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ABSTRACT Purpose: This study aimed to evaluate the total macular thickness as well as the thickness of the inner and outer retinal layers in patients with Parkinson's disease. It also aimed to verify the correlation of these parameters with motor symptoms and cognitive function. Methods: A total of 46 eyes of 23 patients with Parkinson's disease and 40 eyes of 20 healthy controls were included in the study. The patients' cognitive, functional, and nonmotor symptoms were evaluated using the Katz Index of Independence and Pfeffer's Activities of Daily Living, Mini-Mental State Examination, Frontal Assessment Battery, Schwab and England Staging Scales, and Movement Disorders Society Nonmotor Symptoms Scale. The macular thickness measurements obtained via total, inner, and outer optical coherence tomography were recorded. Furthermore, the correlation of the parameters of optical coherence tomography with cognitive, functional, and nonmotor symptoms was assessed. Results: The scores of the Katz Index of Independence and Pfeffer's Activities of Daily Living as well as the Movement Disorders Society Nonmotor Symptoms Scale were significantly lower in patients with Parkinson's disease than in healthy controls. Moreover, the former had greater total macular thickness. The temporal and inferior outer sectors were significantly greater for the ganglion cell complex thickness in patients. A significant correlation was observed between the total macular thickness and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale, Parte III (MDS-UPDRS-III) values. Contrarily, there was a negative correlation between the outer macular thickness and the MDS-UPDRS-III values. Meanwhile, the total macular thickness and ganglion cell complex thickness were significantly correlated with the scores of the Mini-Mental State Examination, Schwab and England Staging Scale, Frontal Assessment Battery, and Katz Index of Independence and Pfeffer's Activities of Daily Living. In addition, the Schwab and England scale was correlated with the outer macular thickness. Conclusion: The total and inner macular thicknesses at the temporal and inferior outer sectors were greater in patients with Parkinson's disease than in the control group. These findings indicate that macular thickness may be greater in those with Parkinson's disease, particularly when associated with mild motor symptoms. In addition, the parameters of the total, inner, and outer optical coherence tomography were significantly associated with motor and nonmotor symptoms as well as cognitive function impairment.

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Resumen Se estima que aproximadamente 1 de cada 100 na cidos vivos presenta una cardiopatía congénita (CC). El déficit cognitivo, las dificultades académicas y ano malías conductuales, en combinación, representan la morbilidad más común que afecta la calidad de vida en sobrevivientes con CC. La disfunción del desarrollo resulta de una interacción compleja entre factores espe cíficos del paciente como susceptibilidad genética, tipo de cardiopatía, desarrollo fetal y factores ambientales tales como eventos preoperatorios, técnicas de apoyo durante la reparación quirúrgica, eventos posoperatorios, estatus socioeconómico. Una evaluación integral del neurodesarrollo en todos los niños con CC es fundamen tal para identificar tempranamente cualquier necesidad de intervención y proporcionar el apoyo necesario para optimizar su desarrollo a largo plazo.

Abstract It is estimated that about 1 in 100 live births has a congenital heart disease (CHD). Cognitive deficit, ac ademic difficulties, and behavioral abnormalities, in combination, represent the most common morbidity affecting quality of life in survivors with CHD. Devel opmental dysfunction results from a complex interac tion between patient-specific factors such as genetic susceptibility, cardiac diagnosis, fetal development, and environmental factors such as preoperative events, sup portive techniques during surgical repair, postoperative events, socioeconomic status. A comprehensive neuro developmental assessment in all children with CHD is critical to identify any need for intervention early and provide the support needed to optimize their long-term development.

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Background: Sleep is a critical component of existence and vital for the rejuvenation of the body. A minimum of 7 h of sleep is needed for adults for optimal wellness. In the present condition, extended periods of wakefulness are a common occurrence. Such wakefulness can be acute total sleep deprivation or chronic partial sleep restriction. Both forms can negatively impact cognitive abilities. It is prevalent among nursing professionals, who play a vital role in health care, remaining alert during working hours, especially night shifts. Aims and Objectives: This study aims to examine the effects of altered sleep patterns on working memory among nursing personnel working day and night shifts. Materials and Methods: The necessary documents for conducting the study were obtained from the institution and the participants. For this cross-sectional study, 31 nursing staff, age group of 25–40 years, males – six, and females – 25 were chosen according to the selection criteria. They were posted to wards on rotational day and night shifts. Rey–Osterrieth figure copy and recall test (Rey–Osterrieth complex figure test [ROCF]) was used for assessing working memory. The performance was based on a copy score and a recall score. Results: A paired “t” test with one-way repeated within the subject analysis of variance test was applied for analysis. Recall scores of ROCF were significantly less. Copy scores of ROCF were also less but statistically insignificant. Conclusion: The present study showed that the recall scores were significantly less in nursing professionals at the end of the night shift duration indicating poor working memory.

