The association between vitamin D and BDNF on cognition in older adults in Southern Brazil.

OBJECTIVE: To estimate the association between vitamin D and the cognitive decline of older adults and evaluate whether this association is mediated by brain-derived neurotrophic factor (BDNF) serum concentration. METHODS: Cross-sectional study nested in a population-based cohort. Of the 604 participants in the complementary examination of the EpiFloripa Study, 576 older adults (60 years or older) were eligible for the study. The outcome is cognitive decline evaluated by the Mini-Mental State Examination, the exposure is vitamin D, and BDNF is the mediator. The control variables are age, sex, per capita family income, and educational level. The direct effect of vitamin D and BDNF on cognitive decline and the indirect effect mediated by BDNF was evaluated using path analysis, with the estimation of standardized coefficients. RESULTS: Among the participants, we observed a direct and positive effect of vitamin D on cognitive function (Coef: 0.06; 95%CI: 0.02 to 0.11; p < 0.001) and serum BDNF concentration (Coef: 21.55; 95%CI: 9.92 to 33.17; p = 0.002), i.e., the higher the vitamin D, the higher the cognitive function and serum level of BDNF. CONCLUSION: There was an association between vitamin D on serum BDNF and on cognitive decline in older adults. Moreover, BDNF did not have an effect on cognitive decline, so BDNF was not a mediator of the vitamin D effect on cognitive decline.

Does cognitive impairment precede self-reported poor hearing? Results from the English longitudinal study of ageing.

OBJECTIVE: To investigate whether cognitive impairment precedes self-reported poor hearing in adults aged 50 and older over a 14-year period. DESIGN: Biennial longitudinal study. STUDY SAMPLE: The data came from the English Longitudinal Study of Ageing carried out in England between 2002 and 2016, with 11,391 individuals aged 50 years and older. For this study, ELSA participants who had a positive perception of hearing at the beginning of the analysis in 2002 (n = 8,895) were eligible. The dependent variable was self-reported poor hearing, and the exposure measure was cognitive impairment. The analyses were performed using Generalised Estimation Equations and adjusted for gender, age, educational level, household wealth, smoking, alcohol consumption, depressive symptoms, ADL/IADL disability, physical activity level, diabetes, and cardiovascular disease. RESULTS: The results showed 33% increased odds of self-reported poor hearing in individuals with cognitive impairment. In the fully adjusted model, individuals who presented cognitive impairment in the previous wave had, over time, 10% increased odds (95% CI: 1.02; 1.19) of presenting self-reported poor hearing. CONCLUSIONS: The exposure to cognitive impairment was associated with a subsequent self-reported poor hearing. These data represent important tools for improving cognitive and hearing impairment diagnosis and treatment.

Can internet use reduce the incidence of cognitive impairment? Analysis of the EpiFloripa Aging Cohort Study (2009-2019).

This study aims to estimate the effect of internet use on the incidence of cognitive impairment in older adults. Data are from the EpiFloripa Aging Cohort Study which has been following a population-based sample of older adults (60+) residing in Florianópolis, southern Brazil, for ten years. The outcome was the incidence of cognitive decline in follow-up waves measured by the Mini-Mental State Examination using cutoff points according to education. The exposure was internet use according to wave (yes/no). We excluded individuals with cognitive impairment from Wave 1 (n = 453). We used a longitudinal analysis model (Generalized Estimating Equations) to estimate incidence rate ratios (IRR) with 95% confidence intervals. We estimated the risk of cognitive impairment in Wave 2 or Wave 3 according to internet use in the previous wave. The incidence of cognitive impairment was 13.4% in Wave 2 and 13.3% in Wave 3. Despite the aging of this cohort, the prevalence of internet users increased from 26.4% in Wave 1 to 32.8% in Wave 2 and 46.8% in Wave 3. The risk of cognitive impairment in Wave 2 or Wave 3 was 70% lower for older adults who used the internet in the previous wave, adjusted for sex, age, years of education, household income, and self-reported comorbidities (IRR = 0.30; 95% CI: 0.15-0.61; p = 0.001). Internet use was associated with a decline in the incidence of cognitive impairment among older adults living in the urban areas of southern Brazil after a period of ten years.

Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country.

