Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, São Paulo, Brazil.

BACKGROUND: Frailty in older adults is a multifactorial syndrome defined by low metabolic reserve, less resistance to stressors, and difficulty in maintaining organic homeostasis due to cumulative decline of multiple physiological systems. The relationship between frailty and cognition remains unclear and studies about Mini-Mental State Examination (MMSE) performance and frailty are scarce. The objective was to examine the association between frailty and cognitive functioning as assessed by the MMSE and its subdomains. METHODS: A cross-sectional population-based study (FIBRA) was carried out in Ermelino Matarazzo, a poor subdistrict of the city of São Paulo, Brazil. Participants were 384 community dwelling older adults, 65 years and older who completed the MMSE and a protocol to assess frailty criteria as described in the Cardiovascular Health Study (CHS). RESULTS: Frail older adults had significantly worse performance on the MMSE (p < 0.001 for total score). Linear regression analyses showed that the MMSE total score was influenced by age (p < 0.001), education (p < 0.001), family income (p < 0.001), and frailty status (p < 0.036). Being frail was associated more significantly with worse scores in Time Orientation (p < 0.004) and Immediate Memory (p < 0.001). CONCLUSIONS: Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

Depressive symptoms in old age: relations among sociodemographic and self-reported health variables.

BACKGROUND: Depression in old age is a complex multifactorial phenomenon that is influenced by several biopsychosocial variables. Depressive symptoms are associated with the presence of chronic diseases, with being female, with low education and low income levels, and with poor perceived health assessment. In impoverished areas, older adults may have more physical disability, as they may have less access to health services. Therefore, they may be more likely to report depressive symptoms. METHODS: Population-based cross-sectional research was undertaken using data from the FIBRA study conducted in Ermelino Matarazzo, a poor subdistrict of the city of São Paulo, Brazil. The participants comprised 303 elderly people, aged 65 years and over, who attended a single-session data collection effort carried out at community centers. The protocol comprised sociodemographic and self-reported health variables, and the Geriatric Depression Scale. RESULTS: The majority of the subjects reported five or fewer symptoms of depression (79.21%), reported one or two self-reported chronic diseases (56.86%), declared themselves to have one or two self-reported health problems (46.15%), and had good perceived health assessment (40.27%). The presence of depressive symptoms was associated with a higher number of self-reported health problems, poor perceived health assessment, and lower schooling levels, in the total sample and in analyses including men only. For women, depressive symptoms were associated with the number of self-reported health problems and family income. CONCLUSION: The presence of health problems, such as falls and memory problems, lower perceived health, and low education (and low family income for women) were associated with a higher presence of depressive symptoms among elderly people in this poor area of São Paulo.

Determinants of cognitive performance among community dwelling older adults in an impoverished sub-district of São Paulo in Brazil.

Determinants of cognitive performance in old age have received limited attention in Latin America. We investigated the association of socio-demographic and health-related variables with cognitive performance in a sample of older adults with limited educational experience living in a poor sub-district of the city of São Paulo. This was a cross-sectional population-based study which included a sample of 384 seniors 65 years and older. Cognition was assessed by the Mini-Mental State Examination (MMSE) and the Brief Cognitive Screening Battery (BCSB) (episodic memory test with 10 pictures, verbal fluency (VF), Clock Drawing Test (CDT)). Results indicated that age, sex, schooling, depressive symptoms, and systolic blood pressure (SBP) level had a significant impact on the cognitive performance of the sample. Therefore, pharmacological and psychosocial interventions with a focus on improving mood and controlling hypertension may have beneficial effects on cognition among seniors with similar socio-demographic characteristics.

Atividades Avançadas de Vida Diária (AAVD) e desempenho cognitivo entre idosos / Advanced Activities of Daily Living (AADL) and cognitive performance among older adults / Actividades Avanzadas de la Vida Diaria (AAVD) y desempeño cognitivo entre ancianos

O estudo objetivou investigar a associação entre Atividades avançadas de vida diária (AAVD) e o desempenho cognitivo entre idosos participantes do estudo FIBRA em Ermelino Matarazzo, São Paulo. Foram investigados 302 idosos sem declínio cognitivo, classificados em muito ativos e pouco ativos nas AAVDs, e avaliados pelo Mini exame do estado mental (MEEM), bateria breve de rastreio cognitivo (BBRC), fluência verbal (FV), teste do desenho do relógio (TDR) e escala de depressão geriátrica (EDG). As AAVDs associaram-se ao desempenho no MEEM e no TDR, nas análises univariadas, mas esta associação perdeu significância no modelo multivariado. O desempenho, no MEEM, esteve associado à idade, escolaridade, sexo e número de sintomas depressivos. O escore, no TDR, associou-se à escolaridade. Conclui-se que a relação entre as AAVDs e o desempenho cognitivo parece ser modulada por variáveis sociodemográficas e por sintomas depressivos...