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Introdução: Alterações no desenvolvimento da fala e linguagem podem estar presentes em pré-escolares com diversos transtornos do neurodesenvolvimento, sendo que, a presença dessas alterações pode indicar um pior prognóstico. Objetivo: Analisar o nível de desenvolvimento dos aspectos linguísticos de crianças pré-escolares com diagnóstico de TDAH. Métodos: Estudo observacional transversal de coleta de dados de forma retrospectiva. Participaram 10 crianças com idade entre 4 anos e 6 anos (9 meninos) com diagnóstico de TDAH realizado por equipe especializada. Os dados coletados para este estudo envolveram o histórico da criança (alterações pré, peri e pós-natal), as medidas de linguagem receptiva e expressiva, vocabulário expressivo, fonologia e aspecto pragmático. A análise estatística foi descritiva. Resultados: as queixas referidas pelos cuidadores/responsáveis englobaram principalmente o comportamento agitado/impulsivo e a linguagem expressiva/fala; em relação à avaliação linguística, algumas crianças não conseguiram finalizar a aplicação de instrumentos de avaliação que eram mais extensos (exigiam maior de tempo de atenção) e complexos. Em relação aos aspectos avaliados, a linguagem expressiva, o aspecto fonológico e o vocabulário expressivo foram os mais alterados (50%, 60% e 50% de alterações respectivamente). O tratamento fonoaudiológico foi indicado para 80% das crianças. Conclusão: alterações de fala e linguagem são prevalentes empré-escolares com TDAH, sendo este um grupo de alto risco. (AU)

Introduction: Changes in speech and language development may be present in preschoolers with various neurodevelopmental disorders, possibly indicating a worse prognosis. Purpose: This study aimed to assess the developmental level of linguistic aspects in preschoolers diagnosed with attention-deficit/hyperactivity disorder (ADHD). Methods: This cross-sectional observational study collected retrospective data from 10 children, aged 4 to 6 years (9 boys), diagnosed with ADHD by a specialized team. Data collection involved a comprehensive examination of the child's history, including pre-, peri-, and post-natal factors, and measures of receptive and expressive language, expressive vocabulary, phonology, and pragmatic aspects. Descriptive statistical analysis was performed. Results: Caregivers/guardians reported complaints primarily related to agitated/impulsive behavior and expressive language/speech difficulties. Some children faced challenges in completing more extensive and complex assessment instruments due to attention deficits. Expressive language, phonological aspects, and expressive vocabulary were identified as the most affected areas, with changes in respectively 50%, 60%, and 50% of cases. Speech-language-hearing therapy was recommended for 80% of the children. Conclusion: The findings highlight the prevalence of speech and language impairments in preschoolers with ADHD, underscoring the importance of early intervention in this high-risk population. (AU)

Introducción: Los cambios en el desarrollo del habla y el lenguaje pueden estar presentes en niños preescolares con diversos trastornos del neurodesarrollo, y la presencia de estos cambios puede indicar un peor pronóstico. Objetivo: Analizar el nivel de desarrollo de los aspectos lingüísticos en niños en edad preescolar con diagnóstico de TDAH. Métodos: Se llevó a cabo un estudio observacional transversal con recolección de datos de manera retrospectiva. Participaron 10 niños con edades entre 4 y 6 años (9 varones) con diagnóstico de TDAH realizado por un equipo especializado. Los datos recolectados para este estudio incluyeron el historial del niño (alteraciones pre, peri y postnatales), medidas de lenguaje receptivo y expresivo, vocabulario expresivo, fonología y aspectos pragmáticos. El análisis estadístico fue descriptivo. Resultados: Las quejas reportadas por los cuidadores/responsables abarcaban principalmente el comportamiento agitado/impulsivo y el lenguaje expresivo/habla; con respecto a la evaluación lingüística, algunos niños no pudieron completar la aplicación de instrumentos de evaluación más extensos (que requerían mayor tiempo de atención) y complejos. En cuanto a los aspectos evaluados, el lenguaje expresivo, el aspecto fonológico y el vocabulario expresivo fueron los más alterados (50%, 60% y 50% de alteraciones respectivamente). Se indicó tratamiento fonoaudiológico para el 80% de los niños. Conclusión: Las alteraciones del habla y el lenguaje son prevalentes en niños en edad preescolar con TDAH, lo que los convierte en un grupo de alto riesgo. (AU)

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Background: Sleep deprivation and cognitive impairment represent significant issues among cancer patients undergoing chemotherapy, significantly impacting their daily activities and treatment journeys. The side effects of chemotherapy frequently contribute to disturbances in sleep and cognitive functions in these individuals. Recognizing the scope of these difficulties is essential for developing tailored interventions that cater to the specific requirements of cancer patients, ultimately improving their quality of life and treatment results. Materials and Methods: The research took place at a tertiary cancer care hospital, where 83 eligible chemotherapy patients were enlisted and assessed for sleep quality using the PSQI questionnaire and cognition using MoCA. Each questionnaire was administered only once. A PSQI total score of ?5 indicated good sleep quality, while a score exceeding 5 indicated poor sleep quality. Similarly, a MoCA score below 26 suggested impaired cognition. Results: Among the entire sample, sleep deprivation was observed in 80.7% of chemotherapy patients, while cognitive impairment was identified in 44.6% of chemotherapy patients. Conclusion: The study deduces that sleep deprivation and cognitive impairment are exceedingly prevalent among cancer patients undergoing chemotherapy.