OBJECTIVE: To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil. DESIGN: Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014. SETTING: Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0-20·7 ng/ml; Q2: 20·8-26·6 ng/ml; Q3: 26·7-32·0 ng/ml and Q4: 32·1-60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group. PARTICIPANTS: 200 men and 371 women aged 60 years or older participated in this study. RESULTS: The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed. CONCLUSION: The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.

A comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction can modify BDNF levels and improve cognition in adults over 50: a randomized controlled pilot study.

OBJECTIVES: To analyze the effect of a comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction, called "Oficina da Lembrança" (OL), on the cognitive status and concentration of biomarkers of neuroplasticity, neurodegeneration in adults aged 50 years and over attending a Memory Clinic. METHODS: In this pilot randomized controlled study, 64 patients without dementia aged 45 to 79 years, seen at a University Memory Clinic in Southern Brazil, were randomly allocated to the intervention and control groups. The intervention consisted of participation in OL for 12 weeks. Serum biomarkers (brain-derived neurotrophic factor [BDNF], S100ß, and neuron-specific enolase [NSE]) and cognitive status were analyzed as primary and secondary outcomes. The Wilcoxon test and Generalized Estimating Equations (GEE) were applied. RESULTS: Of the 64 patients invited to participate in the study, 33 (intervention: 17, control: 16) completed the study with all data. Improvement of cognitive status was significant in the intervention group (22.6 to 24.5) but not in the control group (20.1 to 21.1). There was a significant reduction of BDNF in OL participants, but no significant change was observed in the neurodegenerative biomarkers S100ß or NSE. The concentration of BDNF decreased significantly post-OL in the intervention group (-288.1, 95%CI -362.1 to -94.1), even after adjusting for sex, age, and educational level. Cognitive status was significantly improved in OL participants. CONCLUSION: The OL program improved cognitive status, reduced serum BDNF levels, and empowered digitally excluded older adults. There was no effect of this intervention on S100ß or NSE. CLINICAL TRIAL REGISTRATION: This study has a Universal Trial Number (UTN) U1111-1195-2642 and was registered in the Brazilian Clinical Trials Registry (ReBEC), number RBR-38X665.

The association between vitamin D and BDNF on cognition in older adults in Southern Brazil

ABSTRACT OBJECTIVE To estimate the association between vitamin D and the cognitive decline of older adults and evaluate whether this association is mediated by brain-derived neurotrophic factor (BDNF) serum concentration. METHODS Cross-sectional study nested in a population-based cohort. Of the 604 participants in the complementary examination of the EpiFloripa Study, 576 older adults (60 years or older) were eligible for the study. The outcome is cognitive decline evaluated by the Mini-Mental State Examination, the exposure is vitamin D, and BDNF is the mediator. The control variables are age, sex, per capita family income, and educational level. The direct effect of vitamin D and BDNF on cognitive decline and the indirect effect mediated by BDNF was evaluated using path analysis, with the estimation of standardized coefficients. RESULTS Among the participants, we observed a direct and positive effect of vitamin D on cognitive function (Coef: 0.06; 95%CI: 0.02 to 0.11; p < 0.001) and serum BDNF concentration (Coef: 21.55; 95%CI: 9.92 to 33.17; p = 0.002), i.e., the higher the vitamin D, the higher the cognitive function and serum level of BDNF. CONCLUSION There was an association between vitamin D on serum BDNF and on cognitive decline in older adults. Moreover, BDNF did not have an effect on cognitive decline, so BDNF was not a mediator of the vitamin D effect on cognitive decline.

Stabilometric analysis as a cognitive function predictor in adults over the age of 50: A cross-sectional study conducted in a Memory Clinic.

BACKGROUND: The aging process reduces adaptive balance responses. Two-thirds of older adults with cognitive problems suffer at least one fall every year, a rate three times higher than that observed in older adults without dementia. This cross-sectional study aims to analyze the relationship between balance and cognitive status in adults older than 50 years. METHODS: Individuals over the age of 50, who attended a Memory Clinic, were evaluated for balance changes using stabilometry, with analysis of the center of pressure (CoP). The following CoP parameters were assessed using an S-Plate pressure platform: 1) sway length, 2) sway area, and 3) anteroposterior and laterolateral sway (width, mean deviation, and speed). The individuals were evaluated with eyes open and closed for 30 s in each test. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive status. RESULTS: Eighty-seven subjects participated in the study. The average age was 67.8 years, 81.4% were female, and the average MoCA score was 19.8 points. Greater CoP oscillation was observed in the eyes closed condition, demonstrating greater postural imbalance. We found a significant and direct effect of MoCA score on the CoP area in the eyes open condition. CONCLUSION: The results suggest that stabilometric analysis may be a predictor of cognitive function.

