The Effects of 12-Week Dual-Task Physical-Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study.

This study aims to investigate the effects of dual-task physical-cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time-group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical-cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.

The Association of Obesity and Overweight with Executive Functions in Community-Dwelling Older Women.

Among the risk factors reported for cognitive decline, the literature highlights changes in body composition. Thus, the aim of the present study was to examine the relationship between obesity/overweight and executive functions in cognitively normal older adult women. This cross-sectional study included 224 individuals (60-80 years), stratified into normal weight (n = 45), overweight (n = 98), and obesity (n = 81). As outcomes, body mass index (BMI), waist circumference (WC), and Trail Making Test Parts A and B were assessed. We found positive correlations of BMI and WC with completion times of TMT-A and TMT-B, and a negative correlation of BMI and WC with education. ANCOVA showed an association between higher BMI and slower completion time of TMT-A, TMT-B, and ΔTMT (B-A). Impairment of executive functions of cognitively normal older women may be positively associated with obesity and negatively associated with years of education. The findings may contribute to designing strategies that make it possible to prevent cognitive decline in women during aging.

Predictors of Metabolic Syndrome in Adults and Older Adults from Amazonas, Brazil.

Metabolic syndrome has been considered a factor of vulnerability and a major public health problem because it increases the risk of cardiovascular disease and type 2 diabetes. The present study from Amazonas, Brazil aimed to estimate the prevalence of the individual and general components of metabolic syndrome in adults and older adults and identify the independent predictors of metabolic syndrome. The sample of the present cross-sectional study comprised 942 participants (590 women), with a mean age of 59.8 ± 19.7 (range: 17.5 to 91.8). Blood pressure in men (62.5%), abdominal obesity in women (67.3%), and lower high-density lipoprotein cholesterol (HDL-C) in both (52.2% in men and 65.0% in women) were the most prevalent individual risk factors for metabolic syndrome. Women had a higher prevalence of abdominal obesity (p < 0.001), low HDL-C (p < 0.001), and metabolic syndrome (p < 0.001) than men; however, opposite results were seen in men for blood pressure (p < 0.001). The overall prevalence of metabolic syndrome was 47.5%. Advanced age, being female, having a higher body mass index, and a having lower educational level independently increased the odds of metabolic syndrome. Due to the association of metabolic syndrome with deterioration of health status and increased vulnerability, this study sustains the need for early public health interventions in the Amazonas region.

Face-to-face Assessment of COGTEL in Adolescents: Test-Retest Reliability and Association with School Grades / Aplicação Presencial do COGTEL em Adolescentes: a Fiabilidade Teste-Reteste e a Associação com as Notas Escolares

Abstract The Cognitive Telephone Screening Instrument (COGTEL) has shown to be a brief, reliable, and valid instrument to assess cognitive functioning in adults in face-to-face procedures as well as over the phone. So far, no psychometric evaluation exists on its use in adolescents. The present study set out to evaluate the psychometric properties of the face-to-face application of the COGTEL in adolescents in the school context and to analyse the association with school grades. We assessed cognitive performance using COGTEL in face-to-face assessments of 170 adolescents, with retests after 6 months for test-retest reliability. Predictive validity was assessed using school grades. Test-retest reliability for the COGTEL was good (ICC = .77; p < .001). The partial correlation controlling for age between COGTEL and school grades was medium and positive (r = .40; p < .001). School grades alone explained 42% and 36% of the variance in the COGTEL total score in elementary and secondary students, respectively. The present study suggests that COGTEL is a reliable and valid instrument to assess cognitive functioning in adolescents, with the advantage of feasibility in multiple contexts.

