Tradução, validação cultural e semântica do cognitive reserve index questionnaire (CRIq) o português brasileiro / Cognitive reserve index questionnaire (CRIq) - translation, cultural and semantic validation for Brazilian portuguese

Introdução: A reserva cognitiva pode explicar diferentes respostas do indivíduo após acidentes ou doenças que acometem o sistema nervoso central. É importante ter instrumentos que avaliem tal reserva, não só para serem utilizados quando ocorrem problemas, mas também para avaliar indivíduos de forma profilática, visando o estabelecimento de programas de estimulação cognitiva. Objetivo: Obter a equivalência semântica e cultural do Cognitive Reserve Index questionnaire (CRIq) para o português brasileiro. Método: o questionário foi traduzido por dois tradutores independentes, do italiano para o português brasileiro. Após, foi produzida uma versão única, sintetizada, que foi retrotraduzida para o italiano, novamente por outros dois tradutores, independentes e sem conhecimento das traduções anteriores. A partir das traduções e retrotraduções, foi desenvolvida uma versão semanticamente aceitável para o português, que foi aplicada a 30 pessoas (grupo piloto). A partir desta aplicação foi criada uma nova versão, adaptada culturalmente para o português brasileiro. Resultados: As adaptações foram feitas especialmente na seção que avalia atividades laborativas ao longo da vida (CRIq trabalho) e principalmente no CRI tempo livre. Acredita-se que tais mudanças foram necessárias devido às diferenças culturais no que se refere às atividades realizadas como lazer por italianos e brasileiros. Os resultados obtidos no grupo piloto evidenciaram que houve correlação entre a RC, a idade (r=0,92, p=0,02*) e a escolaridade (r=0,70, p=0,00*). Conclusão: o Cognitive Reserve Index questionaire (CRIq) está traduzido e adaptado para o português brasileiro, sendo uma ferramenta útil para os profissionais que atuam na área, especialmente quando são avaliados indivíduos idosos.(AU)

Introduction: Cognitive reserve can explain the differences among patients' responses after accidents or diseases that affect the central nervous system. It is important to have instruments that assess this reserve, not only to address problems but also to provide individual prophylactic measures through the establishment of cognitive stimulation programs. Objective: To produce the semantic and cultural equivalent of the Cognitive Reserve Index questionnaire (CRIq) in Brazilian Portuguese. Method: The questionnaire was translated by two independent translators, from Italian to Brazilian Portuguese. Afterward, a single, synthesized version was produced and two other independent translators, who were unaware of the previous translations, back-translated it into Italian. From the translations and backtranslations, a semantically acceptable version was produced in Brazilian Portuguese and tested on 30 participants (pilot group). Based on this test, a new version was created that was culturally adapted to Brazilian Portuguese. Results: The section that evaluates work activities throughout life (CRIq work) required the most adaptation, particularly CRIq free time. Such changes may have been necessary due to cultural differences in leisure activities between Italians and Brazilians. The results obtained in the pilot group showed that there was a correlation between CR, age (r = 0.92, p = 0.02 *) and education (r = 0.70, p = 0.00 *). Conclusion: The Cognitive Reserve Index questionnaire (CRIq) has been appropriately translated and adapted into Brazilian Portuguese and may serve as a useful tool for health care professionals, especially those who assess elderly individuals.(AU)

Factores de riesgo cardiometabólico y funcionamiento cognitivo: el rol de la reserva cognitiva / Association between cardiometabolic risk and cognitive impairment

Background: Several risk factors are associated with cognitive impairment in older people, but little attention has been paid to cardiometabolic variables, as well as how cognitive reserve can mediate this association. Aim: To determine the association of cardiometabolic risk factors with cognitive functioning and whether the cognitive reserve mediates this association. Material and Methods: A cross-sectional study with 300 participants with a median age of 56 years (53% male) was conducted. Participants had a cognitive functioning assessment. Fasting glucose, HDL-cholesterol, and blood pressure were measured. Results: A Structural Equation Modeling, revealed a direct effect of cardiometabolic latent risk factors on both a cognitive functioning (β = -.204; p = .056), and cognitive reserve factors (β = -.236, p = .04). Cognitive reserve was directly associated with cognitive functioning (β = .327, p = .01), but did not mediate the association between the cardiometabolic risk factors and cognitive functioning (β = .077, p = .07). The overall goodness of fitness was excellent χ2 (50) = 58.357, p = .195, comparative fit index = .980, Tucker-Lewis Index = .974, root mean square error of approximation = .023 and Standardized Root Mean Square Residual = .041. Conclusions: A direct effect of cardiometabolic risk factors on cognitive functioning was observed.

Aspectos psicosociales, nutricionales, aptitud y actividad física en seis centros de jubilados de la Ciudad de Buenos Aires / Psychosocial and nutritional aspects, physical fitness and activity in six retirement centers of Buenos Aires City

INTRODUCCIÓN: El estado nutricional, la actividad física (AF) y las variables psicosociales plantean nuevos desafíos en los adultos mayores (AM). El objetivo fue explorar y describir aspectos psicosociales, nutricionales, aptitud y AF en AM que asisten a centros de jubilados de la Ciudad Autónoma de Buenos Aires (CABA). MÉTODOS: Se realizó un estudio exploratorio, observacional, transversal y cuantitativo con una muestra no probabilística de AM de ambos sexos, auto-válidos, en seis comunas de CABA durante 2017-2018. Se evaluó edad, sexo, índice de nivel socioeconómico (NSE), valoración sociofamiliar, cuestionario de reserva cognitiva e índice de bienestar de Pemberton, estado nutricional por Mini Nutritional Assessment, antropometría por índice de masa corporal, aptitud física por fuerza muscular y funcionalidad, gasto energético y nivel de AF por acelerometría. RESULTADOS: En una muestra de 150 AM de 74±7 años, el 90% (n=135) eran mujeres. El 48% pertenecía a un NSE bajo. Hubo presencia de riesgo social en el 50%, bienestar en el 97,6% y reserva cognitiva satisfactoria en el 53,6%. El 53,7% presentó sobrepeso/ obesidad con predominio en cuartil 1, y hubo 10,2% con riesgo o malnutrición. La debilidad muscular prevaleció en el tercer y cuarto cuartil. De los 57 AM que usaron acelerómetro, la mayoría tenía AF sedentaria y bajo gasto energético. DISCUSIÓN: La muestra explorada mostró riesgo/ problema social, exceso de peso y sedentarismo

