Diet-induced obesity does not exacerbate cachexia in male mice bearing Lewis-lung carcinoma tumors.

Cachexia is a muscle-wasting syndrome commonly observed in patients with cancer, which can significantly worsen clinical outcomes. Because of a global rise in obesity, the coexistence of cachexia in obese individuals poses unique challenges, with the impact of excessive adiposity on cachexia severity and underlying pathophysiology not well defined. Understanding the interplay between cachexia and obesity is crucial for improving diagnosis and treatment strategies for these patients; therefore, the present study examined differences in cachexia between lean and obese mice bearing Lewis lung carcinoma (LLC) tumors. Nine-week-old, male C57Bl6J mice were placed on either a chow or a high-fat diet (HFD) for 9 wk. After the diet intervention, mice were inoculated with LLC or vehicle. Markers of cachexia, such as body and muscle loss, were noted in both chow and HFD groups with tumors. Tumor weight of HFD animals was greater than that of chow. LLC tumors reduced gastrocnemius, plantaris, and soleus mass, regardless of diet. The tibialis anterior and plantaris mass and cross-sectional area of type IIb/x fibers in the gastrocnemius were not different between HFD-chow, HFD-tumor, and chow-tumor. Using RNA sequencing (RNA-seq) of the plantaris muscle from chow-tumor and HFD-tumor groups, we identified ∼400 differentially expressed genes. Bioinformatic analysis identified changes in lipid metabolism, mitochondria, bioenergetics, and proteasome degradation. Atrophy was not greater despite larger tumor burden in animals fed an HFD, and RNA-seq data suggests that partial protection is mediated through differences in mitochondrial function and protein degradation, which may serve as future mechanistic targets.NEW & NOTEWORTHY This study provides timely information on the interaction between obesity and cancer cachexia. Lean and obese animals show signs of cachexia with reduced body weight, adipose tissue, and gastrocnemius muscle mass. There was not significant wasting in the tibialis anterior, plantaris, or fast twitch fibers in the gastrocnemius muscle of obese animals with tumors. RNA-seq analysis reveals that obese tumor bearing animals had differential expression of mitochondria- and degradation-related genes, which may direct future studies in mechanistic research.

Apolipoprotein E ε4 allele impairs cortical activity in healthy aging and Alzheimer's disease.

AIM: To investigate the influence of apolipoprotein E (APOE) genotype on cortical activity, using the event-related potential P300 in healthy older adults and individuals with Alzheimer's disease (AD). METHODS: A cohort of 37 healthy older adults and 48 with AD participated in this study and completed an auditory oddball task using electroencephalographic equipment with 21 channels (10-20 system). APOE genotyping was obtained by real-time PCR. RESULTS: AD presented increased P300 latency and lower P300 amplitude, compared to healthy older adults. AD APOE ε4 carriers presented increased P300 latency in F3 (420.7 ± 65.8 ms), F4 (412.0 ± 49.0 ms), C4 (413.0 ± 41.1 ms) and P3 (420.4 ± 55.7 ms) compared to non-carriers (F3 = 382.5 ± 56.8 ms, p < 0.01; F4 = 372.2 ± 56.7 ms, p < 0.01; C4 = 374.2 ± 51.7 ms, p < 0.01; P3 = 384.4 ± 44.4 ms, p < 0.01). Healthy older adults APOE ε4 carriers presented lower Fz amplitude (2.6 ± 1.5 µV) compared to non-carriers (4.9 ± 2.9 µV; p = 0.02). Linear regression analysis showed that being a carrier of APOE ε4 allele remained significantly associated with P300 latency even after adjusting for sex, age, and cognitive grouping. APOE ε4 allele increases P300 latency (95% CI 0.11-0.98; p = 0.02). CONCLUSION: APOE ε4 allele negatively impacts cortical activity in both healthy older adults and AD individuals.

Plasma 25-hydroxyvitamin D levels, quality of life, inflammation and depression in older adults: Are they related?

BACKGROUND AND OBJECTIVES: This study aimed to determine whether there is an association between inflammation and depression taking into account the effect of several confounders, but specially plasma 25-hydroxyvitamin D (25[OH]D) levels. MATERIAL AND METHODS: A cross-sectional study was conducted on adults (n = 346) aged 60 years or older recruited from primary healthcare centres. Depression was assessed by the Geriatric Depression Scale (GDS), while plasma 25(OH)D and inflammatory cytokines were measured following routine biochemical laboratory protocols. RESULTS: Subjects were divided into two subgroups according to their depression status, and matched in their baseline conditions using random forest-based propensity scores. Both groups were rather similar in regard to most variables, apart from quality of life (p < 0.001) and plasma levels of IL-6 (p = 0.03). The overall prevalence of vitamin D deficiency was 36.3% (95% Confidence Interval [95% CI], 30.2%-42.5%), without a significant difference between depression groups (p = 0.2). A significant association was observed between GDS score and plasma IL-6 levels only among those with SF-6D score between 0.26 and 0.50 (p = 0.001). CONCLUSIONS: The association between inflammation and depression is more likely to be due to a moderation influence of quality of life rather than plasma 25(OH)D levels. However, further studies are needed to ascertain the effect of a poor quality of life leading to chronic inflammation and poor health upon longer periods of follow-up.