Resumo O Instrumento de Rastreio Cognitivo por Telefone (COGTEL) tem demostrado ser um instrumento fiável, válido e breve para avaliar o funcionamento cognitivo em adultos, quer por telefone, quer de forma presencial. Até à data, não foram estudadas as suas características psicométricas para uso em adolescentes. O presente estudo teve por objetivo avaliar as propriedades psicométricas do COGTEL em adolescentes no contexto escolar, através da aplicação presencial, e analisar a associação dos scores com as notas escolares. O desempenho cognitivo foi avaliado em 170 adolescentes, usando o COGTEL em entrevistas presenciais, com um reteste após 6 meses para avaliar a fiabilidade teste-reteste. A validade preditiva foi avaliada com base nas notas escolares. A fiabilidade teste-reteste para o COGTEL foi boa (ICC = 0.77; p < .001). As correlações parciais, controlando pelo efeito da idade, entre o score total do COGTEL e as notas escolares foram moderadas e positivas (r = .40; p < .001). As notas escolares, individualmente, explicaram 42% e 36% da variância total no score total do COGTEL, em alunos do ensino básico e secundário, respetivamente. O presente estudo sugere que o COGTEL é um instrumento fiável e válido para avaliar o funcionamento cognitivo em adolescentes, com a vantagem de ser aplicável em múltiplos contextos.

The Cognitive Telephone Screening Instrument (COGTEL): a reliable and valid tool for the assessment of cognitive functioning in the Brazilian elderly / Cognitive Telephone Screening Instrument (COGTEL): um instrumento fiável e válido na avaliação do funcionamento cognitivo em pessoas idosas brasileiras

Abstract Objectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.(AU)

Resumo Objetivo: Estudar a fiabilidade/estabilidade do "The Cognitive Telephone Screening Instrument" (COGTEL) na avaliação das funções cognitivas e investigar a validade concorrente (ou seja, a relação entre os escores do COGTEL com variáveis externas, tais como a educação e o resultado do MMSE), num estudo piloto em adultos idosos residentes na comunidade de Apuí, Fonte Boa e Manaus (Amazonas, Brasil). Método: O presente estudo piloto incluiu 90 adultos idosos (29 homens e 61 mulheres) com idades compreendidas entre os 60-85 anos de idade [68,2(±6,7)]. O COGTEL, o MMSE e o questionário socioeconômico foram aplicados sob forma de entrevista duas vezes, com uma semana de intervalo nas mesmas condições. Resultados: O coeficiente de correlação intraclasse no teste-reteste no escore total do COGTEL (e respectivos 6 subtestes), MMSE e nível educacional variou entre aceitável-a-elevado (0,708 < R < 0,946). Verificou-se uma correlação positiva entre o escore total do COGTEL com o MMSE (r=0,682; p<0,001), bem como, com o nível educacional (r=0,604; p<0,001). Conclusão: Este estudo apresenta evidências preliminares de fiabilidade/estabilidade e validade concorrente do COGTEL na avaliação das funções cognitivas em adultos idosos residentes na comunidade. Os resultados do presente estudo suportam a utilização do COGTEL como um instrumento breve, fiável e válido para analisar diferenças interindividuais no funcionamento cognitivo em estudos com adultos idosos.(AU)

Cognitive function and its associations in older adults from Amazonas, Brazil / Função Cognitiva e suas associações em adultos-idosos do estado do Amazonas, Brasil

The objectives of this study were: (1) to investigate the age-related differences in cognitive function (CF), nutritional status (MNA), physical activity (AF), quality of life (QoL), depression, social sat-isfaction (SS) and socioeconomic status (SES), and (2) to explore the relationships between CF and the previous variables. This cross sectional study included 268 men and 433 women (aged 71.4 ± 7.0 years). CF was determined with the Cognitive Telephone Screening Instrument (COGTEL) and the Mini-Mental State Examination (MMSE). Correlates were as follows: Mini Nutritional Assessment (MNA), PA (Baecke questionnaire modified for older adults), Quality of life (QoL SF-12), Geriatrics Depression Scale (GDS), Satisfaction and Social Support Scale, and Socioeconomic status (SES). All instruments were applied in a face to face interview. An independent t-test identi-fied significantly higher scores in young-old adults (≤ 69 years) for CF (p < 0.001), PA (p= 0.046) and SES (p= 0.007), compared to old-old adults (≥ 70 years). The results of multiple linear regression analysis indicated that the most significant CF correlates were SES (ß = 0.45;p< 0.001), age (ß = -0.12;p< 0.001), SS (ß = 0.12;p= 0.001), GDS (ß = -0.11; p= 0.003) and QoL (ß = 0.08;p= 0.017). The overall regression model explained 36% of the total variance in the COGTEL. The oldest and the more depressed adults obtained lower scores for FC. The present study suggests that, between the correlates studied, SES was the strongest predictor in the explanation of CF in older adults