Evaluación de las estrategias de compensación de memoria en adultos mayores sanos mediante el Memory Compensation Questionnaire (MCQ) / Evaluation of memory compensation strategies in healthy older adults with the Memory Compensation Questionnaire (MCQ)

Las estrategias de compensación son un mecanismo de adaptación del adulto mayor por el cual se implementan conductas para mantener la eficacia del procesamiento cognitivo. Objetivo: Evaluar las estrategias de compensación y la influencia de variables sociodemográficas mediante Cuestionario de Compensación de Memoria. Metodología: 139 adultos mayores argentinos, entre los 60 y 90 años (X= 71,53; DS=7,81), 77% mujeres. Resultados: Se estima la fiabilidad del MCQ mediante el ɑ de Cronbach= .86. Los adultos mayores presentan variaciones en el uso de estrategias de compensación según el género y el nivel educativo. Los hombres utilizan más la estrategia Confianza. Las personas con menor nivel educativo obtienen un puntaje mayor en la escala Esfuerzo, demostrando que les cuesta más implementar estrategias de compensación. Conclusiones: El MCQ es una herramienta útil para evaluar la percepción del adulto mayor dando cuenta de cómo se adapta al cambio y a las demandas del ambiente(AU)

Compensation strategies are an adaptation mechanism used by elderly, which are implemented to maintain the effectiveness of cognitive processing. Objective: Evaluate the compensation strategies and the influence of sociodemographic variables using the Memory Compensation Questionnaire. Methodology: 139 Argentine older adults, between 60 and 90 years old (X = 71.53; DS = 7.81), 77% women. Results: The reliability of the MCQ is estimated using Cronbach's a = .86. Older adults show variations in the use of 95 compensation strategies according to gender and educational level. Men use the Reliance strategy more. Participants with a lower educational level obtain a higher score on the Effort scale, showing that it is more difficult for them to implement compensation strategies. Conclusions: The MCQ is a useful tool to assess how the elderly perceives how the adapt to change and environmental demands(AU)

Promotores de reserva cognitiva en adultos mayores con alto riesgo de demencia cortical / Promoters of Cognitive Reserve in the Elderly with High Risk of Cortical Dementia

Introducción: La reserva cognitiva constituye un elemento central para entender cómo responde el cerebro a la neuropatología durante el ciclo vital. Objetivo: Comprender los factores promotores de reserva cognitiva desde la experiencia de vida de adultos mayores sin deterioro cognitivo y con alto riesgo de demencia cortical. Métodos: Estudio cualitativo, con base en método Grounded Theory. Se realizan entrevistas semiestructuradas en profundidad a siete adultos mayores. En el análisis, se aplica la técnica de comparación constante según modelo de Glasser y Straus, utilizando Atlas ti/7. Resultados: Desde el análisis axial surgen cinco categorías interrelacionadas: actividad mental, experiencias gratificantes, cuidados, eventos traumáticos y características de personalidad. Se aprecia un patrón constante de experiencias vitales mentalmente estimulantes, relacionado principalmente a actividades de cuidado y experiencias gratificantes, no asociadas a educación formal. Conclusiones: Se distingue un proceso dinámico que involucra experiencias y eventos de vida cotidiana, tanto personales como ambientales, ocupacionales y del estilo de vida, que operan secuencialmente durante el ciclo vital; estos factores podrían incidir significativamente en los mecanismos neurobiológicos y actuar como promotores de reserva cognitiva. Se obtiene un modelo de promotores de reserva cognitiva que podría utilizarse en programas de salud cognitiva para contrarrestar la neuropatología(AU)

Introduction: Cognitive reserve constitutes an element central to understanding how the brain responds to neuropathology during the life cycle. Objective: To understand the factors that promote cognitive reserve from the life experience of the elderly without cognitive deterioration and with high risk of cortical dementia. Methods: Qualitative study, methodologically based on grounded theory. In-depth semi-structured interviews are conducted on seven elderlies. In the analysis, the constant comparison technique is applied according to the model by Glaser and Strauss, using ATLAS-Ti 7. Results: Five interrelated categories emerge from the axial analysis: mental activity, gratifying experiences, care, traumatic events, and personality traits. There is a constant pattern of mentally-stimulating life experiences, mainly related to care activities and gratifying experiences, not associated with formal education. Conclusions: A dynamic process is distinguished that involves experiences and events of daily life, both personal and environmental, occupational and related to lifestyle, which operate sequentially during the life cycle. These factors could significantly influence neurobiological mechanisms and act as promoters of cognitive reserve. A model of cognitive reserve promoters is obtained that could be used in cognitive health programs to counteract neuropathology(AU)

Avaliação do Impacto do Nível Educacional na Doença de Alzheimer: Artigo Original / Evaluation of the Impact of Educational Level on Alzheimer's Disease: Original Article

