Veronica Somale

Prevalence of Geriatric Depression and Alexithymia and their association with sociodemographic characteristics in a sample of elderly persons living in Buenos Aires, Argentina

Fil: Tartaglini, Maria Florencia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Cardiologicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas; Argentina

Estimulación y rehabilitación cognitiva en un centro ambulatorio: descripción y análisis de las variables iniciales

Resumen Introduccion La rehabilitacion cognitiva es una practica prescrita cada vez con mayor asiduidad en pacientes neurologicos con trastornos en sus funciones mentales superiores. Objetivo Describir las caracteristicas principales y efectuar un analisis comparativo de los puntajes obtenidos en diferentes escalas en pacientes que iniciaron tratamiento de estimulacion/rehabilitacion cognitiva en INEBA. Materiales y metodos Bateria de pruebas que incluyeron memoria episodica verbal, memoria subjetiva, actividades de la vida diaria, calidad de vida y rasgos depresivos. Descripcion y comparacion entre diferentes grupos etiologicos. Resultados Se analizaron los datos de 73 pacientes (38 varones y 35 mujeres; edad media: 59,89 anos [SD 19,42], educacion formal: media 13 anos [SD 3,74]). Dentro de la poblacion predominaron las causas vasculares (20 casos, 27%), los traumatismos encefalocraneanos (9 casos, 12%) y el deterioro cognitivo leve de causa no vascular (8 casos, 11%). En el analisis de los resultados de la bateria administrada se observo una diferencia significativa entre la percepcion subjetiva de memoria de los pacientes vasculares, con traumatismos y con deterioro cognitivo leve en algunas de las dimensiones estudiadas, entre ellas recuerdo de libros y peliculas, conversaciones y acciones a realizar. Conclusiones Se encontraron diferencias en la percepcion subjetiva de memoria entre los grupos considerados. Resulta importante dentro de los programas de rehabilitacion cognitiva considerar junto a la evaluacion del desempeno objetivo, aspectos metacognitivos y de creencias de memoria para asi conocer las fortalezas y debilidades del paciente de manera integral. Esto permitira el empleo de estrategias compensatorias que apunten a mejorar el desempeno funcional del paciente.

PREVALENCE OF GERIATRIC DEPRESSION AND ALEXITHYMIA IN WIFE CAREGIVERS OF PATIENTS WITH DEMENTIA

(observed in the patient) were found between caregivers of DLB and PDD. Self-reported burden profiles were similar across all caregivers. Conclusions:These findings support the hypothesis that there are differences in the experience of caregiving for those with DLB and other dementia types. These findings also support the hypothesis that a greater frequency in behavior problems exhibited by the patient can lead to greater reports of grief in the caregiver. While there were no differences found in the experience of caregiver burden between diseases, the lack of differences may be due to the failure of current measures to capture the unique facets of DLB. The creation of new measures is needed to investigate other potential differences in the caregiving experience for patients with DLB.

OCCUPATIONAL SELF-DIRECTION AND ITS ROLE AS A BUFFERING FACTOR OF COGNITIVE PERFORMANCE IN OLD AGE: PRELIMINARY RESULTS

the particular fMRI experiment. Results: Following 4 months of intensive individual training, we found improvement in tests of memory and executive functions in both physical training groups. In the fMRI experiments,we found reliable responses to story condition in regions that are related to higher order processing of information (temporo-parietal junction, marginal, supramarginal gyri, frontal areas). Moreover, hippocampal activation inmemory encoding task increased followingaerobic intervention. In addition, increasedBDNFwascorrelated with improved cognition, with no association with the type of exercise. Conclusions: The physical training results in functional and structural changes. Our findings demonstrated that cognitive performance can be affected by exercise of both types. The insights gained from the study may have important scientific value and clinical implications for individuals who are at the early stages of AD.

