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The effects of intra-hippocampal manipulation of glycine receptors on the reconsolidation of recent and late long-term spatial memory were evaluated and assessed in the Morris water maze. The results obtained from the intra-hippocampal infusion of glycine and taurine demonstrated that taurine at a 100 nmol/side dose impaired the reconsolidation of recent and late long-term spatial memory. In comparison, at a dose of 10 nmol/side, it only affected the reconsolidation of late long-term spatial memory, reinforcing that there are differences between molecular mechanisms underlying recent and late long-term memory reconsolidation. On the other hand, glycine impaired the reconsolidation of early and late spatial memory when infused at a dose of 10 nmol/side, but not at a dose of 100 nmol/side, unless it is co-infused with an allosteric site antagonist of the NMDA receptor. Altogether these results show that glycine acting in situ in the hippocampal CA1 region exerts a pharmacological effect on U-curve, which can be explained by its concomitant action on its ionotropic receptor GlyR and on its NMDA receptor co-agonist site.
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Glicina , Memoria a Largo Plazo , Ratas Wistar , Receptores de Glicina , Memoria Espacial , Taurina , Animales , Receptores de Glicina/metabolismo , Receptores de Glicina/efectos de los fármacos , Masculino , Glicina/farmacología , Ratas , Memoria Espacial/efectos de los fármacos , Memoria Espacial/fisiología , Memoria a Largo Plazo/efectos de los fármacos , Memoria a Largo Plazo/fisiología , Taurina/farmacología , Taurina/administración & dosificación , Hipocampo/efectos de los fármacos , Hipocampo/metabolismo , Consolidación de la Memoria/efectos de los fármacos , Consolidación de la Memoria/fisiología , Receptores de N-Metil-D-Aspartato/antagonistas & inhibidores , Receptores de N-Metil-D-Aspartato/metabolismo , Receptores de N-Metil-D-Aspartato/efectos de los fármacos , Región CA1 Hipocampal/efectos de los fármacos , Región CA1 Hipocampal/metabolismo , Región CA1 Hipocampal/fisiología , Aprendizaje por Laberinto/efectos de los fármacos , Aprendizaje por Laberinto/fisiologíaRESUMEN
A few epidemiological studies are evaluating the prevalence and mortality rates of Alzheimer's disease, with no one using a nationwide sample of Brazilian elderlies. This study aims to calculate the prevalence of Alzheimer's disease and investigate possible associations with sociodemographic and lifestyle factors and the presence of diseases non-communicable, and the prevalence and mortality for all Brazilian state capitals. This is an ecological design study made with secondary public data provided by the Ministry of Health. Prevalence rates were calculated based on the analysis of the dispensing of Alzheimer's disease-specific drugs. Correlation analyzes were performed between rates and factors, and a multiple linear regression analysis was used to analyze possible associations between variables, controlled for each other. AD prevalence was 313/100,000. Prevalence rates were positively associated with primary health care coverage factors and negatively associated with ultra-processed food consumption and physical activity levels. AD mortality was 98/100,000. Mortality rates were positively associated with the proportion of obese elderly and elderly living on up to half the minimum wage and were inversely associated with the proportion of elderly with diabetes factors. We found positive and negative associations of sociodemographic, behavioral and diabetes indicators with Alzheimer's disease prevalence and mortality, which provide data that can be investigated by studies with different designs.
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Enfermedad de Alzheimer , Anciano , Humanos , Brasil/epidemiología , Prevalencia , Enfermedad de Alzheimer/epidemiología , Alimentos Procesados , RentaRESUMEN
BACKGROUND: Major depressive disorder is a difficult-to-treat psychological disorder. Approximately 30% of patients with major depressive disorder do not respond to conventional therapies; thus, the efficacy of alternative therapies for treating major depressive disorder, such as neurofeedback, a non-invasive neuromodulation method used in the treatment of psychiatric diseases, must be investigated. OBJECTIVE: We aimed to evaluate the efficacy of neurofeedback in minimizing and treating major depressive disorder and its application as a substitute to or an adjuvant with conventional therapies. METHODS: We searched for experimental studies published between 1962-2021 in Scopus, PubMed, Web of Science, and Embase databases and identified 1,487 studies, among which 13 met the inclusion exclusion criteria. RESULTS: We noted that not all patients responded to neurofeedback. Based on depression scales, major depressive disorder significantly improved in response to neurofeedback only in a few individuals. Additionally, the number of training sessions did not influence the results. CONCLUSION: Neurofeedback can reduce depression symptoms in patients; however, not all patients respond to the treatment. Therefore, further studies must be conducted to validate the effectiveness of neurofeedback in treating major depressive disorder.