This study aimed to investigate the association between advanced activities of daily living (AADL) and cognitive performance in a community of dwelling older adults participants of the FIBRA study in Ermelino Matarazzo, São Paulo. 302 older adults without cognitive decline, classified as very active or little active in AADLs, were assessed by the Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), Verbal Fluency (VF), Clock Drawing Test (CDT), and Geriatric Depression Scale (GDS). The AADLs were associated with performance in the MMSE and CDT in univariate analyses, but the association lost statistical significance in the multivariate model. The MMSE score was associated with age, education, sex and depression symptoms. The CDT score was associated with education. The association between AADLs and cognitive performance seems to be modulated by socio-demographic variables and the number of depression symptoms...

Este estudio investigó la asociación entre las Actividades Avanzadas de la Vida Diaria (AAVD) y el desempeño cognitivo entre las personas ancianas, participantes del Estudio FIBRA, en Ermelino Matarazzo, San Pablo. Fueron investigadas 302 ancianos, sin deterioro cognitivo, clasificados en muy activos y poco activos en las AAVD, y evaluadas por el Mini-Examen del Estado Mental (MEEM), la Batería Breve de Rastreo Cognitivo (BBRC), Fluidez Verbal (FV), Test del Dibujo del Reloj (TDR), y la Escala de Depresión Geriátrica (EDG). Las AAVD se asociaron con el rendimiento en el MEEM y en el TDR en los análisis univariados, pero perdieron importancia en el modelo multivariado. El desempeño en el MEEM estuvo asociado a la edad, escolaridad, sexo y número de síntomas depresivos. El resultado en el TDR se asoció a la escolaridad. La relación entre el rendimiento cognitivo y las AAVD parece estar regido por las variables sociodemográficas y por síntomas depresivos...

Relations between memory complaints, depressive symptoms and cognitive performance among community dwelling elderly / Relações entre queixas de memória, sintomas depressivos e desempenho cognitivo em idosos residentes na comunidade

Backgroun: Memory complaints are quite common among the elderly; yet, the clinical relevance of these complaints to diagnose cognitive decline is debatable, since several different factors could be associated with them. Objective: The present paper examined the correlations between memory complaints, depressive symptoms and cognitive performance in a group of 301 elderly individuals who lived in the district of Ermelino Matarazzo, São Paulo, and who participated in the population-based survey entitled Profiles of Frailty in Elderly Brazilians by the FIBRA Network. Methods: Cognitive performance was assessed with the memorization test involving 10 common pictures, the Mini Mental State Examination (MMSE), the Verbal Fluency (VF) test, and the Clock Drawing Test, which comprise the Brief Cognitive Screening Battery (BCSB). Memory complaints were assessed with the Memory Complaint Questionnaire (MAC-Q), and depressive symptoms with the Geriatric Depression Scale (GDS). Results: Female participants had higher rates of memory complaints when compared to male participants (p = 0.013). Subjects with less years of schooling had more severe memory complaints and poorer cognitive performance than those with more years of schooling (p < 0.003). The presence of depressive symptoms was associated with poorer memory assessment scores (r = 0.39, p < 0.001). Discussion: Memory complaints were correlated with sex, schooling and depressive symptoms among elderly individuals residing in the community. No correlation was found between complaints and cognitive performance.

Contexto: A queixa de memória é comum entre pessoas idosas, entretanto sua relevância clínica para o diagnóstico de alterações cognitivas é questionável, visto que diversos fatores podem se associar às queixas. Objetivo: O presente estudo avaliou a relação entre queixas de memória, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Objetivo: O presente estudo avaliou a relação entre queixas de memória, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Métodos: O desempenho cognitivo foi avaliado por meio dos testes de memorização de 10 figuras comuns, Miniexame do Estado Mental (MEEM), Fluência Verbal (FV) e Teste do Desenho do Relógio, que compõem a Bateria Breve de Rastreio Cognitivo (BBRC). As queixas de memória foram avaliadas pelo Questionário de Queixas de Memória (MAC-Q) e os sintomas depressivos, pela Escala de Depressão Geriátrica (EDG). Resultados: Participantes do sexo feminino apresentaram maior índice de queixas de memória, comparado ao dos homens (p = 0,013). Idosos menos escolarizados apresentaram queixas de memória mais intensas e pior desempenho cognitivo, comparados aos de maior escolaridade (p < 0,003). A presença de sintomas depressivos associou-se à pior avaliação da memória (r = 0,39, p < 0,001). Conclusão: As queixas de memória se associaram a sexo, escolaridade e sintomas depressivos, entre idosos residentes na comunidade. Não houve associação entre queixas e desempenho cognitivo. Conclusão: As queixas de memória se associaram a sexo, escolaridade e sintomas depressivos, entre idosos residentes na comunidade. Não houve associação entre queixas e desempenho cognitivo.