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Anxiety is present at various times of sports competitions sometimes limiting the athletes' performance. The objective of this study was to evaluate the effect of transcranial direct current stimulation (tDCS) on athletes' acute anxiety symptoms and cognitive performance when applied for 7 days. This is an experimental, double-blind, randomized study of 23 soccer players with anxiety symptoms. Two groups: anodic tDCS and sham tDCS. Anodic stimulation was performed in the left dorsolateral prefrontal cortex (DLPFC) and the cathode positioned in the right DLPFC, current intensity 2 mA, for 20 minutes on 7 consecutive days and then on the 14th day. Anxiety was assessed by the HAM-A scale and cognitive performance was through the Stroop Color Word Test and the Trail Making Test. For statistical analysis, t-student test and Spearman's correlation coefficient were used. Statistical significance was set at p <0.05. No significant differences were observed between the groups in decreasing anxiety symptoms and improving cognitive performance using a 7-day consecutive protocol. This study provides evidence that there is an inverse correlation between anxiety and inhibitory control. There was no difference in the application of tDCS compared to the control group regarding improvement in anxious symptoms and inhibitory control in this specific population using a seven-day tDCS protocol. (AU)

A ansiedade está presente em diversos momentos das competições esportivas limitando por vezes o desempenho dos atletas. O objetivo do estudo foi avaliar o efeito da estimulação transcraniana por corrente contínua (ETCC) nos sintomas agudos de ansiedade e no desempenho cognitivo de atletas quando aplicada por 7 dias. Este é um estudo experimental, duplo-cego e randomizado com 23 jogadores de futebol com sintomas de ansiedade. Dois grupos: ETCC anódica e ETCC simulada. A estimulação anódica foi realizada no córtex pré-frontal dorsolateral esquerdo (DLPFC) e o cátodo posicionado no DLPFC direito, intensidade de corrente 2 mA, por 20 minutos em 7 dias consecutivos e depois no 14º dia. A ansiedade foi avaliada pela escala HAM-A e o desempenho cognitivo por meio do Stroop Color Word Test e do Trail Making Test. Para análise estatística foram utilizados o teste t-student e o coeficiente de correlação de Spearman. A significância estatística foi fixada em p<0,05. Não foram observadas diferenças significativas entre os grupos na diminuição dos sintomas de ansiedade e na melhoria do desempenho cognitivo usando um protocolo de 7 dias consecutivos. Este estudo fornece evidências de que existe uma correlação inversa entre ansiedade e controle inibitório. Não houve diferença na aplicação da ETCC em comparação ao grupo controle quanto à melhora dos sintomas ansiosos e ao controle inibitório nesta população específica utilizando um protocolo de ETCC de sete dias. (AU)

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Resumen Introducción: El trastorno obsesivo-compulsivo (TOC) se caracteriza por obsesiones y compulsiones. Las obsesiones corresponden a ideas o imágenes intrusivas y la compulsión es el acto motor o cognitivo para aplacar la obsesión. Su prevalência mundial es del 3 % y existen diferentes factores que influyen en su aparición, que pueden ser biológicos, psicológicos o ambientales. Por otra parte, las funciones ejecutivas son un conjunto de habilidades que regulan la cognición y el comportamiento, donde este estudio busca describir la relación y afectación de las funciones ejecutivas en personas que padecen TOC. Materiales y métodos: Artículo de revisión narrativa a partir del estado del arte sobre el TOC y las funciones ejecutivas. Resultados: Diversos estudios han reportado la relación clínico-anatómica entre signos y síntomas característicos del TOC y la alteración evidenciada en funciones ejecutivas. Las funciones ejecutivas impactan el funcionamiento en la vida diaria y se encuentran fuertemente relacionadas al TOC, generando limitaciones funcionales en estos pacientes. Para esta afección hay tratamientos como las terapias farmacológica, psicológica y quirúrgica. Discusión: Se encuentra la necesidad de implementar, dentro de su tratamiento, la rehabilitación neuropsicológica para rehabilitar y fortalecer las funciones ejecutivas, buscando que se desarrolle de manera integral y que le permita a la persona desenvolverse de manera óptima en su día a día. Conclusión: Las funciones ejecutivas son un componente fundamental para nuestro funcionamiento y autonomía, es por esto que al estar el TOC directamente relacionado con fallas en estas funciones, se considera un punto importante para tener en cuenta al acompañar y tratar a personas que presentan este trastorno.

Abstract Introduction: Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions correspond to intrusive ideas or images and compulsion is the motor or cognitive act to appease the obsession. Its worldwide prevalence is 3%. There are different factors that influence its appearance, which can be biological, psychological and environmental. Executive functions are a set of skills that regulate cognition and behavior. The objective is to describe the relationship and impact of executive functions in people who suffer from OCD. Materials and methods: Narrative review article based on the state of the art on obsessive-compulsive disorder and executive functions. Results: Various studies report a clinical-anatomical relationship between characteristic signs and symptoms of OCD and alterations evident in executive functions. Executive functions impact functioning in daily life. These functions are strongly related to OCD, generating functional limitations in these patients. For this condition there are treatments such as pharmacological, psychological and surgical therapy. Discussion: There is a need to implement neuropsychological rehabilitation within its treatment to rehabilitate and strengthen such processes, seeking to develop it comprehensively and allow the person to function optimally in their daily lives. Conclusion: Executive functions are a fundamental component for our functioning and autonomy, which is why, since OCD is directly related to failures in these functions, they are considered an important point to take into account when accompanying and treating people who present this condition. disorder.

