Understanding Left Ventricular Assist Devices.

BACKGROUND/AIMS: Long-term mechanical assist devices are now commonly used in the treatment of severe heart failure to unload the failing ventricle, maintain sufficient end-organ perfusion and improve functional capacity. Depending on the assisted ventricles, 3 categories of long-term assist devices are available: left ventricular assist device (LVAD), biventricular assist device and total artificial heart. Improvements in technology, especially the advent of smaller, durable continuous flow pumps, have led to the use of LVADs in a much broader population of patients in the last 10 years. Both the number of patients living with LVADs and the life expectancy of these patients are increasing. Regarding this growing number of patients with LVAD, intensivists need to understand the physiology of the devices, their functioning, potential complications and their management. METHODS: We performed a narrative review of relevant medical literature regarding the physiology of patients with LVAD and management of common complications relevant to the critical care physicians. RESULTS: The most frequent complications occurring in the LVAD patients after the post-operative period are bleeding, driveline infections, thrombosis, device malfunction, right ventricular failure and arrhythmias. Bleeding is the most frequent adverse event in LVAD due to a combination of anticoagulation and acquired von Willebrand disease secondary to shear stress produced within the pump. Their management includes antiplatelet therapy arrest, reduction of the anticoagulation regimen and specific therapy if feasible. Infection is the second most common cause of death after cardiac failure in LVAD patients. All infections must be aggressively treated to avoid seeding the device. Device thrombosis can develop even when patients are adequately anticoagulated and taking antiplatelet therapy because the LVAD is responsible for a chronic hypercoagulable state. CONCLUSION: Management of these unique patients in the ICU is best accomplished with a multidisciplinary team that includes specialists in advanced heart failure, LVAD nurse coordinators and intensivists.

Forecasting stock prices changes using long-short term memory neural network with symbolic genetic programming.

This study introduces an augmented Long-Short Term Memory (LSTM) neural network architecture, integrating Symbolic Genetic Programming (SGP), with the objective of forecasting cross-sectional price returns across a comprehensive dataset comprising 4500 listed stocks in the Chinese market over the period from 2014 to 2022. Using the S&P Alpha Pool Dataset for China as basic input, this architecture incorporates data augmentation and feature extraction techniques. The result of this study demonstrates significant improvements in Rank Information coefficient (Rank IC) and IC information ratio (ICIR) by 1128% and 5360% respectively when it is applied to fundamental indicators. For technical indicators, the hybrid model achieves a 206% increase in Rank IC and an impressive surge of 2752% in ICIR. Furthermore, the proposed hybrid SGP-LSTM model outperforms major Chinese stock indexes, generating average annualized excess returns of 31.00%, 24.48%, and 16.38% compared to the CSI 300 index, CSI 500 index, and the average portfolio, respectively. These findings highlight the effectiveness of SGP-LSTM model in improving the accuracy of cross-sectional stock return predictions and provide valuable insights for fund managers, traders, and financial analysts.

Severe asthma exacerbation: Changes in patient characteristics, management, and outcomes from 1997 to 2016 in 40 ICUs in the greater Paris area.

Background: Despite advances in asthma treatments, severe asthma exacerbation (SAE) remains a life-threatening condition in adults, and there is a lack of data derived from adult patients admitted to intensive care units (ICUs) for SAE. The current study investigated changes in adult patient characteristics, management, and outcomes of SAE over a 20-year period in 40 ICUs in the greater Paris area. Methods: In this retrospective observational study, admissions to 40 ICUs in the greater Paris area for SAE from January 1, 1997, to December 31, 2016 were analyzed. The primary outcome was the proportion of ICU admissions for SAE during 5-year periods. Secondary outcomes were ICU and hospital mortality, and the use of mechanical ventilation and catecholamine. Multivariate analysis was performed to assess factors associated with ICU mortality. Results: A total of 7049 admissions for SAE were recorded. For each 5-year period, the proportion decreased over time, with SAE accounting for 2.84% of total ICU admissions (n=2841) between 1997 and 2001, 1.76% (n=1717) between 2002 and 2006, 1.05% (n=965) between 2007 and 2011, and 1.05% (n=1526) between 2012 and 2016. The median age was 46 years (interquartile range [IQR]: 32-59 years), 55.41% were female, the median Simplified Acute Physiology Score II was 20 (IQR: 13-28), and 19.76% had mechanical ventilation. The use of mechanical ventilation remained infrequent throughout the 20-year period, whereas the use of catecholamine decreased. ICU and hospital mortality rates decreased. Factors associated with ICU mortality were renal replacement therapy, catecholamine, cardiac arrest, pneumothorax, acute respiratory distress syndrome, sepsis, and invasive mechanical ventilation (IMV). Non-survivors were older, had more severe symptoms, and were more likely to have received IMV. Conclusion: ICU admission for SAE remains uncommon, and the proportion of cases decreased over time. Despite a slight increase in symptom severity during a 20-year period, ICU and hospital mortality decreased. Patients requiring IMV had a higher mortality rate.