A Systematic Review of Altered P300 Event-Related Potential in Apolipoprotein E4 (APOE4) Carriers.

BACKGROUND: Apolipoprotein ε4 allele (APOE4) is the strongest genetic risk factor for Alzheimer's disease and seems to be related to cognitive decline and damaged event-related potential P300, which is a sensitive measure to assess cognitive processing. OBJECTIVE: This research aims to critically review the existing scientific evidence regarding the association between APOE4 and P300. METHODS: A systematic review was carried out up to January 2020 on the following databases: Web of Science, Scopus and Medline/PubMed. Articles were considered for inclusion if they are original research that provided information regarding the association between APOE4 and P300, available in English, Spanish, or Portuguese, and available in full text. The methodological quality of the studies selected was evaluated using the quality assessment tool for observational cohort and cross-sectional studies recommended by Cochrane. RESULTS: Out of 993 studies, 14 met the inclusion criteria. The results obtained showed that APOE4 is related to a longer P300 latency. However, the data supplied do not allow us to confirm if this relationship also occurs in amplitude measures. Moreover, it was observed that APOE genotype may influence P300 in different ages, from younger individuals to demented older people. CONCLUSION: Evidence shows that APOE4 negatively influences cortical activities related to cognitive functions, as indicated by P300.

Are body fat and inflammatory markers independently associated with age-related muscle changes?

BACKGROUND & AIMS: A growing number of studies have shown that body fat and inflammation are associated with age-related changes in body muscle composition. However, most of these studies did not control for potential confounders. The aim was to determine whether there is an association between body fat and inflammatory cytokines with muscle mass/strength decline in community-dwelling older adults. METHODS: Anthropometric, physical and functionality variables were collected. Nutritional status was assessed by the MNA form. Dynapenia was assessed with handgrip strength on the dominant hand using a dynamometer. Sarcopenia was determined using adapted criteria from the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Inflammatory cytokines were evaluated in plasma using a multiplex assay. Associations to muscle mass/strength decline were analyzed using a multinominal logistic regression, adjusted for potential confounders. RESULTS: We recruited a convenience sample of 311 adults aged 60 years or older. Most of subjects were sufficiently active females with a median age of 68 years (interquartile range [IQR], 64-74 years), whereas about a half (46.3%) were at risk of malnutrition. The prevalence of dynapenia was 38.3%, whereas sarcopenia was 13.2%. After controlling for potential confounders, we found that relative fat mass index is independently associated with sarcopenia. Loss of strength was independently associated only with female sex, lower physical activity, worse nutrition and IL-10/TNF-α ratio, whereas female sex, an insufficiently active lifestyle and relative fat mass index were the key determinants of sarcopenia. CONCLUSIONS: These findings highlight the importance of physical activity and healthy diet as effective interventions to prevent muscle mass/strength decline, and points to IL-10/TNF-α ratio and body fat as independently associated factors for dynapenia and sarcopenia, respectively.

Vitamin D Deficient Older Adults Are More Prone to Have Metabolic Syndrome, but Not to a Greater Number of Metabolic Syndrome Parameters.

This study investigated the relationship between metabolic parameters and low serum 25-hydroxyvitamin D (25(OH)D) levels in older adults (n = 265). They were assessed for anthropometrics and metabolic measurements, including 25(OH)D, insulin, glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and other inflammatory markers. Vitamin D deficiency was defined as a 25(OH)D level below 50 nmol/L. Comparisons between groups were performed using Wilcoxon-Mann-Whitney or Pearson's Chi-squared test. A multivariate adjusted Poisson regression was used to model the number of metabolic parameters as a function of a set of explanatory variables. Subjects with 25(OH)D deficiency were predominantly females and presented higher body weight, body mass index, waist circumference, triglycerides and Tumor Necrosis Factor-α (TNF-α), and higher insulin resistance. Metabolic syndrome was also more prevalent among 25(OH)D-deficient subjects. In those without metabolic syndrome, 25(OH)D deficiency was related only to obesity and higher insulin resistance. Female sex, hypertension, higher waist circumference and higher levels of hemoglobin A1C (%), HDL-C, and TG were significantly associated with an increased number of metabolic syndrome parameters after adjusting for covariates, but 25(OH)D was not. The fact that serum 25(OH)D concentration was inversely associated with metabolic syndrome and insulin resistance not only reaffirms the relevance to consider serum 25(OH)D concentration as an influencing factor for insulin resistance, but also the need to actively screen for hypovitaminosis D in all patients with this condition.

Efeitos do treinamento proprioceptivo sobre o controle postural de idosos / Effects of a proprioceptive training and postural control in elderly / Efectos del entrenamiento propioceptivo sobre el control postural de ancianos

O presente estudo identificou que um programa específico, visando a estimular o sistema proprioceptivo, demonstrou efetivamente melhorar o equilíbrio funcional de uma pessoa idosa, associado a uma melhora de suas funções executivas. Futuros estudos com um maior número de participantes, e instrumentos de maior acurácia, são recomendados para confirmar os presentes achados.

Our investigation aimed to infer that a specific program with proprioceptive physical exercises might improve functional balance associated to a improvement in executive functions in elderly. Future researches with a high number of participants and more accurate tools are recommended to confirm our findings.