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Resumen Objetivo: en Colombia, existe una brecha importante entre la reglamentación relacionada con el reconocimiento de derechos, inclusión y mecanismos para la protección de los niños con discapacidad y la implementación de la norma. En este contexto, el objetivo de este estudio fue explorar las representaciones sociales de la parálisis cerebral en madres de niños con parálisis cerebral. Metodología: se realizó un estudio cualitativo bajo el enfoque estructuralista de las representaciones sociales para caracterizar el contenido y la organización de las representaciones sociales de la parálisis cerebral de madres de niños con parálisis cerebral que consultaron a un centro de neurorrehabilitación en Cali, Colombia entre enero y febrero de 2022. Como técnicas de recolección se utilizaron el listado libre y el cuestionario de pares. Resultados: para las madres la parálisis cerebral es la alteración de movimiento que junto con la dificultad de aprendizaje y comunicación generan gran demanda de atención por parte del cuidador acompañado de sentimientos de resignación ante las secuelas de la lesión en el cerebro y la discriminación social percibida. Conclusiones: las representaciones sociales sobre la parálisis cerebral dejan percibir una visión negativa y poco esperanzadora de recuperación, así como resiliencia por parte de los cuidadores.

Abstract Objective: In Colombia, there is a significant gap between the regulations related to the recognition of rights, inclusion, and mechanisms for the protection of children with disabilities and the implementation of the law. In this context, the aim of this study was to explore the social representations of cerebral palsy in mothers of children with cerebral palsy. Methodology: We collected information from mothers with children with cerebral palsy who consulted a neurorrehabilitation center in Cali, Colombia between January and February 2022 using the free list and the peer questionnaire. Results: For mothers, cerebral palsy is a movement disorder that, together with learning and communication difficulties, generates a great demand for care by the caregiver, accompanied by feelings of resignation in the face of the consequences of the brain injury and perceived social discrimination. Conclusions: The social representations on cerebral palsy reveal a negative and hopeless view of recovery, as well as resilience on the part of caregivers.

Resumo Objetivo: Na Colômbia, existe uma brecha importante entre a regulamentação relacionada ao reconhecimento de direitos, inclusão e mecanismos para a proteção dos meninos com deficiência e a implementação da norma. Neste contexto, o objetivo deste estúdio pode explorar as representações sociais da paralisia cerebral em mães de crianças com paralisia cerebral. Metodologia: Recolha a informação das madres com crianças com paralisia cerebral que consulte um centro de neurorreabilitação em Cali, Colômbia entre enero e febrero de 2022 usando o listado livre e o guia de pares. Resultados: Para as mães a paralisia cerebral é a alteração de movimento que se junta com a dificuldade de aprendizagem e comunicação gera grande demanda de atenção por parte do cuidador acompanhado de sentimentos de resignação antes das seqüelas da lesão no cérebro e na discriminação percepção social. Conclusões: Las representaciones sociales sobre la paralisis cerebral dejan ver una visão negativa y poco esperanzadora de recuperação, así como resiliência de parte de los cuidadores.

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RESUMEN Introducción: Las medidas de distanciamiento social debidas a la pandemia por COVID-19 impidieron que muchos chicos con trastornos del neurodesarrollo pudieran acceder a tratamientos presenciales. La telerrehabilitación creció en este tiempo como una herramienta terapéutica alternativa. El objetivo es analizar la telerrehXbilitación cognitiva en trastornos del neurodesarrollo. Métodos: En este estudio prospectivo, cuasi-experimental (antes-después), se incluyó a 22 pacientes (media de edad, 9,41 arios) con trastornos del neurodesarrollo que realizaron telerrehabilitación con el programa Rehametrics por más de 6 meses. Resultados: Luego de 6 meses de telerrahabilitación, se constató una mejoría estadísticamente significativa con un gran tamaño del efecto en áreas de: atención (sostenida, selectiva y dividida), funciones ejecutivas (memoria de trabajo verbal y visual, categorización, velocidad de procesamiento), habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia) y lenguaje (comprensivo y expresivo). En la Escala de Impedimento Funcional de Weiss mejoraron con significancia estadística todas las áreas (familia, aprendizaje y escuela, autoconcepto, actividades de la vida diaria, actividades de riesgo). Se constata una correlación positiva entre la cantidad de sesiones y la mejoría observada en funciones ejecutivas (memoria de trabajo visual, velocidad de procesamiento), atencionales (atención sostenida, atención dividida) y habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia). No encontramos significancia estadística entre la estructura familiar y la cantidad de sesiones realizadas. Se observó un alto grado de percepción de mejora y satisfacción en los padres. Conclusiones: La telerrehabilitación puede ser una herramienta alternativa segura que, sin reemplazar la presencialidad, puede lograr mejoras cognitivas y funcionales significativas en niños con trastornos del neurodesarrollo.

ABSTRACT Introduction: Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Tele-rehabilitation grew at this time as an alternative therapeutic tool. In this study we analyzed remote cognitive rehabilitation in neurodevelopmental disorders. Methods: This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months. Results: After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorization, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents. Conclusions: Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.

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Objetivo: Analisar a influência da prática de atividade física no desempenho cognitivo de adultos de meia-idade e pessoas idosas antes e durante a pandemia. Métodos: Estudo longitudinal e quantitativo, realizado com 200 indivíduos com 45 anos ou mais de idade cadastrados em Unidades de Saúde da Família de Três Lagoas/MS. A coleta aconteceu em dois momentos, antes da pandemia (2018/19) e durante a pandemia (2021). Foram avaliados dados sociodemográficos, a prática de atividade física (Questionário Internacional de Atividade Física - IPAQ) e o desempenho cognitivo (Mini-Exame do Estado Mental ­ MEEM). Os dados foram analisados pelos testes de McNemar, qui-quadrado, teste T e teste de Wilcoxon para amostras pareadas. Resultados: Com relação à prática de atividades físicas, 28% da amostra se tornou inativa no período avaliado, e 12% se tornou ativa, com diferença significativa. Não houve diferença entre os participantes que se tornaram ativos, se tornaram inativos, se mantiveram ativos e se mantiveram inativos com relação às características sociodemográficas, indicando que os grupos são semelhantes. O desempenho cognitivo piorou significativamente na comparação entre as duas avaliações. Ao analisar os grupos separadamente, verificou-se que o grupo que se tornou inativo foi o único que teve um desempenho cognitivo significativamente pior, na comparação antes e durante a pandemia. Conclusão: A redução da prática de atividade física decorrente da pandemia em adultos de meia-idade e pessoas idosas influenciou negativamente no desempenho cognitivo. Os indivíduos que deixam de praticar atividades físicas devem ser o principal alvo de rastreamento e monitoramento cognitivo, especialmente em períodos pandêmicos.