A doença de Alzheimer (DA) consiste em uma doença neurodegenerativa progressiva, irreversível e de aparecimento insidioso. O grau de escolaridade formal, assim como a reserva cognitiva, vem sendo proposto como fator protetor da DA, interagindo com a predisposição genética na gênese e curso evolutivo da doença. Tal estudo tem como objetivo buscar associações da escolaridade formal e outras variáveis, que possam estabelecer relação com valores reduzidos do MEEM. Foram coletados dados como idade, sexo, estado civil, raça, escolaridade e pontuação no MEEM no período do diagnóstico da DA dos pacientes que se encontravam em fase inicial da doença. Os pacientes foram divididos em três grupos de acordo com a idade: 60-69 anos, 70-79 anos e = 80 anos. Após análise estatística, a comparação MEEM versus escolaridade se mostrou significativa (r=0,39; P=0,0001), enquanto MEEM versus idade não apresentou significância (r=-0,13; P=0,86), tal como para associação de MEEM e sexo (P=0,46). Na separação realizada por grupos etários, o nível de escolaridade foi significativamente maior nos indivíduos com idade entre 60-69 anos versus 70-79 versus = 80 anos, todavia, sem diferenças significativas entre os escores do MEEM (13 ± 6,2 versus 13± 6 versus 15 ± 5; mediana ± intervalo interquartil; P = 0,34). Assim sendo, esse estudo aponta relevante relação entre a escolaridade e pontuações obtidas no teste cognitivos, determinando associação entre o nível educacional mais elevado e maior habilidade cognitiva dos pacientes com DA. (AU)

Alzheimers disease (AD) consists of a progressive, irreversible and insidious neurodegenerative disease. The degree of formal schooling, as well as the cognitive reserve, has been proposed as a protective factor of AD, interacting with the genetic predisposition in the genesis and evolutionary course of the disease. This study aims to seek associations of formal schooling and other variables, which may establish a relationship with reduced MMSE values. Data such as age, sex, marital status, race, schooling and MMSE score were collected during the diagnosis of AD in patients who were in the initial phase of the disease. Patients were divided into three groups according to age: 60-69 years, 70-79 years and = 80 years. After statistical analysis, the MMSE versus schooling comparison was significant (r = 0.39, P = 0.0001), while MMSE versus age did not present significance (r = -0.13, P = 0.86), as for association of MEEM and sex (P = 0.46). In the separation by age groups, the educational level was significantly higher in individuals aged 60-69 years versus 70-79 versus = 80 years, however, without significant differences between the MMSE scores (13 ± 6.2 versus 13 ± 6 versus 15 ± 5, median ± interquartile range, P = 0.34). Therefore, this study points out a relevant relationship between schooling and scores obtained in the cognitive test, determining the association between the higher educational level and the greater cognitive ability of patients with AD. (AU)

Diferencias en la reserva neural en relación al entrenamiento musical / Differences in the neural reserve in relation to music training

La reserva neural es un subcomponente de la reserva cognitiva y refiere a las diferencias en los paradigmas cognitivos que subyacen al desempeño de tareas en un cerebro sano. Puede darse por diferencias innatas (inteligencia, edad) o ambientales, como el entrenamiento musical. Éste está relacionado con diferencias cerebrales y cognitivas. El objetivo del presente estudio es realizar una revisión bibliográfica de investigaciones que evaluaron rendimiento cognitivo en músicos como no músicos, y establecer diferencias en la reserva cognitiva y, más específicamente, el subcomponente de reserva neural, entre ambos grupos. Se parte de la suposición de que los músicos poseen un rendimiento superior en tareas cognitivas con respecto a los no músicos y que esto está relacionado con una mayor reserva neural debido al entrenamiento musical. Los resultados son contradictorios. Se encontraron algunas diferencias en dominios cercanos a la práctica musical en adultos jóvenes, y en diversos dominios en adultos mayores. Las diferencias entre grupos, que no diferían en inteligencia, podrían ser atribuibles a una mayor reserva cognitiva. También hay relaciones con el tipo de instrumento, los años y la edad de comienzo de la práctica musical. Se sugiere replicar los hallazgos controlando diversas variables(AU)

Neural reserve is a subcomponent of cognitive reserve and refers to the differences in cognitive paradigms that underlie task performance in a healthy brain. It can occur due to innate (intelligence, age) or environmental differences, such as musical training. This is related to brain and cognitive differences. The aim of the present study is to carry out a bibliographic review of investigations that evaluated cognitive performance in musicians as well as non-musicians, and to establish differences in cognitive reserve and, more specifically, the neural reserve subcomponent, between both groups. It is assumed that musicians have superior cognitive tasks performance compared to non-musicians and that this is related to a greater neural reserve due to musical training. The results are contradictory. Some differences were found in domains close to musical practice in young adults, and in various domains in older adults. The differences between groups, which did not differ in intelligence, could be attributable to a greater cognitive reserve. There are also relationships with the type of instrument, the years and the age of beginning of the musical practice. It is suggested to replicate the findings controlling for various variables(AU)

Reserva Cognitiva: revisión de su conceptualización y relación con la Enfermedad de Alzheimer / Cognitive Reserve: a revision of its conceptualization and its relation with Alzheimer´s Disease

Introducción: La reserva cognitiva permite la activación de conexiones sinápticas adicionales y nuevas redes neurales frente a demandas del ambiente. Objetivo: Delimitar qué variables contribuyen a la formación de la reserva cognitiva y establecer su expresión en el desarrollo de la Enfermedad de Alzheimer. Metodología: Revisión bibliográfica sistemática y evaluativa de tipo cualitativa. Resultados: La educación, actividades de ocio, estilo de vida, estatus socioeconómico e inteligencia son las principales variables que aportan a la formación de la reserva cognitiva. Sujetos con alta reserva tienen menor prevalencia e incidencia de demencia. Aquellos que lleguen a desarrollar la enfermedad lo harán a una edad más tardía y con mayor severidad de síntomas. Conclusión: Las variables que contribuyen a la formación de la reserva cognitiva son, principalmente, variables socio-ambientales. La reserva se considera factor de protección frente a la enfermedad. Además, atrasaría la aparición de la demencia, logrando, en algunos casos, que nunca se llegue a desarrollar la enfermedad(AU)

