Neuroprotective effects of strength training in a neuroinflammatory animal model.

BACKGROUND: The preventive role of muscular strength on diminishing neuroinflammation is yet unknown. In this study, the role of the prophylactic muscular strength exercise was investigated in order to verify whether it would diminish cognitive alterations and modify the antioxidant intracellular scenery in an animal neuroinflammatory model in of the CA1 region of the hippocampus. METHODS: The animals received muscular strength training (SE) three times a week for eight weeks. Subsequently, the stereotaxic surgery was performed with an intra-hippocampal infusion of either saline solution (SAL) or lipopolysaccharide (LPS). Next, we performed the behavioral tests: object recognition and social recognition. Then, the animals were euthanized, and their hippocampus and prefrontal cortex were collected. In another moment, we performed the dosage of the antioxidant activity and histological analysis. RESULTS: The results showed that the muscular strength exercises could show a beneficial prophylactic effect in the cognitive deficiencies caused by acute neuroinflammation. Regarding oxidative stress, there was an increase in catalase enzyme activity (CAT) in the group (SE + LPS) compared to the control groups (p < 0.05). As for the cognitive alterations, there were found in the (SE + LPS) group, diminishing the mnemonic hazard of the discriminative and social memories compared to the control groups (p < 0.05). CONCLUSION: We concluded, therefore, that the exercise performed prophylactically presents a protective effect capable of minimizing such mnemonic deficits and increasing catalase enzyme activity in rats that suffered a local neuroinflammatory process in the hippocampus.

COVID-19: The question of genetic diversity and therapeutic intervention approaches.

Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China's Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients' overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

Memory reconsolidation and its maintenance depend on L-voltage-dependent calcium channels and CaMKII functions regulating protein turnover in the hippocampus.

Immediate postretrieval bilateral blockade of long-acting voltage-dependent calcium channels (L-VDCCs), but not of glutamatergic NMDA receptors, in the dorsal CA1 region of the hippocampus hinders retention of long-term spatial memory in the Morris water maze. Immediate postretrieval bilateral inhibition of calcium/calmodulin-dependent protein kinase (CaMK) II in dorsal CA1 does not affect retention of this task 24 h later but does hinder it 5 d later. These two distinct amnesic effects are abolished if protein degradation by proteasomes is inhibited concomitantly. These results indicate that spatial memory reconsolidation depends on the functionality of L-VDCC in dorsal CA1, that maintenance of subsequent reconsolidated memory trace depends on CaMKII, and these results also suggest that the role played by both L-VDCC and CaMKII is to promote the retrieval-dependent, synaptically localized enhancement of protein synthesis necessary to counteract a retrieval-dependent, synaptic-localized enhancement of protein degradation, which has been described as underlying the characteristic labilization of the memory trace triggered by retrieval. Thus, conceivably, L-VDCC and CaMKII would enhance activity-dependent localized protein renewal, which may account for the improvement of the long-term efficiency of the synapses responsible for the maintenance of reactivated long-term spatial memory.

On the participation of glycine receptors in the reconsolidation of spatial long-term memory in male rats.

The effects of intra-hippocampal manipulation of glycine receptors on the reconsolidation of recent and late long-term spatial memory were evaluated and assessed in the Morris water maze. The results obtained from the intra-hippocampal infusion of glycine and taurine demonstrated that taurine at a 100 nmol/side dose impaired the reconsolidation of recent and late long-term spatial memory. In comparison, at a dose of 10 nmol/side, it only affected the reconsolidation of late long-term spatial memory, reinforcing that there are differences between molecular mechanisms underlying recent and late long-term memory reconsolidation. On the other hand, glycine impaired the reconsolidation of early and late spatial memory when infused at a dose of 10 nmol/side, but not at a dose of 100 nmol/side, unless it is co-infused with an allosteric site antagonist of the NMDA receptor. Altogether these results show that glycine acting in situ in the hippocampal CA1 region exerts a pharmacological effect on U-curve, which can be explained by its concomitant action on its ionotropic receptor GlyR and on its NMDA receptor co-agonist site.

Effects of neurofeedback on major depressive disorder: a systematic review.

