ABSTRACT
This study examines the effect of gender, age, and a 4-year training course for police officers (CFOP) on the physical fitness attributes of Portuguese police academy cadets. This longitudinal cohort study considered 686 police cadets (female, n = 131; male, n = 555 male), corresponding to 2578 fitness assessments (female, n = 509; male, n = 2069). The database of police cadets' physical fitness evaluations (from 2004/2005 to 2019/2020) comprises body size, speed, agility, strength, flexibility, and aerobic capacity first assessment (T0) and evaluations at the end of the first four years of the CFOP (T1, T2, T3, T4). Results showed that (i) female cadets are younger (p < 0.05), shorter, lighter, less fast, less agile, less strong, and perform worse in aerobic capacity assessments than male cadets (all, p < 0.001) but perform better in the flexibility assessment (p < 0.001); (ii) female cadets > 29 years are significantly heavier, slower, jump less, perform fewer sit-ups, and perform less on the Cooper test (but they have more handgrip strength), and male cadets > 29 years are significantly heavier, slower, jump less, perform fewer sit-ups, and have less flexibility and aerobic capacity (still, they have superior back and lumbar strength and handgrip strength); and (iii) from T0 to T4 (Δ), female cadets are significantly faster (60 m, -0.32 s; slalom, -0.78 s), jump further (+4 cm), have more abdominal strength endurance (+2.6 repetitions) and more back and lumbar strength (+89.8 kg), and male cadets are significantly heavier (+3.27 kg), faster (60 m, -0.23 s; 30 m, -0.15 s; slalom, -0.91 s), jump further (+8 cm), complete more repetitions in the sit-ups (+4.9 repetitions) and in pull-ups (+2.5 repetitions) and have more back and lumbar strength (+92.1 kg) and handgrip strength (+8.6 kg) but a lower aerobic capacity (Cooper test, -74.8 m; VO2max, -1.3 mL/kg/min) when compared to T0. The study's findings lead to widely accepted conclusions within the discipline. Nevertheless, this work provides valuable insights into the impact of various factors on the physical fitness of Portuguese police academy cadets, i.e.: (i) it is an essential study with practical implications for recruitment, training, and the ongoing development of Portuguese police academy cadets and police officers; and (ii) these results can also assist in tailoring training programs to different age groups and genders, which is crucial in police training.
ABSTRACT
Personal care products, such as UV filters, are frequently present in aquatic ecosystems, but studies on their impact on marine organisms are still scarce. Here we addressed the effects of benzophenone-3 (BP-3) on the antioxidant status of Perna perna mussels exposed to concentrations of 0.1 and 3 µg.L-1 for 72 h and 7 days. Glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST), glucose-6-phosphate dehydrogenase (G6PDH) activity and lipoperoxidation (MDA) were evaluated in the gills. A significant reduction (p < 0.05) in the activity of G6PDH and GPx was observed after exposure for 7 days to 0.1 µg.L-1. However, no significant differences were observed in GST activity and MDA levels, independently of the exposure time. Principal component analysis (PCA) showed an association of BP-3 highest concentration with GR and MDA at 72 h and only with GR at 7 days of exposure. Similarly, the integrated biomarker response (IBR) demonstrated GR and MDA alterations. In conclusion, environmentally relevant concentrations of BP-3 altered antioxidant and auxiliary enzymes, which could cause long-term damage to P.perna mussels. The need to implement more efficient techniques in wastewater treatment systems is pointed out, especially in summer, when UV filters are used more frequently and abundantly.
Subject(s)
Perna , Water Pollutants, Chemical , Animals , Antioxidants , Perna/physiology , Ecosystem , Catalase , Glutathione Transferase , Glutathione Reductase/pharmacology , Glutathione Peroxidase/pharmacology , Water Pollutants, Chemical/toxicity , BiomarkersABSTRACT
Age increases the risk for cognitive impairment and is the single major risk factor for Alzheimer's disease (AD), the most prevalent form of dementia in the elderly. The pathophysiological processes triggered by aging that render the brain vulnerable to dementia involve, at least in part, changes in inflammatory mediators. Here we show that lipoxin A4 (LXA4), a lipid mediator of inflammation resolution known to stimulate endocannabinoid signaling in the brain, is reduced in the aging central nervous system. We demonstrate that genetic suppression of 5-lipoxygenase (5-LOX), the enzyme mediating LXA4 synthesis, promotes learning impairment in mice. Conversely, administration of exogenous LXA4 attenuated cytokine production and memory loss induced by inflammation in mice. We further show that cerebrospinal fluid LXA4 is reduced in patients with dementia and positively associated with cognitive performance, brain-derived neurotrophic factor (BDNF), and AD-linked amyloid-ß. Our findings suggest that reduced LXA4 levels may lead to vulnerability to age-related cognitive disorders and that promoting LXA4 signaling may comprise an effective strategy to prevent early cognitive decline in AD.
Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Lipoxins , Aged , Alzheimer Disease/genetics , Animals , Arachidonate 5-Lipoxygenase/genetics , Brain-Derived Neurotrophic Factor , Cognition , Cytokines , Endocannabinoids , Humans , Inflammation , Inflammation Mediators , Lipoxins/metabolism , MiceABSTRACT
The aging of the population leads to an increase in the prevalence of dementia and mild cognitive impairment (MCI). Alzheimer's disease (AD) is the most common cause of dementia. Recent studies highlight the early non-amnestic deficits in AD and MCI. The European Union report shows the importance of thoroughly assessing cognitive aspects that have been poorly evaluated, such as processing speed (PS), which could represent early indicators of cognitive decline. OBJECTIVE: To analyze the diagnostic accuracy of PS measures in older adults with MCI, AD, and those who are cognitively-healthy. METHODS: A cross-sectional study was conducted by performing an extensive neuropsychological assessment in three samples: 26 control participants, 22 individuals with MCI, and 21 individuals with AD. Analysis of variance (ANOVA) was employed to test the relationship between dependent variables and the clinical group. Post hoc tests (Bonferroni test) were used when a significant ANOVA result was found. Finally, the Receiver Operating Characteristic (ROC) curve for PS measures was performed in older adults with MCI and AD compared with cognitively-healthy older adults. RESULTS: The results showed that deficits in PS measures can be early indicators of cognitive decline in cases of MCI, even when executive functions (EFs) and functionality are preserved. Conversely, AD versus MCI presented differences in PS, EFs, and functionality. CONCLUSIONS: The ROC analyses showed that PS measures had discriminative capacities to differentiate individuals with MCI, AD, and cognitively-healthy older adults.
O envelhecimento da população leva ao aumento da prevalência de demência e comprometimento cognitivo leve (CCL). A doença de Alzheimer (DA) é a causa mais comum de demência. Estudos recentes destacam os déficits precoces não amnésicos em DA e CCL. O relatório da União Europeia mostra a necessidade de avaliar em maior profundidade aspectos cognitivos que atualmente são negligenciados, como a velocidade de processamento (VP), e que podem representar indicadores precoces de declínio cognitivo. OBJETIVO: O objetivo deste estudo foi analisar a acurácia diagnóstica de medidas de VP em idosos com CCL, DA e participantes controles. MÉTODOS: um estudo transversal foi desenvolvido, no qual realizou-se uma extensa avaliação neuropsicológica em 3 amostras: 26 participantes controles, 22 casos de CCL e 21 DA. A relação entre as variáveis dependentes e o grupo clínico foi testada com uma análise de variância (ANOVA). Se uma ANOVA significativa fosse encontrada, testes post hoc foram utilizados. Por fim, a curva ROC para medidas de VP foi realizada em CCL e DA em comparação com indivíduos controles. RESULTADOS: os resultados mostraram que déficits nas medidas de VP podem ser indicadores precoces do declínio cognitivo nos casos de CCL, mesmo quando as funções executivas (FE) e a funcionalidade estão preservadas. Por outro lado, DA versus CCL mostrou diferenças em VP, EF e funcionalidade. CONCLUSÕES: As análises ROC mostraram que as medidas de PS tinham capacidades discriminativas para diferenciar CCL, DA e participantes controles.