Self-Reported Hearing Loss and Associated Factors in Older Adults at a Memory Clinic.

Purpose The prevalence of dementia has increased in recent years and, along with hearing loss, can negatively impact the health of older adults. The purpose of this retrospective cross-sectional study was to establish self-reported hearing loss and associated factors in older adults at a memory clinic. Method Researchers conducted a retrospective cross-sectional study on factors associated with self-reported hearing loss (i.e., lifestyle, general health, cognition, functional capacity). Data were taken from medical records of older adults (≥ 60 years old) who received care between 2017 and 2018 at a memory clinic located at the Southern Santa Catarina University in Brazil. Analysis included the Pearson chi-squared test and logistic regression, estimation of the crude and adjusted odds ratios (OR), with respective confidence intervals of 95%. Results Researchers analyzed the medical records of 257 older adults and verified a prevalence of 13.2% of these adults with self-reported hearing loss. There was a higher prevalence of the outcome (i.e., self-reported hearing loss) in older adults who reported tinnitus (35.2%), those with mild cognitive impairment (14.7%), and those who were sedentary (19.2%). After adjustment for confusion factors, tinnitus (OR = 4.63; p = .019) and sedentarism (OR = 2.89; p = .029) were still associated with the outcome. Conclusions Tinnitus and sedentarism were associated with hearing loss in older adults receiving care at a memory clinic. As a public health issue, presbycusis needs to be included in the health planning and health promotion agendas, with effective control, prevention, and treatment measures.

Association between deficient and insufficient 25(OH)D serum concentrations and cardiometabolic risk factors: Findings of a population-based study with older adults of southern Brazil.

To investigate the association between deficient and insufficient serum concentrations of 25(OH)D and cardiometabolic risk factors (CMRF), considering that both conditions are important predictors of cardiovascular disease and diabetes mellitus. A cross-sectional study with a subsample of 526 older adults (63-93 years old) who participated in the second wave of the population-based longitudinal study EpiFloripa Idoso. The CMRF analyzed were abdominal obesity, high fasting glucose, high blood pressure, high triglycerides and high LDL-cholesterol. The exposure variable was 25(OH)D serum concentration (≤20 ng/mL = deficient; 21-29 ng/mL = insufficient, ≥30-<100 ng/mL = sufficient). The prevalences of 25(OH)D deficiency and insufficiency were estimated at 21.9% and 43.7%, respectively. The adjusted OR of prevalence of the abdominal obesity (OR 1.99;1.12-3.54), high blood pressure (OR 2.58;1.35-4.94) and high LDL-cholesterol (OR 2.73;1.63-4.6) were higher among those with deficient serum concentration of 25(OH)D. Participants with insufficient serum concentrations of 25(OH)D also presented higher adjusted OR of prevalence for abdominal obesity (OR 2.14;1.31-3.48). No significant adjusted association was found between 25(OH)D with the outcomes high fasting glucose and high triglycerides. Significant effect modification/interaction by age was also observed in the tested associations for abdominal obesity (P < 0.001), blood pressure (P < 0.001) and LDL-cholesterol (P < 0.001), in which deficient and insufficient 25(OH)D values were associated with higher values of these FRCM. 25(OH)D serum concentrations between 30 and 100 ng/mL can contribute to preventing and controlling CMRF such as abdominal obesity, high blood pressure and high LDL-cholesterol. The understanding this particular interaction may indicate ways to prevent/control cardiometabolic outcomes, health problems common in the older adults.

Factors associated with dementia in elderly. / Fatores associados à demência em idosos.