BACKGROUND: Major depressive disorder is a difficult-to-treat psychological disorder. Approximately 30% of patients with major depressive disorder do not respond to conventional therapies; thus, the efficacy of alternative therapies for treating major depressive disorder, such as neurofeedback, a non-invasive neuromodulation method used in the treatment of psychiatric diseases, must be investigated. OBJECTIVE: We aimed to evaluate the efficacy of neurofeedback in minimizing and treating major depressive disorder and its application as a substitute to or an adjuvant with conventional therapies. METHODS: We searched for experimental studies published between 1962-2021 in Scopus, PubMed, Web of Science, and Embase databases and identified 1,487 studies, among which 13 met the inclusion exclusion criteria. RESULTS: We noted that not all patients responded to neurofeedback. Based on depression scales, major depressive disorder significantly improved in response to neurofeedback only in a few individuals. Additionally, the number of training sessions did not influence the results. CONCLUSION: Neurofeedback can reduce depression symptoms in patients; however, not all patients respond to the treatment. Therefore, further studies must be conducted to validate the effectiveness of neurofeedback in treating major depressive disorder.

Factors associated with Alzheimer's disease prevalence and mortality in Brazil-An ecological study.

A few epidemiological studies are evaluating the prevalence and mortality rates of Alzheimer's disease, with no one using a nationwide sample of Brazilian elderlies. This study aims to calculate the prevalence of Alzheimer's disease and investigate possible associations with sociodemographic and lifestyle factors and the presence of diseases non-communicable, and the prevalence and mortality for all Brazilian state capitals. This is an ecological design study made with secondary public data provided by the Ministry of Health. Prevalence rates were calculated based on the analysis of the dispensing of Alzheimer's disease-specific drugs. Correlation analyzes were performed between rates and factors, and a multiple linear regression analysis was used to analyze possible associations between variables, controlled for each other. AD prevalence was 313/100,000. Prevalence rates were positively associated with primary health care coverage factors and negatively associated with ultra-processed food consumption and physical activity levels. AD mortality was 98/100,000. Mortality rates were positively associated with the proportion of obese elderly and elderly living on up to half the minimum wage and were inversely associated with the proportion of elderly with diabetes factors. We found positive and negative associations of sociodemographic, behavioral and diabetes indicators with Alzheimer's disease prevalence and mortality, which provide data that can be investigated by studies with different designs.

Different types of physical exercise in brain activity of older adults: A systematic review.

BACKGROUND: To verify the effects of different modalities of physical exercise on brain activity of older adults. METHODS: Systematic searches were conducted according to the PICOS strategy and the following databases were searched: PubMed, Web of Science, PsycInfo and Scielo. Two independent evaluators performed the initial selection from reading the title and abstract based on the stipulated eligibility criteria. RESULTS: The searches resulted in 1935 titles, of which 97 were duplicated and 1793 were excluded based on reading the titles and abstracts. This phase resulted in 45 articles for detailed analysis. At this stage, 35 articles were excluded because they did not meet the eligibility criteria. The information for qualitative analysis was extracted from 10 articles that met the criteria. CONCLUSION: There was improvement in the brain activity of older adults regardless of the type of physical exercise performed (aerobic, neuromuscular, flexibility or neuromotor), but with a discrete advantage for balance and coordination exercises (neuromotor).

Hypothesis on ontogenesis and pathophysiology of Alzheimer's disease.

Alzheimer's disease is a neurodegenerative condition that causes changes in memory and cognition, in addition to behavioral disorders, and most commonly affects the elderly. Several studies in the literature have presented therapeutic measures in an attempt to interfere with the pathogenic mechanisms of the disease and to mitigate its clinical manifestations. Some factors, such as excitotoxicity, cholinergic dysfunctions, oxidative stress, tau protein hyperphosphorylation, changes in amyloid-beta peptide metabolism, herpes viruses, apolipoprotein E, glycogen synthase kinase 3, insulin resistance, and the endocannabinoid system seem to be related to pathophysiology of Alzheimer's disease. Given this, a literature review was carried out to address the molecular mechanisms associated with the pathophysiological hypotheses previously mentioned, aiming to better understanding their underlying causes and contributing to possible pharmacological strategies about treatment of the disease.