ABSTRACT
ABSTRACT The aging of the population leads to an increase in the prevalence of dementia and mild cognitive impairment (MCI). Alzheimer's disease (AD) is the most common cause of dementia. Recent studies highlight the early non-amnestic deficits in AD and MCI. The European Union report shows the importance of thoroughly assessing cognitive aspects that have been poorly evaluated, such as processing speed (PS), which could represent early indicators of cognitive decline. Objective: To analyze the diagnostic accuracy of PS measures in older adults with MCI, AD, and those who are cognitively-healthy. Methods: A cross-sectional study was conducted by performing an extensive neuropsychological assessment in three samples: 26 control participants, 22 individuals with MCI, and 21 individuals with AD. Analysis of variance (ANOVA) was employed to test the relationship between dependent variables and the clinical group. Post hoc tests (Bonferroni test) were used when a significant ANOVA result was found. Finally, the Receiver Operating Characteristic (ROC) curve for PS measures was performed in older adults with MCI and AD compared with cognitively-healthy older adults. Results: The results showed that deficits in PS measures can be early indicators of cognitive decline in cases of MCI, even when executive functions (EFs) and functionality are preserved. Conversely, AD versus MCI presented differences in PS, EFs, and functionality. Conclusions: The ROC analyses showed that PS measures had discriminative capacities to differentiate individuals with MCI, AD, and cognitively-healthy older adults.
RESUMO O envelhecimento da população leva ao aumento da prevalência de demência e comprometimento cognitivo leve (CCL). A doença de Alzheimer (DA) é a causa mais comum de demência. Estudos recentes destacam os déficits precoces não amnésicos em DA e CCL. O relatório da União Europeia mostra a necessidade de avaliar em maior profundidade aspectos cognitivos que atualmente são negligenciados, como a velocidade de processamento (VP), e que podem representar indicadores precoces de declínio cognitivo. Objetivo: O objetivo deste estudo foi analisar a acurácia diagnóstica de medidas de VP em idosos com CCL, DA e participantes controles. Métodos: um estudo transversal foi desenvolvido, no qual realizou-se uma extensa avaliação neuropsicológica em 3 amostras: 26 participantes controles, 22 casos de CCL e 21 DA. A relação entre as variáveis dependentes e o grupo clínico foi testada com uma análise de variância (ANOVA). Se uma ANOVA significativa fosse encontrada, testes post hoc foram utilizados. Por fim, a curva ROC para medidas de VP foi realizada em CCL e DA em comparação com indivíduos controles. Resultados: os resultados mostraram que déficits nas medidas de VP podem ser indicadores precoces do declínio cognitivo nos casos de CCL, mesmo quando as funções executivas (FE) e a funcionalidade estão preservadas. Por outro lado, DA versus CCL mostrou diferenças em VP, EF e funcionalidade. Conclusões: As análises ROC mostraram que as medidas de PS tinham capacidades discriminativas para diferenciar CCL, DA e participantes controles.
Subject(s)
Humans , Cognition , Diagnosis , Alzheimer Disease , Cognitive DysfunctionABSTRACT
Current treatments for Alzheimer's disease are only symptomatic and limited to reduce the progression rate of the mental deterioration. Mild Cognitive Impairment, a transitional stage in which the patient is not cognitively normal but do not meet the criteria for specific dementia, is associated with high risk for development of Alzheimer's disease. Thus, non-invasive techniques to predict the individual's risk to develop Alzheimer's disease can be very helpful, considering the possibility of early treatment. Diffusion Tensor Imaging, as an indicator of cerebral white matter integrity, may detect and track earlier evidence of white matter abnormalities in patients developing Alzheimer's disease. Here we performed a voxel-based analysis of fractional anisotropy in three classes of subjects: Alzheimer's disease patients, Mild Cognitive Impairment patients, and healthy controls. We performed Support Vector Machine classification between the three groups, using Fisher Score feature selection and Leave-one-out cross-validation. Bilateral intersection of hippocampal cingulum and parahippocampal gyrus (referred as parahippocampal cingulum) is the region that best discriminates Alzheimer's disease fractional anisotropy values, resulting in an accuracy of 93% for discriminating between Alzheimer's disease and controls, and 90% between Alzheimer's disease and Mild Cognitive Impairment. These results suggest that pattern classification of Diffusion Tensor Imaging can help diagnosis of Alzheimer's disease, specially when focusing on the parahippocampal cingulum.