El presente estudio identificó que un programa específico, destinado a estimular el sistema propioceptivo, demostró efectivamente mejorar el equilibrio funcional de una persona anciana, asociado a una mejora de sus funciones ejecutivas. Los futuros estudios con un mayor número de participantes, e instrumentos de mayor exactitud, se recomiendan para confirmar los presentes hallazgos.

Serotoninergic antidepressants positively affect platelet ADAM10 expression in patients with Alzheimer's disease.

BACKGROUND: Studies have demonstrated a decreased platelet ADAM10 expression in patients with Alzheimer's Disease (AD), classifying this protein as a blood-based AD biomarker. About 50% of the patients with AD are diagnosed with depression, which is commonly treated with tricyclic and tetracyclic antidepressants, monoaminoxidade (MAO) inhibitors and, more preferably, with selective serotonin reuptake inhibitors (SSRIs). Considering that a large proportion of patients with AD takes antidepressant medications during the course of the disease we investigated the influence of this medication on the expression of platelet ADAM10, which is considered the main α-secretase preventing beta-amyloid (ßA) formation. METHODS: Blood was collected for protein extraction from platelets. ADAM10 was analyzed by using western blotting and reactive bands were measured using ß-actin as endogenous control. RESULTS: Platelet ADAM10 protein expression in patients with AD was positively influenced by serotoninergic medication. CONCLUSION: More studies on the positive effects of serotonergic antidepressants on ADAM10 platelet expression should be performed in order to understand its biological mechanisms and to verify whether these effects are reflected in the central nervous system. This work represents an important advance for the study of AD biomarkers, as well as for more effective pharmacological treatment of patients with AD and associated depression.

Physical exercise improves peripheral BDNF levels and cognitive functions in mild cognitive impairment elderly with different bdnf Val66Met genotypes.

The benefits of physical exercise on improvements in brain-derived neurotrophic factor (BDNF) levels and cognitive functioning have been reported in the literature. However, the variability of individual responses may be linked to genetic differences. BDNF is considered one of the most plausible factors involved in the cognitive benefits associated with physical activity practice. A single nucleotide polymorphism localized in the gene that codes BDNF results in a missense mutation that promotes an amino acid substitution (Val66Met) in the protein. This process has been associated with decreased levels of BDNF secretion, with corresponding impairments in specific cognitive functions. Therefore, the objective of this study was to analyze the effects of a multimodal physical exercise program on peripheral BDNF levels and cognitive functions in elderly individuals with mild cognitive impairment (MCI). The participants were genotyped for the BDNF Val66Met polymorphism. Cognitive functions were assessed by the Montreal Cognitive Assessment (MoCA) prior to and after the intervention. Forty-five participants were assigned to the control and trained groups. The trained group participated in a multimodal physical training for a 16-week period. The results showed a significant between-subjects interaction (p < 0.05), which indicates the beneficial contribution of training on cognitive functions independent of the BDNF genotype. However, only participants with BDNF-Met genotypes exhibited significant improvements in peripheral BDNF levels. The BDNF genotype appears to modulate the effects of physical exercise on BDNF secretion, but it does not influence cognition. This is the first study that evaluated the influence of a BDNF polymorphism on physical activity and cognition performance in elderly MCI individuals.

Effects of Square-Stepping Exercise on balance and depressive symptoms in older adults / Efeitos do Square-Stepping Exercise (SSE) no equilíbrio e sintomas depressivos de idosos / Efectos del Square-Stepping Exercise (SSE) en equilibrio y síntomas depresivos en adultos mayores

The aim of this study was analyze the effects of Square-Stepping Exercise (SSE) on depressive symptoms, balance and functional mobility in older adults. Participants were distributed into two groups: Trained Group (TG), who performed a 16-week intervention with SSE and Control Group (CG), who performed only evaluations. The Berg Balance Scale and Time Up and Go Test (TUG) constituted the evaluation protocol to verify balance and functional mobility. Geriatric Depression Scale-short form (GDS-15) was applied for measure depressive symptoms. Evaluations were realized pre and post 16-week. Significant improvements were observed in the TG with the maintenance of GDS-15 scores and on the time to perform the TUG test which reflects better functional mobility than the CG. This could lead to conclude that the SSE is an important tool for improve balance, prevent falls and decrease depression symptoms...

"Efeitos do Square-Stepping Exercise (SSE) no equilíbrio e sintomas depressivos de idosos." O objetivo desse estudo foi analisar os efeitos do Square-Stepping Exercise (SSE) nos sintomas depressivos, equilíbrio e mobilidade funcional de idosos. Os participantes foram distribuídos em dois grupos: Grupo Treinamento (TG), que realizou 16 semanas de intervenção com o SSE e Grupo Controle (CG), que penas respondeu as avaliações. A Escala de Equilíbrio de Berg e o Time Up and Go Test (TUG) constituíram o protocolo de avaliação, e verificaram o equilíbrio e a mobilidade funcional. A Escala Geriátrica de Depressão curta (GDS-15) foi aplicada para mensurar os sintomas depressivos. Avaliações Foram realizadas pré e após 16 semanas. Resultados significativos foram observados no TG, como a manutenção do escore da GDS-15 e melhora do tempo para realizar o TUG, o que reflete em uma mobilidade funcional melhor que no CG. Podemos concluir que o SSE é uma importante ferramenta para promover equilíbrio, prevenir que das e diminuir os sintomas depressivos...