Association between cognitive performance and sarcopenic obesity in older adults with Alzheimer's disease.

Sarcopenic obesity (SO), the co-occurrence of sarcopenia and obesity, is associated with functional loss, frailty, and incapacity in older adults. Recently, SO was associated with reduced cognitive performance in adults. However, no SO studies have been done with older adults with Alzheimer's disease (AD). Objective: The objective of this study was to verify the occurrence of SO and associated factors in 43 older adults with AD. Methods: We applied the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). SO was verified by using dual-emission X-ray absorptiometry. Results: We found five women with SO. Women had higher body fat and lower muscle mass compared with men. There was a significant relationship between body fat and cognitive performance only in men (r=0.65; p<0.01) adjusted by age and education. Men with obesity and aged >75 years had better cognitive performance compared with non-obese men aged <75 years (p=0.010) and women with obesity aged >75 years (p=0.033). Conclusions: Women with AD had higher body fat and lower muscle mass than men. SO occurs in older women with AD. Men with higher body fat showed better cognitive performance, independent of age and education.

A obesidade sarcopênica (SO), coocorrência de sarcopenia e obesidade, está associada à perda funcional, à fragilidade e à incapacidade em idosos. Recentemente, verificou-se que a SO está associada ao desempenho cognitivo reduzido em adultos. No entanto, não foram feitos estudos de SO em idosos com doença de Alzheimer (AD). Objetivo: Verificar a ocorrência de obesidade sarcopênica e fatores associados em 43 adultos idosos com doença de Alzheimer. Métodos: Aplicamos o miniexame do estado mental (MEEM) e a avaliação clínica da demência (CDR). A SO foi verificada utilizando a absorciometria de dupla emissão de raios X. Resultados: Foram classificadas cinco idosas com SO. As mulheres idosas tinham maior gordura corporal e menor massa muscular em comparação com os homens. Houve relação significativa, ajustada por idade e educação, entre gordura corporal e desempenho cognitivo apenas nos homens (r=0,65; p<0,01). Os homens com obesidade e com mais de 75 anos tiveram melhor desempenho cognitivo em comparação com os homens não obesos <75 anos (p=0,010) e com as mulheres com obesidade >75 anos (p=0,033). Conclusões: As mulheres com AD tinham maior gordura corporal e menor massa muscular do que os homens. A SO ocorreu em mulheres mais velhas com AD. Os homens com maior gordura corporal apresentaram melhor desempenho cognitivo, independentemente da idade e da educação.

Histamine facilitates consolidation of fear extinction.

Non-reinforced retrieval induces memory extinction, a phenomenon characterized by a decrease in the intensity of the learned response. This attribute has been used to develop extinction-based therapies to treat anxiety and post-traumatic stress disorders. Histamine modulates memory and anxiety but its role on fear extinction has not yet been evaluated. Therefore, using male Wistar rats, we determined the effect of the intra-hippocampal administration of different histaminergic agents on the extinction of step-down inhibitory avoidance (IA), a form of aversive learning. We found that intra-CA1 infusion of histamine immediately after non-reinforced retrieval facilitated consolidation of IA extinction in a dose-dependent manner. This facilitation was mimicked by the histamine N-methyltransferase inhibitor SKF91488 and the H2 receptor agonist dimaprit, reversed by the H2 receptor antagonist ranitidine, and unaffected by the H1 antagonist pyrilamine, the H3 antagonist thioperamide and the antagonist at the NMDA receptor (NMDAR) polyamine-binding site ifenprodil. Neither the H1 agonist 2-2-pyridylethylamine nor the NMDAR polyamine-binding site agonist spermidine affected the consolidation of extinction while the H3 receptor agonist imetit hampered it. Extinction induced the phosphorylation of ERK1 in dorsal CA1 while intra-CA1 infusion of the MEK inhibitor U0126 blocked extinction of the avoidance response. The extinction-induced phosphorylation of ERK1 was enhanced by histamine and dimaprit and blocked by ranitidine administered to dorsal CA1 after non-reinforced retrieval. Taken together, our data indicate that the hippocampal histaminergic system modulates the consolidation of fear extinction through a mechanism involving the H2-dependent activation of ERK signalling.

