Renne P. Alegria

Comparative study of the uses of grammatical categories: Adjectives, adverbs, pronouns, interjections, conjunctions and prepositions in patients with Alzheimer's disease

Background:Mortality in Brazil has undergone important changes over the years, with a drop of infectious diseases and increase in chronic degenerative diseases. Such changes are reflections of an aging population associated with changes in lifestyle such as unhealthy eating habits, smoking, alcohol, physical inactivity, poor education and social inequalities that contribute to the multiple comorbidities. In the elderly population, increasing neurodegenerative diseases such as Alzheimer’s Disease (AD) is characterized by progressive memory impairment and the presence of one or more cognitive deficits. In the world according Burdelin et al. (2009), in 2010, an estimated prevalence of 35 million individuals with AD, the year 2030. The World Health Organization estimates that this prevalence occurs mainly in developing countries like Brazil, China, Russia and India. The study of mortality rates, especially the AD, is an important mechanism for knowledge to action planning specific to the elderly in care and the provision of health services network of the Unified Health System (SUS) and support system the social population. Methods: This is a descriptive study of mortality Alzheimer’s disease, whose data were obtained from the Mortality Information System (SIM), the Ministry of Health were selected statements deaths in the states of Rio de Janeiro (RJ) and St. Paulo (SP) and individuals 60 more years in 2008. We calculated the standardized mortality rate for the Brazilian population mortality AD states. Results: In 2008, the states were analyzed mortality by 3548 AD and found higher prevalence in females was 2327, male was 1221, rightly female rates of 1.7 and 1.5 per 100 000 hab. to the male, and RJ respective SP. The overall mortality rate was SP, 12.4 and RJ of 4.9 per 100 000 habitants. Conclusions: The results point to the need for reorganization of health services and social support to people with AD and their families with the preparation of action plan for the promotion of health and prevention of known risk factors for the disease, integration and intersectoral actions to securing life with more dignity by the people with AD.

Retained lexis in people with Alzheimer's disease

Mini-Mental Status Exam (0-30) 23 4.95 4 30 MMSE score 0-10 (severe) 2% MMSE score 11-20 (moderate) 22% MMSE score 21-26 (mild) 28% MSSE score 27-30 (normal) 48% Geriatric Depression Scale (0-15) 3 2.72 0 12 GDP score 0-4 (normal) 80% GDP score 5-10 (mild) 18% GDP score 11-15 (severe) 2% Neuropsychiatric Inventory (% experiencing symptom) Delusions 21% Hallucinations 10% Agitation 42% Depression 60% Anxiety 48% Elation 5% Apathy 47% Disinhibition 29% Irritability 53% Aberrant Motor Activity 15% Nighttime Disturbances 43% Appetite Change 43% Caregiver Burden Scale (0-88) 25 17.05 0 71 CBS Score 0-20 (little/no) 47% CBS Score 21-40 (mild/ moderate) 33%

Discourse analysis of Alzheimer's disease patients: From the lexicon to discourse

Background: Little attention has been given to the population with Alzheimer’s disease concerning the sociolinguistic underpinnings of their discourses. Language performance research has been the focus recently, especially for advancing our understanding of the multiple cognitive and sociolinguistic influences on the patients with dementia. Objective: to demonstrate the sociolinguistic underpinnings of Alzheimer’s disease patients Methods: The participants for this study were eight Alzheimer’s disease patients and six controls. The patients were four men and four women aged 80 and older, and the controls were three male and three female, aged 75 and older.All the patients were from PROTEROld Age Program ambulatory care of the Institute of Psychiatry of the School of Medicine of the University of São Paulo. The controls were their caregivers and/or relatives. The patients and controls had 4 to 11 years of education, their Mini Mental State Exam (MMSE) scores 13 to 30. The controls were also evaluated by other scales such as SRQ-20.Their discursive performances were recorded and analyzed by the computational tool Stablex, based on mathematical-statistical-computer assisted program which mainly distinguish the results of preferential, basic and differential vocabulary. Results: The sociolinguistic influences of the discourses of the patients are not necessarily destroyed compared to the discourse of the control subjects. The program Stablex shows that preferential vocabulary is constituted of the thematic vocabulary and the lexical components of more sociolinguistic frequency in the discourses. The patients produced more preferential words than the controls and they were shown to be statistically significant. The patients preserve more words with ideological, historical and cultural meanings Conclusions: Assessing the discourse performance of patients with Alzheimer’s disease provides opportunities to unravel the connections and changes among language, communication and behavior. For patients with dementia, analysis of sociolinguistic discourse is an access for a better communication with their caregivers.