We analyzed the factors associated with dementia in the elderly attended at a memory outpatient clinic of the University of Southern Santa Catarina (UNISUL). This is a cross-sectional study with data analysis of medical records from January 2013 to April 2016. The outcome was the clinical diagnosis of dementia. The control variables were: serum vitamin D level at the time of diagnosis, gender, skin color, schooling, age, type 2 diabetes, hypertension, and depression. We performed a crude and adjusted analysis with logistic regression. The sample consisted of 287 elderly, with the predominance of age between 60 and 69 years (48.78%), female (79.09%) and white (92.33%). The mean number of years of study was 6.95 years (SD ± 4.95) and mean vitamin D was 26.09 ng/mL (SD ± 9,20). The prevalence of elderly with dementia was 16.72%. Depression was the most prevalent (42.50%) among the morbidities, followed by hypertension (31.71%). The following were independently associated with dementia: vitamin D (OR = 0.92, 95%CI, 0.88;0.97), depression (OR = 4.09, 95%CI, 1.87;8.94), hypertension (OR = 2.65, 95%CI, 1.15;6.08) and individuals aged 80 years and over (OR = 3.97 95%CI, 1.59;9.91). Dementia prevalence was high and diagnosed dementia was associated with lower levels of vitamin D. Vitamin D is a modifiable factor, opening up essential perspectives for public health policies.

Analisar os fatores associados à demência em idosos atendidos em um ambulatório de memória da Universidade do Sul de Santa Catarina (Unisul). Estudo transversal com análise de dados de prontuário no período de 01/2013 a 04/2016. O desfecho foi o diagnóstico clínico de demência. As variáveis de controle foram: nível sérico de vitamina D na época do diagnóstico, sexo, cor da pele, escolaridade, idade, diabetes tipo 2, hipertensão arterial e depressão. Foi realizada análise bruta e ajustada com regressão logística. Amostra de 287 idosos, com predominância de idade entre 60 e 69 anos (48,78%), sexo feminino (79,09%), cor da pele branca (92,33%). A média de anos de estudo foi de 6,95 anos (DP ± 4,95) e da vitamina D 26,09 ng/mL (DP ± 9,20). A prevalência de idosos com demência foi de 16,72%. Dentre as morbidades a depressão foi a de maior prevalência seguida pela hipertensão arterial. Estiveram independentemente associadas à demência: vitamina D (OR = 0,92 IC 95% 0,88;0,97), depressão (OR = 4,09 IC95% 1,87;8,94), hipertensão arterial (OR = 2,65 IC95% 1,15;6,08) e indivíduos com idade igual e maior que 80 anos. A prevalência de demência foi alta, e houve associação de níveis mais baixos de vitamina D com diagnóstico de demência. Sendo a vitamina D um fator modificável, abrindo importantes perspectivas para políticas de saúde pública.

Fatores associados à demência em idosos / Factors associated with dementia in elderly

Resumo Analisar os fatores associados à demência em idosos atendidos em um ambulatório de memória da Universidade do Sul de Santa Catarina (Unisul). Estudo transversal com análise de dados de prontuário no período de 01/2013 a 04/2016. O desfecho foi o diagnóstico clínico de demência. As variáveis de controle foram: nível sérico de vitamina D na época do diagnóstico, sexo, cor da pele, escolaridade, idade, diabetes tipo 2, hipertensão arterial e depressão. Foi realizada análise bruta e ajustada com regressão logística. Amostra de 287 idosos, com predominância de idade entre 60 e 69 anos (48,78%), sexo feminino (79,09%), cor da pele branca (92,33%). A média de anos de estudo foi de 6,95 anos (DP ± 4,95) e da vitamina D 26,09 ng/mL (DP ± 9,20). A prevalência de idosos com demência foi de 16,72%. Dentre as morbidades a depressão foi a de maior prevalência seguida pela hipertensão arterial. Estiveram independentemente associadas à demência: vitamina D (OR = 0,92 IC 95% 0,88;0,97), depressão (OR = 4,09 IC95% 1,87;8,94), hipertensão arterial (OR = 2,65 IC95% 1,15;6,08) e indivíduos com idade igual e maior que 80 anos. A prevalência de demência foi alta, e houve associação de níveis mais baixos de vitamina D com diagnóstico de demência. Sendo a vitamina D um fator modificável, abrindo importantes perspectivas para políticas de saúde pública.