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Trastorno Depresivo Mayor , Neurorretroalimentación , Humanos , Trastorno Depresivo Mayor/terapia , Neurorretroalimentación/métodosRESUMEN
ABSTRACT Background Major depressive disorder is a difficult-to-treat psychological disorder. Approximately 30% of patients with major depressive disorder do not respond to conventional therapies; thus, the efficacy of alternative therapies for treating major depressive disorder, such as neurofeedback, a non-invasive neuromodulation method used in the treatment of psychiatric diseases, must be investigated. Objective We aimed to evaluate the efficacy of neurofeedback in minimizing and treating major depressive disorder and its application as a substitute to or an adjuvant with conventional therapies. Methods We searched for experimental studies published between 1962-2021 in Scopus, PubMed, Web of Science, and Embase databases and identified 1,487 studies, among which 13 met the inclusion exclusion criteria. Results We noted that not all patients responded to neurofeedback. Based on depression scales, major depressive disorder significantly improved in response to neurofeedback only in a few individuals. Additionally, the number of training sessions did not influence the results. Conclusion Neurofeedback can reduce depression symptoms in patients; however, not all patients respond to the treatment. Therefore, further studies must be conducted to validate the effectiveness of neurofeedback in treating major depressive disorder.
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Alzheimer's disease is a neurodegenerative condition that causes changes in memory and cognition, in addition to behavioral disorders, and most commonly affects the elderly. Several studies in the literature have presented therapeutic measures in an attempt to interfere with the pathogenic mechanisms of the disease and to mitigate its clinical manifestations. Some factors, such as excitotoxicity, cholinergic dysfunctions, oxidative stress, tau protein hyperphosphorylation, changes in amyloid-beta peptide metabolism, herpes viruses, apolipoprotein E, glycogen synthase kinase 3, insulin resistance, and the endocannabinoid system seem to be related to pathophysiology of Alzheimer's disease. Given this, a literature review was carried out to address the molecular mechanisms associated with the pathophysiological hypotheses previously mentioned, aiming to better understanding their underlying causes and contributing to possible pharmacological strategies about treatment of the disease.
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Enfermedad de Alzheimer , Resistencia a la Insulina , Anciano , Humanos , Cognición , Estrés OxidativoRESUMEN
Objetivo: Avaliar o estadiamento demencial e o desempenho físico-funcional, bem como suas possíveis correlações, de idosos diagnosticados com Doença de Alzheimer, atendidos por um centro de referência. Método: Estudo clínico transversal de abordagem quantitativa. Foram avaliados idosos de ambos os sexos com idade igual e/ou superior a 60 anos, que tivessem o diagnóstico médico comprovado para Doença de Alzheimer. Os idosos foram avaliados por meio do Timed Up and Go Test (TUG), Teste de Sentar e Levantar de Rikli & Jones, Escala de Equilíbrio de Berg e por meio do Clinical Dementia Rating Score (CDR). A análise estatística e os gráficos foram realizados com o Software IBM Statistics SPSS 20. O nível significância foi 0,05. Resultados: Compuseram a amostra 46 indivíduos de ambos os sexos com idade média de 78,72±7,37 anos. Os indivíduos foram divididos em idosos frágeis e não frágeis. Os idosos também foram classificados em demência questionável a leve e demência moderada a grave e comparados. Ocorreu correlação significativa entre idade e TUG (r= 0,532; p= 0,041), entre idade e Berg (r= -0,343; p= 0,040), entre TUG e Berg (r= -0,562; p= 0,029), e entre o teste de sentar-levantar e Berg (r= 0,706; p= 0,003). Conclusão: Os idosos avaliados apresentaram desempenho inferior aos descritos na literatura para os instrumentos avaliativos propostos nessa pesquisa, o que indica que está diretamente relacionado ao seu desempenho em testes físico-funcionais.