Cognitive evaluation in unaccompanied refugee children: a systematic review.

OBJECTIVE: This study aims to identify what existing literature has shown about possible cognitive alterations in unaccompanied refugee children. DATA SOURCES: The search was performed in the Web of Science, PsycInfo, Scopus, and PubMed databases, including articles published in any year and in any language. The research was submitted to the Prospero protocol (ID: CRD42021257858), and the quality of the included articles was evaluated using the Mixed Methods Appraisal Tool. DATA SYNTHESIS: Memory and attention are the main topics identified, largely because they are related to symptoms of post-traumatic stress disorder. However, low specificity was observed in the conduction of cognitive assessments, leading to relevant inconsistencies in the collected data. CONCLUSIONS: The use of psychological assessment instruments that are either poorly adapted or not adapted at all to the populations studied casts doubt on the validity of the data produced so far.

Effectiveness of music-based interventions for cognitive rehabilitation in Parkinson's disease: a systematic review of randomized controlled clinical trials.

BACKGROUND: Music-based interventions are promising for cognitive rehabilitation in Parkinson's disease; however, systematic reviews covering the topic are scarce. OBJECTIVE: To analyze the effectiveness of music-based interventions for cognitive rehabilitation in PD. METHOD: Systematic review study based on PRISMA criteria. The descriptors Parkinson's disease, Parkinson's disease, idiopathic Parkinson's disease, music-based interventions, music therapy, music training, auditory stimulation, music, rhythm, rhythmic, cognition, and cognitive were used. Five databases were searched PubMed/MEDLINE, PsycInfo, Scopus, Web of Science, and Cochrane in May 2022. Only randomized controlled trials with no limit on publication date or language were included. Risk of bias was assessed following Cochrane Collaboration criteria for development of systematic intervention reviews. RESULTS: Nine hundred nineteen articles were found by the descriptors; 266 were excluded for being repeated; 650 for not meeting the inclusion criteria. The remaining three articles were included and analyzed. The interventions consisted of practices with emphasis on rhythm and were conducted in groups. Risks of important biases were observed, such as lack of blinding in the allocation of participants and in the assessment of outcomes, as well as incomplete data for some outcomes. CONCLUSION: Overall, the results showed no evidence of efficacy of music-based interventions for cognitive outcomes in PD.

Stroop Test for Parkinson's Disease with Deep Brain Stimulation: A Systematic Review.

Background: Deep brain stimulation (DBS) is considered an alternative treatment for patients with rapidly developing Parkinson's disease (PD). DBS can cause cognitive changes, and it is necessary to perform an executive assessment before and after DBS to better define the prognosis. Objective: The aim of this study was to analyze the use of the Stroop test for assessment of cognitive functions in patients with PD undergoing DBS. Methods: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pubmed, Scopus, PsycInfo, and Web of Science were used as electronic databases. All included studies assessed the cognitive ability of patients with PD undergoing DBS through the application of the Stroop test. Results: Thirty-five articles met the inclusion criteria. Among the studies, there were different formats of Stroop applications. Twenty-three articles presented negative results in relation to the individuals' performances in Stroop, compared to the control groups. The results suggested that there was no correlation between low performance in the test and global cognitive risk for the patients. Conclusion: Patients with DBS declined in Stroop performance and showed impairments in response inhibition and speed. These results are not related to the lack of cognitive security of DBS. The Stroop test can be combined with other cognitive instruments to ensure greater approximation of results with reality measures.

[Treatment of cancer associated thrombosis]. / Traitement de la maladie veineuse thromboembolique au cours du cancer.

