ABSTRACT
Objective Toinvestigatethechangesofcognitiveimpairmentandcerebralhemodynamics inpatientswithacutelacunarcerebralinfarctionwithin2weeksafteronset.Methods Nineteenpatients with lacunar cerebral infarction (a patient group)were consecutive enrolled in the study. Twenty-three sex-and age-matched inpatients without ischemic cerebrovascular disease or healthy volunteers of outpatient department over the same period were used as a control group. The cerebral hemodynamic features were evaluated with transcranial Doppler (TCD)breath-holding test and single photon emission computed tomography (SPECT)resting + adenosine stress imaging. Simultaneously,the neuropsychological tests were performed,the Montreal cognitive assessment (MoCA)was performed including executive capacity, structural capacity,memory (including auditory memory,visual memory,and logic memory ),information processing speed,and visual-spatial ability. Results (1 )There were no significant differences in the years of education,hypertension,diabetes,hyperlipidemia,coronary heart disease,and smoking between the 2 groups (all P>0. 05). Compared with the control group,there were significant differences in the MoCA score,visual memory,executive function,structural capacity,and information processing speed of the patient group (all P<0. 05). (2)19 patients completed the SPECT resting + load test (12 in the control group and 7 in the patient group). There were significant differences in the uptake ratio (UR)in the right basal ganglia (8. 91[-2. 48 - 5. 87]and -6. 21 [-10. 39 - 5. 42 respectively])and left frontal lobe UR (11. 62 [2. 93-16. 87]and 1. 04 [-10. 17- 3. 82]respectively)between the patient group and the control group (P<0. 05). (3)26 patients completed the breath-holding test + head-up tilt table test (n=13 in each group]. The vascular motor reactivities were 13 ± 5 on the left and 21 ± 7 on the right, and the breath-holding indexes were 0. 66 ± 0. 26 on the left and 1. 0 ± 0. 4 on the right in the patient group;the vascular motor reactivities were 24 ± 11 on the left and 30 ± 9 on the right,and the breath-holding indexes were 1. 21 ± 0. 57 on the left and 1. 5 ± 0. 4 on the right in the control group. There were significant differencesbetweenthe2groups(P<0.05).Conclusion Attheearlystageoflacunarinfarction,the patients have presented varying degrees of cognitive impairment and the changes of cerebral hemodynamics.
ABSTRACT
Durante el envejecimiento, la pérdida de audición es considerada como uno de los problemas de salud pública más importante por su impacto sobre el bienestar físico, emocional y social de la persona, disminuyendo de manera notable la calidad de vida de quien la padece. Esto se debe a que un déficit auditivo no sólo afecta la percepción y la comprensión del habla, también condiciona el nivel de participación social. Esto último se manifiesta en una tendencia a la depresión, a la disminución de la autoestima, al aislamiento social y al aumento significativo del estrés familiar, hechos que también son observables en personas con cierto grado de demencia. Diferentes autores (Pouchain, Dupuy, San Julian et al, 2007; Lin et al. 2011; entre otros) sostienen que las dificultades en la comunicación observadas en las personas adultas mayores no sólo se deben a alteraciones en la función auditiva periférica, sino también a un deterioro de las habilidades cognitivas y de las funciones auditivas centrales. En el presente trabajo se pretende considerar la relación entre las alteraciones auditivas y el grado de deterioro cognitivo. Se han explorado 35 personas, de ambos sexos, residentes en el Hospital Geriátrico Provincial de Rosario, con edades comprendidas entre los 58 y los 90 años de edad. El estudio consistió en la evaluación de la función auditiva periférica y central y en la determinación del nivel cognitivo. En general se han observado una serie de correlaciones estadísticas que corroboran la estrecha relación entre la pérdida auditiva y el deterioro cognitivo leve durante el envejecimiento.
During ageing, hearing loss is considered to be one of the most important public health problems due to its impact on the persons physical, emotional and social wellbeing, as it remarkably decreases the quality of life of those who suffer from it. This is because a hearing deficit not only affects speech perception and comprehension but also conditions the level of social participation. The latter aspect can be seen in a tendency towards depression, lower selfesteem, social isolation, and significant increase in family stress, all of which can also be seen in people with some degree of dementia. Different authors (Pouchain, Dupuy, San Julian et al, 2007; Lin et al. 2011; among others) consider that communication difficulties observed in old adult people are not only due to alterations in their peripheral auditory system but also to some impairment in their cognitive skills and central auditory system. In this project, the aim is to consider the relationship between hearing alterations and the degree of cognitive deterioration. 35 people, of both genders, resident in the Old Peoples Provincial Hospital in Rosario, were examined. Their age ranged from 58 to 90 years old. The study consisted in assessing their peripheral and central auditory functions and determining their cognitive level. In general, a series of statistical correlations were observed that corroborate the close relationship between hearing loss and mild cognitive deterioration during ageing.