Histaminergic mechanisms for modulation of memory systems.

Encoding for several memory types requires neural changes and the activity of distinct regions across the brain. These areas receive broad projections originating in nuclei located in the brainstem which are capable of modulating the activity of a particular area. The histaminergic system is one of the major modulatory systems, and it regulates basic homeostatic and higher functions including arousal, circadian, and feeding rhythms, and cognition. There is now evidence that histamine can modulate learning in different types of behavioral tasks, but the exact course of modulation and its mechanisms are controversial. In the present paper we review the involvement of the histaminergic system and the effects histaminergic receptor agonists/antagonists have on the performance of tasks associated with the main memory types as well as evidence provided by studies with knockout models. Thus, we aim to summarize the possible effects histamine has on modulation of circuits involved in memory formation.

Early postnatal maternal deprivation in rats induces memory deficits in adult life that can be reversed by donepezil and galantamine.

Early postnatal maternal deprivation is known to cause long-lasting neurobiological effects. Here, we investigated whether some of the cognitive aspects of these deficits might be related to a disruption of the cholinergic system. Pregnant Wistar rats were individually housed and maintained on a 12:12h light/dark cycle with food and water freely available. The mothers were separated from their pups for 3h per day from postnatal day 1 (PND-1) to PND-10. To do that, the dams were moved to a different cage and the pups maintained in the original home cage, which was transferred to a different room kept at 32 degrees C. After they reached 120-150 days of age, maternal-deprived and non-deprived animals were either sacrificed for brain acetylcholinesterase measurement, or trained and tested in an object recognition task and in a social recognition task as described by Rossato et al. (2007) [Rossato, J.I., Bevilaqua, L. R.M., Myskiw, J.C., Medina, J.H., Izquierdo, I., Cammarota, M. 2007. On the role hippocampal synthesis in the consolidation and reconsolidation of object recognition memory. Learn. Mem. 14, 36-46] and Lévy et al. (2003) [Lévy, F., Melo. A.I., Galef. B.G. Jr., Madden, M., Fleming. A.S. 2003. Complete maternal deprivation affects social, but not spatial, learning in adult rats. Dev. Psychobiol. 43, 177-191], respectively. There was increased acetylcholinesterase activity in hippocampus and perirhinal cortex of the deprived animals. In addition, they showed a clear impairment in memory of the two recognition tasks measured 24h after training. Oral administration of the acetylcholinesterase inhibitors, donepezil or galantamine (1mg/kg) 30min before training reversed the memory impairments caused by maternal deprivation. The findings suggest that maternal deprivation affects memory processing at adulthood through a change in brain cholinergic systems.

Nutritional and hematological factors associated with the progression of Alzheimer's disease: a cohort study.

OBJECTIVE: We studied the users of the Specialized Drug Distribution Program of the public health network. METHODS: A prospective cohort examined the elderly at two intervals of three years and included 30 patients in phase I and 16 in phase II. The methodology was composed of home visits, anthropometric, nutritional and hematological evaluation. For the progression of AD, the Clinical Dementia Rating (CDR) scale was used. RESULTS: According to the CDR, the disease evolved, since in 2014 most of the patients were in CDR 3. In the analysis of the micronutrients, only the B vitamins (B1, B2, B3, B5, B6) presented a significant reduction in 2014. The consumption of carbohydrates and lipids increased in the 2014 evaluation, and protein consumption decreased. As for the average weight of the elderly, there was an increase in 2014, 65.9 (± 15.6) Kg, with a BMI of 26.75 (± 4, 5), in 2011 the average weight was 62.44 kg (± 14, 36), BMI 24.64 (± 4.97). CONCLUSION: The hypothesis that patients are likely to be overweight or obese before the development of AD and that this may be associated with an increased risk of dementia is suggested.

Delta-Aminolevulinate dehydratase and glutathione peroxidase activity in Alzheimer's disease: a case-control study.