In active cancers, venous thromboembolism is a poor prognosis factor and one of the main causes of death. Venous thromboembolism is 4 to 7 times more common in patients with active cancer compared with the general population. The risk of thrombosis depends on characteristics related to the patient, cancer, and current treatments. The management of these patients is essentially based on therapeutic anticoagulation, which prevents the progression of the thrombus and reduces the risk of recurrence. Risks of thromboembolism recurrence and bleeding are increased in oncologic context, despite therapeutic anticoagulation, which complicates the management of these patients. Low molecular weight heparins have been the treatment of choice in recent decades, because more effective than vitamin K antagonists with a similar tolerance profile. More recently, several studies have evaluated direct oral anticoagulants, which are easier to use, in cancer-associated thrombosis. Compared with low molecular weight heparins, direct oral anticoagulants have similar efficacity concerning thromboembolism recurrence, but an increased risk of bleeding observed mainly in gastrointestinal and urogenital cancers. This overview summarizes the epidemiology, pathophysiology, and therapeutic management of cancer-associated thrombosis.

Depressive symptoms may be associated with semantic memory decline in elderly adults.

Depressive symptoms are associated with a decline of episodic memory, but the relationship with semantic memory remains unclear. OBJECTIVE: The aim of the study was to analyze the relationship of depressive symptoms with the semantic memory in a community-based sample of elderly adults. The sample comprised two groups, namely, clinical (with depressive symptoms) and control. METHODS: The following instruments were used General Evaluation Questionnaire, Montreal Cognitive Assessment-Basic, Wechsler Abbreviate Scale of Intelligence, Geriatric Depression Scale-30 (GDS-30), Beck Depression Inventory-II, Boston Nomination Test (BNT), vocabulary, verbal fluency test (fruits and animals), and Brief Cognitive Screening Battery. RESULTS: The results showed a significant difference between groups only in BNT. A significant correlation was observed between the BNT and GDS-30. Participants with symptoms of severe depression performed poorly on BNT when compared with individuals with mild symptoms. CONCLUSION: These results support the hypothesis that depressive symptoms in elderly adults can affect semantic memory and may worsen with the severity of symptoms.

Sintomas depressivos estão associados ao declínio da memória episódica, mas sua relação com a memória semântica permanece obscura. OBJETIVO: O objetivo deste estudo foi analisar a relação dos sintomas depressivos à memória semântica em idosos que vivem na comunidade. A amostra foi composta de dois grupos: clínico (com sintomas depressivos) e controle. MÉTODO: Foram utilizados os seguintes instrumentos: Questionário de Avaliação Geral, Montreal Cognitive Assessment-Basic (MoCA-B), Wechsler Abbreviate Scale of Intelligence (WASI), Geriatric Depression Scale-30 (GDS-30), Beck Depression Inventory-II (BDI-II), Teste de Nomeação de Boston (TNB), Vocabulário, Fluência Verbal (Frutas e Animais) e Bateria Breve de Rastreio Cognitivo. RESULTADOS: Os resultados evidenciaram diferença significativa entre os grupos apenas no BNT. Foi observada uma correlação significativa entre TNB e GDS-30. Os participantes com sintomas de depressão grave tiveram um desempenho pior no BNT, quando comparados aos indivíduos com sintomas leves. CONCLUSÃO: Esses resultados apoiam a hipótese de que os sintomas depressivos em idosos podem afetar a memória semântica e aumentam com a gravidade dos sintomas.

Relations between subjective well-being and Alzheimer's disease: A systematic review.

Subjective Well-Being (SWB) is determined by the degree of satisfaction with one's own life and the intensity/frequency with which we experience negative and positive emotions. Current studies indicate that SWB is beneficial for health. OBJECTIVE: The aim of this systematic review was to analyze the methodological quality of published articles on SWB in people with Alzheimer's disease (AD). METHODS: The keywords "Well-Being" and "Alzheimer" were used. Inclusion criteria were a) articles with a sample of the elderly population; b) empirical articles; c) articles published between 2014 and 2019. Analysis of the selected articles was performed using the Downs and Black Checklist. RESULTS: 13 articles were selected for further analysis. The results showed that only one of the articles reached a high methodological quality level. The other articles had an average level, ranging from 46% to 67%, of total protocol compliance. CONCLUSION: The studies analyzed had a medium level of methodological quality. It is important to improve the methodological quality of studies on SWB in people with AD.

