Thais Bento Lima da Silva

Treino cognitivo para idosos baseado em estratégias de categorização e cálculos semelhantes a tarefas do cotidiano

Intervencoes cognitivas podem melhorar o desempenho entre idosos. Objetivou-se testar a eficacia de um programa de treino cognitivo baseado em tarefas ecologicas, que mimetizam tarefas de compra, envolvendo a memorizacao de itens de supermercado e calculos matematicos simples. Realizou-se estudo de intervencao com grupo controle, com avaliacao pre e pos-treino; 21 idosos participaram de oito sessoes de treino e 12 idosos somente completaram as avaliacoes pre e pos-teste. Como medida de eficacia, foram usadas as provas da bateria CERAD, a Escala de Depressao Geriatrica, e quatro questoes extraidas da Escala de Satisfacao com a Vida. Durante o treino, os participantes realizaram tarefas semelhantes as atividades diarias, como a memorizacao de listas de supermercado, categorizacao dos itens de mercado e manuseio de dinheiro em tarefas de troco. O grupo treino apresentou melhora significativa particularmente no teste de fluencia verbal categoria animais e no resgate imediato da lista de palavras (somatorio das 3 tentativas) da bateria CERAD. O grupo controle nao apresentou alteracoes significativas entre o pre e o pos-teste, para as variaveis avaliadas. Os resultados sugerem que o treino cognitivo pode gerar melhora no desempenho em tarefas de memorizacao e calculos entre idosos.

Fluência verbal e variáveis sociodemográficas no processo de envelhecimento: um estudo epidemiológico

Verbal fluency is a marker of executive functions which involves the ability of searching and retrieving information, organizational skills, self-regulation and working memory. The objective of this paper was to identify differences in verbal fluency (number of animals, categories, clusters and category switching) associated with gender, age, education and income. Three hundred eighty three elderly (60 or older) participated in an epidemiological cross-sectional study. Participants answered sociodemographic questions and completed the verbal fluency animal category test. Verbal fluency variables were influenced by gender, age, and education. Higher performance was reported for men and participants with lower age and higher education. Results confirm that performance in verbal fluency must be interpreted in the light of sociodemographic information.

Relations between memory complaints, depressive symptoms and cognitive performance among community dwelling elderly

Contexto A queixa de memoria e comum entre pessoas idosas, entretanto sua relevância clinica para o diagnostico de alteracoes cognitivas e questionavel, visto que diversos fatores podem se associar as queixas. Objetivo: O presente estudo avaliou a relacao entre queixas de memoria, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Objetivo O presente estudo avaliou a relacao entre queixas de memoria, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Metodos O desempenho cognitivo foi avaliado por meio dos testes de memorizacao de 10 figuras comuns, Miniexame do Estado Mental (MEEM), Fluencia Verbal (FV) e Teste do Desenho do Relogio, que compoem a Bateria Breve de Rastreio Cognitivo (BBRC). As queixas de memoria foram avaliadas pelo Questionario de Queixas de Memoria (MAC-Q) e os sintomas depressivos, pela Escala de Depressao Geriatrica (EDG). Resultados Participantes do sexo feminino apresentaram maior indice de queixas de memoria, comparado ao dos homens (p = 0,013). Idosos menos escolarizados apresentaram queixas de memoria mais intensas e pior desempenho cognitivo, comparados aos de maior escolaridade (p < 0,003). A presenca de sintomas depressivos associou-se a pior avaliacao da memoria (r = 0,39, p < 0,001). Conclusao: As queixas de memoria se associaram a sexo, escolaridade e sintomas depressivos, entre idosos residentes na comunidade. Nao houve associacao entre queixas e desempenho cognitivo. Conclusao As queixas de memoria se associaram a sexo, escolaridade e sintomas depressivos, entre idosos residentes na comunidade. Nao houve associacao entre queixas e desempenho cognitivo.