Alzheimer's disease (AD) is a neurodegenerative pathology that affects elderly people all over the world. Several studies have demonstrated that oxidative stress is an aggravating factor for AD development and progression. Therefore, this study aimed to evaluate the activity of two oxidative stress markers, glutathione peroxidase (GPx) and δ-aminolevulinate dehydratase (δ-ALA-D), as well as correlate them with blood metal levels and AD progression. For this purpose, 88 elderly individuals were divided in two groups: AD group (34 patients diagnosed with AD) and control group (34 subjects paired by age with the AD group). The Mini-Mental State Examination and the Clinical Dementia Rating (CDR) were used as tools to classify the AD progression. GPx and δ-ALA-D activities were measured in all subjects through blood tests. Both enzymes' activities were decreased in AD patients when compared to the age-matched control group, regardless of the CDR. Moreover, GPx activity was positively correlated with selenium levels in the blood; and the δ-ALA-D activity was negatively correlated with blood copper levels. Taken together, our results indicated that, for the first time, blood δ-ALA-D activity was significantly inhibited in AD patients. While literature reports conflicting data regarding GPx activity in AD patients, the δ-ALA-D activity seems to be a more consistent tool to be applied as an earlier AD marker.

Effects of neurofeedback on major depressive disorder: a systematic review

ABSTRACT Background Major depressive disorder is a difficult-to-treat psychological disorder. Approximately 30% of patients with major depressive disorder do not respond to conventional therapies; thus, the efficacy of alternative therapies for treating major depressive disorder, such as neurofeedback, a non-invasive neuromodulation method used in the treatment of psychiatric diseases, must be investigated. Objective We aimed to evaluate the efficacy of neurofeedback in minimizing and treating major depressive disorder and its application as a substitute to or an adjuvant with conventional therapies. Methods We searched for experimental studies published between 1962-2021 in Scopus, PubMed, Web of Science, and Embase databases and identified 1,487 studies, among which 13 met the inclusion exclusion criteria. Results We noted that not all patients responded to neurofeedback. Based on depression scales, major depressive disorder significantly improved in response to neurofeedback only in a few individuals. Additionally, the number of training sessions did not influence the results. Conclusion Neurofeedback can reduce depression symptoms in patients; however, not all patients respond to the treatment. Therefore, further studies must be conducted to validate the effectiveness of neurofeedback in treating major depressive disorder.

The Relationship Between Copper, Iron, and Selenium Levels and Alzheimer Disease.

This study aimed to evaluate the concentrations of copper, iron, and selenium in elderly people with Alzheimer disease (AD), comparing the same parameters in a paired group of healthy people, in order to verify if the amount of these metals may influence the cognitive impairment progression. Patients' cognitive impairment was evaluated by Clinical Dementia Rating (CDR). The elementary quantification of erythrocytes was performed by inductively coupled plasma mass spectrometry technique. The statistical analyses were carried out by SPSS software 20.0 version, employing Shapiro-Wilk, Wilcoxon, Kruskall-Wallis, and Spearman correlation tests, considering significant results of p < 0.05. The sample was composed of 34% (n = 11) of women and 66% (n = 21) of men in each group. The AD group was characterized by a higher concentration of copper (p < 0.0001) and iron (p < 0.0001); however, there is no significant difference in selenium level. The analyses of the metal levels in different stages of AD were not significant in CDR-1, however in CDR-2 and CDR-3, elevated levels of copper and iron were observed; in CDR-3 patients, the level of selenium was lower (p < 0.008) compared to that of healthy controls. Patients with Alzheimer disease studied present increase in biometal blood levels, especially of copper and iron, and such increase can be different according to the disease stage and can cause more impairment cognitive functions in AD.

Nutritional evaluation of geriatric patients with Alzheimer's disease in Southern Brazil: case-control study.