"Efectos del Square-Stepping Exercise (SSE) en equilibrio y síntomas depresivos en adultos mayores." El objetivo de este estudio fue analizar los efectos del SSE (Square-Stepping Exercise) en los síntomas depresivos, equilibrio y movilidad funcional de ancianos. Los participantes fueron divididos en dos grupos: Grupo de Entrenamiento (TG), que celebró 16 semanas de intervención con SSE y Grupo Control (GC), que respondió evaluaciones plumas. El rango de equilibrio de Berg Balance de el Time Up nd Go Test (TUG) constituyeron el protocolo de evaluación, y se encontró el equilibrio y la movilidad funcional. La Escala de Depresión Geriátrica breve (GDS-15) se utilizó para medir los síntomas depresivos. Las evaluaciones se realizaron antes y después de 16 semanas. Los resultados significativos se observaron en TG, como el mantenimiento de la puntuación GDS-15 y la mejora de tiempo para realizar el TUG, que se refleja en una mejor movilidad funcional en CG. Podemos concluir que la ESS es una herramienta importante para promover el equilibrio, la prevención y disminución de los síntomas depresivos...

Physical exercise in MCI elderly promotes reduction of pro-inflammatory cytokines and improvements on cognition and BDNF peripheral levels.

The benefits of physical exercise to reduce low-grade inflammation and improve Brain-Derived Neurotrophic Factor (BDNF) levels and cognitive function became a growing field of interest. Low-grade inflammation is common during aging and seems to be linked to neurodegenerative process. Regular physical exercises can help to reduce pro-inflammatory cytokines levels and to improve BDNF peripheral concentrations. The main goal of this research was to analyze the effects of a 16-week multimodal physical exercise program on peripheral BDNF levels and on Tumor Necrosis-α (TNF-α) and Interleukin- 6 (IL-6) as pro-inflammatory markers in cognitive healthy elderly individuals and in elderly with mild cognitive impairment (MCI). Cognitive functions were assessed by the Montreal Cognitive Assessment (MoCA) prior to and after the intervention. Thirty cognitively healthy participants and thirty-seven MCI participants were assigned to the control (CG) and trained (TG) groups. The TG participated in a multimodal physical training program for a 16-week period. The results showed a significant between-subjects interaction, which indicates the beneficial contribution of training on the reduction of TNF-α (p=0.001) and IL-6 (p<0.001) and on the improvement of BDNF (p<0.001) peripheral concentrations. Cognitive functions also presented significant improvements for MCI trained group (p=0.03). In conclusion, physical exercise was effective to reduce pro-inflammatory cytokines and to improve BDNF peripheral levels, with positive reflexes on cognition. To the best of our knowledge, this is the first study that evaluated longitudinally the effects of a multimodal physical exercises protocol on peripheral concentrations of pro-inflammatory cytokines and cognition performance in elderly MCI individuals.

Effect of a multimodal exercise program on sleep disturbances and instrumental activities of daily living performance on Parkinson's and Alzheimer's disease patients.

AIM: To assess the contribution of a multimodal exercise program on the sleep disturbances (SD) and on the performance of instrumental activities daily living (IADL) in patients with clinical diagnosis of Alzheimer's disease (AD) and Parkinson's disease patients (PD). METHODS: A total of 42 consecutive patients (23 training group, 19 control group) with PD and 35 demented patients with AD (19 trained group, 16 control group) were recruited. Participants in both training groups carried out three 1-h sessions per week of a multimodal exercise program for 6 months. The Pfeffer Questionnaire for Instrumental Activities and the Mini-Sleep Questionnaire were used to assess the effects of the program on IADL and SD respectively. RESULTS: Two-way ancova showed interactions in IADL and SD. Significant improvements were observed for these variables in both intervention groups, and maintenance or worsening was observed in control groups. The analysis of effect size showed these improvements. CONCLUSION: The present study results show that a mild to moderate intensity of multimodal physical exercises carried out on a regular basis over 6 months can contribute to reducing IADL deficits and attenuating SD.

Exercícios físicos generalizados capacidade funcional e sintomas depressivos em idosos brasileiros / Physical exercises, functional capacity and depressive symptoms in Brazilian elderly

O objetivo deste estudo foi verificar os efeitos de 16 semanas de exercícios físicos generalizados sobre componentes da capacidade funcional, aptidão funcional geral e sintomas depressivos em idosos. Cinquenta e cinco idosos (67,3±5,8 anos) participaram do estudo. Os grupos foram distribuídos de acordo com a participação no protocolo proposto: a) grupo treinado (GT), composto de 27 participantes que atenderam pelo menos 75% do total de sessões de exercícios físicos generalizados por 16 semanas e; b) grupo controle (GC), participantes que não estiveram participando de nenhum tipo de programa regular de atividades físicas. A capacidade funcional foi avaliada por meio da bateria de testes para idosos da AAHPERD que é composta por cinco testes: coordenação, flexibilidade, resistência de força, agilidade e equilíbrio dinâmico e resistência aeróbia geral. Os sintomas depressivos foram medidos por meio da Escala de Depressão e Geriatria- versão curta (GDS-15). Os resultados demonstraram que os idosos do GT apresentaram melhor desempenho nos testes motores. Os sintomas depressivos não sofreram alterações em ambos os grupos. Desta maneira, nossos resultados indicam que 16 semanas são suficientes para promover benefícios na aptidão funcional geral de idosos, enquanto que idosos que permanecem sedentários tendem a apresentar decréscimo em sua aptidão física geral. O programa proposto não foi capaz de provocar alterações significativas em idosos com baixos valores relatados de sintomas depressivos para esta variável. As evidências do presente estudo possibilitam predizer que um programa generalizado pode auxiliar na prevenção de doenças crônicas, evitar declínios funcionais e produzir efeitos positivos na qualidade de vida.

