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1.
Alzheimers Dement ; 20(3): 2309-2322, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38275208

RESUMO

Coping with dementia requires an integrated approach encompassing personal, health, research, and community domains. Here we describe "Walking the Talk for Dementia," an immersive initiative aimed at empowering people with dementia, enhancing dementia understanding, and inspiring collaborations. This initiative involved 300 participants from 25 nationalities, including people with dementia, care partners, clinicians, policymakers, researchers, and advocates for a 4-day, 40 km walk through the Camino de Santiago de Compostela, Spain. A 2-day symposium after the journey provided novel transdisciplinary and horizontal structures, deconstructing traditional hierarchies. The innovation of this initiative lies in its ability to merge a physical experience with knowledge exchange for diversifying individuals' understanding of dementia. It showcases the transformative potential of an immersive, embodied, and multi-experiential approach to address the complexities of dementia collaboratively. The initiative offers a scalable model to enhance understanding, decrease stigma, and promote more comprehensive and empathetic dementia care and research.


Assuntos
Demência , Estigma Social , Humanos , Espanha , Demência/terapia
2.
Aging Clin Exp Res ; 34(4): 827-835, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34648173

RESUMO

BACKGROUND: Dual tasking, or the ability to executing two tasks simultaneously, has been used in recent research to predict cognitive impairments, physical frailty, and has been linked with cognitive frailty in old adults. AIM: This study aimed to determine age-related variables can predict dual-task (DT) performance in the older population. METHODS: A total of 258 healthy community-dwelling participants + 60 years were assessed in relation to their functional capacity, health, well-being, social support and years of education. Performance of a cognitive (Fluency) task and a cognitive-motor (Tracking) task was recorded under single and DT conditions. Multiple linear regression analysis was carried out for each dependent variable, in separate models including cognitive, functional and psychosocial variables. RESULTS: Performance in Fluency in DT conditions was predicted by cognitive variables, whereas performance in Tracking DT conditions was predicted by positive interaction, health status, age and motor variables. DISCUSSION: The findings suggest that a wide range of cognitive, psychological, social, physical and functional variables influence cognitive and motor performance in aging. CONCLUSION: DT methodology is sensitive to different age-related changes and could be related to frailty conditions in aging.


Assuntos
Fragilidade , Análise e Desempenho de Tarefas , Envelhecimento , Cognição , Humanos , Vida Independente , Caminhada
3.
Clin Gerontol ; 45(1): 31-35, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34047685

RESUMO

OBJECTIVES: The COVID-19 pandemic required a population lockdown during the first wave in March 2020. Evidence has shown a circular relationship between perceived threat and the risk of developing negative mood, which might impact the affect balance of older adults. We aimed to investigate the positive and negative feelings expressed by young-old (60-70 years) and old-old (over 71 years) Spanish adults during the lockdown of the COVID-19 first wave, and the social and psychological variables associated. METHODS: Cross-sectional study conducted in 528 participants using a questionnaire composed of sociodemographic data and validated scales for resilience (Brief Resilient Coping Scale) and emotions (Scale of Positive and Negative Experience). RESULTS: We found a positive balance between positive and negative feelings with no differences between both groups. Regression analysis showed that social network and resilience, but not age, are significant predictors of both greater positive feelings and lower negative feelings. CONCLUSIONS: Our results evidence the relevance of promoting targeted support psychological and social measures that effectively help older adults to cope with such a difficult scenario as the current pandemic. CLINICAL IMPLICATIONS: Health-care providers must develop targeted care strategies aimed at providing emotional support for older adults from a holistic perspective.


Assuntos
COVID-19 , Idoso , Controle de Doenças Transmissíveis , Estudos Transversais , Emoções , Humanos , Pandemias , SARS-CoV-2
4.
Psychol Med ; 51(14): 2465-2475, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-32375918