Objective: To analyze the influence of physical activity on the cognitive performance of middle-aged and older adults before and during the pandemic. Methods: Longitudinal and quantitative study, carried out with 200 individuals aged 45 years or older enrolled in Family Health Units in Três Lagoas/MS. The data collection took place in two moments, before the pandemic (2018/19) and during the pandemic (2021). Socio-demographic data, physical activity practice (International Physical Activity Questionnaire - IPAQ) and cognitive performance (Mini-Mental State Examination - MMSE) were evaluated. Data were analyzed using McNemar, chi-square, t-test and Wilcoxon test for paired samples. Results: Regarding the practice of physical activities, 28% of the sample became inactive during the period evaluated, and 12% became active, with a significant difference. There was no difference between participants who became active, became inactive, remained active and remained inactive with regard to sociodemographic characteristics, indicating that the groups are similar. Cognitive performance significantly worsened when comparing the two assessments. When analyzing the groups separately, it was found that the group that became inactive was the only one that had a significantly worse cognitive performance, in the comparison before and during the pandemic. Conclusion: The reduction in the practice of physical activity due to the pandemic in middle-aged and older adults negatively influenced cognitive performance. Individuals who stop practicing physical activities should be the main target for tracking and cognitive monitoring, especially in pandemic periods.

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Resumen Antecedentes: Compuestos específicos de la dieta son fundamentales para la salud cognitiva. Objetivo: Examinar las diferencias en el consumo de macronutrimentos y nutrimentos inorgánicos en personas con mayor y menor riesgo de deterioro cognitivo. Material y métodos: Análisis transversal del estudio 3Ollin. El estado cognitivo se determinó con el Examen Mínimo del Estado Mental (MMSE, Mini-Mental State Examination). A partir de la mediana de la puntuación del MMSE se obtuvieron dos grupos: mayor y menor riesgo de deterioro cognitivo. La dieta se evaluó mediante dos recordatorios de 24 horas. Se realizó estadística descriptiva, análisis de comparación de medianas con U de Mann-Whitney y análisis de correlación de Spearman entre los nutrimentos y las puntuaciones del MMSE. Los resultados se consideraron estadísticamente significativos con valor de p ≤ 0.05. Resultados: Se analizaron los datos de 425 personas, la mediana de edad fue 71 años (P25-P75 = 65-77). En el grupo con menor riesgo de deterioro cognitivo se observó un mayor consumo de calorías, proteína, hidratos de carbono, fibra, folato, fósforo, ácido ascórbico, vitamina E, alfa-tocoferol, vitamina B6, vitamina B12, cinc, selenio y licopeno, y un mayor consumo de frutas y verduras en conjunto (p < 0.005). Conclusiones: Existen diferencias significativas en la dieta entre los grupos de riesgo de deterioro cognitivo.

Abstract Background: Specific dietary compounds are essential for cognitive health. Objective: To examine differences in the consumption of macronutrients and inorganic nutrients between people with a higher and lower risk of cognitive impairment. Material and methods: Cross-sectional analysis of the 3Ollin study. Minimal Mental State Examination determined cognitive status. Two groups were obtained from the median of the score: higher and lower risk of cognitive deterioration. Diet was assessed using two 24-hour recalls. Descriptive statistics and comparison analysis of medians using Mann-Whitney U and Spearman correlation analysis were performed between nutrients and MMSE scores. The results were considered statistically significant when p ≤ 0.05. Results: Data from 425 people were analyzed; the median age was 71 years (P25-P75 = 65-77). In the group with a lower risk of cognitive impairment, a higher consumption of calories, protein, carbohydrates, fiber, folate, phosphorus, ascorbic acid, vitamin E, alpha-tocopherol, vitamin B6, vitamin B12, zinc, selenium, and lycopene were observed. Also, a greater consumption of fruits and vegetables (p < 0.005). Conclusions: There are significant differences in diet between groups at risk for cognitive impairment.

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Introduction: Parkinson’s disease manifests as bradykinesia, stiffness, tremors, and abnormalities in gait and balance. When performing dual activities, people with cognitive impairments exhibit noticeable alterations in mobility. The purpose of this study was to determine whether balance during dual tasking is related to cognitive deterioration. The aim was to compare balance during dual?task in?between cognitively impaired (CI) and nonimpaired individuals with Parkinson’s disease. The objective was to evaluate balance using timed up and go test (TUG), TUG?manual (TUG?m), and TUG?cognitive (TUG?c) and to compare its scores in both the groups. Materials and Methods: It was a cross?sectional observational study carried out at outpatient department and Parkinson’s societies. The sampling technique was purposive sampling, and the sample size was 22. Subjects were divided into two groups (by stratification method) according to Montreal Cognitive Assessment (MOCA) scores as CI and nonimpaired group. Both groups performed TUG with manual task and cognitive task. The time taken to complete all TUG tests was measured. Results: Comparison of TUG between the groups showed a highly significant difference in TUG and TUG?m tests (P < 0.001) and a significant difference in TUG?c (P = 0.028). Conclusion: The study found a significant difference in balance scores, assessed by the TUG test during dual?task conditions, between CI and nonimpaired individuals with Parkinson’s disease. This highlights the important role cognition plays in balance regulation in Parkinson’s disease.