The objective of our study was to investigate the effects of 16 weeks of multimodal exercise on functional capacity components, general functional fitness and depressive symptoms in the elderly. Fifty-five elderly (67.3 ± 5.8 years) participated in the study. The groups were distributed according to the participation on the proposed protocol: a) trained group (TG) composed of 27 participants who attended at least 75% of the total generalized physical exercise sessions for 16 weeks; and b) control group (CG), participants who did not attend any regular physical activity program. Functional capacity was assessed using the AAHPERD battery of motor tests for elderly, which consists of five tests: coordination, flexibility, muscular resistance, agility/dynamic balance, and overall aerobic endurance. Depressive symptoms were measured using the short version of the Geriatric Depression Scale (GDS-15). The results showed that elderly on TG had better performance on motor tests. Depressive symptoms did not change for both groups. Thus, our results indicate that 16 weeks is sufficient to improve general functional fitness in elderly, while those who remain sedentary tend to decrease their overall physical fitness. The proposed program could not induce significant changes in the elderly with low levels of depressive symptoms reported for this variable. The evidence of this study allows the prediction that a generalized program can help prevent chronic diseases, reduce functional decline and produce positive effects on quality of life.

Efeitos de um programa de atividade física sobre os sintomas depressivos e a qualidade de vida de idosos com demência de Alzheimer / Effects of a physical activity program on depressive symptoms and quality of life of elderly with Alzheimer's dementia / Efectos de un programa de actividad física en los síntomas depressivos y la calidad de vida del ancianos con demencia de Alzheimer

O objetivo do estudo foi analisar os efeitos de um programa de exercícios físicos sobre os sintomas depressivos e a percepção da Qualidade de vida (QV) de pacientes com Doença de Alzheimer (DA) e de seus cuidadores. Seis idosas realizaram um programa de exercícios físicos durante seis meses, outras seis compuseram o grupo controle. O Mini-Exame do Estado Mental, a Escala de Qualidade de Vida e a Escala de Depressão em Geriatria foram aplicados para avaliação das variáveis. Os dados foram analisados através de uma ANOVA "two-way" e correlação de Pearson, com nível de significância de 5% (p < 0,05).Os resultados mostraram que o programa proposto pode auxiliar na redução dos sintomas depressivos de pacientes com DA, mas não promoveu melhoras significativas na percepção da QV destes pacientes e nem de seus cuidadores. Entretanto menores comprometimentos da percepção da qualidade de vida foram observados em pacientes e cuidadores que eram fisicamente ativos.

The aim of the study was to analyze the effects of a physical exercises' program on depressive symptoms and quality of life (QL) in elderly with Alzheimer's Disease (AD) and QL of their caregivers. Six elderly women performed a physical exercises' program with six months of duration, and the other six composed the control group. The Mini-Mental State Examination, the Quality of Life Scale and the Geriatric Depression Scale were applied to evaluate the variables. Data were analyzed by Analyze of Variance (Two-way) and Pearson's correlations. The level of significance was set at 5% (p < 0.05). The results showed that the physical exercises' program proposed could aid on the reduction of depressive symptoms of AD patients. However less worsening was observed on QL of patients and caregivers from the physically active group.

El objetivo del estudio fue analizar los efectos de un programa de ejercicios en los síntomas depresivos y la percepción de calidad de vida (CV) de los pacientes con Demencia de Alzheimer (DA) y sus cuidadores. Seis personas ancianas realizaran un programa de ejercicio físico por un periodo del seis meses, otro grupo estaba formado por el grupo de control. El Mini Examen del Estado Mental, la Escala de Calidad de Vida y la Escala de Depresión Geriátrica fueran utilizados para evaluar las variables. Los datos fueron analizados por análisis de varianza de dos entradas (ANOVA de dos vías) y la correlación de Pearson, con un nivel de significancia de 5% (p < 0,05). Los resultados muestran que el programa propuesto puede ayudar en la reducción de los síntomas depresivos en pacientes con DA, pero no promove mejoras significativas en la percepción de la calidad de vida de estos pacientes ni sus cuidadores. Sin embargo menos daños de la percepción de calidad de vida se observaron en los pacientes y los cuidadores que eran físicamente activos.

Serum homocysteine and physical exercise in patients with Parkinson's disease.