Emotional Regulation Questionnaire (ERQ): indicadores psicométricos e relações com medidas afetivas em amostra idosa

We examined psychometric indicators of the Emotional Regulation Questionnaire (ERQ) and their relationship with measures of affective experience, satisfaction with life and depression in the elderly. One hundred and fifty-three elderly people (M = 66.8 years, SD = 5.20, 71.2% female) of an Open University for Seniors responded to the ERQ, the Positive and Negative Affect Schedule (PANAS), the Life Satisfaction Scale and the Geriatric Depression Scale (GDS-15). Two factors (Cognitive Reappraisal and Emotional Suppression) explained 50.1% of variance; internal consistency and temporal stability were above .70. There were positive relations between Cognitive Reappraisal and life satisfaction and positive affect; and there were negative relations with depression. Increased use of Cognitive Reappraisal is an indication of emotional health in the elderly.

Depressive symptoms in elderly participants of an open university for elderly

Although the prevalence of depressive disorders among the elderly is lower than among the younger population, the presence of significant symptoms of depression is common in this group. Studies report that participation in social, educational and leisure activities is related to fewer depressive symptoms in this population. Objective The aim of this study was to examine the prevalence of depression among elderly participants of an Open University for the Third Age, in terms of the time studying. Methods The study had a cross-sectional design and the participation of 95.2% (n=184) of total enrollers in the first half of 2010 on the activities of the Third Age Open University’s School of Arts, Sciences and Humanities of the University of São Paulo. All participants answered a socio-demographic questionnaire and the Geriatric Depression Scale (GDS-15). Results An association between studying time of over one semester at the University of the Third Age and a lower rate of depressive symptoms, was observed. Conclusion Study time of over one semester was associated with less depressive symptoms, acting as a possible protective factor against depression.

Motivational Factors and Predictors for Attending a Continuing Education Program for Older Adults

The objectives were to describe the stated motives of participants who enrolled in a program at the Open University for the Elderly (UnATI, in Portuguese), identify correlations between the stated motives and sociodemographic data, and find a set of predictors related to the listed motives. A total of 306 middle-aged and elderly adults aged 50 or older were surveyed through a sociodemographic questionnaire and a five-item scale to check their motives to enroll in the program. The following motivational factors were identified, in order of importance: enhancing general knowledge, investing in personal development, increasing social interaction, learning more in order to help others, and employing ones free time profitably. Age and years of schooling combined were strong predictors of participants seeking new knowledge. Being single and not retired was correlated with the motive Investing in Personal Development. Having attended elementary school only and being married was closely correlated to the motive Increasing Social Interaction. Employing Ones Free Time Profitably was associated with single or widowed individuals with family income between 3.1 and 4.0 times the minimum wage. As for Learning More in Order to Help Others, no predictors were found for this motive. It was found that participants seek to satisfy a desire to learn/ know more, to be up-to-date, to exercise their rights as citizens, and to play an active role in society. Our data suggest that these are the assumptions that drive middle-aged and elderly adults to look for various types of educational programs.

Apathy and functional disability in behavioral variant frontotemporal dementia

Background Behavioral variant frontotemporal dementia (bvFTD) has profound consequences on patients and their families. In this multicenter study, we investigated the contribution of cognitive and neuropsychiatric factors to everyday function at different levels of overall functional impairment. Methods In a retrospective cross-sectional study, 109 patients with bvFTD from 4 specialist frontotemporal dementia centers (Australia, England, India, and Brazil) were included. The measures administered evaluated everyday function (Disability Assessment for Dementia [DAD]), dementia staging (Clinical Dementia Rating [CDR]), general cognition (Addenbrookes Cognitive Examination–revised [ACE-R]), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). Patients were then subdivided according to functional impairment on the DAD into mild, moderate, severe, and very severe subgroups. Three separate multiple linear regression analyses were run, where (1) total DAD, (2) basic activities of daily living (BADL), and (3) instrumental activities of daily living (IADL) scores were dependent variables; ACE-R total score and selected NPI domains (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) were used as independent variables. Age, sex, education, and country of origin were controlled for in the analyses. Results Cognitive deficits were similar across the mild, moderate, and severe subgroups but significantly worse in the very severe subgroup. NPI domain scores (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) did not differ across the DAD subgroups. In the multiple regression analyses, a model including ACE-R and NPI apathy explained 32.5% of the variance for total DAD scores. For IADL, 35.6% of the variance was explained by the ACE-R only. No model emerged for BADL scores. Conclusions Cognitive deficits and apathy are key contributors to functional disability in bvFTD but factors underlying impairment in BADLs remain unclear. Treatments targeting reduction of disability need to address apathy and cognitive impairment to ensure greater efficacy, especially in regards to IADLs.