RESUMO

BACKGROUND: Mild cognitive impairment (MCI), as a stage in the cognitive continuum between normal ageing and dementia, is mainly characterized by memory impairment. The aims of this study were to examine CANTAB measures of temporal changes of visual memory in MCI and to evaluate the usefulness of the baseline scores for predicting changes in cognitive status. METHODS: The study included 201 participants aged over 50 years with subjective cognitive complaints. Visual memory was assessed with four CANTAB tests [paired associates learning (PAL), delayed matching to sample (DMS), pattern recognition memory (PRM) and spatial span (SSP)] administered at baseline and on two further occasions, with a follow-up interval of 18-24 months. Participants were divided into three groups according to the change in their cognitive status: participants with subjective cognitive complaints who remained stable, MCI participants who remained stable (MCI-Stable) and MCI participants whose cognitive deterioration continued (MCI-Worsened). Linear mixed models were used to model longitudinal changes, with evaluation time as a fixed variable, and multinomial regression models were used to predict changes in cognitive status. RESULTS: Isolated significant effects were obtained for age and group with all CANTAB tests used. Interactions between evaluation time and group were identified in the PAL and DMS tests, indicating different temporal patterns depending on the changes in cognitive status. Regression models also indicated that CANTAB scores were good predictors of changes in cognitive status. CONCLUSIONS: Decline in visual memory measured by PAL and DMS tests can successfully distinguish different types of MCI, and considered together PAL, DMS, PRM and SSP can predict changes in cognitive status.


Assuntos
Disfunção Cognitiva/diagnóstico , Transtornos da Memória/diagnóstico , Testes Neuropsicológicos/estatística & dados numéricos , Idoso , Envelhecimento/fisiologia , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Reconhecimento Visual de Modelos/fisiologia
5.
J Asthma ; 58(9): 1237-1246, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-32475186

RESUMO

OBJECTIVE: Mindfulness is the ability to pay attention to the present moment without judgment. Mindfulness interventions have proved to be effective in improving the management of psychological symptoms of chronic patients. The objective of this work is to update the evidence about the effects of mindfulness interventions on psychological symptoms in patients with asthma and chronic obstructive pulmonary disease (COPD). METHODOLOGY: Data sources were PubMed and PsycInfo. From a first set of 109 articles, 12 about mindfulness-interventions in adult populations with asthma or COPD were finally included in the review. RESULTS: Of the total of 12 studies included, 5 were qualitative and 6 quantitative (5 randomized controlled trials). One quantitative study reported long-term psychological effects in asthma patients, two studies reported short-term psychological effects in COPD patients. Relevant themes identified in qualitative studies included increased awareness, development of new relationships with dyspnea, including new cognitive strategies, and slowing down. CONCLUSIONS: Mindfulness interventions could increase psychological resources in situations related to asthma and COPD symptoms. More randomized control trials are needed.


Assuntos
Asma/psicologia , Atenção Plena , Doença Pulmonar Obstrutiva Crônica/psicologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Appl Nurs Res ; 62: 151505, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34815001

RESUMO

BACKGROUND: Family caregivers of persons with dementia often experience a negative impact on their health. More studies based on nursing theories are needed to improve the provision of care. AIMS: To describe the care provided by family caregivers of persons with dementia and the impact on their health, as well as to analyse how personal variables of caregivers are related to care tasks and their health impact. METHODS: Multi-centric cross-sectional prospective study conducted on a sample of 423 primary family caregivers of persons with dementia from Spain. Data were collected through ICUB97-R questionnaire (January-April 2019), based on the fourteen needs of Virginia Henderson's Nursing Model. Data was analysed through one-way analysis of variance and Student's t-test. RESULTS: The caregiver profile was a middle-aged married woman without higher education living with the cared person, predominantly her mother. The most frequently provided care corresponded to "nutrition" and "movement" needs. Lack of free time, modifications on leisure activities, reduced sleep or rest and disruption of family life emerged as the greatest repercussions on the caregiver's health. The age of the caregiver and time caring showed differences on impact of care and care tasks, respectively. CONCLUSION: The identification of the types of care provided, the health impact of caring and the variables affecting the family caregiver's vulnerability is essential to develop effective individualised nursing care plans, including health education interventions to improve the quality of life of both caregivers and persons cared for.