BACKGROUND: Hyperhomocysteinemia is a major risk factor for cerebral and peripheral vascular diseases, as well as cortical and hippocampal injury, including an increased risk of dementia and cognitive impairment. Elevated serum homocysteine (Hcy) concentrations are common in patients with Parkinson's disease (PD) who have been treated with levodopa; however, physical exercises can help reduce Hcy concentrations. The aim of the present study was to compare serum Hcy levels in patients with PD who partook in regular physical exercises, sedentary PD patients, and healthy controls. METHODS: Sixty individuals were enrolled in the present study across three groups: (i) 17 patients who did not partake of any type of exercise; (ii) 24 PD patients who exercised regularly; and (iii) 19 healthy individuals who did not exercise regularly. All participants were evaluated by Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale (UPDRS) and Schwab and England scale (measure daily functionality). The serum levels of Hcy were analyzed by blood samples collected of each participant. An analysis of variance and a Tukey's post hoc test were applied to compare and to verify differences between groups. Pearson's correlation and stepwise multiple regression analyses were used to consider the association between several variables. RESULTS: Mean plasma Hcy concentrations in individuals who exercised regularly were similar to those in the healthy controls and significantly lower than those in the group that did not exercise at all (P= 0.000). In addition, patients who did not exercise were receiving significantly higher doses of levodopa than those patients who exercised regularly (P= 0.001). A positive relationship between levodopa dose and Hcy concentrations (R(2) = 0.27; P= 0.03) was observed in patients who did not exercise, but not in those patients who exercised regularly (R(2) = 0.023; P= 0.15). CONCLUSIONS: The results of the present study suggest that, even with regular levodopa therapy, Hcy concentrations in PD patients who exercise regularly are significantly lower than in patients who do not exercise and are similar Hcy concentrations in healthy controls.

Relação entre níveis de ansiedade-traço competitiva e idade de atletas de voleibol e análise destes níveis pré e pós-competição / Relationship between levels of competitive anxiety and age of volleyball athletes and analyze of these levels pre and post-competition

O objetivo do estudo foi analisar os níveis de ansiedade traço-competitivo pré e pós- competição em jogadoras de voleibol e ainda, verificar a associação destes níveis com a idade destas atletas. Durante uma competição, 12 atletas de voleibol do sexo feminino (21,5 ± 2,9 (15-24) anos) responderam a Escala de Ansiedade Traço-Competitivo (SCAT) antes do início da partida e imediatamente após o término desta. Os resultados demonstraram que após a competição houve uma redução significativa dos valores de ansiedade traço-competitivo nas atletas de voleibol (p=0,01) e que há uma correlação significativa em que atletas mais jovens apresentaram níveis mais elevados de ansiedade traço-competitivo antes do início do jogo (p=0,001; r=0,76), sugerindo o fator de idade possa predizer os níveis de ansiedade. A análise de regressão múltipla revelou que a idade pode ser um fator significante na análise dos níveis de ansiedade de jogadoras de voleibol (p=0,003; R2=0,82). Estes resultados sugerem que: a) Os níveis de ansiedade traço competitiva apresentaram uma redução significativa após o término da partida que quando comparados na situação pré-competitiva, entretanto, esses níveis ainda são considerados altos segundo os valores de referencia da escala utilizada e; b) Atletas mais jovens apresentam níveis mais altos de ansiedade traço-competitivo, o que permite inferir que esta variável pode ser modulada pela idade e experiência.

The aim of present study was to analyze the levels of competitive anxiety pre and post competitive on volleyball female players and, verify the association between these levels with the age of these athletes. During a competition, 12 female athletes of volleyball with mean of age of 21,5 ± 2,9 (15-24) years answered the Sport Competition Anxiety Test (SCAT) after and immediately before the start of the game. The data were analyzed by non parametric statistics. To verify significant differences on pre and post competition moments were realized a Wilcoxon test. To analyze the association between age and levels of anxiety it was realized the Spearman's correlation and a stepwise multiple regression. The results showed that on post competition moment there was a significant decrease (p=0,01) of competitive anxiety and there is significant correlation (p=0,001; r=0,76) with higher ages and lower levels of competitive anxiety. It suggests that the factor age can predict the levels of anxiety. The multiple regression revealed that the age can be a significant factor on analyze of competitive anxiety of female volleyball players (p=0,003; R2=0,82). These results suggest that: a) Levels of competitive anxiety presented a significant decrease after the end of the game when compared with the begging of the same game; b) Younger athletes presented higher levels of competitive anxiety.

Apathy in Alzheimer's disease - Contribution to a clinical view on progression of dementia / Apatia na doença de Alzheimer - contribuição para uma visão clínica da progressão da demência

In addition to cognitive impairment, apathy is increasingly recognized as an important neuropsychiatric syndrome in Alzheimers disease (AD). Aims: To identify the relationship between dementia severity and apathy levels, and to discuss the association of this condition with other psychopathological manifestations in AD patients. Methods: This study involved 15 AD patients (mean age: 77 years; schooling: 4.9 years), with mild, moderate and severe dementia, living in Rio Claro SP, Brazil. Procedures included evaluation of cognitive status by the Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale. Apathy syndrome was assessed by the Apathy Evaluation Scale and Neuropsychiatric Inventory (NPI-apathy domain). Other psychopathological manifestations such as depression were also considered. Results: Patients with more severe dementia presented higher levels of apathy, reinforcing the hypothesis that apathy severity aggravates as the disease progresses. Using the Spearman coefficient correlation an association was identified between the MMSE and Apathy Evaluation Scale (r=0.63; p=0.01), and also between the MMSE and NPI-apathy domain (r=0.81; p=0.01). Associations were also found between the Global Deterioration Scale and Apathy Evaluation Scale (r=0.58; p=0.02), and between the Global Deterioration Scale and NPI-apathy domain (r=0.81; p=0.01). Conclusions: Apathy is a distinct syndrome among patients with AD and increases with global deterioration.