Objective: To evaluate dementia staging, physical-functional performance, and their possible correlations of elderlies with Alzheimer's Disease, assisted by a referral center.Method: Quantitative cross-sectional study of elderlies of both sexes, aged 60 years or older, with a clinical diagnosis of Alzheimer's Disease. The participants were evaluated with the Timed Up and Go Test (TUG), Rikli & Jones Sit and stand Test, Berg Balance Scale, and the Clinical Dementia Rating Score (CDR). Statistical analysis classified and compared groups of frail and non-frailparticipants with unpaired tests. The significance level was 0.05.Results: 46 participants of both sexes with a mean age of 78.72±7.37 years. Subjects were divided into frail and non-frail elderly. Older people were classified into questionable to mild dementia and moderate to severe dementia and matched. There was a significant correlation between age and TUG (r=0.532; p=0.041), age and Berg (r=-0.343; p=0.040), TUG and Berg (r=-0.562; p=0.029), and sit-stand test and Berg (r=0.706; p=0.003).Conclusion:Lower performance compared to the specialized literature for the assessment instruments proposed in this research was found, indicating that AD progression was directly related to their performance in physical-functional tests.
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Sarcopenic obesity (SO), the co-occurrence of sarcopenia and obesity, is associated with functional loss, frailty, and incapacity in older adults. Recently, SO was associated with reduced cognitive performance in adults. However, no SO studies have been done with older adults with Alzheimer's disease (AD). Objective: The objective of this study was to verify the occurrence of SO and associated factors in 43 older adults with AD. Methods: We applied the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). SO was verified by using dual-emission X-ray absorptiometry. Results: We found five women with SO. Women had higher body fat and lower muscle mass compared with men. There was a significant relationship between body fat and cognitive performance only in men (r=0.65; p<0.01) adjusted by age and education. Men with obesity and aged >75 years had better cognitive performance compared with non-obese men aged <75 years (p=0.010) and women with obesity aged >75 years (p=0.033). Conclusions: Women with AD had higher body fat and lower muscle mass than men. SO occurs in older women with AD. Men with higher body fat showed better cognitive performance, independent of age and education.
A obesidade sarcopênica (SO), coocorrência de sarcopenia e obesidade, está associada à perda funcional, à fragilidade e à incapacidade em idosos. Recentemente, verificou-se que a SO está associada ao desempenho cognitivo reduzido em adultos. No entanto, não foram feitos estudos de SO em idosos com doença de Alzheimer (AD). Objetivo: Verificar a ocorrência de obesidade sarcopênica e fatores associados em 43 adultos idosos com doença de Alzheimer. Métodos: Aplicamos o miniexame do estado mental (MEEM) e a avaliação clínica da demência (CDR). A SO foi verificada utilizando a absorciometria de dupla emissão de raios X. Resultados: Foram classificadas cinco idosas com SO. As mulheres idosas tinham maior gordura corporal e menor massa muscular em comparação com os homens. Houve relação significativa, ajustada por idade e educação, entre gordura corporal e desempenho cognitivo apenas nos homens (r=0,65; p<0,01). Os homens com obesidade e com mais de 75 anos tiveram melhor desempenho cognitivo em comparação com os homens não obesos <75 anos (p=0,010) e com as mulheres com obesidade >75 anos (p=0,033). Conclusões: As mulheres com AD tinham maior gordura corporal e menor massa muscular do que os homens. A SO ocorreu em mulheres mais velhas com AD. Os homens com maior gordura corporal apresentaram melhor desempenho cognitivo, independentemente da idade e da educação.
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BACKGROUND: The preventive role of muscular strength on diminishing neuroinflammation is yet unknown. In this study, the role of the prophylactic muscular strength exercise was investigated in order to verify whether it would diminish cognitive alterations and modify the antioxidant intracellular scenery in an animal neuroinflammatory model in of the CA1 region of the hippocampus. METHODS: The animals received muscular strength training (SE) three times a week for eight weeks. Subsequently, the stereotaxic surgery was performed with an intra-hippocampal infusion of either saline solution (SAL) or lipopolysaccharide (LPS). Next, we performed the behavioral tests: object recognition and social recognition. Then, the animals were euthanized, and their hippocampus and prefrontal cortex were collected. In another moment, we performed the dosage of the antioxidant activity and histological analysis. RESULTS: The results showed that the muscular strength exercises could show a beneficial prophylactic effect in the cognitive deficiencies caused by acute neuroinflammation. Regarding oxidative stress, there was an increase in catalase enzyme activity (CAT) in the group (SE + LPS) compared to the control groups (p < 0.05). As for the cognitive alterations, there were found in the (SE + LPS) group, diminishing the mnemonic hazard of the discriminative and social memories compared to the control groups (p < 0.05). CONCLUSION: We concluded, therefore, that the exercise performed prophylactically presents a protective effect capable of minimizing such mnemonic deficits and increasing catalase enzyme activity in rats that suffered a local neuroinflammatory process in the hippocampus.