FAMILY CAREGIVERS OF PATIENTS WITH DEMENTIA: AN ANALYSIS OF THE FEELING OF BURDEN ACCORDING TO THEIR VULNERABILITY AND PSYCHOSOCIAL RESOURCES

Background:Mild Cognitive Impairment (MCI) is regarded as both a risk state for dementia and an intermediate state between normal aging and dementia (Gauthier et al., 2006; Luis et al., 2003; DeCarli, 2003). There is no standard treatment for MCI. Regular participation in dance preserves cognition into old age (Katenstroth, 2010) and leisure activities which include dancing likewise reduce the risk for dementia (Verghese, 2003). Dance combines physical activity, social and emotional engagement, and cognitive stimulation all thought to maintain synaptic connections and plasticity. A structured modular ballroom dance program called “indak” or rhythm was designed by a multidisciplinary team using concepts of visualization, musicality exercise, improvisation and dance recall, and increasing complexity. Indak was pilot tested and showed compliance was good. We examined whether ballroom dancing could improve cognition. Methods: This single-blinded (blind assessor) observational study was done on elderly diagnosed with MCI based on the Petersen criteria. We used Alzheimer’s Disease Assessment Scale (ADAS-Cog), Montreal Cognitive Assessment-Philippines (MoCA-P), Mini-Mental State ExamPhilippines (MMSE-P) for baseline and post-intervention assessment. The intervention consisted of one-hour dance sessions twice weekly for 12 months and conducted by professionally certified dance teachers. Paired t-testswere used to compare preand post-interventions scores, and unpaired t-test for comparing post-intervention scores between dancers and non-dancers. Results: All 207 Filipino elderly with MCI underwent baseline assessment. One hundred one vounteered to participate in the intervention. Baseline versus post-intervention scores showed the dancers’ mean change improved in ADAS-Cog, MoCA-P and MMSE-P (3.1665.99, 0.9663.33, 0.8962.39 respectively) and all were significant (p<0.01). Among controls, only theMMSE significantly improved. When the post-intervention scores were compared between dancers and controls, the difference in the MoCA-P, Logical Memory and Boston Naming were likewise significant. Conclusions: Indak is a 12-month ballroom dance program that is novel and effective yet relatively inexpensive non-pharmacological strategy to improve cognition among community-dwelling elderly Filipinos with MCI. Ballroom dance can then be studied in a randomized controlled trial, alone or as part of multidimensional intervention, to delay dementia onset or modify progression of MCI.

Influence of the affective valence of visual materials in recognition among healthy individuals and patients with Alzheimer's disease dementia

OBJECTIVE: To research into the influence of the affective valence of picture in visual recognition tests among healthy individuals and patients with mild Alzheimer’s Disease Dementia (ADD). BACKGROUND:Patients with Alzheimer’s disease (AD) present with impairments both at the structures associated with emotions, and in episodic memory. The involvement of the amygdala in patients with AD might imply emotional deficit in information processing. It has been reported that the impairment of patients with AD to perceive emotions might be lower than their deficit at the level of other cognitive functions, with a higher recalling of materials when the materials have emotional content. DESIGN/METHODS: Fifteen healthy individuals (age (mean±Standard Deviation) 73±8.48 years, education 13.2±3.9 years, Mini Mental State Examination (MMSE) 29.4±1.55), and 15 patients with ADD (age 75.47±7.61 years, education 10.8±4 years, MMSE 24.6±2.85), paired by age and education were included. Ten pictures with neutral valence and 10 pictures with negative valence were selected from the International Affective Picture System, paired by arousal level. Successful recognition of pictures and reaction time by picture valence were assessed by ANOVA test. RESULTS: A better performance was recorded both in terms of the number of successful recognition instances (F=1570;p=0.01) and of reaction time (F=285.40;p=0.01) in the control group compared to patients with ADD. Both groups evidenced a better recognition accuracy with negative-valence pictures than with neutral-valence pictures (F=4.66;p=0.04). CONCLUSIONS: A better performance of the control group was noted both in terms of processing rate and of recognition accuracy. In both groups, the recognition accuracy was higher with negative-valence prompts. These findings suggest that the emotional content of the information facilitates recognition. Disclosure: Dr. Irrazabal has nothing to disclose. Dr. Saux has nothing to disclose. Dr. Feldberg has nothing to disclose. Dr. Somale has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. DEMEY has nothing to disclose.