Subject(s)
Alzheimer Disease/diagnostic imaging , Hippocampus/diagnostic imaging , Aged , Anisotropy , Case-Control Studies , Female , Humans , Male , Organ Specificity , Support Vector MachineABSTRACT
This proposed novel method consists of three levels of analyses of diffusion tensor imaging data: 1) voxel level analysis of fractional anisotropy of white matter tracks, 2) connection level analysis, based on fiber tracks between specific brain regions, and 3) network level analysis, based connections among multiple brain regions. Machine-learning techniques of (Fisher score) feature selection, (Support Vector Machine) pattern classification, and (Leave-one-out) cross-validation are performed, for recognition of the neural connectivity patterns for diagnostic purposes. For validation proposes, this multilevel approach achieved an average classification accuracy of 90% between Alzheimer's disease and healthy controls, 83% between Alzheimer's disease and mild cognitive impairment, and 83% between mild cognitive impairment and healthy controls. The results indicate that the multilevel diffusion tensor imaging approach used in this analysis is a potential diagnostic tool for clinical evaluations of brain disorders. The presented pipeline is now available as a tool for scientifically applications in a broad range of studies from both clinical and behavioral spectrum, which includes studies about autism, dyslexia, schizophrenia, dementia, motor body performance, among others.
Subject(s)
Alzheimer Disease , White Matter , Alzheimer Disease/diagnostic imaging , Anisotropy , Brain/diagnostic imaging , Diffusion Tensor Imaging , Humans , Magnetic Resonance Imaging , White Matter/diagnostic imagingABSTRACT
BACKGROUND: Narrative discourse (ND) refers to one's ability to verbally reproduce a sequence of temporally and logically-linked events. Impairments in ND may occur in subjects with Amnestic Mild Cognitive Impairment (aMCI) and Alzheimer's Disease (AD), but correlates across this function, neuroimaging and cerebrospinal fluid (CSF) AD biomarkers remain understudied. OBJECTIVES: We sought to measure correlates among ND, Diffusion Tensor Imaging (DTI) indexes and AD CSF biomarkers in patients within the AD spectrum. RESULTS: Groups differed in narrative production (NProd) and comprehension. aMCI and AD presented poorer inference abilities than controls. AD subjects were more impaired than controls and aMCI regarding WB (p<0.01). ROIs DTI assessment distinguished the three groups. Mean Diffusivity (MD) in the uncinate, bilateral parahippocampal cingulate and left inferior occipitofrontal fasciculi negatively correlated with NProd. Changes in specific tracts correlated with T-tau/Aß1-42 ratio in CSF. CONCLUSIONS: AD and aMCI patients presented more ND impairments than controls. Those findings were associated with changes in ventral language-associated and in the inferior parahippocampal pathways. The latest were correlated with biomarkers' levels in the CSF. METHODS: AD (N=14), aMCI (N=31) and Control (N=39) groups were compared for whole brain (WB) and regions of interest (ROI) DTI parameters, ND and AD CSF biomarkers.
Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Neuropsychological Tests , White Matter/pathology , Aged , Biomarkers/cerebrospinal fluid , Female , Humans , MaleABSTRACT
The human brain is a complex network of interacting regions. The gray matter regions of brain are interconnected by white matter tracts, together forming one integrative complex network. In this article, we report our investigation about the potential of applying brain connectivity patterns as an aid in diagnosing Alzheimer's disease and Mild Cognitive Impairment (MCI). We performed pattern analysis of graph theoretical measures derived from Diffusion Tensor Imaging (DTI) data representing structural brain networks of 45 subjects, consisting of 15 patients of Alzheimer's disease (AD), 15 patients of MCI, and 15 healthy subjects (CT). We considered pair-wise class combinations of subjects, defining three separate classification tasks, i.e., AD-CT, AD-MCI, and CT-MCI, and used an ensemble classification module to perform the classification tasks. Our ensemble framework with feature selection shows a promising performance with classification accuracy of 83.3% for AD vs. MCI, 80% for AD vs. CT, and 70% for MCI vs. CT. Moreover, our findings suggest that AD can be related to graph measures abnormalities at Brodmann areas in the sensorimotor cortex and piriform cortex. In this way, node redundancy coefficient and load centrality in the primary motor cortex were recognized as good indicators of AD in contrast to MCI. In general, load centrality, betweenness centrality, and closeness centrality were found to be the most relevant network measures, as they were the top identified features at different nodes. The present study can be regarded as a "proof of concept" about a procedure for the classification of MRI markers between AD dementia, MCI, and normal old individuals, due to the small and not well-defined groups of AD and MCI patients. Future studies with larger samples of subjects and more sophisticated patient exclusion criteria are necessary toward the development of a more precise technique for clinical diagnosis.