Assuntos
Cuidadores , Demência , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários
7.
Aten Primaria ; 53(7): 102065, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33901769

RESUMO

Our aim was to calculate the 'Timed Up & Go' (TUG) normative scores in a Spanish sample composed of functional older adults. The TUG test provides a measure of global ambulation skills and its total score has been successfully related with functionality and other important health variables in older adults. Reliable norms are needed for adults 50 years and older that allow the early identification and intervention in motor disturbances. The study was carried out with adults from Galicia and Valencia living in the community. A total of 314 Spanish community-living participants, aged from 50 to 90 years and functionality preserved were assessed through the implementation of a cross-sectional design. Health, comorbidity, physical activity, cognitive status, functionality measures and TUG test scores were obtained. TUG scores were successfully predicted by age and gender, and significantly correlated with cognitive status and comorbidity. TUG norms were calculated by age-group for women and men. TUG normative scores were below 13s and slightly lower in men. Normative scores for women and men were lower than those proposed in studies carried-out in our context. Our norms showed risk reference scores close to those obtained by meta-analytical procedures.


Assuntos
Avaliação Geriátrica , Caminhada , Idoso , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Medição de Risco , Fatores de Risco
8.
Psychogeriatrics ; 21(3): 272-278, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33598981

RESUMO

BACKGROUND: Apathy and agitation are often recognized as the most problematic behavioural and psychological symptoms in care settings. In this study, we analyze the relationship between apathy and agitation symptoms other and their relationship with demographic, cognitive, and neuropsychiatric variables and psychotropic medication use. METHODS: A retrospective study was conducted at a gerontological care centre in Láncara, Spain. Participants were 196 residents of the gerontological care centre, including 143 with a diagnosis of dementia. Apathy and agitation were assessed with the Apathy Scale for Institutionalized Patients with Dementia, Nursing Home version, and the Spanish version of the Cohen-Mansfield Agitation Inventory, respectively. Two-stage hierarchical cluster analysis (hierarchical cluster analysis in a first exploratory stage and K-means clustering to obtain the final solution in the second stage) was conducted to assign residents to different groups based on apathy and agitation scores. RESULTS: In cluster 1, a certain level of apathy, the highest levels of agitation, and the most frequent intake of atypical antipsychotics and clomethiazole were observed. The highest levels of apathy and the most frequent intake of memantine were seen in cluster 2. The lowest levels of agitation and apathy and the highest levels of cognitive performance were found in cluster 3. CONCLUSIONS: In this study, subjects with dementia were in a state of high agitation and eventual apathy, had low cognitive status, and were very old. Patients with this profile require well-designed non-pharmacological interventions.


Assuntos
Apatia , Demência , Idoso , Humanos , Agitação Psicomotora , Estudos Retrospectivos , Espanha/epidemiologia
9.
Int J Geriatr Psychiatry ; 35(11): 1358-1366, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32662207

RESUMO

OBJECTIVE: The aim of this pilot study was to investigate differences on dual- and triple-task performance in institutionalized prefrail and frail older adults. Performance on these tasks is relevant since many activities of daily living involve simultaneous motor and cognitive tasks. METHODS: We used a phenotypic description of frailty based on the presence or absence of five criteria related to physical fitness and metabolism (unintentional weight loss, self-reported exhaustion, muscle weakness, low gait speed, and low physical activity). Thirty-three institutionalized older adults (≥ 65 years, 78.8% females) were divided according to their frailty status. Participants completed cognitive tasks (a phonemic verbal fluency task and a visuospatial tracking task) while cycling on a stationary cycle (upper- and lower-extremity function was assessed). Cycling (number of arm and foot cycles) and cognitive (number of correct answers) performances were measured during single-, dual-, and triple-task conditions. Performances and costs of dual -and triple- tasking on cycling and cognitive performances were compared between prefrail and frail groups. RESULTS: Prefrail and frail older adults did not differ in their performance in dual-tasks; however, frail older adults showed a poorer performance in the triple-task. CONCLUSIONS: Although future studies need to confirm our observations in larger samples, this pilot study suggests that developing new tools based on triple tasking could be useful for the comprehensive assessment of frailty.


Assuntos
Idoso Fragilizado , Análise e Desempenho de Tarefas , Atividades Cotidianas , Idoso , Feminino , Avaliação Geriátrica , Humanos , Masculino , Projetos Piloto
10.
Int Psychogeriatr ; 32(4): 515-524, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31547899