O bem-estar subjetivo (SWB) é determinado pelo grau de satisfação com a própria vida e pela intensidade/frequência que experimenta emoções negativas e positivas. Atualmente, existem estudos indicando que o SWB é benéfico para a saúde. Objetivo: O objetivo desta revisão sistemática foi analisar a qualidade metodológica dos artigos publicados sobre aspectos do bem-estar subjetivo em pessoas com doença de Alzheimer. MÉTODOS: Foram utilizadas as palavras-chave "Bem-Estar" e "Alzheimer". Os critérios de inclusão foram: a) artigos com amostra da população idosa; b) artigos empíricos; c) artigos publicados de 2014 a 2019. A análise dos artigos selecionados foi realizada por meio da "Checklist Downs and Black". RESULTADOS: 13 artigos foram selecionados para análise. Os resultados indicam que apenas um dos artigos atingiu um alto nível de qualidade metodológica, conforme protocolo utilizado. Os demais atingiram um nível médio, variando de 46% a 67% da total adesão ao protocolo. CONCLUSÃO: Os estudos analisados ​​apresentam um nível médio de qualidade metodológica. É importante melhorar o método de estudos que visam estudar os aspectos do bem-estar subjetivo em pessoas com DA.

Executive Functions in Parkinson's disease with and without Deep Brain Stimulation (DBS): A systematic review.

Given the aging of the world population, it is essential to investigate which methods are most effective for treating the diseases that manifest with age. This study addresses Parkinson's disease (PD), for which Deep Brain Stimulation (DBS) has been increasingly used to treat the disease. OBJECTIVE: To investigate Executive Functions (EF) in patients with and without DBS. METHODS: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyzes (PRISMA) criteria. Scientific papers published on the Scopus, Web of Science and PsycInfo databases were selected. RESULTS: 13 articles were selected. Results showed no standardization of instruments used to evaluate EF and that, in most studies, lack of a control group may have affected results. CONCLUSION: Decline in EF was observed in terms of verbal fluency and processing speed in patients with DBS.

Observando o envelhecimento da população mundial, é essencial investigar quais métodos são mais eficazes no tratamento das doenças que aparecem com a idade. Este estudo aborda a doença de Parkinson (DP). Na DP tem aumentado o uso da Estimulação Cerebral Profunda (DBS) para o tratamento da doença. OBJETIVO: Investigar a Função Executiva (FE) em pacientes com e sem DBS. MÉTODOS: Foi realizada uma revisão sistemática da literatura de acordo com os critérios de Principais Itens para relatar Revisão Sistemática e Meta-Análises (PRISMA). Selecionamos artigos científicos publicados nas bases de dados Scopus, Web of Science e PsycInfo. RESULTADOS: 13 artigos foram selecionados. Observou-se que não há padronização nos instrumentos utilizados para avaliar a FE e, na maioria dos estudos, a falta de controle de grupo pode ter afetado os resultados. CONCLUSÃO: Observou-se declínio na FE na fluência verbal e velocidade de processamento em pacientes com DBS.

A meta-analysis on verbal working memory in children and adolescents with ADHD.

Objective: Previous meta-analyses have demonstrated verbal working memory (WM) dysfunction in children and adolescents with attention deficit/hyperactivity disorder (ADHD); however, the findings are inconsistent. The main objective of this meta-analysis was to investigate the performance of children and adolescents with ADHD in the Digit Span Backwards (DSB) subtest from the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale. We also sought to provide an updated meta-analysis on WM in children and adolescents with ADHD.Method: PubMed, PsyINFO, Scopus, and Web of Science were searched to locate studies published between 1990 and 2016 that report DSB scores both of children and adolescents with ADHD and matched controls. Potential moderator variables were also analyzed.Results: Forty-nine studies comparing children and adolescents with ADHD (n = 4956) against healthy controls (n = 3249) generated a medium-sized effect (Hedges' g) of 0.56 (95% CI [0.49, 0.64]), indicating poorer verbal WM performance in those with ADHD. A subgroup meta-analysis of studies with participants aged 8-16 years only demonstrated low heterogeneity (I2 = 17.06, cf. 55.50 for the main analysis). Moreover, the meta-regression showed a negative association (ß = -.05, p = .02) between DSB performance differences and increasing age, indicating that for every one year increase in age the effect size decreased by .05.Conclusion: These results, which emanated from the largest meta-analysis concerning verbal WM in ADHD reported to date, reinforce WM as a key domain of cognitive dysfunction in ADHD, and point to age as the main variable influencing DSB performance difficulties.

Impulsiveness and executive functions in Parkinson's disease.