Functional capacity, cognitive deficit and falls in Alzheimer's disease: A pilot study

with CDRS score 0.5, who did not meet the DSM-IV dementia criteria, were selected and diagnosed as MCI. 38 subjects with CDRS score 0.5 or more, who met the DSM-IV dementia criteria were diagnosed as AD. Old age, low levels of education, histroy of head trauma were associated significantly with AD (p<0.01, p<0.01 p<0.05). Interestingly, the proportion of subjects on DM medications was significantly different among the three groups (p<0.05). There were significant differences in the mean score of MMSE-KC and GDS-K among normal, MCI and the AD group (p<0.01, p<0.01). These scores were significantly correlated with each other in this study population (p<0.05). There was a significant correlation between the MMSE-KC score and serum total cholesterol and triglyceride levels in MCI group (p<0.05, p<0.05), but not in normal controls and AD group. Finally, we found that the mean score of Hachinski Ischemic Scale was significantly different among three groups (p<0.05). Conclusions: Our results strongly suggested that many vascular risk factors are associated with cognitive impairments in MCI and AD patients. In this study,serum lipid levels were associated with global cognitive dysfunction in MCI group. We confirmed that DM is a risk factor for MCI and AD in our Korean population.

P3-039: Performance of the long and short Brazilian versions of the IQCODE as screening for dementia in low-educated elderly

this study to determine the clinimetrical properties (construct validity and reliability) of the NPI Q and NPI D in a group of Mexican demented patients. Methods: We conducted a transversal, analytical and validation essay. We selected 100 dyads, with dementia diagnosis (of any type). The dyads were interviewed with neuropsychological tools (Mini Mental State Examination, Geriatric Depression Scale, Screening Caregiver Burden, Sleep Disorders Inventory NPI Q, NPI D), sociodemographic questionnaire (age, sex, caregiver relationship, work status, scholarship, etc), a thorough record of comorbidities, medications, and an exploration to complete the Mini Nutritional Assessment. NPI Q s total score was correlated with MMSE, GDS, NPI D and SCB; and individual domains were also evaluated (depression, psychotic symptoms, nutrition and sleep). The NPI D s total score was correlated with SCB and NPI Q. Six patients were selected for a test-retest, to evaluate reliability. Spearman s one tailed correlation, intraclass correlation coefficient (ICC) and Cronbach s alpha, were performed for statistical analysis. Results: Eighty-seven dyads were interviewed, general characteristics are shown in Table 1. The NPI-Q had a significant correlation with MMSE of 0,190 (p 0.001), NPI-D of r 0,887 (p 0,001), with GDS of r 0,385 (p 0.0001). The NPI-Q with a testretest of r 0,829 (p 0.021), ICC 0.824 and internal consistency of 0.778, the individual domain results are shown in Table 2. The NPI D had a significant correlation of r 0.555 with the SCB; test-retest r 0.986, ICC 0.857 and 0.779. Conclusions: Our NPI-Q and NPI-D versions are valid in the evaluation of Mexican patients with dementia. Our results are similar to those reported previously, but add the significant evaluation in the individual domains of sleep and oral intake.

P3-472: Pilot study of art therapy with family caregivers of patients with Alzheimer's disease

about caregiver burdens, including psychosocial burden, biological burden, negative thinking; people relationship, the dependence of patients, the ignominy burden. Moreover, there produced affective, tool, and information support factors, respectively, from the demand and satisfaction aspect. The reliability of each factor has greater than 0.6. Pearson Production Moment analysis revealed that psychosocial, biological burden factors were significant correlation with information and tool support factors, respectively. Furthermore, the dependence of dementia patient factor is marked significantly related with affective support factor. However, the negative thinking burden factor is significant negative correlation with information support. Conclusions: Armed with the results of above mentioned, the need of supports, in terms of information, tool, affective, for the caregiver burden of dementia family members is strong and not satisfied. Thus, to bridge the gap of the demand and satisfaction between dementia family members and multiple aspects supports is urgent.

P2-456: Clinical and psychiatric comorbidities and drug use among patients with dementia

Background: The prevalence of Dementia in the elderly is very high as the chance to develop other chronic diseases that can disable them functionally. The use of medication for the control of the diseases is very common. The comorbid profile of these patients and the drugs that are most frequently taken by them are very important for the planning of effective therapeutic schemes that do not offer potential side effects or other complications related to the drug abuse and drugs interactions.Objective: To assess medication use and comorbidity in patients with dementia. Methods: Data review of patients in ambulatory care from 2003 to 2007 (n 71) at a tertiary hospital. Dementia diagnosis was made using DSM-IV-TR criteria, physical examination, test application (CAMCOG, MMSE, NPI and B-ADL) and laboratory exams. The patients were classified according the CDR classification. Results: It was verified that approximately 81.7% of patients were diagnosed with Alzheimer’s disease, while 18.3% had other types of Dementia. The average index of CIRS comorbidity was 0.97 and the index of CIRS severity was 1.24. The most frequent clinical comorbidity was high blood pressure, and the most common psychiatric comorbidity was mood disorder. At least one medication was taken regularly by 82.2% of patients, and 29.5% took more than tree medications. According to CDR, patients with CDR 1 and 2 used less medication than those with CDR 0.5 and 3. Conclusions: High blood pressure and mood disorders are the most common comorbidities in patients with dementia and the cholinesterase inhibitors and antihipertensives are the most commonly used drugs.