Hippocampal mean diffusivity is a biomarker of neuronal injury in patients with mild cognitive impairment and Alzheimer’s disease dementia

OBJECTIVE: To analyze Mean Diffusivity in Magnetic Resonance Imaging (MD-MRI) at areas of the medial temporal cortex, both in healthy controls and in patients with degenerative amnesic Mild Cognitive Impairment (aMCI) and Alzheimer’s Disease Dementia (ADD). BACKGROUND: Different areas of the medial temporal cortex are usually involved in Alzheimer’s Disease (AD). MD-MRI measurements enable the analysis of water movements at tissue level, and increased diffusivity is associated with the presence of microstructure damages. DESIGN/METHODS: Forty-eight individuals (age 74.71±7.18 years) [16 healthy control individuals, 15 patients with aMCI, and 17 patients with ADD], right-handed, paired by age and education level were included in the study. The findings of MD-MRI among the different groups were analyzed at the level of the hippocampus, the Parahippocampal Gyrus (PG), and the Entorhinal Cortex (EC) with ANOVA (post-hoc Bonferroni test). These findings were correlated with their performance at the California Verbal Learning Test (CVLT), with Pearson test. RESULTS: MD-MRI right hippocampus measurements enabled the identification of 3 groups (ADD-controls: p<0.001, ADD-aMCI: p<0,05, aMCI-controls: p<0.05), with ADD patients presenting with the highest values, and patients with aMCI with intermediate results. Significant differences were noted at the left hippocampus between ADD-aMCI patients (p<0.01) and ADD-controls (p<0.001), without significant differences noted between controls and aMCI patients. Differences were also noted among the groups at the left PG (ADD-controls: p<0.05), left EC (ADD-controls: p<0.05), and right EC (ADD-controls: p<0.01). When analyzing the 3 groups as a whole, the 6 areas assessed showed significant negative correlations between MD-MRI values and patient performance in CVLT coding and delay recall tests. CONCLUSIONS: MD-MRI at these areas revealed differences among the 3 groups, thus reflecting the progressive microstructure damage present throughout the AD spectrum. These findings were also evidenced by patients9 performance at the episodic memory tests based on these structures. Disclosure: Dr. DEMEY has nothing to disclose. Dr. Ventrice has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. Allegri has nothing to disclose. Dr. Zubiri has nothing to disclose. Dr. Somale has nothing to disclose.

CORRELATION BETWEEN CORTICAL THICKNESS MEASUREMENTS FROM MAGNETIC RESONANCE IMAGING AND COGNITIVE PERFORMANCE ON EPISODIC AND SEMANTIC MEMORY TESTS