Introduction: Cognitive reserve allows the activation of additional synaptic connections and new neural networks against environmental demands. Objective: Establish the variables that contribute to the formation of cognitive reserve and its expression in relation with Alzheimer´s Disease. Method: Systematic and evaluative review of qualitative type. Results: Education, leisure activities, lifestyle, socioeconomic status and intelligence are the main variables which contribute to the formation of cognitive reserve. Subjects with high reserve have lower prevalence and incidence of dementia. Those who develop Alzheimer´s Disease will do so at a later age and with more severe symptoms. Conclusions: The variables which contribute to the formation of cognitive reserve are, mainly, socio-environmental variables. The reserve is considered a protective factor against disease. It delays the onset of dementia avoiding, in some cases, the development of the pathology(AU)

Anatomic and neuropsychological findings in low-educated cognitively intact elderly from a Brazilian cohort / Achados Anatômicos e Neuropsicológicos de Idosos Cognitivamente Saudáveis com Baixa Escolaridade em uma Coorte Brasileira

ABSTRACT In elderly individuals, low educational level may represent a risk factor for the development of dementia and a proxy of cognitive reserve. Objective: This study examined the cognitive and neuroanatomic correlates of high versus low educational levels in cognitively healthy community-dwelling older adults in Brazil. Methods: Fifty-three older adults (mean age: 68±5.3 years) were divided into a "low education" group [LE; 1-4 years of education (N=33)] and "high education" group [HE; >11 years of education (N=20)]. Both groups completed a comprehensive neuropsychological battery and underwent in vivo structural MRI close to the time of testing. Results: Higher educational level increased the chance of having better scores on neuropsychological tests, including verbal and visual delayed recall of information, verbal learning, category fluency, global cognition, and vocabulary. Better scores on these tests were observed in the HE group relative to the LE group. Despite this, there were no group differences between MRI measures. Conclusion: Older adults with higher educational levels showed better scores on neuropsychological measures of cognition, highlighting the need for education-adjusted norms in developing countries. Given the absence of differences in structural anatomy between the groups, these findings appear to be best explained by theories of cognitive reserve.

RESUMO Sabe-se que baixos níveis de educação são comuns em países em desenvolvimento. Em indivíduos idosos, em particular, baixos níveis de educação podem representar um fator de risco para o desenvolvimento de demência. Objetivo: Este estudo examina os correlatos cognitivos e neuroanatômicos de escolaridade alta versus baixa, em idosos cognitivamente saudáveis,vivendo em comunidade no Brasil. Métodos: Cinquenta e três idosos (média de idade: 68±5,3) foram divididos em um grupo de "baixa escolaridade" [LE; 1-4 anos de escolaridade (N=33)] e um grupo de "alta escolaridade" [HE; >11 anos de escolaridade (N=20)]. Ambos os grupos completaram uma bateria neuropsicológica abrangente e foram submetidos à RM estrutural in vivo próximo à testagem. Resultados: O nível educacional aumentou a chance de se obter melhores pontuações em testes neuropsicológicos, incluindo evocação verbal e visual da informação, aprendizagem verbal, fluência de categoria, cognição global e vocabulário. Escores mais altos foram encontrados no grupo HE, em detrimento do LE. Apesar disso, não houve diferenças entre os grupos nas medidas de ressonância magnética in vivo. Conclusão: Idosos com maiores níveis de escolaridade apresentaram melhores pontuações nas medidas neuropsicológicas da cognição, destacando a necessidade de normas ajustadas à educação nos países em desenvolvimento. Não havendo diferenças na anatomia estrutural entre os grupos, os achados parecem ser melhor explicados pelas teorias da "reserva cognitiva".

Reserva Cognitiva e Abertura à Experiência em idosos sem demência: um estudo correlacional / Cognitive reserve and openness to experience in non-demented elderly people: a correlational study / Reserva cognitiva y apertura a la experiencia en ancianos sin demencia: un estudio correlacional

O objetivo deste artigo foi investigar acerca da Reserva Cognitiva (RC) e da Abertura à Experiência (AE) em idosos sem demência. Trata-se de uma pesquisa de campo, descritiva, correlacional e quantitativa, da qual participaram 31 idosos divididos em dois grupos: Saudável e Comprometimento Cognitivo Leve (CCL). Houve correlação moderada, positiva e significativa (r = 0,463; p < 0,01) entre RC e AE. Percebeu-se que os idosos saudáveis (M = 0,53; DP = 0,10) apresentaram significativamente [t = (29) 3,785; p < 0,01] maior índice de RC em comparação aos idosos com CCL (M = 0,39; DP = 0,11). Os dados confirmaram que existe associação entre RC e AE, e que idosos saudáveis apresentam maior RC, comparados a idosos com CCL. Este estudo possibilitou conhecer possíveis relações e diferenças subjacentes ao processo de aquisição das reservas cognitivas e de fatores relativos a AE, podendo contribuir para que mais pesquisas sejam feitas, buscando maiores evidências no campo da ciência.

El objetivo de este trabajo fui investigar la Reserva Cognitiva (RC) y la Apertura a la Experiencia (AE) en ancianos sin demencia. Es una investigación de campo, descriptiva, correlacional y cuantitativa. Los participantes fueron 31 ancianos divididos en dos grupos: ancianos cognitivamente saludables (GS) y ancianos con deterioro cognitivo leve (DCL). Existió una correlación moderada, positiva y significativa (r = 0.463; p < 0.01) entre RC y AE. El GS (M = 0.53; SD = 0.10) presentó significativamente [t = (29) 3,785; p <0.01] mayor índice RC comparado con el DCL (M = 0.39; SD = 0.11). Los datos confirmaron que existió una asociación entre RC y AE, y que los ancianos cognitivamente sanos tuvieron una RC más alta en comparación con los ancianos con DCL. Este estudio permitió conocer las posibles relaciones y diferencias subyacentes al proceso de adquisición de reservas cognitivas y factores relacionados con la AE y puede contribuir a una mayor investigación, buscando mayor evidencia en el campo de la ciencia.