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Background: According to the United Nations, about one in five Indians will be 60 years or older by year 2050. Following this demographic shift, an increase in the proportion of cognitive disorders is expected. This study aims to identify those who have cognitive impairment among the rural elderly and study the factors associated. Methodology: The cross-sectional study was done on patients attending rural health and training centre of a tertiary care medical college and hospital in Chennai. One hundred seventy-eight participants above 60 years of age were screened with the Mini-CogTM tool. Those who scored less than 4 on the Mini-Cog scale were referred for cognitive evaluation by a clinical psychologist. Results: The overall prevalence of individuals positive for cognitive impairment was 41.6%. On bivariate analysis, individuals older than 65 years of age, those who were leading a retired life, not living with spouse, current alcoholics and smokers were associated with impaired cognition. Multivariate logistic regression analysis revealed participants who were retired and not living with spouse were independently associated with cognitive impairment. Conclusion: A high proportion of participants screened positive for cognitive impairment. Integrating cognitive health with primary care can help in giving attention and support for the ageing population.

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Avaliar o efeito dos exergamesno controle postural de pessoas idosas durante tarefas simples (TS) e duplas (TD). Estudo quase experimental com os matriculados na USP60+. Os participantes foram alocados em grupos controle (GC, n=15, 66,5±6,3 anos, 73,3% mulheres) e treinamento (GT, n=16, 67,1±4,6 anos, 71,2% mulheres). Antes e após a intervenção, a oscilação do centro de pressão (COP) foi registrada durante TS e TD, utilizando uma plataforma de força portátil. O treinamento foi realizado por 12 semanas (2x/sem e 50 min/sessão). Os deltas das variáveis relacionadas ao COP foram calculados e os dados analisados por testes não-paramétricos e pela correlação bisserial (tamanho do efeito). Nível de significância estabelecido foi de p<0,05. A oscilação do COP foi maior durante as TD. Houve redução da área do COP (superfície instável + tarefa cognitiva) no GT após o treinamento. A oscilação corporal de pessoas idosas é maior nas tarefas duplas. O treinamento com exergames melhorou a oscilação postural no GT, especialmente, durante atividades de dupla tarefa

To evaluate the effect of exergames on postural control in older adults during single (ST) and dual (DT) tasks. A quasi-experimental study involving older adults enrolled in USP60+. Participants were allocated into control (CG, n=15, 66.5±6.3 years, 73.3% women) and training (TG, n=16, 67.1±4.6 years, 71.2% women) groups. Before and after the intervention, the oscillation of the center of pressure (COP) was recordedduring ST and DT, using a portable force platform. Training was performed for 12 weeks (2x/week and 50 min/session). The deltas of the variables related to COP were calculated and the data was analyzed by non-parametric tests and biserial correlation (effect size). The significance level was set at p<0.05. COP sway was greater during DT, and the COP area (unstable surface + cognitive task) decreased in the TG after training. Body sway in older adultstends to be worse in dual tasks. Training with exergames improved postural sway in the TG, especially during complex dual-task activities.(AU)

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Introdução: Estudos anteriores demonstraram que o desequilíbrio não está relacionado apenas à doença vestibular periférica, pois a disfunção vestibular envolve conexões neurais do núcleo vestibular para regiões límbicas e corticais envolvidas tanto na cognição quanto na orientação. Desta forma, a disfunção vestibular também se associa à funcionalidade e sintomas depressivos, porém os mecanismos envolvidos na associação entre disfunção vestibular e comprometimento cognitivo ainda não estão claros. Objetivo: verificar a correlação entre exames e provas vestibulares com habilidades cognitivas, funcionalidade e depressão em idosos com disfunção vestibular. Métodos: estudo transversal, observacional e analítico. A amostra foi composta por 50 idosos, de ambos os sexos, com idade entre 60 e 86 anos. Foram incluídos idosos com disfunção vestibular confirmada pelos testes Potencial Evocado Miogênico Vestibular (VEMP) e Video Head Impulse Test(v-HIT). O equilíbrio e o impacto da tontura na qualidade de vida foram avaliados por meio de testes e escalas vestibulares. A cognição, a funcionalidade e os sintomas depressivos foram avaliados em uma sala silenciosa por meio de testes e escalas. A análise univariada foi realizada por meio do teste de Spearman. As variáveis que apresentaram correlação ≤ 0,2 foram selecionadas para análise multivariada por regressão linear. Adotou-se o nível de significância de 5% (p< 0,05). Resultados: Houve correlação entre disfunção vestibular e desequilíbriocom os resultados da avaliação neuropsicológica (p<0,001), sintomas depressivos (p=0,001) e funcionalidade (p=0,002). Conclusão: Observou-se correlação entre disfunção e desequilíbrio vestibular com os piores índices clínicos e funcionais, pior funcionalidade, sintomas depressivos e dificuldade nas habilidades de função visuoespacial, funções executivas e praxias.(AU)