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Fármacos Neuroprotectores , Entrenamiento de Fuerza , Animales , Antioxidantes/farmacología , Catalasa/farmacología , Modelos Animales de Enfermedad , Hipocampo , Humanos , Lipopolisacáridos/farmacología , Aprendizaje por Laberinto , Enfermedades Neuroinflamatorias , Fármacos Neuroprotectores/farmacología , Estrés Oxidativo , Ratas , Ratas WistarRESUMEN
OBJETIVO: verificar associação do declínio cognitivo e dos fatores socioeconômicos com o risco cardiovascular em idosos com Alzheimer. MÉTODO: estudo transversal, em que se incluíram 75 idosos com Alzheimer. Verificaram-se pressão de pulso, risco cardiovascular, Miniexame do Estado Mental, Miniavaliação Nutricional e exames bioquímicos. RESULTADOS: 92% dos pacientes apresentaram declínio cognitivo, com média de três anos de escolaridade. Houve prevalência entre as mulheres (62,3%) e idosos com duas ou mais comorbidades (62,3%). Eram hipertensos (65,2%), estavam com a pressão de pulso elevada (85%), com sobrepeso (49%) e em risco nutricional (78%). Média diária de dois anti-hipertensivos, e a classe medicamentosa mais utilizada foi bloqueador do receptor da angiotensina. CONCLUSÃO: a população estudada apresentou risco cardiovascular aumentado. A consulta de enfermagem foi importante para o reconhecimento dos dados clínicos, como declínio cognitivo, risco cardiovascular, risco nutricional e análise bioquímica.
OBJECTIVE: To verify the association between cognitive decline, socioeconomic factors, and cardiovascular risk in older adults with Alzheimer's disease. METHOD: A cross-sectional study was carried out with 75 older adults with Alzheimer's disease. Pulse pressure, cardiovascular risk, Mini-Mental State Examination, Mini-Nutritional Assessment, and biochemical tests were performed. RESULTS: Ninety-two percent of patients had cognitive decline, with an average of three years of schooling. There was a predominance of women (62.3%) and older adults with two or more comorbidities (62.3%). Most participants had arterial hypertension (65.2%), had elevated pulse pressure during the examination (85%), were overweight (49%), and were at nutritional risk (78%). The daily average of antihypertensive drugs was 2, and angiotensin receptor blockers were the most used drugs. CONCLUSION: The population studied had an increased cardiovascular risk. The nursing consultation was important for recognizing clinical data, such as cognitive decline, cardiovascular risk, nutritional risk, and altered biochemical results.
OBJETIVO: Verificar la asociación entre deterioro cognitivo, factores socioeconómicos y riesgo cardiovascular en ancianos con enfermedad de Alzheimer. MÉTODO: Se realizó un estudio transversal con 75 ancianos con enfermedad de Alzheimer. Se realizaron pruebas de presión de pulso, riesgo cardiovascular, Mini-Examen del Estado Mental, Mini-Evaluación Nutricional y pruebas bioquímicas. RESULTADOS: El 92% de los pacientes presentó deterioro cognitivo, con un promedio de tres años de escolaridad. Hubo predominio de mujeres (62,3%) y ancianos con dos o más comorbilidades (62,3%). La mayoría de los participantes tenía hipertensión arterial (65,2%), presión de pulso elevada durante el examen (85%), sobrepeso (49%) y riesgo nutricional (78%). El promedio diario de fármacos antihipertensivos fue de 2, siendo los bloqueadores de los receptores de angiotensina los más utilizados. CONCLUSIÓN: La población estudiada presentaba riesgo cardiovascular aumentado. La consulta de enfermería fue importante para el reconocimiento de datos clínicos, como deterioro cognitivo, riesgo cardiovascular, riesgo nutricional y análisis bioquímico.