This paper aimed to analyze the relationship between Cognitive Reserve (CR) and Openness to Experience (OE) in non-demented elderly people. Descriptive, correlational and quantitative research was undertaken. The sample consisted of thirty-one elderly people divided into two groups: healthy and Mild Cognitive Impairment (MCI). There was a moderate, positive and significant correlation (r = 0.463; p < 0.01) between CR and OE. It was found that the healthy controls (M = 0.53; SD = 0.10) present significantly [t = (29) 3,785; p < 0.01] higher CR compared to the elderly with MCI (M = 0.39; SD = 0.11). The data confirm that there was an association between CR and OE and that healthy controls have higher CR compared to the MCI group. This study allowed to know possible relationships and differences underlying the acquisition process of cognitive reserves and factors related to OE and may contribute to further research, seeking more evidence in the field of science.

Reserva cognitiva y demencias: Limitaciones del efecto protector en el envejecimiento y el deterioro cognitivo / Limited protective effects of cognitive reserve on the progression of cognitive impairment

Aging constitutes a series of physical, physiological and cognitive changes, affecting independence in the activities of daily living. During this stage, neurodegenerative diseases and cognitive impairment are common. Cognitive Reserve allows to face neuropathological changes and maintain cognitive function in the presence of brain damage. However, there are cases where a high cognitive reserve fails to attenuate and delay the effects of neuropathology, allowing the progression of cognitive damage to advanced stages. The objective of this systematic review is to identify evidence where high cognitive reserve does not limit the effects of cognitive impairment. Results indicate that the protective effect of cognitive reserve occurs only in the presence of minimal cognitive impairment, but not at later stages.

Fluidez verbal, inteligencia y velocidad de procesamiento en adultos jóvenes con y sin actividad escolar: el impacto de la reserva cognitiva en adultos jóvenes / Verbal fluency, intelligence and processing speed in young adults with and without school activity: The impact of the cognitive reserve in young adults

Es conocido el impacto positivo de la reserva cognitiva y de mantenerse activo intelectualmente en el funcionamiento cognitivo en el adulto mayor, sin embargo, el impacto de dichas variables en funciones ejecutivas en jóvenes apenas ha sido investigada. Por ello, el objetivo de la presente investigación fue comparar el desempeño de la fluidez verbal (fonológica, semántica y de verbos), inteligencia (fluida y cristalizada) y velocidad de procesamiento entre jóvenes con diferentes grados académicos y personas con el mismo grado, pero que han dejado de estudiar. Participaron 68 adultos, de 20 a 35 años de edad; todos ellos sanos y residentes de la ciudad de Morelia. Los resultados señalan que el grupo sin actividad escolarizada (con nivel de licenciatura) obtuvo peor rendimiento respecto a los grupos activamente escolarizados (de licenciatura y maestría) en las pruebas de fluidez verbal semántica y de verbos, mientras que no se reportan diferencias significativas entre los grupos conformados por estudiantes activos. En fluidez fonológica el grupo con grado de licenciatura inactivo obtuvo menor rendimiento que el grupo de mayor grado escolar activo. Se concluye que la actividad escolar incide favorablemente en el desempeño de fluidez verbal en jóvenes adultos. Ello no sólo puede ser un elemento que a largo plazo puede transferirse en reserva cognitiva, sino que también puede tener una injerencia notable en la propia vida adulta a nivel laboral.

The positive impact of cognitive reserve and of being intellectually active in cognitive functioning in the elderly is known, however, the impact of these variables on executive functions in young people has hardly been investigated. Therefore, the objective of this research was to compare the performance of verbal fluency (phonological, semantic and verbs), intelligence (fluid and crystallized) and processing speed among young people with different academic degrees and people with the same degree, but who have stopped studying. 68 adults participated, from 20 to 35 years of age; all of them healthy and residents of the city of Morelia. The results indicate that the group with no school activity (with a bachelor's degree) performed worse than the groups actively enrolled (undergraduate and master's degree) in verbal semantic fluency and verbs, while no significant differences were reported between the groups made up of active students. In phonological fluency, the group with an inactive bachelor's degree obtained lower performance than the group with the highest active school grade. It is concluded that school activity has a favorable impact on the performance of verbal fluency in young adults. This can not only be an element that can be transferred in cognitive reserve in the long term, but it can also have a notable interference in adult life at work level.

Medición de reserva cognitiva: estudio en una muestra de adultos chilenos / Cognitive reserve assessment: a study in a sample of chilean adults

Mayor reserva se asocia con resistencia al deterioro en sujetos con enfermedades neurodegenerativas. En personas sanas explica las diferencias interindividuales en el rendimiento de tareas. Medir los factores de reserva cognitiva permite contar con un índice numérico de la ganancia cognitiva acumulada por un sujeto. Este índice puede ser correlacionado con otras funciones cuantificables. El presente trabajo tiene como objetivo presentar los índices de reserva obtenidos por una población chilena en la aplicación del Cognitive Reserve Index Questionnaire (CRIq). Para ello 90 adultos (18-85 años) sin evidencias de trastorno cognitivo, de la región de Valparaíso-Chile, fueron entrevistados sobre actividades de estudio, laborales y de tiempo libre ejecutadas desde los 18 años.Los resultados muestran que los índices de reserva de los sujetos varían en función del tiempo de ejecución de actividades promotoras de reserva y no por su edad. Se encontraron diferencias estadísticamente significativas entre los grupos etarios. Estos resultados permiten concluir que la ejecución de actividades de estudio, laborales, sociales, entre otras aumenta los índices de reserva cognitiva, que es una variable diferenciadora entre individuos. La medición de dichos índices puede ser útil en un amplio campo de disciplinas (medicina, neurología, neuropsicología, educación, psicología, fonoaudiología, neurociencias y en las ciencias cognitivas en general).