Introduction: Previous studies have demonstrated that the imbalance is not just related to peripheral vestibular disease, as vestibular dysfunction involves neural connections from the vestibular nucleus to limbic and cortical regions involved in both cognition and orientation. Thus, vestibular dysfunction is also associated with functionality and depressive symptoms, but the mechanisms involved in the association between vestibular dysfunction and cognitive impairment are still unclear. Objective: to verify the correlation between vestibular exams and tests with cognitive abilities, functionality and depression in elderly people with vestibular dysfunction. Methods: cross-sectional, observational and analytical study. The sample consisted of 50 elderly people of both sexes, aged between 60 and 86 years. Elderly people with vestibular dysfunction confirmed by the Vestibular Evoked Myogenic Potential (VEMP) and Video Head Impulse Test (v-HIT) tests were included. Balance and the impact of dizziness on quality of life were assessed using vestibular tests and scales. Cognition, functionality and depressive symptoms were assessed in a quiet room using tests and scales. Univariate analysis was performed using the Spearman test. Variables that presented correlation ≤ 0.2 were selected for multivariate analysis by linear regression. A significance level of 5% was adopted (p< 0.05). Results: There was a correlation between vestibular dysfunction and imbalance with the results of the neuropsychological assessment (p=0.000), depressive symptoms (p=0.001) and functionality (p=0.002). Conclusion: A correlation was observed between vestibular dysfunction and imbalance with worse clinical and functional indices, worse functionality, depressive symptoms and difficulty in visuospatial function skills, executive functions and praxis.(AU)

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O objetivo da pesquisa foi avaliar a associação entre as variáveis queixas cognitivas e suspeita de demência com alterações visuais e auditivas autorrelatadas na aplicação do Índice de Vulnerabilidade Clínico Funcional (IVCF-20). Trata-se de pesquisa transversal, realizada de julho de 2023 a janeiro de 2024, com 3.128 pessoas idosas, residentes em uma região do Paraná. Os dados foram coletados por meio do Sistema de Informação da Pessoa Idosa no Paraná, no qual constava o registro das informações do IVCF-20. Os dados foram analisados pelo SPSS v.25.0. Dos 3.128 participantes, 905 (28,9%) apresentaram queixas cognitivas e 240 (7,8%) suspeita de demência. Dos que possuíam queixas cognitivas 328 (36,2%) relataram alteração na visão (OR 2,35; p<0,01) e 210 (23,2%) na audição (OR 3,82; p<0,01). Dos com suspeita de demência, 106 (44,2%) apresentaram alteração visual (OR 2,69; p<0,01), e 73 (30,4%) alteração auditiva (OR 3,74; p<0,01). Alterações na visão e audição estão associadas ao aumento de suspeita de demência e queixa cognitiva. É necessário rastrear essas alterações, e intervir precocemente,pois enxergar e ouvir permite que idosos mantenham sua funcionalidade.(AU)

The objective of the research was to evaluate the association between the variablescognitive complaints and suspicion of dementia with self-reported visual and auditory alterations in the application of the Functional Clinical Vulnerability Index (IVCF-20). This is a cross-sectional survey conducted from July 2023 to January 2024, with 3,128 older people living in a region of Paraná. Data were collected through the Information System for Older People in Paraná, which contains the IVCF-20 information record. The analyzed using SPSS v.25.0. Of the 3,128 participants, 905 (28.9%) had cognitive complaints and 240 (7.8%) suspected dementia. Of those who had cognitive complaints, 328 (36.2%) reported changes in vision (OR 2.35; p<0.01) and 210 (23.2%) in hearing (OR 3.82; p<0.01). Of those with suspected dementia, 106 (44.2%) had visual impairment (OR 2.69; p<0.01), and 73 (30.4%) had auditory impairment (OR 3.74; p<0.01). Changes in vision and hearing are associated with increased suspicion of dementia and cognitive complaint. It is necessary to screen for changes, and intervene old, as seeing and hearing properlyallows the older people to maintain their functionality.(AU)

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Background: Cognitive dysfunction can occur in a significant proportion of patients with chronic kidney disease (CKD). Subclinical uremic encephalopathy (SUE) is defined as cognitive impairment (CI) greater than expected for normal aging and educational level. SUE is characterized by declining cognitive function that becomes irreversible if left untreated. However, there is no specific test to confirm the diagnosis of SUE. Aim and Objectives: To determine the diagnostic accuracy of psychometric hepatic encephalopathy score (PHES) and critical flicker fusion frequency (CFFF) tests in SUE in CKD Stage 5 patients and to estimate the prevalence of CI among CKD patients. Materials and Methods: It was a cross-sectional study conducted at a tertiary care center in Chennai, South India, during September 2022–October 2022, among 35 patients diagnosed with CKD Stage 5. All patients were subjected to MMSE (Mini-mental state examination), PHES test, and CFFF test consecutively and their scores were recorded. The collected data were analyzed with IBM SPSS Statistics for Windows, Version 29.0. The scores of PHES and CFFF were compared against MMSE and their diagnostic accuracy was tested using the receiver operating characteristics curve (ROC) along with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, and P < 0.05 was considered statistically significant. Results: Of all 35 patients, 19 (54%) were males with a median age of 60 years. Fifteen patients (43%) were on hemodialysis. The prevalence of CI among CKD patients was 60%. CI was detected with MMSE in 21 patients (60%). Out of the 21 patients, 18 were positive with PHES (P < 0.01) and 19 were positive with CFFF (P < 0.05). PHES showed better sensitivity (90.9%), specificity (90.0%), PPV (90.9%), and NPV (90.0%) than CFFF, which showed a sensitivity of (89.7%), specificity (85.3%), PPV (86.8%), and NPV (87.5%). PHES was more accurate (accuracy – 90.5%) than CFFF (85.5%). 29 (83%) patients completed MMSE and 24 (69%) patients completed PHES, whereas all patients (100%) completed CFFF test. The average time taken in minutes to complete MMSE, PHES, and CFFF was 14.68 ± 2.02, 30.11 ± 4.13, and 5.48 ± 1.44 min, respectively. Cognitive function scores did not differ significantly with the duration of CKD and between patients with CKD receiving dialysis. Conclusion: Both PHES and CFFF are effective in detecting impaired cognition and can be used as reliable tools in the diagnosis of SUE. Moreover, CFFF was less time-consuming and easier to complete, making it an ideal bedside test. The prevalence of CI among CKD patients was considerably high (60%). Hence, early detection and treatment would prevent patients from going into overt uremic encephalopathy where CI can become irreversible.