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Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Factores Socioeconómicos , Salud del Anciano , Enfermedad de Alzheimer , Disfunción Cognitiva , Factores de Riesgo de Enfermedad Cardiaca , Epidemiología Descriptiva , Estudios TransversalesRESUMEN
BACKGROUND: To verify the effects of different modalities of physical exercise on brain activity of older adults. METHODS: Systematic searches were conducted according to the PICOS strategy and the following databases were searched: PubMed, Web of Science, PsycInfo and Scielo. Two independent evaluators performed the initial selection from reading the title and abstract based on the stipulated eligibility criteria. RESULTS: The searches resulted in 1935 titles, of which 97 were duplicated and 1793 were excluded based on reading the titles and abstracts. This phase resulted in 45 articles for detailed analysis. At this stage, 35 articles were excluded because they did not meet the eligibility criteria. The information for qualitative analysis was extracted from 10 articles that met the criteria. CONCLUSION: There was improvement in the brain activity of older adults regardless of the type of physical exercise performed (aerobic, neuromuscular, flexibility or neuromotor), but with a discrete advantage for balance and coordination exercises (neuromotor).
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Terapia por Ejercicio , Ejercicio Físico , Anciano , Encéfalo , HumanosRESUMEN
Abstract Alzheimer's disease is a neurodegenerative condition that causes changes in memory and cognition, in addition to behavioral disorders, and most commonly affects the elderly. Several studies in the literature have presented therapeutic measures in an attempt to interfere with the pathogenic mechanisms of the disease and to mitigate its clinical manifestations. Some factors, such as excitotoxicity, cholinergic dysfunctions, oxidative stress, tau protein hyperphosphorylation, changes in amyloid-beta peptide metabolism, herpes viruses, apolipoprotein E, glycogen synthase kinase 3, insulin resistance, and the endocannabinoid system seem to be related to pathophysiology of Alzheimer's disease. Given this, a literature review was carried out to address the molecular mechanisms associated with the pathophysiological hypotheses previously mentioned, aiming to better understanding their underlying causes and contributing to possible pharmacological strategies about treatment of the disease.
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Although malnutrition and risk of falls in the elderly have increased in recent years, uncertainties exist as to whether these conditions are associated after controlling for sociodemographic variables, body composition, metabolic condition, and Alzheimer's disease (AD). This study aimed to analyze the association between nutritional status and risk of fall in the elderly population. Participants were matched by gender and age, after they had been grouped on the basis of diagnosis of AD. The risk of falls, nutritional status, and mental status were assessed using the Downton Fall Risk Score (FRS), Mini Nutritional Assessment (MNA), and Mini Mental State Evaluation (MMSE), respectively. Logistic regression modelsadjusted for the main confounders were used in the analyses. Among the 68 elderly individuals studied, participants who were malnourished or at risk of malnutrition were more likely to fall (odds ratio = 8.29; 95% confidence interval = 1.49-46.04) than those with normal nutritional status, regardless of gender, age, education, body composition, and metabolic condition. This association did not remain significant after adjustment for AD, a potential confounder in this association. Malnutrition or its risk was independently associated with high risk of fall; thus, malnutrition should be considered in the prevention of falls among the elderly population.
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Humanos , Masculino , Femenino , Accidentes por Caídas/prevención & control , Nutricion del Anciano , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/metabolismo , Composición Corporal/fisiología , Anciano/fisiología , Envejecimiento/fisiología , Estado Nutricional/fisiología , Demencia/complicaciones , Desnutrición/complicaciones , Metabolismo/fisiologíaRESUMEN
Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China's Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients' overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.
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Assess the nutritional and biochemical state of patients with Alzheimer Disease (AD) compared to a control group. This is an observational, case-control and descriptive type study, based on the recruiting of 22 elderly individuals with a clinical diagnosis of AD considered as the case group, and 22 other elderly individuals considered as the control group. Evaluations were made using the results from the following scales Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), anthropometric measurements for obtaining the body mass index (BMI) and biochemical analyses. The analyses were performed on the program SPSS version 20.0, using absolute and relative measures, T test for independent samples for measurement comparisons and the Spearman correlation test. In the cognitive evaluation MMSE, those participants with AD present higher risk of cognitive decline (81.8%), greater risk of malnutrition according to MNA (45.5%) and altered levels of leptin (90.9%). Upon performing the comparison analysis between the group with AD and the control group, there existed noteworthy differences between the means for the variables MNA (4.40; BMI95% 2.75 6.06), MMSE (10.54; BMI95% 7.09 13.99) and doses of HDL (High Density Lipoproteins) (14.53; BMI95% 6.18 22.88). As well as differences in the p-value < 0.09 in the leptin doses (11.54; BMI95% (-24.98 1.89) and transferrin dose (-72.31; BMI95% -159.48 14.84). The Spearman correlation demonstrated that the cognitive decline in the group of senior citizens with AD was strongly associated with nutritional conditions MNA (R 0.484) and the leptin dose (R 0.590). Senior citizens with AD present worse nutritional conditions, cognitive decline and biochemical alterations when compared to senior citizens in the control group. As such, the study demonstrated the need for an integrated healthcare assistance concerning senior citizens with AD.