A higher cognitive reserve is linked to higher resistance to deterioration among subjects suffering from neurodegenerative disorders. In healthy persons the cognitive reserve explains inter-individual differences in task performance. Measuring the cognitive reserve factors involves obtaining a numerical index of the cumulative cognitive gain accumulated by a subject. This index can be correlated with other measurable functions.This study was conceived to determine the reserve indexes accumulated by a Chilean sample, by means of the administration of the Cognitive Reserve Index Questionnaire (CRIq).In order to do so, 90 adults (18-85 years old) without evidence of cognitive disorder, living in Valparaíso region, Chile, were interviewed about their education, their work environment and their and leisure activities carried out since they were 18 years old.Results showed that reserve indexes of the subjects vary as a function of the time of execution of reserve-promoting activities, not age. Statistically significant differences were found among age-groups. These findings allow us to conclude that studying, working and engaging in social activities, among other things, increase the cognitive reserve indexes, which are a differentiating variable among individuals.The measurement of these indexes can be useful in a wide array of disciplines: medicine, neurology, neuropsychology, education, psychology, phonoaudiology, neurosciences and cognitive sciences in general.

Instruments for measuring cognitive reserve: a systematic review / Instrumentos de medida de reserva cognitiva: uma revisão sistemática / Instrumentos de medida de reserva cognitiva: una revisión sistemática

The Cognitive Reserve (CR) construct seeks to explain the brain's ability of compensate for degeneration caused by age or neuropathology. However, standardized measures of CR are incipient. Through a systematic review, this study aimed to investigate the instruments in the form of scales and questionnaires used as objective measures of CR, through the measurement of multiple variables related to activities conducted throughout the lifetime. The search for articles was conducted in the PubMed, Scopus, Science Direct, PsycINFO, VHL and Cochrane databases. Seven studies were selected after applying the inclusion and exclusion criteria. The existence of five scales/questionnaires that measure CR was verified. The instruments present a short duration, however, they vary in the items/variables measured, there being a lack of in-depth studies with large and diversified samples. Further studies are needed to improve the validity evidence and to conduct cross-cultural adaptations of the CR scale/questionnaires.

O construto reserva cognitiva (RC) busca explicar a capacidade de o cérebro compensar a degeneração causada pela idade ou neuropatologia. Contudo, medidas padronizadas de RC são incipientes. Por meio de uma revisão sistemática, este estudo objetivou investigar os instrumentos em formato de escalas e questionários utilizados como medida objetiva de RC, a partir da mensuração de múltiplas variáveis relacionadas a atividades realizadas ao longo da vida. A busca por artigos foi realizada nas bases de dados PubMed, Scopus, ScienceDirect, PsychINFO, BVS e Cochrane. Sete estudos foram selecionados após a aplicação dos critérios de inclusão e exclusão. Constatouse a existência de cinco escalas/questionários que mensuram RC. Os instrumentos são de curta duração, porém variam quanto aos itens/às variáveis mensuradas e carecem de estudos aprofundados, com amostras amplas e diversificadas. São necessários mais estudos que busquem aprimorar as evidências de validade e realizar adaptações transculturais das escalas/dos questionários de RC.

La Reserva cognitiva (RC) busca explicar la capacidad del cerebro para compensar el declive causado por la edad y neuropatologías. Además, las escalas estandarizadas de RC son aún incipientes. La presente revisión sistemática, tuvo como objetivo investigar los instrumentos utilizados para medir objetivamente la RC, a partir de la evaluación de diversas variables asociadas con actividades realizadas durante el ciclo vital. La búsqueda se realizó en las bases de datos PubMed, Scopus, Science Direct, PsycInfo, Bvs y Cochrane. Después de aplicar los criterios de inclusión y exclusión siete artículos fueron seleccionados. Se identificó cinco instrumentos que miden RC. Dichos instrumentos son de corta duración, pero varían en cuanto a los ítems evaluados y carecen de estudios con muestras más amplias y diversas. Es necesaria la elaboración de estudios que busquen mejorar la validez, así como realizar adaptaciones transculturales de las escalas de RC.

Maior risco de delirium no pós-operatório está associado à idade avançada, anemia e baixa reserva cognitiva / Greater risk of postoperative delirium is associated with advanced age, anemia, and low cognitive reserve

INTRODUÇÃO: Delirium é uma mudança aguda na cognição e atenção, comum no período pós-operatório em pessoas idosas, associada ao aumento de custos e à permanência hospitalar. OBJETIVO: Avaliar frequência, fatores de risco e influência no período de permanência hospitalar de delirium pós-operatório em pacientes idosos submetidos a cirurgias não cardíacas eletivas. MÉTODO: Estudo do tipo transversal, observacional, de pessoas idosas (65 anos de idade ou mais), internadas para realização de cirurgia eletiva não cardíaca. Durante o período pré-operatório imediato (24 horas) foram avaliados os fatores de risco: idade, gênero, cognição (MiniCog), funcionalidade (Katz e time up and go), fármacos e aspectos clínicos. O delirium, no pós-operatório imediato (até 72 horas), foi avaliado através do Confusion Assesment Method (CAM). RESULTADOS: Oitenta e três pacientes foram incluídos na pesquisa, sendo 44,6% (n = 37) de cirurgia ortopédica, 42,16% (n = 35) de cirurgia geral e 13,3% (n = 11) de cirurgia urológica. Predominou o sexo masculino (53%), com idade média de 73 anos (65 a 94) anos. Na amostra de pacientes, 9,6% (n = 8) apresentaram delirium pós-operatório: 6% do tipo hiperativo (n = 5), 2,4% do tipo hipoativo (n = 2) e 1,2% do tipo misto (n = 1). Eram mais idosos (p = 0,02), com maior declínio cognitivo (p = 0,01), anemia (p = 0,04) e prolongamento na permanência hospitalar (p = 0,001). CONCLUSÃO: O delirium pós-operatório foi observado com maior frequência nos pacientes mais idosos, portadores de declínio cognitivo e anemia, com influência no período de hospitalização, demonstrando a importância de uma avaliação preventiva mais abrangente no período pré-operatório.