Effects of three interventions in facilitating voluntary pelvic floor muscle contraction in women: a randomized controlled trial

OBJECTIVE To evaluate the effect of vaginal palpation, vaginal palpation associated with posterior pelvic tilt, and intravaginal electrical stimulation in facilitating voluntary contraction of the pelvic floor muscles in women. METHODS A randomized controlled trial in which 132 women with pelvic floor muscles function graded at 0 or 1 using the Modified Oxford Scale were randomized into four groups: vaginal palpation (n=33); vaginal palpation with posterior pelvic tilt (n=33); intravaginal electrical stimulation (n=33) and a control group (n=33) that only received verbal instructions. The primary outcome was evaluated by the Modified Oxford Scale and the secondary using the ICIQ-UI-SF. The assessment was performed at baseline with follow-up assessment after eight weeks. RESULTS A total of 69.7% of the women from posterior pelvic tilt; 63.6% from vaginal palpation; 33.3% from intravaginal electrical stimulation; and 18.2% from control group (p<0.001) were able to attain Modified Oxford Scale greater than or equal to 2 after eight weeks. In comparison with control group, the posterior pelvic tilt (OR=10.35; 95% CI=3.26-32.84) and vaginal palpation (OR=7.87; 95% CI=2.53-24.47) had the most significant improvement as opposed to intravaginal electrical stimulation (OR=2.25; 95% CI=0.72-7.06). There was significant improvement among all of the groups in UI. The largest changes respectively were noted in the vaginal palpation, posterior pelvic tilt, intravaginal electrical stimulation and control group. There were no reports of adverse effects. CONCLUSION Vaginal palpation with posterior pelvic tilt and vaginal palpation were more effective interventions to facilitate pelvic floor muscles contraction when compared with intravaginal electrical stimulation and controls. Vaginal palpation was the most effective in improving urinary incontinence. Clinical Trials Identifier: ClinicalTrial.gov: NCT02062242.

Functionality and cognitive performance of patients with behavioral variant frontotemporal dementia

temporo-parietal areas. MIBG myocardial scintigraphy showed mild abnormalities. Patient 3: A 75-year old right-handed man became confused with multiple tasks for six months and then had difficulty in word finding and comprehension. Impairment in naming, comprehension and repetition of sentences, phonological paraphasia and cognitive decline was detected. Brain atrophy and hypoperfusion were noted at the left temporo-parietal areas. Uptake on MIBG myocardial scintigraphy was slightly decreased. P-tau and A b 42 in CSF suggested AD pathology. Patient 4: A 67-year old right-handed woman became forgetful and poorer in consecutive calculation, and the family noticed that the patient often misidentified her two sons interchangeably. At presentation, she scored 24/30 on a short cognitive test; mental manipulation of numbers was more impaired than memory. Although the patient did not show physical signs, abnormal MIBGmyocardial scintigraphy and normal brain MRI suggested DLB. SPECT showed bilateral frontoparietal uptake decreases. Two years after the onset, the patient developed difficulty in producing the first sound of sentences. Language evaluations revealed characteristics of apraxia of speech but no aphasia. Conclusions: Clinical DLB may present logopenic aphasia and rarely apraxia of speech. Concomitant AD pathology may possibly contribute to logopenic aphasia in DLB.

Verbal fluency and physical activity in the aging process: An epidemiological study carried out in São Paulo, Brazil

group have been seen for Wave 2. Cross-sectional data have raised interesting questions about the validity of current MCI diagnostic criteria. Over 95% of participants and/or their informants affirmed at least one of the questions about decline in memory and/or other cognitive abilities, calling into question the utility of the subjective complaints criterion. We have also highlighted the problems inherent in defining cognitive impairment for the MCI criteria and the considerable variability in prevalence depending on methods used to operationalize cognitive impairment. Early neuroimaging results, using the new DARTEL method of voxel-based morphometry (VBM) to evaluate the relationship between grey matter volume and verbal fluency performance, and the ability of DTI measures to reliably discriminate individuals with MCI from healthy elderly, are promising. Conclusions: The Memory and Ageing Study provides a large comprehensively assessed cohort with clinical, psychological, functional and biometric data, which will be a valuable resource for collaborative research on cognitive disorders in the elderly.