Avaliar o estado nutricional e bioquímico de pacientes com Doença de Alzheimer (DA) comparando com um grupo controle. Materiais e métodos: trata-se de um tipo observacional, caso-controle e descritivo a partir do recrutamento de 22 idosos diagnosticados clinicamente com DA considerados grupo caso e outros 22 idosos considerados controle, foi utilizado a escala Mini Avaliação nutricional (MNA), Mini Exame do Estado Mental (MMSE), medidas antropométricas para obtenção do índice de massa corporal (IMC) e análises bioquímicas. As análises foram realizadas no programa SPSS versão 20.0, utilizou-se de medidas absolutas e relativas, teste T para amostras independentes para comparação de médias e o teste de correlação de Spearman. Na avaliação cognitiva MMSE os participantes com DA apresentaram maior prevalência de declínio cognitivo (81,8%), maior prevalência de risco para desnutrição segundo MNA (45,5%) e níveis alterados de leptina (90,9%). Ao se realizar a análise de comparação o grupo com DA e o controle observou-se diferenças significativas entre as médias das variáveis MNA (4,40; IC95% 2,75 6,06), MMSE (10,54; IC95% 7,09 13,99) e dosagens de HDL (14,53; IC95% 6,18 22,88). E diferenças com o p-valor < 0,09 nas dosagens de leptina (11,54; IC95% (-24,98 1,89) e dosagem de transferrina (-72,31; IC95% -159,48 14,84). A correlação de Spearman demonstrou que o declínio cognitivo no grupo de idosos com DA, esteve associado significativamente às condições nutricionais MNA (R 0,484) e dosagem de leptina (R 0,590). Idosos com DA apresentaram piores condições nutricionais, declínio cognitivo e alterações bioquímicas, ao compara-los com idosos controles. Desta forma, o estudo demonstra a necessidade de uma assistência integral a esses idosos.
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Anciano , Biomarcadores , Evaluación Nutricional , Leptina , Enfermedad de AlzheimerRESUMEN
Alzheimer's disease (AD) is a neurodegenerative pathology that affects elderly people all over the world. Several studies have demonstrated that oxidative stress is an aggravating factor for AD development and progression. Therefore, this study aimed to evaluate the activity of two oxidative stress markers, glutathione peroxidase (GPx) and δ-aminolevulinate dehydratase (δ-ALA-D), as well as correlate them with blood metal levels and AD progression. For this purpose, 88 elderly individuals were divided in two groups: AD group (34 patients diagnosed with AD) and control group (34 subjects paired by age with the AD group). The Mini-Mental State Examination and the Clinical Dementia Rating (CDR) were used as tools to classify the AD progression. GPx and δ-ALA-D activities were measured in all subjects through blood tests. Both enzymes' activities were decreased in AD patients when compared to the age-matched control group, regardless of the CDR. Moreover, GPx activity was positively correlated with selenium levels in the blood; and the δ-ALA-D activity was negatively correlated with blood copper levels. Taken together, our results indicated that, for the first time, blood δ-ALA-D activity was significantly inhibited in AD patients. While literature reports conflicting data regarding GPx activity in AD patients, the δ-ALA-D activity seems to be a more consistent tool to be applied as an earlier AD marker.
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OBJECTIVE: We studied the users of the Specialized Drug Distribution Program of the public health network. METHODS: A prospective cohort examined the elderly at two intervals of three years and included 30 patients in phase I and 16 in phase II. The methodology was composed of home visits, anthropometric, nutritional and hematological evaluation. For the progression of AD, the Clinical Dementia Rating (CDR) scale was used. RESULTS: According to the CDR, the disease evolved, since in 2014 most of the patients were in CDR 3. In the analysis of the micronutrients, only the B vitamins (B1, B2, B3, B5, B6) presented a significant reduction in 2014. The consumption of carbohydrates and lipids increased in the 2014 evaluation, and protein consumption decreased. As for the average weight of the elderly, there was an increase in 2014, 65.9 (± 15.6) Kg, with a BMI of 26.75 (± 4, 5), in 2011 the average weight was 62.44 kg (± 14, 36), BMI 24.64 (± 4.97). CONCLUSION: The hypothesis that patients are likely to be overweight or obese before the development of AD and that this may be associated with an increased risk of dementia is suggested.