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OBJECTIVE: To perform a pilot study to investigate the association between working memory and cortical thickness in a sample of attention deficit/hyperactivity disorder (ADHD) children. METHODS: Seventeen children aged 7-10 years diagnosed with ADHD and 16 healthy children underwent a magnetic resonance scan for cortical thickness measurements. Data was correlated with working memory performance using the Backwards Digit Span subtest of the Wechsler Intelligence Scale for Children. RESULTS: Working memory impairment, evidenced by lower scores on the Backwards Digit Span, was observed in patients with ADHD compared to healthy controls. There was a direct correlation between working memory and cortical thickness of the left medial temporal lobe (Spearman's correlation coefficient: 0.499; p < 0.005). CONCLUSIONS: Our data suggests, for the first time, a correlation between working memory, evaluated by the Backwards Digit Span, and left medial temporal cortical thickness.
Subject(s)
Attention Deficit Disorder with Hyperactivity/physiopathology , Memory, Short-Term/physiology , Temporal Lobe/anatomy & histology , Temporal Lobe/physiopathology , Age Factors , Case-Control Studies , Child , Female , Humans , Magnetic Resonance Imaging , Male , Neuropsychological Tests , Pilot Projects , Reference Values , Sex Factors , Statistics, Nonparametric , Surveys and Questionnaires , Temporal Lobe/diagnostic imaging , Wechsler ScalesABSTRACT
ABSTRACT Objective To perform a pilot study to investigate the association between working memory and cortical thickness in a sample of attention deficit/hyperactivity disorder (ADHD) children. Methods Seventeen children aged 7-10 years diagnosed with ADHD and 16 healthy children underwent a magnetic resonance scan for cortical thickness measurements. Data was correlated with working memory performance using the Backwards Digit Span subtest of the Wechsler Intelligence Scale for Children. Results Working memory impairment, evidenced by lower scores on the Backwards Digit Span, was observed in patients with ADHD compared to healthy controls. There was a direct correlation between working memory and cortical thickness of the left medial temporal lobe (Spearman’s correlation coefficient: 0.499; p < 0.005). Conclusions Our data suggests, for the first time, a correlation between working memory, evaluated by the Backwards Digit Span, and left medial temporal cortical thickness.
RESUMO Objetivo Realizar estudo piloto para investigar a associação entre memória de trabalho e espessura cortical em crianças com transtorno de défict de atenção e hiperatividade (TDAH). Métodos Dezessete crianças com TDAH, entre 7 e 10 anos, e dezesseis crianças saudáveis foram submetidas a ressonância magnética para aferição de espessura cortical. Os dados foram correlacionados com desempenho da memória de trabalho usando a ordem inversa do subteste Dígitos da Escala de Inteligência Wechsler para Crianças. Resultados Prejuízos na memória de trabalho, evidenciado pela menor pontuação na ordem inversa do subteste Dígitos, foram observados em pacientes com TDAH, em comparação com crianças saudáveis. Observou-se correlação direta entre memória de trabalho e espessura do lobo temporal médio à esquerda (coeficiente de correlação de Spearman: 0,499; p < 0,005). Conclusões Nossos dados sugerem, pela primeira vez, uma correlação entre memória de trabalho, avaliada através da pontuação na ordem inversa do subteste Dígitos, e espessura do córtex temporal medial à esquerda.