Durante o envelhecimento, a perda de audição é considerada um dos problemas de saúde pública mais importante devido ao seu impacto sobre o bem-estar físico, emocional e social da pessoa, diminuindo de maneira notável a qualidade de vida de quem a padece. Isso se deve a que um déficit auditivo não só afeta a percepção e a compreensão da fala, mas também condiciona o nível de participação social. Este último se manifesta em uma tendência à depressão, à diminuição da autoestima, ao isolamento social e ao aumento significativo do estresse familiar, fatos que também são observados em pessoas com determinado grau de demência. Diferentes autores (Pouchain, Dupuy, San Julian et al, 2007; Lin et al. 2011; entre outros) sustentam que as dificuldades na comunicação observadas nas pessoas idosas não só se devem a alterações na função auditiva periférica, mas também a uma deterioração das habilidades cognitivas e das funções auditivas centrais. No presente trabalho, pretende-se considerar a relação entre as alterações auditivas e o grau de deterioração cognitiva. Foram analisadas 35 pessoas, de ambos os sexos, residentes do Hospital Geriátrico Provincial de Rosario, com idades entre 58 e 90 anos. O estudo consistia na avaliação da função auditiva periférica e central e na determinação do nível cognitivo. No geral, foi observada uma série de correlações estatísticas que corroboram a estreita relação entre a perda auditiva e a deterioração cognitiva leve durante o envelhecimento.
Subject(s)
Male , Female , Humans , Middle Aged , Aged , Aged, 80 and over , Hearing Disorders/diagnosis , Hearing Loss/diagnosis , Cognitive Aging , Cognition Disorders/diagnosis , Dichotic Listening Tests , Quality of LifeABSTRACT
Introducción: El cuidado a las personas con Deterioro Cognitivo representa una sobrecarga objetiva importante en el cuidador primario, en términos de tiempo, lo cual repercute en sus diferentes ámbitos; laboral, familiar, social y de salud1, 2 Objetivo: Evaluar la sobrecarga del cuidador primario del adulto mayor con deterioro cognitivo en relación con el tiempo de cuidado. Metodología: Es un estudio descriptivo, resultado de una prueba piloto; realizada en el periodo de Marzo-Abril de 2010, en "la Fundación Alzheimer México" y "la Fundación Alzheimer Querétaro", la muestra se constituyo de 40 cuidadores primarios de personas con deterioro cognitivo o demencia, a quienes se les aplicó la "Escala de Sobrecarga de Zarit".3 Resultados: El 58% de la muestra presenta sobrecarga y sobrecarga intensa; en relación con las horas de cuidado el 74% dedica más de 5 horas al día y en años, el 65% más de 5 años. Discusión: Los resultados socio demográficos encontrados en el presente estudio son similares a los encontrados por otros autores españoles,11 Conclusiones: Se logró; evaluar la sobrecarga y las horas de cuidado, sin embargo falta profundizar en los factores predisponentes para sobrecarga y el acceso a la información para brindar cuidado a la persona a su cargo y generar mecanismos de autocuidado. El estudio aporta otra perspectiva de investigación y un panorama de oportunidad para el ejercicio del profesional de enfermería en el hogar.
Introduction: Having important impacts on their labor, family, social, and health situations, taking care of cognitive-impaired patients is a work overload among primary care professionals 1,2 . Objective: Assess the work overload of cognitiveimpaired elder patient care professionals. Methodology: Descriptive pilot study carried out between March and April 2010 in the "Fundación Alzheimer México" and the "Fundación Alzheimer Querétaro". The sample included 40 cognitive-impaired elder patient care professionals who completed the "Escala de Sobrecarga de Zarit3 Results: 58% of the sample showed work overload or intense work overload. 74% reported spending more than 5 hours per day to this type of care, and 65% reported having been working in this area for more than 5 years. Discussion: Findings were similar to those reported by other Spanish authors 11. Conclusion: Work overload and care hours were assessed, however it is necessary to further analyze underlying factors in order to provide better care, and generate self-care initiatives. This study offers a research perspective and a paramount of opportunity for the Nursing professionals working in homes.