RESUMO

OBJECTIVE: To study the influence of cognitive reserve (CR) on cognitive performance of individuals with subjective cognitive complaints (SCCs) within a period of 36 months. DESIGN: We used a general linear model repeated measures procedure to analyze the differences in performance between three assessments. We used a longitudinal structural equation modeling to analyze the relationship between CR and cognitive performance at baseline and at two follow-up assessments. SETTING: Participants with SCCs were recruited and assessed in primary care health centers. PARTICIPANTS: A total of 212 participants older than 50 years with SCCs. MEASUREMENTS: Cognitive reserve data were collected with an ad hoc questionnaire administered to the subjects in an interview. General cognitive performance (GCP), episodic memory (EM), and working memory (WM) have been evaluated. The Mini-Mental State Examination and the total score of Spanish version of the Cambridge Cognitive Examination evaluated the GCP. Episodic memory was assessed with the Spanish version of the California Verbal Learning. Working memory was evaluated by the counting span task and the listening span task. RESULTS: The satisfactory fit of the proposed model confirmed the direct effects of CR on WM and GCP at baseline, as well as indirect effects on EM and WM at first and second follow-up. Indirect effects of CR on other cognitive constructs via WM were observed over time. CONCLUSION: The proposed model is useful for measuring the influence of CR on cognitive performance over time. Cognitive response acquired throughout life may influence cognitive performance in old age and prevent cognitive deterioration, thus increasing processing resources via WM.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Disfunção Cognitiva/diagnóstico , Reserva Cognitiva/fisiologia , Função Executiva/fisiologia , Transtornos da Memória/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Disfunção Cognitiva/classificação , Disfunção Cognitiva/psicologia , Feminino , Humanos , Análise de Classes Latentes , Masculino , Memória Episódica , Memória de Curto Prazo/fisiologia , Pessoa de Meia-Idade , Modelos Estatísticos , Testes Neuropsicológicos , Inquéritos e Questionários , Aprendizagem Verbal/fisiologia
11.
Int Psychogeriatr ; 32(3): 381-392, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31455461

RESUMO

OBJECTIVES: To use a Machine Learning (ML) approach to compare Neuropsychiatric Symptoms (NPS) in participants of a longitudinal study who developed dementia and those who did not. DESIGN: Mann-Whitney U and ML analysis. Nine ML algorithms were evaluated using a 10-fold stratified validation procedure. Performance metrics (accuracy, recall, F-1 score, and Cohen's kappa) were computed for each algorithm, and graphic metrics (ROC and precision-recall curves) and features analysis were computed for the best-performing algorithm. SETTING: Primary care health centers. PARTICIPANTS: 128 participants: 78 cognitively unimpaired and 50 with MCI. MEASUREMENTS: Diagnosis at baseline, months from the baseline assessment until the 3rd follow-up or development of dementia, gender, age, Charlson Comorbidity Index, Neuropsychiatric Inventory-Questionnaire (NPI-Q) individual items, NPI-Q total severity, and total stress score and Geriatric Depression Scale-15 items (GDS-15) total score. RESULTS: 30 participants developed dementia, while 98 did not. Most of the participants who developed dementia were diagnosed at baseline with amnestic multidomain MCI. The Random Forest Plot model provided the metrics that best predicted conversion to dementia (e.g. accuracy=.88, F1=.67, and Cohen's kappa=.63). The algorithm indicated the importance of the metrics, in the following (decreasing) order: months from first assessment, age, the diagnostic group at baseline, total NPI-Q severity score, total NPI-Q stress score, and GDS-15 total score. CONCLUSIONS: ML is a valuable technique for detecting the risk of conversion to dementia in MCI patients. Some NPS proxies, including NPI-Q total severity score, NPI-Q total stress score, and GDS-15 total score, were deemed as the most important variables for predicting conversion, adding further support to the hypothesis that some NPS are associated with a higher risk of dementia in MCI.


Assuntos
Sintomas Comportamentais/epidemiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Demência/epidemiologia , Demência/psicologia , Depressão/epidemiologia , Aprendizado de Máquina , Idoso , Idoso de 80 Anos ou mais , Agressão , Ansiedade , Disfunção Cognitiva/classificação , Delusões/epidemiologia , Demência/classificação , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Transtornos do Sono-Vigília/epidemiologia
12.
Int J Geriatr Psychiatry ; 34(7): 941-949, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30854737