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Enfermedad de Alzheimer/fisiopatología , Progresión de la Enfermedad , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/sangre , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Estudios Prospectivos , Factores de RiesgoRESUMEN
SUMMARY OBJECTIVE: We studied the users of the Specialized Drug Distribution Program of the public health network. METHODS: A prospective cohort examined the elderly at two intervals of three years and included 30 patients in phase I and 16 in phase II. The methodology was composed of home visits, anthropometric, nutritional and hematological evaluation. For the progression of AD, the Clinical Dementia Rating (CDR) scale was used. RESULTS: According to the CDR, the disease evolved, since in 2014 most of the patients were in CDR 3. In the analysis of the micronutrients, only the B vitamins (B1, B2, B3, B5, B6) presented a significant reduction in 2014. The consumption of carbohydrates and lipids increased in the 2014 evaluation, and protein consumption decreased. As for the average weight of the elderly, there was an increase in 2014, 65.9 (± 15.6) Kg, with a BMI of 26.75 (± 4, 5), in 2011 the average weight was 62.44 kg (± 14, 36), BMI 24.64 (± 4.97). CONCLUSION: The hypothesis that patients are likely to be overweight or obese before the development of AD and that this may be associated with an increased risk of dementia is suggested.
RESUMO OBJETIVO: Foram estudados os usuários do programa de distribuição de medicamentos especializados da rede pública de saúde de Guarapuava, Paraná, Brasil. MÉTODOS: Uma coorte prospectiva, em que os idosos foram examinados em dois momentos, com um intervalo de três anos, com 30 pacientes na fase I e 16 na fase II. A metodologia foi composta por visitas domiciliares, avaliação antropométrica; avaliação nutricional e hematológica. Para a progressão da DA, utilizou-se a escala Clinical Demential Rating (CDR). Os testes de Shapiro-Wilk, teste de Wilcoxon e correlações com associações (Δ%), p < 0,05 para as análises estatísticas. RESULTADOS: A progressão da doença, segundo o CDR, evoluiu, pois, em 2014, a maioria dos pacientes encontrava-se em CDR 3. Na análise dos micronutrientes, somente as vitaminas do complexo B (B1, B2, B3, B5, B6) apresentaram redução significativa em 2014. O consumo de carboidratos e lipídeos aumentou na avaliação de 2014, e o consumo de proteínas diminuiu. Quanto ao peso médio dos idosos, houve um aumento em 2014, 65,9 (± 15,6) kg, com IMC 26,75 (± 4, 5); em 2011, o peso médio foi 62,44 kg (± 14,36), IMC 24,64 (± 4,97). CONCLUSÃO: Não foram encontrados pacientes anêmicos ou desnutridos na amostra. A hipótese de que os pacientes provavelmente já apresentavam sobrepeso ou obesidade antes do desenvolvimento da DA, e que isso pode estar associado com um aumento de risco de demência, pode ser sugerida.
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Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Enfermedad de Alzheimer/fisiopatología , Estado Nutricional , Estudios Prospectivos , Factores de Riesgo , Estudios de Cohortes , Enfermedad de Alzheimer/sangre , Persona de Mediana EdadRESUMEN
INTRODUCTION: elderly's malnutrition is linked, among other factors, to chronic-degenerative diseases, requiring an improvement in the clinical evaluation of nutritional status of this population. Studies have tried to find out new tools to assess aged-people nutritional status. One of most used scales to investigate nutritional status on geriatric patients is the Mini Nutritional Assessment (MNA). OBJECTIVE: the present study aims to evaluate nutritional status of Alzheimer's disease (AD) patients, by comparison with a control group, via Mini Nutritional Assessment. METHODS: a cross-sectional study, which includes 35 alzheimer's old-people and 43 control old-people, was performed evaluating nutritional status with MNA. RESULTS: total score of MNA in the alzheimer group shows that 71.42% were in malnutrition risk, 14.28% were malnourished and 14.25% presented normal nutritional status. In addition, in the control group 79.06% of patients (n = 34) were classified as having normal nutritional status and 20.93% (n = 9), as being at risk of malnutrition. CONCLUSION: results reinforce the purpose that MNA can be used as a proper instrument to evaluate nutritional status in elderly, mainly in AD, because measuring risk and nutritional status of this population is indispensable.