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This study was conducted to investigate the effects of some energy drinks mixture with Flunitrazepam on endurance pattern and cognitomotor activities in male Wistar rats. 45 Wistar rats were divided into 8 groups. Group 1 received distilled water; Group 2 received energy drink (A) (3.75 mg/kg). Group 3 energy drink (A) (7.5 mg/kg) Group 4 received energy drink (B) (3.75 mg/kg). Group 5 energy drink (B) (7.5 mg/kg) Group 6 received flunitrazepam (0.03 ml/kg), Group 7 received 3.75 ml/kg of energy drink (A) and 0.03 ml/kg of flunitrazepam, and Group 8 received 3.75 ml/kg of energy drink (B) and 0.03 ml/kg of flunitrazepam. Administration of the mixture lasted for 28 days while endurance test/Cognitive and motor functions test were conducted weekly using Handgrip test, beam walk test and navigational maze test. The result reveals significant improvement in endurance pattern and cognitomotor functions in groups administered with energy drinks alone at week one, however the mixture of energy drink with various doses of Flunitrazepam showed significant impairment in both endurance pattern, and cognitomotor activities. It was therefore concluded that while the combination of energy drinks and flunitrazepam may offer short-term benefits in terms of endurance, and alertness, there is a dose and time dependent significant decline in cognitive and motor functions functions in wistar rats. The findings suggest significant variations in endurance and cognitive-motor performance across different groups, highlighting the complex interactions between stimulant and sedative substances and their implications for health and behavior.

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Background: The smoked and smokeless forms of tobacco consist of about 4000 chemical constituents having carcinogenic potential and nicotine is the major among these. A considerable amount of evidence states that long-term administration of nicotine can change the fundamental properties of cholinergic neurotransmission, leading to changes in synaptic efficacy and resulting in modified behaviors. The effects of nicotine on cognition have been interesting, but knowledge regarding it seems to be inconsistent. As there are very few studies in India to the influence of nicotine on reaction time, especially in the case of smokeless tobacco users, this study was undertaken with an attempt to find out whether “smokeless tobacco” effects cognition by assessing the reaction time. Aims and Objectives: To estimate and compare the auditory reaction time (ART) and visual reaction time (VRT) of tobacco users with non-tobacco users. Materials and Methods: This study is conducted on 70 male participants with 35 healthy male tobacco chewers in the age group of 18–55 years and an equal number of healthy age- matched male controls (non-tobacco chewers). ART and VRT were recorded in both groups using a reaction time apparatus with an inbuilt chronoscope. Results: Both ART and VRTs are faster in tobacco chewers compared to non-tobacco chewers, and the difference is statistically highly significant. Conclusion: This study, hence, demonstrates that nicotine shortens reaction times, thereby temporarily improving cognition, which can be attributed to the stimulatory effect of nicotine that may be due to an accelerated response to the various stimuli caused by the effect of nicotine. This can be due to catecholamine release in the brain that affects the central nervous system of chronic tobacco users to have significant consequences in the near future.

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Objectives: To verify the effect of strength, aerobic, and concurrent training on the memory of cognitively preserved older adults. Methods: A randomized controlled clinical trial will be conducted. Sedentary older adults (aged 60 to 75 years) of both genders will participate. Outcome measures will include blood biomarkers, cognitive tests, depressive symptoms, socioeconomic data, and physical assessments. Participants will be randomized into the following groups: strength training, aerobic training, concurrent training, or control. Interventions will be conducted for 12 weeks, with adherence to training sessions monitored. Pre-training values will be compared between groups using a one-way ANOVA test. Training effects will be evaluated through two-way ANOVA (time × group). The research protocol was registered in The Brazilian Registry of Clinical Trials (ReBEC) (RBR-655vxdd). Expected results: We believe that concurrent training may yield greater efficacy in improving memory outcomes, combining the benefit of both training modalities. Relevance: Considering the increase in population aging and that few studies have evaluated the chronic effect of physical exercise on the memory of cognitively preserved older adults, this is a relevant topic, since much of the literature has focused on investigating older adults with some cognitive decline. Furthermore, our aim is to provide an alternative training option by combining the benefits of aerobic and strength training, thereby optimizing time and enhancing both physical capacity and memory. (AU)