Abstract We analyzed the factors associated with dementia in the elderly attended at a memory outpatient clinic of the University of Southern Santa Catarina (UNISUL). This is a cross-sectional study with data analysis of medical records from January 2013 to April 2016. The outcome was the clinical diagnosis of dementia. The control variables were: serum vitamin D level at the time of diagnosis, gender, skin color, schooling, age, type 2 diabetes, hypertension, and depression. We performed a crude and adjusted analysis with logistic regression. The sample consisted of 287 elderly, with the predominance of age between 60 and 69 years (48.78%), female (79.09%) and white (92.33%). The mean number of years of study was 6.95 years (SD ± 4.95) and mean vitamin D was 26.09 ng/mL (SD ± 9,20). The prevalence of elderly with dementia was 16.72%. Depression was the most prevalent (42.50%) among the morbidities, followed by hypertension (31.71%). The following were independently associated with dementia: vitamin D (OR = 0.92, 95%CI, 0.88;0.97), depression (OR = 4.09, 95%CI, 1.87;8.94), hypertension (OR = 2.65, 95%CI, 1.15;6.08) and individuals aged 80 years and over (OR = 3.97 95%CI, 1.59;9.91). Dementia prevalence was high and diagnosed dementia was associated with lower levels of vitamin D. Vitamin D is a modifiable factor, opening up essential perspectives for public health policies.

Polifarmácia e cognição em pacientes com idade avançada / Polypharmacy and cognition in elderly patients

Objetivo: Avaliar a prevalência da polifarmácia e da prescrição de medicações inapropriadas, bem como suas associações com a capacidade cognitiva e funcional do idoso. Métodos: Estudo observacional transversal, no qual foram analisadas as medicações prescritas em 141 prontuários para pacientes acima de 50 anos, em associação com testes que quantificaram a capacidade funcional e cognitiva deles. Resultados: Observou-se média de 4,41 medicamentos por paciente, sendo que 0,41 deles foram considerados inapropriado, segundo o critério de Beers. Verificou-se também relação estatisticamente significativa quanto ao número de medicações e testes que mediam a capacidade funcional e cognitiva dos idosos. Conclusão: O aumento da polifarmácia e da prescrição de medicações potencialmente inadequadas acarretou significativa piora da capacidade cognitiva e funcional do idoso

Objective: To evaluate the prevalence of polypharmacy and of the prescription of inappropriate medications, as well as their associations with the cognitive and functional capacity of the elderly. Methods: Cross-sectional observational study which analyzed the drugs prescribed in 141 medical records for patients over 50 years of age, associated with tests that quantified their functional and cognitive capacity. Results: An average of 4.41 medications per patient was observed, and 0.41 were considered inappropriate according to the Beers criteria. There was also a statistically significant relation regarding the number of medications and tests that measure the functional and cognitive capacity of the elderly. Conclusion: The increase in polypharmacy and in the prescription of potentially inappropriate medications led to a significant impairment of the cognitive and functional capacity of the elderly

Association between use of internet and the cognitive function in older adults, populational longitudinal study EpiFloripa Idoso. / Associação entre o uso de internet e a função cognitiva de idosos, estudo longitudinal populacional Epifloripa Idoso.

OBJECTIVE: To estimate the association between the internet and the gain or loss cognite along of four years in older adults. METHODS: Longitudinal study, a population-based, with older adults residents in a capital of southern Brazil (≥ 60 years) surveyed in 2009-10 (baseline) and in 2013-14 (follow-up). The outcome was assessed by clinically significant gain or loss of four or more points in the score of the Mini Mental State Examination between the two interviews. The use of internet was measured longitudinally (maintained or not internet usage, stop use of internet, started using the internet, retained the use of internet). Odds Ratios (OR) were estimated adjusted for sex, age, household income, education level and cognitive screening at baseline. RESULTS: Respondents were 1.705 older adults in 2009-10 and 1.197 in 2013-14. There was a significant association between keep using internet and cognitive performance, with greater chance of cognitive gain (OR= 3.3; 95%CI 1.1 - 9.8) and lower cognitive impairment (OR = 0.39; 95%CI 0.17 - 0.88) for older adults who kept using the internet. CONCLUSION: Older adults who continue using the internet were more likely to gain significant cognitive and lower cognitive loss. Topromote the internet use in older adults can help a strategy for cognitive stimulation in older adults.