Os objetivos deste estudo foram: (1) investigar as diferenças associadas à idade na função cognitiva (FC), status nutricional (MNA), atividade física (AF), qualidade de vida (QV ), depressão, satisfação social (SS) e estatuto socioeconômico (ESSE), e (2) explorar as relações entre a FC e as varáveis anteriores. Este estudo, de natureza transversal, incluiu 268 homens e 433 mulheres (71,4 ± 7,0 anos de idade). A FC foi determinada a partir do Cognitive Telephone Screening Instrument (COGTEL) e do Mini-Mental State Examination (MMSE). Os preditores analisados incluíram: o Mini Nutritional Assessment (MNA), a AF (questionário de Baecke modificado para idosos), a QV (SF-12), a Escala de Depressão em Geriatria (GDS), a Escala de Satisfação com o Suporte Social e o ESSE (Estatuto Socioeconômico). Todos os instrumentos foram aplicados sob forma de entrevista. Um t-teste de medidas independentes identificou scores significativamente mais elevados nos adultos-idosos mais jovens (60 - 69 anos de idade) na FC (p < 0,001), AF (p = 0,046) e ESSE (p = 0,007), comparativamente aos mais idosos (70 - 91 anos de idade). Os resultados da análise de regressão linear múltipla indicaram que os preditores mais significativos da FC foram: ESSE (ß = 0,45; p < 0,001), idade (ß = -0,12; p < 0,001), SS (ß = 0,12; p = 0,001), GDS (ß = -0,11; p = 0,003) e QV (ß = 0,08; p = 0,017). O modelo de regressão testado, explicou 36% da variância total do COGTEL. As pessoas mais idosas e deprimidas obtiveram scores mais baixos na FC. Este estudo sugere que entre os preditores estudados, o ESSE é a variável mais forte na explicação da FC nos adultos idosos

The relationship of physical activity to high-density lipoprotein cholesterol level in a sample of community-dwelling older adults from Amazonas, Brazil.

OBJECTIVES: (1) To study the relation of physical activity (PA) to high-density lipoprotein cholesterol (HDL-C) and (2) to investigate if the strength of these associations holds after adjustments for sex, age, and other key correlates. METHODS: This study included 550 older adults from Amazonas. HDL-C was derived from fasting blood samples. PA at sport and leisure, smoking, alcohol consumption, and socioeconomic status (SES) were interviewed. Waist circumference (WACI) was assessed. RESULTS: HDL-C was positively related to PA sport, PA leisure, and SES (0.22≤r≤0.34; p≤0.001) and negatively related to smoking and WACI (r≤-0.10; p<0.05). Controlling for sex and age did not affect these relationships. Hierarchical multiple regression analyses showed that the relation of HDL-C to PA sport and leisure remained significant when controlling for all other investigated correlates (0.14≤ß≤0.24; p≤0.001). DISCUSSION: In order to prevent low HDL-C in older adults, promoting PA seems to be an important additional component besides common recommendations concerning weight reduction.

High-Density Lipoprotein Cholesterol Level Relates to Working Memory, Immediate and Delayed Cued Recall in Brazilian Older Adults: The Role of Cognitive Reserve.

AIMS: The present study set out to investigate the relation of the high-density lipoprotein cholesterol (HDL-C) level to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. METHODS: We assessed tests of working memory, immediate and delayed cued recall in 701 older adults from Amazonas, Brazil. The HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity. RESULTS: A critically low HDL-C level (<40 mg/dL) was significantly related to lower performance in working memory, immediate and delayed cued recall. Moderation analyses suggested that the relations of the HDL-C level to working memory and delayed cued recall were negligible in individuals with longer education, a higher cognitive level of the job, and greater engagement in cognitive leisure activity. CONCLUSION: Cognitive reserve accumulated during the life course may reduce the detrimental influences of a critically low HDL-C level on cognitive functioning in old age.

The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty.

BACKGROUND: It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. METHODS: We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. RESULTS: Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. CONCLUSIONS: Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.