OBJECTIVE: To draw a correlation between the performance on Episodic Memory (EM) and Semantic Memory (SM) tests and Cortical Thickness (CT) measurements in healthy controls, patients with amnesic Mild Cognitive Impairment (aMCI) of degenerative etiology, and patients with Alzheimer’s disease (AD) dementia. BACKGROUND: CT measurements have been related to cognitive performance, and cortical thinning in regions of interest can be associated to lower scores in neuropsychological tests. EM and SM are different types of declarative, long-term memory, usually involved in AD. DESIGN/METHODS: 14 AD dementia patients (age: (median±SD) 76,29±8,74 years; education: 11,79±4,74 years) 10 aMCI patients (age:78,50±3,53 years; education: 11,40±4,00 years) and 7 healthy controls (age:73,43±8,22 years; education:12,86±5,24 years) were included. Raw scores on the coding and on the 20-minute delayed free-recall on the California Verbal Learning Test (CVLT) were used to measure EM performance, and raw scores on the Boston Naming Test (BNT) and on Semantic Fluency (FS) were used to measure SM performance, respectively. CT was measured with FreeSurfer. Correlations between patients’ raw scores and CT measurements were analyzed with Pearson´s correlation. RESULTS: Raw scores on the coding on the CVLT were positively correlated with left superior frontal gyrus (r:,356;p:,049) and with left parahippocampal gyrus (r:,449;p:,011) CT; raw scores on the 20-minute delayed free-recall on the CVLT with left parahippocampal gyrus (r,470;p:,008) and with circular sulcus of the insula (r:,422;p:,018) CT; raw scores on the BNT with left temporal pole (r:,580;p:,001) and with left inferior temporal sulcus (r:,496;p:,005) CT; and raw scores on FS with left middle temporal gyrus (r:,422; p:,018) and with right cingulate gyrus (r:,521;p,003) CT, among other significant results. CONCLUSIONS: Based on the results obtained in healthy controls, aMCI and AD dementia patients, the performance on EM and SM tests showed significant positive correlations with CT at several regions of interest. Study Supported by: Fundacion INEBA. Disclosure: Dr. Demey has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. Somale has nothing to disclose. Dr. Ventrice has nothing to disclose.

REGIONAL BRAIN DIFFERENCES IN CORTICAL THICKNESS BETWEEN PATIENTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT AND ALZHEIMER'S DISEASE DEMENTIA

OBJECTIVE: To compare regional brain differences in Cortical Thickness measurements from Magnetic Resonance Imaging (CT-MRI) in patients with amnesic Mild Cognitive Impairment (aMCI) of degenerative etiology and Alzheimer`s Disease (AD) dementia. BACKGROUND: Patients with aMCI are considered to be in a prodromal state of AD, and show an increased risk of progression to AD dementia. Both β-amyloid deposition and Tau hyperphosphorylation are involved in the pathogenesis of AD, and may lead to synapse loss and neuronal death. CT- MRI measurements can detect cortical thinning and regional atrophy in these conditions. DESIGN/METHODS: The study population included 10 aMCI patients (5 female patients; age: (median±SD) 78,50±3,53 years; education: (median±SD) 11,40±4,00 years; Mini Mental State Examination (MMSE) score: (median±SD) 27,60±1,07), and 14 AD dementia patients (8 female patients; age: 76,29±8,74 years; education: 11,79±4,74 years; MMSE: 20,21±6,79), right-handed, matched for age and level of education. Cortical thickness (CT) was measured with FreeSurfer, and differences in patterns of reduced CT in the different patient groups were assessed using one-way ANOVA. RESULTS: Significant differences in CT measurements were found at different regions of interest and amongst the different patient groups. Compared to aMCI patients, patients with AD dementia showed cortical thinning at the posterior dorsal area of the cingulate gyrus (left) (F:5,866;p:,024); medial occipitotemporal sulcus (collateral sulcus), and lingual sulcus (left) (F:4,564;p,044); inferior precentral sulcus (left) (F:7,279;p:,013); inferior temporal sulcus (left) (F:7,769;p:,011); posterior transverse collateral sulcus (right) (F:4,288;p:,050); pericallosal sulcus (right) (F:6,411;p:,019), and inferior temporal sulcus (right) (F:5,727;p:,026). CONCLUSIONS: Patients with AD dementia showed cortical thinning at several cortical regions usually involved in the pathogenesis of AD. CT measurements may represent an inexpensive and widely available biomarker of cortical damage, useful in early diagnosis of AD as well as of other degenerative dementias. Study Supported by: Fundacion INEBA. Disclosure: Dr. Demey has nothing to disclose. Dr. Ventrice has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. Somale has nothing to disclose. Dr. Allegri has nothing to disclose. Dr. Bevacqua has nothing to disclose. Dr. Lescano has nothing to disclose.