OBJETIVO: Estimar a associação entre o uso de internet e o ganho/perda cognitivo ao longo de quatro anos em idosos. MÉTODO: Estudo longitudinal, de base populacional, com idosos residentes em uma capital do sul do Brasil (≥ 60 anos), entrevistados em 2009-2010 (baseline) e em 2013-2014 (seguimento). O desfecho foi avaliado pelo ganho/perda clinicamente significativo de quatro pontos ou mais no escore do mini exame do estado mental (MEEM) entre as duas entrevistas. O uso de internetfoi avaliado de forma longitudinal (manteve o não uso de internet; deixou de usar; passou a usar; manteve o uso). Foram estimadas razões de chances (OR) ajustadas por sexo, idade, renda familiar, escolaridade e rastreamento de déficit cognitivo no baseline. RESULTADOS: Entrevistaram-se 1.705 idosos em 2009-2010 e 1.197 em 2013-2014. Houve associação significativa entre manter-se usando internet e o desempenho cognitivo, com chance maior de ganho cognitivo (OR = 3,3; IC95% 1,1 - 9,8) e menor de perda cognitiva (OR = 0,39; IC95% 0,17 - 0,88) para os idosos que se mantiveram usando a internet. CONCLUSÃO: Idosos que se mantiveram utilizando a internet tiveram chance significativamente maior de apresentar ganho cognitivo e menor de apresentar declínio cognitivo. Promover o uso da internet em idosos pode ser uma estratégia para estimular a função cognitiva nessa população.

Programa intergeracional de estimulação cognitiva: Benefícios relatados por idosos e monitores participantes / Intergenerational cognitive stimulation program: Benefits reported by elderly and monitors participating

Resumo Investigaram-se os benefícios percebidos pelos idosos e monitores participantes do programa intergeracional de manutenção, estimulação e/ou reabilitação cognitiva, mediado pelo uso de computadores e prática de atividades físicas "Oficina da Lembrança". Realizou-se uma pesquisa qualitativa descritiva, com dez idosos e seis monitores participantes da Oficina da Lembrança. Aplicou-se entrevista semiestruturada, interpretada pela análise de conteúdo. Os idosos relataram: aprendizagem do uso de computadores, melhora da memória, sociabilização, ter atividade de lazer, emagrecimento, melhora da qualidade de vida, saúde e sociabilização. Monitores: contato com idosos, melhora da relação com pessoas/pacientes, preparação para situações diversas e conhecimentos sobre idosos. Conclui-se que a Oficina da Lembrança pode proporcionar vários benefícios para seus praticantes e para seus monitores, principalmente a intergeracionalidade.

Abstract We investigated the benefits perceived by older people and monitors participants of the intergenerational program intergenerational of maintenance, stimulation/rehabilitation cognitive, mediated by the use of computers and physical activity "Oficina da Lembrança". We performed a descriptive qualitative research with ten elderly and six monitors participants of Oficina da Lembrança. We applied semi-structured interviews, which were interpreted by content analysis. The elderly related: learning the use of computers, improved memory, socialization, having leisure activity, weight loss, improved quality of life, health and socialization. Monitors: contact with elderly, improvement of the relationship with people and patients, preparation for different situations and acquiring more knowledge about the elderly. In conclusion, Oficina da Lembrança can provide several benefits to its practitioners and monitors, especially the intergenerationality.

Associação entre o uso de internet e a função cognitiva de idosos, estudo longitudinal populacional Epifloripa Idoso / Association between use of internet and the cognitive function in older adults, populational longitudinal study EpiFloripa Idoso

RESUMO: Objetivo: Estimar a associação entre o uso de internet e o ganho/perda cognitivo ao longo de quatro anos em idosos. Método: Estudo longitudinal, de base populacional, com idosos residentes em uma capital do sul do Brasil (≥ 60 anos), entrevistados em 2009-2010 (baseline) e em 2013-2014 (seguimento). O desfecho foi avaliado pelo ganho/perda clinicamente significativo de quatro pontos ou mais no escore do mini exame do estado mental (MEEM) entre as duas entrevistas. O uso de internetfoi avaliado de forma longitudinal (manteve o não uso de internet; deixou de usar; passou a usar; manteve o uso). Foram estimadas razões de chances (OR) ajustadas por sexo, idade, renda familiar, escolaridade e rastreamento de déficit cognitivo no baseline. Resultados: Entrevistaram-se 1.705 idosos em 2009-2010 e 1.197 em 2013-2014. Houve associação significativa entre manter-se usando internet e o desempenho cognitivo, com chance maior de ganho cognitivo (OR = 3,3; IC95% 1,1 - 9,8) e menor de perda cognitiva (OR = 0,39; IC95% 0,17 - 0,88) para os idosos que se mantiveram usando a internet. Conclusão: Idosos que se mantiveram utilizando a internet tiveram chance significativamente maior de apresentar ganho cognitivo e menor de apresentar declínio cognitivo. Promover o uso da internet em idosos pode ser uma estratégia para estimular a função cognitiva nessa população.