INTRODUCTION: elderly's malnutrition is linked, among other factors, to chronic-degenerative diseases, requiring an improvement in the clinical evaluation of nutritional status of this population. Studies have tried to find out new tools to assess aged-people nutritional status. One of most used scales to investigate nutritional status on geriatric patients is the Mini Nutritional Assessment (MNA). OBJECTIVE: the present study aims to evaluate nutritional status of Alzheimer's disease (AD) patients, by comparison with a control group, via Mini Nutritional Assessment. METHODS: a cross-sectional study, which includes 35 alzheimer's old-people and 43 control old-people, was performed evaluating nutritional status with MNA. RESULTS: total score of MNA in the alzheimer group shows that 71.42% were in malnutrition risk, 14.28% were malnourished and 14.25% presented normal nutritional status. In addition, in the control group 79.06% of patients (n = 34) were classified as having normal nutritional status and 20.93% (n = 9), as being at risk of malnutrition. CONCLUSION: results reinforce the purpose that MNA can be used as a proper instrument to evaluate nutritional status in elderly, mainly in AD, because measuring risk and nutritional status of this population is indispensable.

Estadiamento demencial e a correlação com o desempenho funcional de idosos com doença de Alzheimer: um estudo transversal / Dementia staging and the correlation with the functional performance of the elderly with Alzheimer's disease: a cross-sectional study

Objetivo: Avaliar o estadiamento demencial e o desempenho físico-funcional, bem como suas possíveis correlações, de idosos diagnosticados com Doença de Alzheimer, atendidos por um centro de referência. Método: Estudo clínico transversal de abordagem quantitativa. Foram avaliados idosos de ambos os sexos com idade igual e/ou superior a 60 anos, que tivessem o diagnóstico médico comprovado para Doença de Alzheimer. Os idosos foram avaliados por meio do Timed Up and Go Test (TUG), Teste de Sentar e Levantar de Rikli & Jones, Escala de Equilíbrio de Berg e por meio do Clinical Dementia Rating Score (CDR). A análise estatística e os gráficos foram realizados com o Software IBM Statistics SPSS 20. O nível significância foi 0,05. Resultados: Compuseram a amostra 46 indivíduos de ambos os sexos com idade média de 78,72±7,37 anos. Os indivíduos foram divididos em idosos frágeis e não frágeis. Os idosos também foram classificados em demência questionável a leve e demência moderada a grave e comparados. Ocorreu correlação significativa entre idade e TUG (r= 0,532; p= 0,041), entre idade e Berg (r= -0,343; p= 0,040), entre TUG e Berg (r= -0,562; p= 0,029), e entre o teste de sentar-levantar e Berg (r= 0,706; p= 0,003). Conclusão: Os idosos avaliados apresentaram desempenho inferior aos descritos na literatura para os instrumentos avaliativos propostos nessa pesquisa, o que indica que está diretamente relacionado ao seu desempenho em testes físico-funcionais.

Objective: To evaluate dementia staging, physical-functional performance, and their possible correlations of elderlies with Alzheimer's Disease, assisted by a referral center.Method: Quantitative cross-sectional study of elderlies of both sexes, aged 60 years or older, with a clinical diagnosis of Alzheimer's Disease. The participants were evaluated with the Timed Up and Go Test (TUG), Rikli & Jones Sit and stand Test, Berg Balance Scale, and the Clinical Dementia Rating Score (CDR). Statistical analysis classified and compared groups of frail and non-frailparticipants with unpaired tests. The significance level was 0.05.Results: 46 participants of both sexes with a mean age of 78.72±7.37 years. Subjects were divided into frail and non-frail elderly. Older people were classified into questionable to mild dementia and moderate to severe dementia and matched. There was a significant correlation between age and TUG (r=0.532; p=0.041), age and Berg (r=-0.343; p=0.040), TUG and Berg (r=-0.562; p=0.029), and sit-stand test and Berg (r=0.706; p=0.003).Conclusion:Lower performance compared to the specialized literature for the assessment instruments proposed in this research was found, indicating that AD progression was directly related to their performance in physical-functional tests.

