Rodolfo Herberto Schneider

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.

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

AIMS: To evaluate the levels of vitamin D, parathyroid hormone and calcium in individuals with spinal cord injury and to identify related factors. METHODS: A cross-sectional study included men with spinal cord injury, living in the South Region of Brazil. A questionnaire was applied to evaluate socioeconomic data, life habits and health. The time elapsed since the spinal cord injury was considered. Vitamin D was evaluated in plasma via liquid chromatography; calcium and PTH were measured in serum by a colorimetric method and electrochemiluminescence respectively. For data analysis, linear regression and chi-square test were utilized. Values of p<0.05 were considered significant. RESULTS: The study included 39 paraplegic or tetraplegic men with spinal cord injury. The mean age was 35.52±9.78 years, and the mean time since injury was 6.09±5.55 years. The mean biochemical levels were: 19.0 ±6.98 ng/mL for vitamin D; 9.54±0.52 mg/dL for total calcium; and 34.81±10.84 pg/mL for parathyroid hormone. Individuals with sun exposure for more than two hours daily had higher vitamin D levels than those exposed up to one hour per day (p=0.001). Linear regression identified an inverse relationship between lesion time and vitamin D levels (regression coefficient: -0.424; p=0.029), while the other parameters did not show significant differences regarding the time elapsed since the lesion. Subjects with income above four minimum wages had higher vitamin D values (mean 25.67±5.45 ng/mL) when compared to those with income up to four minimum wages (mean 18.43±6.79 ng/mL) (p=0.021). CONCLUSIONS: Levels of vitamin D were inversely correlated to the time elapsed since the spinal cord injury, probably due to insufficient sun exposure resulting from prolonged limitation of mobility. In addition, lower levels of vitamin D were associated to lower income. These factors may aggravate bone loss associated with decreased mobility resulting from spinal cord injury.

Time of delirium onset and prognosis amongst Southern Brazilian hospitalized elderly patients

The prognostic significance of delirium in hospitalized elderly has not yet been fully clarified. Objectives The present study was designed to evaluate the relationship between prevalent delirium (PrD), incident delirium (InD) and final outcome. Methods A historical cohort of 261 patients was selected. delirium was diagnosed using the Confusion Assessment Method. Results The total frequency of delirium detected was 42.5%-31.4% PrD and 16.2% InD. Among patients with InD, the average length of hospital stay was 9.1 days longer than for patients without delirium (p=0.002), and the hospital mortality associated with InD was 48% versus 2.7% for those without delirium (p< 0.001). However, no difference was observed between patients with PrD and those without delirium. Conclusions These results suggest that, when investigating delirium and prognosis amongst hospitalized elderly, it is fundamental to differentiate in terms of time of onset. Furthermore, the absence of delirium seems to be an important protective factor.