RESUMO

OBJECTIVES: The overall aim of the present study was to explore the role of cognitive reserve (CR) in the conversion from mild cognitive impairment (MCI) to dementia. We used traditional and machine learning (ML) techniques to compare converter and nonconverter participants. We also discuss the predictive value of CR proxies in relation to the ML model performance. METHODS: In total, 169 participants completed the longitudinal study. Participants were divided into a control group and three MCI subgroups, according to the Petersen criteria for diagnosis. Information about the participants was compared using nine ML classification techniques. Seven relevant performance metrics were computed in order to evaluate the accuracy of prediction regarding converter and nonconverter participants. RESULTS: ML algorithms applied to socio-demographic, basic health, and CR proxy data enabled prediction of conversion to dementia. The best performing models were the gradient boosting classifier (accuracy (ACC) = 0.93; F1 = 0.86, and Cohen κ = 0.82) and random forest classifier (ACC = 0.92; F1 = 0.79, and Cohen κ = 0.71). Use of ML techniques corroborated the protective role of CR as a mediator of conversion to dementia, whereby participants with more years of education and higher vocabulary scores survived longer without developing dementia. CONCLUSIONS: We used ML approaches to explore the role of CR in conversion from MCI to dementia. The findings indicate the potential value of ML algorithms for detecting risk of conversion to dementia in cognitive aging and CR studies. Further research is required to develop an ML-based procedure that can be used to make robust predictions.


Assuntos
Disfunção Cognitiva/diagnóstico , Reserva Cognitiva/fisiologia , Demência/diagnóstico , Aprendizado de Máquina , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
13.
Int Psychogeriatr ; 31(2): 231-239, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30017017

RESUMO

ABSTRACTObjectives:To estimate the prevalence of Mild Behavioral Impairment (MBI) in people with Subjective Cognitive Decline (SCD), and validate the Mild Behavioral Impairment Checklist (MBI-C) with respect to score distribution, sensitivity, specificity, and utility for MBI diagnosis, as well as correlation with other neuropsychological tests. DESIGN: Correlational study with a convenience sampling. Descriptive, logistic regression, ROC curve, and bivariate correlations analyses were performed. SETTING: Primary care health centers. PARTICIPANTS: 127 patients with SCD. MEASUREMENTS: An extensive evaluation, including Questionnaire for Subjective Memory Complaints, Mini-Mental State Examination, Cambridge Cognitive Assessment-Revised, Neuropsychiatric Inventory-Questionnaire (NPI-Q), the Geriatric Depression Scale-15 items (GDS-15), the Lawton and Brody Index and the MBI-C, which was administered by phone to participants' informants. RESULTS: MBI prevalence was 5.8% in those with SCD. The total MBI-C scoring was low and differentiated people with MBI at a cut-off point of 8.5 (optimizing sensitivity and specificity). MBI-C total scoring correlated positively with NPI-Q, Questionnaire for Subjective Cognitive Complaints (QSCC) from the informant and GDS-15. CONCLUSIONS: The phone administration of the MBI-C is useful for detecting MBI in people with SCD. The prevalence of MBI in SCD was low. The MBI-C detected subtle Neuropsychiatric symptoms (NPS) that were correlated with scores on the NPI-Q, depressive symptomatology (GDS-15), and memory performance perceived by their relatives (QSCC). Next steps are to determine the predictive utility of MBI in SCD, and its relation to incident cognitive decline over time.


Assuntos
Sintomas Comportamentais/epidemiologia , Lista de Checagem , Disfunção Cognitiva/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Curva ROC , Sensibilidade e Especificidade , Espanha , Inquéritos e Questionários
15.
Int Psychogeriatr ; 29(10): 1669-1680, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28660844

RESUMO

BACKGROUND: Cognitive performance is not easily predicted, since different variables play an important role in the manifestation of age-related declines. The objective of this study is to analyze the predictors of cognitive performance in a Spanish sample over 50 years from a multidimensional perspective, including socioeconomic, affective, and physical variables. Some of them are well-known predictors of cognition and others are emergent variables in the study of cognition. METHODS: The total sample, drawn from the "Longitudinal Study Aging in Spain (ELES)" project, consisted of 832 individuals without signs of cognitive impairment. Cognitive function was measured with tests evaluating episodic and working memory, visuomotor speed, fluency, and naming. Thirteen independent variables were selected as predictors belonging to socioeconomic, emotional, and physical execution areas. Multiple linear regressions, following the enter method, were calculated for each age group in order to study the influence of these variables in cognitive performance. RESULTS: Education is the variable which best predicts cognitive performance in the 50-59, 60-69, and 70-79 years old groups. In the 80+ group, the best predictor is objective economic status and education does not enter in the model. CONCLUSIONS: Age-related decline can be modified by the influence of educational and socioeconomic variables. In this context, it is relevant to take into account how easy is to modify certain variables, compared to others which depend on each person's life course.