INTRODUCTION: Delirium is an acute change in cognition and attention, common in the postoperative period in older patients, associated with increased costs and longer hospital stay. OBJECTIVE: To evaluate the frequency, risk factors, and influence of postoperative delirium in older patients submitted to elective noncardiac surgery. METHOD: This was a cross-sectional, observational study of older adults (65 years or older) hospitalized for elective noncardiac surgery. During the immediate preoperative period (24 hours), risk factors such as age, sex, cognition (MiniCog), functional status (Katz and Timed Up and Go), medications, and clinical aspects were evaluated. Delirium, in the immediate postoperative period (up to 72 hours), was evaluated using the Confusion Assessment Method (CAM). RESULTS: A total of 83 patients were included in the study. Of these, 44.6% (n = 37) had undergone orthopedic surgery, 42.16% (n = 35), general surgery, and 13.3% (n = 11), urological surgery. Most participants were men (53%), with a mean age of 73 (65­94) years. Overall, 9.6% (n = 8) had postoperative delirium: 6% of the hyperactive subtype (n = 5), 2.4% of the hypoactive subtype (n = 2), and 1.2% of the mixed subtype (n = 1). These patients were older (p = 0.02), had greater cognitive decline (p = 0.01), anemia (p = 0.04), and prolonged hospital stay (p = 0.001). CONCLUSION: Postoperative delirium was more commonly observed in the older old with cognitive decline and anemia, with an impact on hospital length of stay, highlighting the importance of a more comprehensive preventive evaluation in the preoperative period.

Cognitive reserve and dementia: a scientometric review / Reserva cognitiva e demência: uma revisão cientométrica

ABSTRACT. Research into cognitive reserve (CR) and dementia is advancing rapidly. This paper analyses the intellectual structure, emerging trends and relevant shifts in the development of available knowledge. Data collected from the Web-of-Science produced an expanded network of 564 articles and 12,504 citations in the 1998-2017 period. The co-citation network visualized was characterized by a scientometric review using CiteSpace. The results revealed that author Stern Y had the highest number of publications and citations. The network of journals, institutions and countries showed a central-peripheral structure with Neurology, Harvard University and the USA ranked first, respectively. While cognitive reserve remains the most prominent area of research in this field, studies related to functional ability, executive control, mortality data and reserve mechanisms have grown considerably. The identification of critical articles and the development of emerging trends highlights new insights in the area of research, better communicating key findings and facilitating the exploration of data.

RESUMO. A pesquisa em reserva cognitiva e demência avança rapidamente. Este artigo analisa a estrutura intelectual, tendências emergentes e mudanças relevantes no desenvolvimento do conhecimento coletivo. Dados coletados do Web-of-Science, construíram uma rede expandida de 564 artigos e 12.504 citações, entre 1998-2017. A rede de cocitação visualizada foi caracterizada através de uma revisão cientométrica utilizando o CiteSpace. Os resultados revelam Stern Y com o maior número de publicações e citações. A rede de revistas científicas, instituições e países apresenta uma estrutura central-periférica, respetivamente com Neurologia, Universidade de Harvard e EUA em primeiro lugar. Enquanto a reserva cognitiva continua a ser a área de pesquisa mais proeminente neste campo, estudos relacionados à capacidade funcional, controle executivo, dados de mortalidade e mecanismos de reserva têm experimentado um crescimento considerável. A identificação de artigos críticos e o desenvolvimento de novas tendências emergentes destacam novos insights sobre a área de pesquisa, comunicando melhor as principais descobertas e facilitando a exploração de dados.

Association Between Dental Implants and Cognitive Function in Community-dwelling Older Adults in Korea / 예방의학회지

OBJECTIVES: This study aimed to evaluate the association between dental implants and cognitive function in community-dwelling older adults. METHODS: Data were collected from the baseline survey (2016–2017) of the Korean Frailty and Aging Cohort Study. The study sample comprised 1115 community-dwelling people aged 70 years to 84 years who had 0-19 natural teeth. Dental implants and natural teeth were identified by panoramic radiography, while the cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The association between dental implants and cognitive function was analyzed by multiple linear regression. Sensitivity analysis was performed to test for potential bias. RESULTS: The mean number of natural teeth in the study population was 9.50 (standard deviation [SD], 6.42), and the mean MMSE-KC score was 24.93 (SD, 3.55). In the simple univariate analysis, tooth replacement, age, sex, smoking status, alcohol consumption, body mass index, osteoporosis, number of natural teeth, periodontitis, chewing discomfort, tooth-brushing frequency, education level, monthly household income, participation in economic activity, living alone, and marital status had a significant impact on the association. After adjusting for confounders, the association between dental implants and cognitive function remained significant (B, 0.85; standard error, 0.40; p<0.05). Age, body mass index, periodontitis, tooth-brushing frequency, and education level were also significantly associated with cognitive function. The results of the sensitivity analyses were consistent with those of the primary analysis. CONCLUSIONS: Dental implants were associated with cognitive function in older adults living in the community. Dental implants as tooth replacements may play a role in preserving cognitive function.