A apatia tem sido reconhecida como uma importante síndrome na doença de Alzheimer (DA), além do comprometimento cognitivo. Objetivo: Avaliar a relação entre gravidade da demência e níveis de apatia e discutir a associação de apatia com outras manifestações psicopatológicas em pacientes com DA. Sujeitos: 15 pacientes com DA com demência leve, moderada e avançada, residentes em Rio Claro SP, Brasil. Métodos: Avaliação do status cognitivo por meio do Mini-Exame do Estado Mental, Escore Clínico de Demência e Escala de Deterioração Global. A avaliação da apatia incluiu a Escala de Avaliação de Apatia e o Inventário Neuropsiquiátrico (NPI-domínio apatia). Depressão também foi aferida. Resultados: Os pacientes com demência avançada apresentaram níveis mais elevados de apatia, o que reforça a hipótese de que ela se agrava na medida em que a doença progride. Por meio do coeficiente de correlação de Spearman, verificou-se associação do Mini-Exame do Estado Mental com a Escala de Avaliação de Apatia (r=0,63; p=0,01) e com o NPI-domínio apatia (r=0,81; p=0,01); também se constatou associação da Escala de Deterioração Global com a Escala de Avaliação de Apatia (r=0,58; p=0,02) e com o NPI-domínio apatia (r=0,81; p=0,01). Conclusões: A apatia é uma síndrome distinta em pacientes com DA e que se agrava com a deterioração global imposta pela doença.

Apathy in Alzheimer's disease: Contribution to a clinical view on progression of dementia.

In addition to cognitive impairment, apathy is increasingly recognized as an important neuropsychiatric syndrome in Alzheimer's disease (AD). AIMS: To identify the relationship between dementia severity and apathy levels, and to discuss the association of this condition with other psychopathological manifestations in AD patients. METHODS: This study involved 15 AD patients (mean age: 77 years; schooling: 4.9 years), with mild, moderate and severe dementia, living in Rio Claro SP, Brazil. Procedures included evaluation of cognitive status by the Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale. Apathy syndrome was assessed by the Apathy Evaluation Scale and Neuropsychiatric Inventory (NPI-apathy domain). Other psychopathological manifestations such as depression were also considered. RESULTS: Patients with more severe dementia presented higher levels of apathy, reinforcing the hypothesis that apathy severity aggravates as the disease progresses. Using the Spearman coefficient correlation an association was identified between the MMSE and Apathy Evaluation Scale (r=0.63; p=0.01), and also between the MMSE and NPI-apathy domain (r=0.81; p=0.01). Associations were also found between the Global Deterioration Scale and Apathy Evaluation Scale (r=0.58; p=0.02), and between the Global Deterioration Scale and NPI-apathy domain (r=0.81; p=0.01). CONCLUSIONS: Apathy is a distinct syndrome among patients with AD and increases with global deterioration.

A apatia tem sido reconhecida como uma importante síndrome na doença de Alzheimer (DA), além do comprometimento cognitivo. OBJETIVO: Avaliar a relação entre gravidade da demência e níveis de apatia e discutir a associação de apatia com outras manifestações psicopatológicas em pacientes com DA. SUJEITOS: 15 pacientes com DA com demência leve, moderada e avançada, residentes em Rio Claro SP, Brasil. MÉTODOS: Avaliação do status cognitivo por meio do Mini-Exame do Estado Mental, Escore Clínico de Demência e Escala de Deterioração Global. A avaliação da apatia incluiu a Escala de Avaliação de Apatia e o Inventário Neuropsiquiátrico (NPI-domínio apatia). Depressão também foi aferida. RESULTADOS: Os pacientes com demência avançada apresentaram níveis mais elevados de apatia, o que reforça a hipótese de que ela se agrava na medida em que a doença progride. Por meio do coeficiente de correlação de Spearman, verificou-se associação do Mini-Exame do Estado Mental com a Escala de Avaliação de Apatia (r=0,63; p=0,01) e com o NPI-domínio apatia (r=0,81; p=0,01); também se constatou associação da Escala de Deterioração Global com a Escala de Avaliação de Apatia (r=0,58; p=0,02) e com o NPI-domínio apatia (r=0,81; p=0,01). CONCLUSÕES: A apatia é uma síndrome distinta em pacientes com DA e que se agrava com a deterioração global imposta pela doença.