ABSTRACT: Objective: To estimate the association between the internet and the gain or loss cognite along of four years in older adults. Methods: Longitudinal study, a population-based, with older adults residents in a capital of southern Brazil (≥ 60 years) surveyed in 2009-10 (baseline) and in 2013-14 (follow-up). The outcome was assessed by clinically significant gain or loss of four or more points in the score of the Mini Mental State Examination between the two interviews. The use of internet was measured longitudinally (maintained or not internet usage, stop use of internet, started using the internet, retained the use of internet). Odds Ratios (OR) were estimated adjusted for sex, age, household income, education level and cognitive screening at baseline. Results: Respondents were 1.705 older adults in 2009-10 and 1.197 in 2013-14. There was a significant association between keep using internet and cognitive performance, with greater chance of cognitive gain (OR= 3.3; 95%CI 1.1 - 9.8) and lower cognitive impairment (OR = 0.39; 95%CI 0.17 - 0.88) for older adults who kept using the internet. Conclusion: Older adults who continue using the internet were more likely to gain significant cognitive and lower cognitive loss. Topromote the internet use in older adults can help a strategy for cognitive stimulation in older adults.

Sociodemographic, behavioral, and health factors associated with positive self-perceived health of long-lived elderly residents in Florianópolis, Santa Catarina, Brazil. / Fatores sociodemográficos, comportamentais e de saúde associados à autopercepção de saúde positiva de idosos longevos residentes em Florianópolis, Santa Catarina.

The objective of this study was to identify the factors associated with positive self-perceived health of long-lived elderly (80+) individuals. This cross-sectional study was conducted in the city of Florianópolis, Santa Catarina, Brazil, and included 239 elderly participants from the EpiFloripa Ageing Project. We used collection instruments to verify sociodemographic and economic data, self-reported health status, falls, and lifestyle. Then, we identified factors associated with positive self-perceived health using a Poisson regression adjusted for sex. We found that a positive self-reported health status was more prevalent among the long-lived elderly who were not depressed (PR = 0.49), and among those who consumed alcohol (PR = 1.99). Understanding which variables may interfere in the self-perceived health of the long-lived elderly can result in better health options for this population, mainly, new methods to prevent depression. Additionally, this information can help reduce costs associated with hospitalizations, medications and health treatments, all of which are very common among the long-lived elderly.

Factors associated with maintenance of the use of internet, EpiFloripa Idoso longitudinal study.

OBJECTIVE: To describe the use of the internet and to identify the sociodemographic and health factors associated with changes in the use of the internet over four years in older adults participating in the Brazilian EpiFloripa Idoso study. METHODS: This is a longitudinal home-based, population-based study with 1,197 older adults who live in the urban area of Florianópolis, State of Santa Catarina, Brazil. We applied a face-to-face interview. We describe the use of internet according to frequency, place, devices, and motives of the use of the internet. To identify factors associated with changes in the use of the internet, we categorized the outcome as: non-use of the internet, stopped using the internet, started using the internet, and kept using the internet. The independent variables were sex, age, family income, education level, family arrangement, marital status, presence of caregiver, paid work, and cognitive impairment screening. We used multinomial logistic regression with risk ratio (RR) estimates and their respective confidence intervals (95%CI). RESULTS: The prevalence of the use of internet increased from 22.9% in 2009-2010 to 26.6% in 2013-2014. Of the total number of older adults who participated in the study, 7.5% started using the internet, 3.2% stopped using it, 19.1% kept their use, and 70.2% kept their non-use in the analyzed period. Of the older adults who used the internet, most used it every day or almost every day of the week, in their own home, on desktop or portable computers, mainly to send and receive messages, to search for information to learn or investigate something, to find information about goods and services, and to use news, social networking, and health information websites. The factors associated with the use of internet over four years were: being male (RR = 2.19, 95%CI 1.48-3.26), higher monthly family income (RR = 3.53, 95%CI 1.35-9.23), higher education level (RR = 2.64, 95%CI 1.57-4.43), and no presence of caregiver (RR = 0.08, 95%CI 0.02-0.31). CONCLUSIONS: Although the use of the internet is increasing among older adults, most of the population is still digitally excluded, especially women with lower income and education level. Strategies that promote the digital inclusion of older adults should be stimulated, aiming to universalize the use of the internet, and they should take into account socioeconomic and gender inequalities.