Cognitive functions, such as impulsiveness and executive functions, are often impaired in Parkinson's disease. OBJECTIVE: to analyze the relationship between impulsiveness and executive functions (EF) in people with Parkinson's disease (PD). METHODS: a correlation study involving a sample of 50 patients with an established diagnosis of PD aged 40 years or older was conducted using the following instruments: Demographic Questionnaire, Montreal Cognitive Assessment Basic (MOCA-B), Barratt's Impulsiveness Scale (BIS-11) and Frontal Assessment Battery (FAB). RESULTS: Pearson's correlation analysis indicated low associations (p<0.05) between the MOCA-B and BIS-11, with a value of -0.11, and between the FAB and BIS-11, with a value of -0.16. A significant correlation between the MOCA-B and FAB was found, with a value of 0.73. CONCLUSION: this study revealed an association between EF and other cognitive functions, but no association between impulsivity and EF in Parkinson's disease.

As funções cognitivas, tais como impulsividade e funções executivas, muitas vezes estão alteradas na doença de Parkinson. Objetivo: analisar a relação entre a impulsividade e as funções executivas (FE) em pessoas com a doença de Parkinson (DP). Métodos: estudo de correlação, com uma amostra de 50 pessoas a partir de 40 anos de idade, com diagnóstico estabelecido da doença de Parkinson utilizando-se os seguintes instrumentos: Questionário Demográfico, Montreal Cognitive Assessment Basic (MOCA-B), Escala de Barrat para Impulsividade (BIS-11) e Frontal Assessment Batery (FAB). Resultados: a análise de Correlação de Pearson indicou baixas associações (p<0,05) entre o Moca-B e BIS-11 com -0,11 e o FAB com o BIS-11 tiveram um valor de -0,16. O valor que teve significativa correlação apareceu no Moca-B com o FAB 0,73. Conclusão: este estudo evidenciou uma associação entre as FE e outras funções cognitivas, mas não evidenciou associação entre impulsividade e funções executivas na doença de Parkinson.

Sensitivity and specificity of the Brazilian version of the Montreal Cognitive Assessment - Basic (MoCA-B) in chronic kidney disease.

INTRODUCTION: Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. As a complex pathology, at all stages of CKD patients need to have a good understanding of the need for drug and nutritional adherence. Cognitive screening is the starting point for detection of cognitive impairments. OBJECTIVE: To determine the specificity and sensitivity of the Brazilian Portuguese version of the Montreal Cognitive Assessment - Basic (MoCA-B) for identification of cognitive impairment in the CKD population. METHODS: This was a cross-sectional study with 163 CKD patients undergoing hemodialysis treatment. The Mini-Mental State Examination (MMSE) and MoCA-B were administered. RESULTS: The MoCA-B has reliable internal consistency (Cronbach's alpha = 0.74). A cutoff point of ≤ 21 points provides the best sensitivity and specificity for detection of cognitive impairment. The education variable had less impact on the total MoCA-B score than on the total MMSE score. CONCLUSIONS: The MoCA-B is a suitable screening instrument for evaluating the global cognition of hemodialysis patients. The results can help health professionals to conduct evaluations and plan clinical management.

Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review.

INTRODUCTION: There is evidence in the literature that cognitive impairment is more prevalent in individuals with chronic kidney disease (CKD) than in the general population. The Montreal Cognitive Assessment (MoCA) is an instrument with a good application profile for cognitive evaluation of patients with CKD-like impairments. The objective of this study is to perform a systematic review of MoCA use in the context of CKD. METHOD: The keywords "Montreal Cognitive Assessment", "Kidney Disease" and "Chronic Kidney Disease" were used to search the databases. The inclusion criteria were: a) empirical articles; b) approach to cognitive impairment in CKD; c) papers in Portuguese and English. RESULTS: The studies were mostly cross-sectional, published in medical journals, with research carried out mostly in Europe. About 45% of the studies had samples of less than 150 participants and variations in the prevalence of cognitive impairment were found ranging from 28.9% to 74.6%. The cutoff point for the identification of the impairment presented variation between the studies. DISCUSSION: The results' analysis demonstrates the need for more complete studies on MoCA scoring and adaptation in its different versions. We recommend to the health professionals who will use the results in the clinical setting that the interpretation of the results be made in the light of studies more related to the context lived by the patients. CONCLUSIONS: The instrument is efficient to be used in several stages and treatment modalities of the disease. We point to the need to adapt a cut-off point for the instrument in the different translations of the instrument.