Estágios de mudança de comportamento e barreiras percebidas à prática de atividade física em idosos residentes em uma cidade de médio porte do Brasil / Stages of behavior change and perceived barriers to physical activity in the elderly living in a medium size city in Brazil

O objetivo foi analisar a prevalência dos estágios de mudança do comportamento (EMC), e as barreiras percebidas para a prática de atividade física em idosos residentes em uma cidade de médio porte do estado de São Paulo, Brasil. Setenta e nove idosos participaram do estudo. Os EMC foram avaliados por meio do Questionário de Mudanças de Comportamento e as barreiras percebidas à prática de atividade física foram mensuradas por meio do Questionário de Barreiras à Prática de Atividade Física para Idosos (QBPAFI). A análise estatística foi composta pelo teste de qui-quadrado (p<0,05). Os dados revelaram que:a) 64,6% dos idosos não praticam atividade física e somente 22,8% realizam esta prática regularmente por mais de 6 meses; b) As barreiras mais percebidas foram: " Suficientemente Ativo"," Muito Velho ","Necessidade de descanso" e; "Doença ou Lesão"; c) Os EMC parecem modular significativamente a percepção de barreiras (p<0,05). Podemos concluir que: a) A maioria das pessoas idosas encontram-se no estágio de comportamento de pré-contemplação, contemplação e preparação dos EMC, ainda; b) O gênero influencia não interfere significativamente na percepção de barreiras e; c) os EMC interferem no tipo de barreira percebida. Tais conclusões reforçam sugestões de que é necessário desenvolver estratégias específicas para idosos e para os diferentes estágios de mudança no comportamento, quando o objetivo for minimizar barreiras. Isto pode ajudar a encontrar a formas mais eficazes para incentivar a mudança de comportamento, incentivando o estilo de vida ativo em idosos.

The aim was to analyze the prevalence of the stages of behavior change (BCS) and the perceived barriers to physical activity in older people residents in a medium size city of Sao Paulo state, Brazil. Seventy-nine older people participated of the study. The BCS was assessed by the Questionnaire of Behavior Chance Stages and those on perception of barriers by the Questionnaire on Barriers to the Practice of Physical Activity in Older People (QBPPAE). Statistical analyses was comprised by the Chisquare test (p<0.05). Data showed that: a) 64,6% of the older people do not practice physical activity and only 22,8% of them have been practicing it on a regular basis for more than 6 months; b) The most perceived barriers were: “Active enough”, “Too old”; “Need to rest” and; “Disease or injury”; c) The BCS seems modulate significantly the perception of barriers (p<0.05). We can conclude that: a) most of the older people are in the pre-contemplation, contemplation and preparation stages of the BCS, yet; b) gender influences almost nothing with perception of barriers and; c) the BCS interferes with the type of perceived barriers. Such conclusions support the suggestions that it is necessary to develop specific strategies for different stages of behavior change if it is to minimize the barriers. This may help to find the most effective way to change to more active lifestyle in the elderly.

Capacidade aeróbia de ratos alimentados com dieta rica em frutose / Aerobic capacity of rats fed with fructose rich diet

INTRODUÇÃO: Evidências apontam que a ingestão exacerbada de frutose pode desencadear distúrbios característicos da síndrome metabólica. OBJETIVOS: Analisar os efeitos da ingestão de dieta rica em frutose sobre aspectos metabólicos de ratos da linhagem Wistar. Adicionalmente, verificar a capacidade aeróbia através da identificação da máxima fase estável de lactato (MFEL). MÉTODOS: Dezesseis ratos foram separados em dois grupos de oito animais: a) controle, alimentados com dieta balanceada, e b) frutose, alimentados com dieta rica em frutose. Foram analisadas a tolerância à glicose (área sob a curva de glicose durante teste de tolerância à glicose), sensibilidade à insulina (taxa de remoção da glicose sérica após sobrecarga exógena de insulina), perfil lipídico sérico e concentração de lactato sanguíneo [lac]s durante exercício na intensidade da MFEL. RESULTADOS: Teste t não pareado (p < 0,05) revelou diferença para a tolerância à glicose e triglicérides, porém não houve diferença na sensibilidade à insulina e na [lac]s. Anova one way com post hoc de Newman-Keuls (p < 0,05) revelou diferença para a cinética da glicose durante o teste de tolerância, mas não para a cinética do lactato durante exercício na MSSL. CONCLUSÃO: As Alterações fisiológicas provocadas pela dieta rica em frutose e inerentes à síndrome metabólica não prejudicam a capacidade aeróbia de ratos.

INTRODUCTION: Evidence points that exacerbated ingestion of fructose may trigger disturbs characteristic of the metabolic syndrome. OBJECTIVES: To analyze the effects of a fructose rich diet on metabolic aspects of Wistar lineage rats. Additionally, to verify the aerobic capacity, through the identification of the maximal lactate steady state (MSSL). PROCEDURES: Sixteen rats were separated in two groups of eight animals: a) Control, fed a balanced diet, and b) fructose, fed a fructose-rich diet. The glucose tolerance, (area under serum glucose during a glucose tolerance test), insulin sensibility (glucose disappearance rate after exogenous insulin administration), serum lipid profile and blood lactate concentration [lac]b during exercise at MSSL intensity, have been analyzed. RESULTS: Non-paired t test (p<0.05) revealed difference between groups in the area under the curve of glucose and serum triglycerides, no difference in insulin sensibility or in [lac]b was detected, though. One-way ANOVA with Newman Keuls post hoc revealed difference in the glucose kinetics during tolerance test, but not in the lactate kinetics during the MSSL. CONCLUSION: The physiological alterations promoted by fructose-rich diet and intrinsic to the metabolic syndrome do not harm the aerobic capacity of rats.