Fatores socioeconômicos e risco cardiovascular associados ao declínio cognitivo em idosos com Alzheimer: estudo transversal / Socioeconomic factors and cardiovascular risk associated with cognitive decline in older adults with Alzheimer's disease: a cross-sectional study / Factores socioeconómicos y riesgo cardiovascular asociados al deterioro cognitivo en ancianos con enfermedad de Alzheimer: un estudio transversal

OBJETIVO: verificar associação do declínio cognitivo e dos fatores socioeconômicos com o risco cardiovascular em idosos com Alzheimer. MÉTODO: estudo transversal, em que se incluíram 75 idosos com Alzheimer. Verificaram-se pressão de pulso, risco cardiovascular, Miniexame do Estado Mental, Miniavaliação Nutricional e exames bioquímicos. RESULTADOS: 92% dos pacientes apresentaram declínio cognitivo, com média de três anos de escolaridade. Houve prevalência entre as mulheres (62,3%) e idosos com duas ou mais comorbidades (62,3%). Eram hipertensos (65,2%), estavam com a pressão de pulso elevada (85%), com sobrepeso (49%) e em risco nutricional (78%). Média diária de dois anti-hipertensivos, e a classe medicamentosa mais utilizada foi bloqueador do receptor da angiotensina. CONCLUSÃO: a população estudada apresentou risco cardiovascular aumentado. A consulta de enfermagem foi importante para o reconhecimento dos dados clínicos, como declínio cognitivo, risco cardiovascular, risco nutricional e análise bioquímica.

OBJECTIVE: To verify the association between cognitive decline, socioeconomic factors, and cardiovascular risk in older adults with Alzheimer's disease. METHOD: A cross-sectional study was carried out with 75 older adults with Alzheimer's disease. Pulse pressure, cardiovascular risk, Mini-Mental State Examination, Mini-Nutritional Assessment, and biochemical tests were performed. RESULTS: Ninety-two percent of patients had cognitive decline, with an average of three years of schooling. There was a predominance of women (62.3%) and older adults with two or more comorbidities (62.3%). Most participants had arterial hypertension (65.2%), had elevated pulse pressure during the examination (85%), were overweight (49%), and were at nutritional risk (78%). The daily average of antihypertensive drugs was 2, and angiotensin receptor blockers were the most used drugs. CONCLUSION: The population studied had an increased cardiovascular risk. The nursing consultation was important for recognizing clinical data, such as cognitive decline, cardiovascular risk, nutritional risk, and altered biochemical results.

OBJETIVO: Verificar la asociación entre deterioro cognitivo, factores socioeconómicos y riesgo cardiovascular en ancianos con enfermedad de Alzheimer. MÉTODO: Se realizó un estudio transversal con 75 ancianos con enfermedad de Alzheimer. Se realizaron pruebas de presión de pulso, riesgo cardiovascular, Mini-Examen del Estado Mental, Mini-Evaluación Nutricional y pruebas bioquímicas. RESULTADOS: El 92% de los pacientes presentó deterioro cognitivo, con un promedio de tres años de escolaridad. Hubo predominio de mujeres (62,3%) y ancianos con dos o más comorbilidades (62,3%). La mayoría de los participantes tenía hipertensión arterial (65,2%), presión de pulso elevada durante el examen (85%), sobrepeso (49%) y riesgo nutricional (78%). El promedio diario de fármacos antihipertensivos fue de 2, siendo los bloqueadores de los receptores de angiotensina los más utilizados. CONCLUSIÓN: La población estudiada presentaba riesgo cardiovascular aumentado. La consulta de enfermería fue importante para el reconocimiento de datos clínicos, como deterioro cognitivo, riesgo cardiovascular, riesgo nutricional y análisis bioquímico.

Hypothesis on ontogenesis and pathophysiology of Alzheimer's disease

Abstract Alzheimer's disease is a neurodegenerative condition that causes changes in memory and cognition, in addition to behavioral disorders, and most commonly affects the elderly. Several studies in the literature have presented therapeutic measures in an attempt to interfere with the pathogenic mechanisms of the disease and to mitigate its clinical manifestations. Some factors, such as excitotoxicity, cholinergic dysfunctions, oxidative stress, tau protein hyperphosphorylation, changes in amyloid-beta peptide metabolism, herpes viruses, apolipoprotein E, glycogen synthase kinase 3, insulin resistance, and the endocannabinoid system seem to be related to pathophysiology of Alzheimer's disease. Given this, a literature review was carried out to address the molecular mechanisms associated with the pathophysiological hypotheses previously mentioned, aiming to better understanding their underlying causes and contributing to possible pharmacological strategies about treatment of the disease.