Reserva cognitiva y rendimiento cognitivo en adultos mayores sanos con historia de práctica musical reglada / Cognitive reserve and cognitive performance in the elderly with a history of musical training / Reserva cognitiva e rendimento cognitivo em adultos maiores saudáveis com história de prática musical reglada

Objetivo: la reserva cognitiva (RC) se define como la capacidad cerebral de tolerar y soportar las neuropatologías antes de alcanzar el umbral que da inicio a las manifestaciones clínicas. Debido al aumento de la esperanza de vida, este concepto surge con el propósito de identificar factores que mantengan la funcionalidad e independencia de los adultos mayores, favoreciendo así la calidad de vida en este grupo poblacional. El objetivo de este estudio fue analizar la relación entre el tiempo de exposición a práctica musical dirigida y el rendimiento cognitivo de adultos mayores sanos. Metodología: estudio observacional descriptivo de 11 adultos mayores sanos con historia de práctica musical dirigida. Se aplicó el cuestionario de Reserva Cognitiva, y se evaluó el rendimiento neurocognitivo con el test de capacidad intelectual K-BIT y la batería NEURONORMA COLOMBIA. Resultados: en personas con entrenamiento musical, la reserva cognitiva está relacionada con mejor desempeño en tareas de denominación, memoria de trabajo visoespacial y verbal, atención focalizada y alternante, fluidez verbal fonológica y rendimiento semántico. Por otra parte, el tiempo de exposición a práctica musical dirigida se asoció a mejor desempeño en lenguaje semántico y favorece la memoria de trabajo y a largo plazo. Conclusiones: el tiempo de exposición a la práctica musical dirigida, la edad y el nivel educativo, favorecen la reserva cognitiva en los dominios lingüísticos y mnémicos.

Objective: cognitive reserve (CR) is defined as the brain's ability to tolerate and support neuropathologies before reaching the threshold that gives rise to clinical manifestations. Due to the increase in life expectancy, this concept arises with the purpose of identifying factors that maintain the functionality and independence of the elderly, thus favoring the quality of life in this population group. The objective of this study was to analyze the relationship between the time of exposure to directed musical practice and the cognitive performance of healthy older adults. Methodology: Observational, descriptive study including 11 healthy, older adults with a history of guided musical practice. The Cognitive Reserve questionnaire was applied and neurocognitive performance was evaluated using the K-BIT intellectual capacity test and the NEURONORMA COLOMBIA battery. Results: in people with musical training, cognitive reserve was associated to better performance in tasks of denomination, visuospatial and verbal working memory, focused and alternating attention, phonological verbal fluency and semantic performance. On the other hand, the time of exposure to directed musical practice was associated to better performance in semantic language and favored working memory and in the long term. Conclusions: time of exposure to directed musical practice, age, and educational level favor cognitive reserve in the linguistic and mnemonic domains.

Objetivo: a reserva cognitiva (RC) se define como a capacidade cerebral de tolerar e suportar as neuropatologias antes de alcançar o umbral que dá início às manifestações clínicas. Devido ao aumento da esperança de vida, este conceito surge com o propósito de identificar fatores que mantenham a funcionalidade e independência dos adultos maiores, favorecendo assim a qualidade de vida neste grupo populacional. O objetivo deste estudo foi analisar a relação entre o tempo de exposição a prática musical dirigida e o rendimento cognitivo de adultos maiores saudáveis. Metodologia: estudo observacional descritivo de 11 adultos maiores saudáveis com história de prática musical dirigida. Se aplicou o questionário de Reserva Cognitiva, e se avaliou o rendimento neurocognitivo com o teste de capacidade intelectual K-BIT e a bateria NEURONORMA COLÔMBIA. Resultados: em pessoas com treinamento musical, a reserva cognitiva está relacionada com melhor desempenho em tarefas de denominação, memória de trabalho visoespacial e verbal, atenção focalizada e alternante, fluidez verbal fonológica e rendimento semântico. Por outra parte, o tempo de exposição a prática musical dirigida se associou a melhor desempenho em linguagem semântico e favorece a memória de trabalho e a longo prazo. Conclusões: o tempo de exposição à prática musical dirigida, a idade e o nível educativo, favorecem a reserva cognitiva nos domínios linguísticos e mnêmicos.

Capacidad física y reserva cognitiva como factores protectores de las funciones atencionales en adultos mayores / Physical activity and cognitive reserve as protective factors for attentional functioning in older people

Background: Attention is considered a central control mechanism in cognitive processing systems. Attention deficits contribute to the symptomatic profile of Alzheimer's disease (AD). Physical exercise and cognitive reserve, could delay cognitive impairment and constitute a protective factor against clinical manifestations of AD. Aim: To relate the functionality of the attentional networks with physical activity and cognitive reserve. Material and Methods: Three groups of 20 older adults each (control, physical activity and with osteoarthritis) were studied. The Functional capacity assessment test, Cognitive Reserve Questionnaire and the Attention Networks Test - for Interactions and Vigilance or ANTI-V were applied to participants. Results: Significant differences were observed in the response times of the alert, orientation and executive network, and the percentage of success in the network orientation and executive network. No differences between groups were observed for the different indicators of vigilance. Conclusions: These results confirm the benefits of physical exercise as a protective factor for attentional functioning.

Funcionamiento cognitivo en adultos mayores: rol de la reserva cognitiva, apoyo social y depresión / Cognitive reserve, depression and social support. Analysis of 206 older adults

Background: Cognitive reserve (CR) is a protective factor in aging. Depression and perceived social support are associated with cognitive performance in older adults. However, their role in the relationship between CR and cognitive functioning is less clear. Aim: To determine the relationship between CR and cognitive functioning and whether this relationship is mediated by depression and moderated by social support. Material and Methods: CR, depression, perceived social support, and cognitive functioning scales were applied to a convenience sample of 206 older adults, aged 69 ± 1 years (77% women). Structural equation analysis and moderate mediation analysis were performed. Results: There was a direct effect of CR in cognitive functioning (β = 0.223, p = 0.005), which was not mediated by depression (β = 0.040, p = 0.096). High CR scores were associated with lower depression scores (β = −0.203, p = 0.002). Higher depression scores were associated with worse cognitive functioning (β = −0.168, p = 0.040). The effect of CR on depression was moderated by social support (β = −0.161, p = 0.032) controlling for income and age. Conclusions: The relationship between CR and cognition in older adults allows an early assessment of cognitive dysfunction risk. Depression is an independent risk factor for cognitive functioning. Social support protects individuals with high CR from developing depression.