Effectiveness of music-based interventions for cognitive rehabilitation in Parkinson's disease: a systematic review of randomized controlled clinical trials

Abstract Background Music-based interventions are promising for cognitive rehabilitation in Parkinson's disease; however, systematic reviews covering the topic are scarce. Objective To analyze the effectiveness of music-based interventions for cognitive rehabilitation in PD. Method Systematic review study based on PRISMA criteria. The descriptors Parkinson's disease, Parkinson's disease, idiopathic Parkinson's disease, music-based interventions, music therapy, music training, auditory stimulation, music, rhythm, rhythmic, cognition, and cognitive were used. Five databases were searched PubMed/MEDLINE, PsycInfo, Scopus, Web of Science, and Cochrane in May 2022. Only randomized controlled trials with no limit on publication date or language were included. Risk of bias was assessed following Cochrane Collaboration criteria for development of systematic intervention reviews. Results Nine hundred nineteen articles were found by the descriptors; 266 were excluded for being repeated; 650 for not meeting the inclusion criteria. The remaining three articles were included and analyzed. The interventions consisted of practices with emphasis on rhythm and were conducted in groups. Risks of important biases were observed, such as lack of blinding in the allocation of participants and in the assessment of outcomes, as well as incomplete data for some outcomes. Conclusion Overall, the results showed no evidence of efficacy of music-based interventions for cognitive outcomes in PD.

Cognitive evaluation in unaccompanied refugee children: a systematic review / Avaliação cognitiva em crianças refugiadas desacompanhadas: uma revisão sistemática

Abstract Objective: This study aims to identify what existing literature has shown about possible cognitive alterations in unaccompanied refugee children. Data sources: The search was performed in the Web of Science, PsycInfo, Scopus, and PubMed databases, including articles published in any year and in any language. The research was submitted to the Prospero protocol (ID: CRD42021257858), and the quality of the included articles was evaluated using the Mixed Methods Appraisal Tool. Data synthesis: Memory and attention are the main topics identified, largely because they are related to symptoms of post-traumatic stress disorder. However, low specificity was observed in the conduction of cognitive assessments, leading to relevant inconsistencies in the collected data. Conclusions: The use of psychological assessment instruments that are either poorly adapted or not adapted at all to the populations studied casts doubt on the validity of the data produced so far.

RESUMO Objetivo: Identificar o que a literatura tem apresentado a respeito de possíveis alterações cognitivas em crianças refugiadas desacompanhadas. Fontes de dados: Foi realizada uma busca nas bases de dados Web of Science, PsycInfo, Scopus e PubMed, que incluiu artigos indexados produzidos em qualquer período e em qualquer idioma. A pesquisa foi submetida ao protocolo do International Prospective Register of Systematic Reviews — Prospero (ID: CRD42021257858), e a qualidade dos artigos selecionados foi avaliada por meio do Mixed Methods Appraisal Tool. Síntese dos dados: Memória e atenção foram os principais tópicos identificados, em grande parte por sua relação com sintomas de transtorno do estresse pós-traumático. Contudo, foi observada baixa especificidade na condução dos testes cognitivos, levando a importantes inconsistências entre os dados coletados. Conclusões O uso de instrumentos de avaliação psicológica mal adaptados ou inadaptados para as populações estudadas coloca em dúvida a validade dos dados produzidos.

Five-factor model of personality and Parkinson's Disease: a systematic review

Some studies have associated Parkinson's disease with specific personality traits. We aimed to analyze personality profiles in Parkinson's disease based on the Five- Factor Model, using the following 3 instruments as parameters: NEO Personality Inventory, revised NEO Personality Inventory, and NEO Five-Factor Inventory. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The PsycINFO, PubMed, Scopus, and Web of Science databases were searched. The initial search resulted in 232 studies, and 11 studies were selected for full-text review. The personality traits most commonly associated with Parkinson's disease were high neuroticism and low extraversion and conscientiousness. These results cannot be attributed only to Parkinson's disease because other associated diseases were present in the included studies. Evidence from these studies is insufficient to state that there is a typical personality profile associated with Parkinson's disease, given that this profile is nonspecific and found in many psychopathological disorders that differ considerably from each other. This study was registered with PROSPERO (registration number CRD42021271526)

