em ambas as modalidades de evocacao. Os resultados desse estudo sugerem a importância de oferecer dados normativos de idosos brasileiros, adequados a idade e a escolaridade, em tarefas de fluencia verbal.