Asunto(s)
Enfermedad de Alzheimer/metabolismo , Evaluación Geriátrica , Evaluación Nutricional , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Desnutrición/epidemiología , Estado Nutricional , Medición de RiesgoRESUMEN
This study aimed to evaluate the concentrations of copper, iron, and selenium in elderly people with Alzheimer disease (AD), comparing the same parameters in a paired group of healthy people, in order to verify if the amount of these metals may influence the cognitive impairment progression. Patients' cognitive impairment was evaluated by Clinical Dementia Rating (CDR). The elementary quantification of erythrocytes was performed by inductively coupled plasma mass spectrometry technique. The statistical analyses were carried out by SPSS software 20.0 version, employing Shapiro-Wilk, Wilcoxon, Kruskall-Wallis, and Spearman correlation tests, considering significant results of p < 0.05. The sample was composed of 34% (n = 11) of women and 66% (n = 21) of men in each group. The AD group was characterized by a higher concentration of copper (p < 0.0001) and iron (p < 0.0001); however, there is no significant difference in selenium level. The analyses of the metal levels in different stages of AD were not significant in CDR-1, however in CDR-2 and CDR-3, elevated levels of copper and iron were observed; in CDR-3 patients, the level of selenium was lower (p < 0.008) compared to that of healthy controls. Patients with Alzheimer disease studied present increase in biometal blood levels, especially of copper and iron, and such increase can be different according to the disease stage and can cause more impairment cognitive functions in AD.
Asunto(s)
Enfermedad de Alzheimer/sangre , Cobre/sangre , Hierro/sangre , Selenio/sangre , Anciano , Enfermedad de Alzheimer/diagnóstico , Femenino , Humanos , Masculino , Espectrometría de MasasRESUMEN
Objetivo: Avaliar a funcionalidade de pacientes com Doença de Alzheimer (DA) residentes na comunidade, no município de Guarapuava PR, região Sul do Brasil. Métodos: Foi realizado um estudo transversal, com pacientes com DA residentes na comunidade, no município de Guarapuava PR. Os participantes foram classificados de acordo com a Escala Clínica de Demência em CDR 1 (DA leve), CDR 2 (DA moderada) e CDR 3 (DA severa). O estado mental foi avaliado através do Mini Exame do Estado Mental; as atividades básicas de vida diária (ABVD) através do Índice de Barthel e as atividades instrumentais de vida diária (AIVD) através do Índice de Lowton e Brody. Resultados: Foram avaliados 58 idosos com diagnóstico de DA, dos quais 14 (24,1%) estavam em CDR 1, 21 (36,2%) em CDR 2 e 23 (39,7%) em CDR 3. Houve diferença significativa entre os níveis de dependência para a realização das ABVD e AIVD entre todas as fases da DA (p <0,001), sendo que a dependência foi maior nos participantes estadeados em CDR 2 e CDR 3. Conclusão: O nível de dependência para a realização das atividades básicas e instrumentais de vida diária é maior nas fases mais avançadas da DA e a dependência para a realização das AIVD está presente em todas as fases da doença, sendo maior do que a dependência para a realização das ABVD desde a fase inicial da DA, sugerindo uma perda progressiva da funcionalidade
Objective: To evaluate the functionality of patients with Alzheimer's disease (AD) living in a community, in the city of Guarapuava PR, South of Brazil. Methods: A cross-sectional study was performed with patients with AD living in the community. Participants were classified according to Clinical Dementia Rating as CDR 1 (mild AD), CDR 2 (moderate AD) and CDR 3 (severe AD). The mental state was assessed by the Mini Mental State Examination; the basic activities of daily living (ADLs) was determined by the Barthel Index and instrumental activities of daily living (IADLs) via by Lowton and Brody Index. Results: 49 elderly patients with AD diagnosis were evaluated, 14 (24.1%) of which were classified as CDR 1, 21 (36.2%) as CDR 2, and 23 (39.7%) as CDR 3. There was a significant difference between the levels of dependence for the performance of the basic ADLs and IADLs among all phases of AD (p <0.001). The dependence was higher in both CDR 2 and CDR 3. Conclusion: Functional dependence for basic activities of daily living becomes more frequent in the most advanced stages of AD, whereas dependence for IADLs is onset since early stages of AD, even more noticeable than dependence for basic ADLs, what suggests a progressive loss of functionality