Assuntos
Envelhecimento/psicologia , Cognição , Emoções , Memória de Curto Prazo , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Escolaridade , Feminino , Humanos , Vida Independente , Modelos Lineares , Estudos Longitudinais , Masculino , Memória Episódica , Pessoa de Meia-Idade , Testes Psicológicos , Fatores Socioeconômicos , Espanha
16.
Aging Clin Exp Res ; 28(3): 497-504, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26298686

RESUMO

BACKGROUND: It has been hypothesized that the deterioration in the ability to name famous people in normal aging and cognitive impairment is a continuum in which meaning-based representations and form-based representations are differentially impaired, with early impairments in lexical access but not in semantic access. AIMS: This hypothesis is tested in a follow-up study comparing the performance of fifty-six participants with amnestic mild cognitive impairment and forty-one control participants were assessed. METHOD: A lexical task was conducted involving recognition and naming of famous people from photographs. Proportional semantic and phonological access measures were calculated. RESULTS: Comparisons revealed significant differences between baseline and follow-up, with improvements in semantic access in the control group and decrements in phonological access in the group with amnestic mild cognitive impairment. Phonological access and reaction time measures were significantly and positively correlated, and semantic access and reaction time were significantly and negatively correlated. CONCLUSIONS: These results add evidence to the hypothesis that the decrease of processing resources is related to the increase of difficulties in lexical access throughout aging. Patterns of change must be replicated over longer periods of time.


Assuntos
Disfunção Cognitiva/psicologia , Semântica , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fonética , Tempo de Reação , Aprendizagem Verbal
17.
Int J Geriatr Psychiatry ; 30(7): 669-76, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25315251

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) is a complex entity, which can involve persistence of the symptoms, conversion to dementia or improvement. The aim was to study the transitions between normal cognitive ageing and three MCI subtypes by using Markov transition models for different intervals between baseline and the follow-up assessment. METHODS: A total of 294 participants over 50 years old attending primary care centres were assessed and diagnosed at baseline as multi-domain amnestic MCI (22 participants), single domain amnestic MCI (44), non-amnestic MCI (non-amnestic MCI) (26) or controls (202). We adopted an overlapping interval strategy by constructing six different mid-point time intervals according to the time between the baseline and the follow-up assessment. We used Markov transition models to study diagnostic changes in the groups in the different time intervals RESULTS: The rate of change was lowest in the control group. In the single domain amnestic MCI and non-amnestic MCI groups, the same diagnosis was usually retained or changed to normal cognitive functioning. In the multi-domain amnestic MCI group, the rate of transition to normal functioning was lowest, and the conversion to dementia was the highest of all groups. The best fit to the Markov models was found for the period between 18-21 months, whereas the worst fit was for the period between 9-15 months CONCLUSIONS: Markov models provide a comprehensive view of transitions between MCI and normal cognitive functioning. Time interval strategies seem to provide a good opportunity to monitor diagnostic transitions, although wider intervals including subsequent assessments are needed. The low rates of conversion to dementia are discussed.


Assuntos
Disfunção Cognitiva/diagnóstico , Cadeias de Markov , Idoso , Idoso de 80 Anos ou mais , Amnésia/diagnóstico , Amnésia/psicologia , Estudos de Casos e Controles , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/psicologia , Demência/diagnóstico , Demência/psicologia , Progressão da Doença , Feminino , Humanos , Masculino , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Modelos Psicológicos , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Psicometria , Fatores de Risco
18.
Int J Geriatr Psychiatry ; 29(10): 1040-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24633821