Association between internet use and physically active leisure time: "EpiFloripa Idoso" longitudinal study / Associação entre uso de internet e manter-se ativo no lazer, estudo longitudinal EpiFloripa Idoso

Abstract The aim of this study was to verify the association between internet use and physically active leisure time during four years in older adults included in the "EpiFloripa Idoso" study, a population and longitudinal study with older adults (60+) residents in Florianópolis, Brazil, interviewed in 2009-10 (baseline) and 2013-14 (follow-up). The outcome was self-reported level of leisure physical activity, measured by the long version of the International Physical Activity Questionnaire, classified as remaining inactive; becoming inactive; becoming active; remaining active. Covariates were: gender; age (in years); per capita income in Reais; schooling (years of study); internet use longitudinally measured (remaining not using, stopping using, starting using, remaining using); and cognitive decline at baseline assessed by the Mini Mental State Examination. Relative risk ratio (RRR) adjusted by independent variables were estimated. Participants were 1,705 older adults at baseline and 1,197 at follow-up. The prevalence of remaining physically active during leisure time was 15.8% (95% CI 12.6 to 19.0) and was associated with being male (RRR = 2.14, 95% CI 1.50 to 3.05), less schooling (RRR = 0.99, 95% CI 0.99 to 0.99), starting using (RRR = 4.1, 95% CI 2.06 to 8.55) and remaining using the internet (RRR = 5.52,95% CI 3.25 to 9.36). This study can contribute to public policies for active and healthy aging through stimulation of internet use, since this technological behavior can help increasing the level of leisure physical activity in this population.

Resumo Objetivou-se verificar a associação entre mudanças no uso de internet e na prática de atividade física no lazer ao longo de quatro anos em idosos do estudo EpiFloripa Idoso. Estudo populacional longitudinal, com idosos residentes em Florianópolis/Brasil, entrevistados em 2009-10 (baseline) e em 2013-14 (seguimento). O desfecho foi o nível de atividade física no lazer autorreferido, mensurado pelo Questionário Internacional de Atividade Física versão longa, avaliado de forma longitudinal (manteve-se inativo; passou a ser inativo; passou a ser ativo; manteve-se ativo). Outras variaveis foram: sexo; idade (em anos completos); renda familiar per capita em Reais; escolaridade (em anos de estudo); uso de internet avaliado longitudinalmente (manteve o não uso; deixou de usar; passou a usar; manteve o uso); e o declinio cognitivo no baseline avaliado pelo Mini Exame do Estado Mental. Foram estimados razão de riscos relativos (RRR) ajustados pelas variáveis independentes, por regressão logística multinomial. Foram entrevistados 1.705 idosos no baseline e 1.197 no seguimento. A prevalência de manter-se ativo fisicamente no lazer (no seguimento) foi de 15,8% (IC95%=12,6-19,0) e associou-se ao sexo masculino (RRR=2,14; IC95%=1,50-3,05), menor escolaridade (RRR=0,99; IC95%=0,99-0,99), a passar a usar (RRR=4,1; IC95%=2,06-8,55) e a manter-se usando internet (RRR=5,52; IC95%=3,25-9,36). Os resultados deste estudo podem ter grande impacto nas políticas de envelhecimento ativo e saudável pois mostram que além de estimular a prática regular de atividades físicas de lazer deve-se estimular também o uso de internet, pois este comportamento tecnológico pode auxiliar no incremento do nível de atividade física de lazer de idosos.

Effects of physical exercise programs on cognitive function in Parkinson's disease patients: A systematic review of randomized controlled trials of the last 10 years.

BACKGROUND: Given the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions. PURPOSE: To determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group. DATA SOURCES: Medline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016). STUDY SELECTION: Randomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review. DATA EXTRACTION: Characteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality. DATA SYNTHESIS: Most eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients. LIMITATIONS: The diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs. CONCLUSIONS: Physical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition.