Tooth loss is associated with severe cognitive impairment among older people: findings from a population-based study in Brazil.

BACKGROUND: A consistent and low-to-moderate association between markers of oral infection and loss of cognitive function has been demonstrated in the literature. However, such evidence comes from population studies carried out mainly in the USA. OBJECTIVES: To assess the association between tooth loss and loss of cognitive function in older people from Southern Brazil, with particular interest on how age may modify such association. In addition, we also test the association between loss of cognition (exposure) and tooth loss (outcome). METHODS: Data from a baseline population-based cohort study were cross-sectionally analyzed, including tooth loss, cognitive impairment, sex, income, educational attainment, color/race, smoking status and a range of self-reported chronic diseases. Participants (n = 1705) were 60 years of age and over, from a midsized Southern Brazilian city. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using multivariable logistic and partial ordinal logistic analyses. RESULTS: Edentate status was associated (OR 3.3; 95%CI 1.2-9.3) with severe cognitive impairment in the fully adjusted model. Moreover, there was an interaction between number of teeth and age on severe cognitive impairment. A weak association between severe cognitive impairment (exposure) and tooth loss (outcome) was identified after the adjustment for potential covariates. CONCLUSIONS: This study lends support to hypothesized association between tooth loss and severe cognitive impairment. Older adults seem to be particularly vulnerable to such effects. However, the bidirectional association between tooth loss and severe cognitive impairment cannot be ruled out.

English Longitudinal Study of Aging: can Internet/E-mail use reduce cognitive decline?

BACKGROUND: Cognitive decline is a major risk factor for disability, dementia, and death. The use of Internet/E-mail, also known as digital literacy, might decrease dementia incidence among the older population. The aim was to investigate whether digital literacy might be associated with decreased cognitive decline in older adulthood. METHODS: Data from the English Longitudinal Study of Aging cohort with 6,442 participants aged 50-89 years, followed for 8 years, with baseline cognitive testing and four additional time points. The main outcome variable was the relative percentage change in delayed recall from a 10-word-list learning task across five separate measurement points. In addition to digital literacy, socioeconomic variables, including wealth and education, comorbidities, and baseline cognitive function were included in predictive models. The analysis used Generalized Estimating Equations. RESULTS: Higher education, no functional impairment, fewer depressive symptoms, no diabetes, and Internet/E-mail use predicted better performance in delayed recall. CONCLUSIONS: Digital literacy may help reduce cognitive decline among persons aged between 50 and 89 years.

Validação da versão em português do Inventário de Depressão Maior / Validation of the Portuguese version of the Major Depression Inventory

OBJETIVO: Validar, adaptar e aferir a fidedignidade do Inventário de Depressão Maior (Major Depression Inventory - MDI) para a língua portuguesa. MÉTODOS: O questionário passou pelo processo de adaptação transcultural. Foi realizado um pré-teste para avaliar sua aplicabilidade. Para avaliação de reprodutibilidade, utilizou-se medida repetida com intervalo de 1 a 2 semanas e coeficiente de correlação intraclasse. O MDI e a escala de Hamilton foram aplicados em 30 pacientes com diagnóstico de depressão, que foram pareados com 90 controles aos quais foi aplicado o MDI. A curva ROC foi realizada com 120 pacientes e escore final do MDI. Para análise da validade interna, utilizou-se o alfa de Cronbach. RESULTADOS: Sensibilidade e especificidade foram 0,86 e 0,75, respectivamente, com escores 16/17. O alfa de Cronbach para a escala total foi 0,91. O coeficiente de Pearson entre o total do MDI e o total da escala de depressão de Hamilton foi 0,56. A análise fatorial revelou dois fatores: o primeiro explicava 53,9 por cento da variação enquanto o segundo explicava somente 13,6 por cento. A confiabilidade teste-reteste foi excelente (com coeficiente de correlação intraclasse variando de 0,50 e 0,93 para itens individuais e 0,90 para o escore total). CONCLUSÃO: As propriedades psicométricas do MDI se mostraram adequadas para aplicação na população brasileira, entretanto outros estudos se fazem necessários.

OBJECTIVE: To validate, adapt and assess the reliability for the Major Depression Inventory (MDI) to the Portuguese language. METHODS: The questionnary underwent a cultural adaptation process. A pre-test was made to check on its aplicability. To analise the reprodutibility, repeted mesuare was used in two oportunities, 1 and 2 weeks later, using the Intraclasses Correlation Coeficient. The MDI and the Hamilton Depression Escale were applied in 30 pacients with depression and pared with 90 controls to whom the MDI was applied to. The ROC curve was performed with 120 pacients and the final MDI score. The internal consistency was evaluated by means of Cronbach's alpha. RESULTS: Sensitivity and specificity were 0.86 and 0.75, respectively, with scors 16/17. Cronbach alfa's for the total scale was 0.91. The Pearson's coeficient between MDI and Hamilton depression scale was 0.56. The factor analisis revealed 2 factors: the first explained 53.9 percent of variance while the second explained only 13.6 percent. The test-retest reliability was excellent (with intraclass coeficient correlation between 0.50 and 0.93 for individuals itens and 0.90 for total scale). CONCLUSION: MDI's properties showed to be appropriate to apply in the Brasilian population, but further studies are necessary.