RESUMO

OBJECTIVE: Although visual memory has been shown to be impaired in amnestic mild cognitive impairment (aMCI), the differences between MCI subtypes are not well defined. The current study attempted to investigate visual memory profiles in different MCI subtypes. METHODS: One hundred and seventy volunteers aged older than 50 years performed several visual memory tests included in the CANTAB battery. Participants were classified into four groups: (1) multiple domain aMCI (mda-MCI) (32 subjects); (2) single domain aMCI (sda-MCI)(57 subjects); (3) multiple domain non amnestic MCI (mdna-MCI) (32 subjects); and (4) controls (54 healthy individuals without cognitive impairment). Parametric and non parametric analyses were performed to compare the groups and to obtain their corresponding memory profiles. RESULTS: The mda-MCI group exhibited impairments in both dimensions of episodic memory (recognition and recollection/recall), and also in learning and working memory, whereas the sda-MCI only showed impairment in recollection-delayed recall and learning. The mdna-MCI group displayed impairment in working memory but good preservation of learning and episodic memory. CONCLUSION: The CANTAB visual memory profiles may contribute to better cognitive characterization of patients with different MCI subtypes, allowing comparison across several processes involved in visual memory such as attention, recognition, recollection and working memory.


Assuntos
Disfunção Cognitiva/diagnóstico , Memória Episódica , Memória de Curto Prazo/fisiologia , Idoso , Análise de Variância , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Reconhecimento Visual de Modelos/fisiologia
19.
Int J Geriatr Psychiatry ; 29(6): 602-9, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24150876

RESUMO

OBJECTIVE: Although visual recognition memory and visuospatial paired associates learning has been shown to be impaired in amnestic mild cognitive impairment (aMCI), the sensitivity and specificity of the visual memory tests used to identify aMCI are not well defined. The current study attempted to analyze the sensitivity and specificity of three visual episodic memory tests (Pattern Recognition Memory [PRM], Delayed Matching to Sample [DMS], and Paired Associated Learning [PAL]) from the CANTAB, in differentiating aMCI patients from control healthy participants. METHODS: Seventy seven aMCI patients and 85 cognitive normal controls aged over 50 years performed the PRM, DMS, and PAL tests. Univariate and multivariate logistic regression and receiver operating characteristic curve analyses were used to study the relationships between aMCI and visual memory measures. RESULTS: The three Cambridge Neuropsychological Test Automated Battery measures significantly predicted aMCI. The optimal predictive model combined the total percent correct responses for PRM and DMS with the PAL total errors (six shapes adjusted), with a sensitivity of 72%, specificity of 83%, and achieved predictive accuracy of 80%. CONCLUSION: Visual episodic memory tasks such as those involved in the PRM, DMS, and PAL tests (included in the Cambridge Neuropsychological Test Automated Battery) may sensitively discriminate aMCI patients from normal controls. These tests may be useful for correct diagnosis of aMCI.


Assuntos
Amnésia/diagnóstico , Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Estudos de Casos e Controles , Análise Discriminante , Feminino , Humanos , Modelos Logísticos , Masculino , Memória Episódica , Pessoa de Meia-Idade , Reconhecimento Visual de Modelos , Sensibilidade e Especificidade
20.
Int Psychogeriatr ; 26(4): 615-25, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24331456

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) often includes episodic memory impairment, but can also involve other types of cognitive decline. Although previous studies have shown poorer performance of MCI patients in working memory (WM) span tasks, different MCI subgroups were not studied. METHODS: In the present exploratory study, 145 participants underwent extensive cognitive evaluation, which included three different WM span tasks, and were classified into the following groups: multiple-domain amnestic MCI (mda-MCI), single-domain amnestic MCI (sda-MCI), and controls. General linear model was conducted by considering the WM span tasks as the within-subject factor; the group (mda-MCI, sda-MCI, and controls) as the inter-subject factor; and processing speed, vocabulary and age as covariates. Multiple linear regression models were also used to test the influence of processing speed, vocabulary, and other cognitive reserve (CR) proxies. RESULTS: Results indicate different levels of impairment of WM, with more severe impairment in mda-MCI patients. The differences were still present when processing resources and CR were controlled. CONCLUSIONS: Between-group differences can be understood as a manifestation of the greater severity and widespread memory impairment in mda-MCI patients and may contribute to a better understanding of continuum from normal controls to mda-MCI patients. Processing speed and CR have a limited influence on WM scores, reducing but not removing differences between groups.


Assuntos
Disfunção Cognitiva/diagnóstico , Reserva Cognitiva , Memória Episódica , Memória de Curto Prazo/fisiologia , Idoso , Estudos de Casos e Controles , Disfunção Cognitiva/classificação , Disfunção Cognitiva/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tempo de Reação/fisiologia , Vocabulário
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