Alguns estudos têm associado a doença de Parkinson a traços de personalidade específicos. Esta pesquisa teve como objetivo analisar o perfil de personalidade na doença de Parkinson com base no Modelo dos Cinco Fatores, utilizando como parâmetro três instrumentos baseados nessa teoria: NEO Personality Inventory, NEO Personality Inventory revisado e NEO Five-Factor Inventory. Foi realizada uma revisão sistemática de acordo com os critérios de Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Foram consultadas as bases de dados PsycINFO, PubMed, Scopus e Web of Science. A busca inicial resultou em 232 estudos, e 11 deles foram selecionados para análise completa. Os traços de personalidade mais frequentemente associados à doença de Parkinson foram o elevado neuroticismo e baixos níveis de extroversão e de conscienciosidade. Estes resultados não podem ser atribuídos apenas à doença de Parkinson, uma vez que outras doenças associadas estavam presentes nos trabalhos avaliados. Não há evidências suficientes nestes estudos para afirmar que existe um perfil de personalidade típico associado à doença de Parkinson, visto que esse perfil é inespecífico e encontrado em muitos transtornos psicopatológicos que diferem consideravelmente entre si. Este estudo foi registrado na plataforma International Prospective Register of Systematic Reviews ­ PROSPERO (número CRD4202127151526)

Depressive symptoms may be associated with semantic memory decline in elderly adults / Sintomas depressivos podem estar associados a declínio na memória semântica em idosos

ABSTRACT Depressive symptoms are associated with a decline of episodic memory, but the relationship with semantic memory remains unclear. Objective: The aim of the study was to analyze the relationship of depressive symptoms with the semantic memory in a community-based sample of elderly adults. The sample comprised two groups, namely, clinical (with depressive symptoms) and control. Methods: The following instruments were used General Evaluation Questionnaire, Montreal Cognitive Assessment-Basic, Wechsler Abbreviate Scale of Intelligence, Geriatric Depression Scale-30 (GDS-30), Beck Depression Inventory-II, Boston Nomination Test (BNT), vocabulary, verbal fluency test (fruits and animals), and Brief Cognitive Screening Battery. Results: The results showed a significant difference between groups only in BNT. A significant correlation was observed between the BNT and GDS-30. Participants with symptoms of severe depression performed poorly on BNT when compared with individuals with mild symptoms. Conclusion: These results support the hypothesis that depressive symptoms in elderly adults can affect semantic memory and may worsen with the severity of symptoms.

RESUMO Sintomas depressivos estão associados ao declínio da memória episódica, mas sua relação com a memória semântica permanece obscura. Objetivo: O objetivo deste estudo foi analisar a relação dos sintomas depressivos à memória semântica em idosos que vivem na comunidade. A amostra foi composta de dois grupos: clínico (com sintomas depressivos) e controle. Método: Foram utilizados os seguintes instrumentos: Questionário de Avaliação Geral, Montreal Cognitive Assessment-Basic (MoCA-B), Wechsler Abbreviate Scale of Intelligence (WASI), Geriatric Depression Scale-30 (GDS-30), Beck Depression Inventory-II (BDI-II), Teste de Nomeação de Boston (TNB), Vocabulário, Fluência Verbal (Frutas e Animais) e Bateria Breve de Rastreio Cognitivo. Resultados: Os resultados evidenciaram diferença significativa entre os grupos apenas no BNT. Foi observada uma correlação significativa entre TNB e GDS-30. Os participantes com sintomas de depressão grave tiveram um desempenho pior no BNT, quando comparados aos indivíduos com sintomas leves. Conclusão: Esses resultados apoiam a hipótese de que os sintomas depressivos em idosos podem afetar a memória semântica e aumentam com a gravidade dos sintomas.

Associação entre limitação funcional e deficit cognitivo em pacientes idosos hospitalizados / Association between functional disability and cognitive deficit in hospitalized elderly patients

Resumo Introdução A hospitalização é reconhecida como um fator de risco para o declínio funcional do idoso, bem como para o declínio cognitivo. Entretanto, a associação entre essas variáveis ainda não é bem estabelecida, sobretudo no contexto hospitalar. Objetivo Verificar a associação entre deficit cognitivo e limitação funcional em atividades básicas da vida diária entre idosos hospitalizados. Método Estudo seccional, com idosos internados em dois hospitais públicos. Foi verificada a presença de deficit cognitivo por meio do teste de rastreio Mini Exame do Estado Mental e a presença de limitação funcional pelo Índice Katz para Atividades Básicas de Vida Diária. Foi realizada análise descritiva da amostra e regressão logística, estimando-se os valores de odds ratio e respectivos intervalos de confiança (95%). Resultados A prevalência de deficit cognitivo foi de 51,5% (IC95%, 41,6-61,4) e 37,6% dos idosos apresentaram dependência em uma ou mais atividades básicas de vida diária. Os resultados mostraram que tanto o número de atividades comprometidas (p=0,002) quanto a classificação final do índice Katz (p=0,001) foram diferentes estatisticamente entre os grupos de idosos com e sem deficit cognitivo. Entre os idosos que eram dependentes parciais para as atividades, 14,9% apresentaram deficit cognitivo; já entre aqueles que eram dependentes totais, o valor foi de 13,9%. Os idosos dependentes nas atividades apresentaram 5,08 vezes (IC95%, 1,84-14,01) maior chance de deficit cognitivo. Conclusão: O deficit cognitivo foi associado à limitação funcional e os resultados colaboraram no direcionamento da sistematização da assistência precoce direcionada, a fim de minimizar perdas cognitivas e funcionais na hospitalização.

Abstract Introduction Hospitalization is recognized as a risk factor for the functional decline and cognitive decline of elderly people. However, the association between these variables is still well unestablished, especially in the hospital context. Objective To verify the association between cognitive deficit and functional disability in hospitalized elderly people. Method Cross-sectional study with elderly patients admitted to two public hospitals. The presence of cognitive deficit was verified through the Mini-Mental State Examination screening test and the presence of functional disability through the Basic Daily Life Activities Scale. Descriptive sample analysis of the sample and logistic regression was made, estimating the odds ratio values and respective intervals of confidence (95%). Results The prevalence of cognitive deficit was 51.5% (IC95%, 41,6-61,4) and 37.6% of the elderly had one or more basic activities in their daily living. The results showed that either the number of compromised activities (p=0,002) and the final classification of the Katz index (p=0.001) were statistically different between the groups of elderly people with or without a cognitive deficit. Among the elderly who were partially dependents for activities, 14.9% had a cognitive deficit and 13.9% among those who were fully dependent elderly. Most dependents elderly are 5,08 times (IC95%, 1,84-14,01) more likely to have a cognitive deficit. Conclusion Cognitive deficits were associated with functional disability and the results collaborate in directing the systematization of early care, to minimize cognitive and functional losses in hospitalization.

Relations between subjective well-being and Alzheimers disease: A systematic review / Relações entre bem-estar subjetivo e a doença de alzheimer: revisão sistemática

ABSTRACT. Subjective Well-Being (SWB) is determined by the degree of satisfaction with one's own life and the intensity/frequency with which we experience negative and positive emotions. Current studies indicate that SWB is beneficial for health. Objective: The aim of this systematic review was to analyze the methodological quality of published articles on SWB in people with Alzheimer's disease (AD). Methods: The keywords "Well-Being" and "Alzheimer" were used. Inclusion criteria were a) articles with a sample of the elderly population; b) empirical articles; c) articles published between 2014 and 2019. Analysis of the selected articles was performed using the Downs and Black Checklist. Results: 13 articles were selected for further analysis. The results showed that only one of the articles reached a high methodological quality level. The other articles had an average level, ranging from 46% to 67%, of total protocol compliance. Conclusion: The studies analyzed had a medium level of methodological quality. It is important to improve the methodological quality of studies on SWB in people with AD.

RESUMO. O bem-estar subjetivo (SWB) é determinado pelo grau de satisfação com a própria vida e pela intensidade/frequência que experimenta emoções negativas e positivas. Atualmente, existem estudos indicando que o SWB é benéfico para a saúde. Objetivo: O objetivo desta revisão sistemática foi analisar a qualidade metodológica dos artigos publicados sobre aspectos do bem-estar subjetivo em pessoas com doença de Alzheimer. Métodos: Foram utilizadas as palavras-chave "Bem-Estar" e "Alzheimer". Os critérios de inclusão foram: a) artigos com amostra da população idosa; b) artigos empíricos; c) artigos publicados de 2014 a 2019. A análise dos artigos selecionados foi realizada por meio da "Checklist Downs and Black". Resultados: 13 artigos foram selecionados para análise. Os resultados indicam que apenas um dos artigos atingiu um alto nível de qualidade metodológica, conforme protocolo utilizado. Os demais atingiram um nível médio, variando de 46% a 67% da total adesão ao protocolo. Conclusão: Os estudos analisados ​​apresentam um nível médio de qualidade metodológica. É importante melhorar o método de estudos que visam estudar os aspectos do bem-estar subjetivo em pessoas com DA.