Subject(s)
Humans , Male , Female , Child , Attention Deficit Disorder with Hyperactivity/physiopathology , Temporal Lobe/anatomy & histology , Temporal Lobe/physiopathology , Memory, Short-Term/physiology , Reference Values , Temporal Lobe/diagnostic imaging , Wechsler Scales , Magnetic Resonance Imaging , Case-Control Studies , Pilot Projects , Sex Factors , Surveys and Questionnaires , Age Factors , Statistics, Nonparametric , Neuropsychological TestsABSTRACT
Objective: To investigate whether the level of awareness of memory deficits is useful for discriminating between major depressive disorder (MDD) and mild cognitive impairment (MCI) in the elderly. Methods: Sixty-three consecutively referred patients (38 women and 25 men) with memory concerns comprising three groups (clinical control, MDD and MCI) underwent a memory test (Rey Auditory Verbal Learning Test [RAVLT]) and completed the Memory Assessment Complaints-Questionnaire (MAC-Q). Level of awareness was estimated by the difference between the MAC-Q score and the score on the fifth presentation of the RAVLT. Memory performance, Mini-Mental State Examination (MMSE) and depressive symptoms (Geriatric Depression Scale [GDS]) were also assessed. Results: The control (n=25), MDD (n=16), and MCI (n=22) groups were similar in age, educational level, and MMSE (p > 0.05). Among the groups, the MDD group had the most memory complaints, whereas the MCI group had the worst objective memory performance. Level of awareness was capable of discriminating between MDD and MCI (p < 0.05), but not between MDD and clinical controls (p > 0.05). MDD subjects tended to underestimate their memory functioning as compared to controls (p < 0.05). Conclusion: Level of awareness of memory deficits was significantly useful to discriminate between MCI and MDD, which is a common difficulty faced by clinicians. Future studies with larger samples are needed to confirm these findings.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Awareness , Depressive Disorder, Major/diagnosis , Cognitive Dysfunction/diagnosis , Memory Disorders/diagnosis , Case-Control Studies , Predictive Value of Tests , Surveys and Questionnaires , Analysis of Variance , Statistics, Nonparametric , Depressive Disorder, Major/physiopathology , Diagnosis, Differential , Cognitive Dysfunction/physiopathology , Memory Disorders/physiopathology , Middle Aged , Neuropsychological TestsABSTRACT
Este artigo consiste numa apresentação de informações a respeito das mobilizações e debates causados pela discussão acerca da redução da maioridade penal no Brasil em 2015, proposta feita pelo Projeto de Emenda Constitucional (PEC) nº 171/1993, colocando em foco a questão da opinião pública e suas influências, em perspectiva comparada a acontecimento semelhante ocorrido no Uruguai em 2014 que teve como atores influentes organizações da sociedade civil, empenhadas na mudança da opinião pública a respeito do tema em discussão.
This article consists in a set of informations about reducing the legal age in Brazil, presenting the debates involved in the proposal made by the Constitutional Amendment Project (PEC) nº 171/1993 which was discussed in the country in 2015. The artice focuss the question of public opinion and their influences comparing to a similar event occurred in Uruguay in 2014, which had as an important actor the civil society organizations, committed to changing public opinion on the subject under discussion.
El artículo consiste en una presentación de informaciones sobre las manifestaciones y debates provocados por la discusión de reducción de la edad penal en Brasil en 2015, propuesta realizada por el Proyecto de Enmienda Constitucional (PEC) nº 171/1993, poniendo de relieve la cuestión de la opinión pública y sus influencias en comparación al evento similar ocurrido en Uruguay en 2014, que tenía como actor importante la sociedad civil organizada en el proceso de cambio de la opinión pública sobre el tema de reducción.
Cet article concerne la présentation d'informations sur les mobilisations et les débats suscités par la discussion sur la réduction de la majorité criminelle au Brésil en 2015, proposée par le projet de modification constitutionnelle (PEC) nº 171/1993, portant sur la question de la l'opinion publique et ses influences, en perspective par rapport à un événement similaire survenu en Uruguay en 2014 qui avait comme acteurs influents les organisations de la société civile, engagés à changer l'opinion publique sur le sujet en discussion.
ABSTRACT
A 45-year-old married woman with fits of episodic dyscontrol since an early age suffered a bilateral injury of the dorsolateral temporal lobe after which such episodes vanished for good. The remission of her lifelong proneness to aggression was so remarkable that her relatives and friends unanimously welcomed her "new personality". The post-traumatic taming in this case was an unanticipated collateral effect of brain damage with a salutary change of personality. This change possibly resulted from the release, due to the bitemporal injury, of inclinations that had not hitherto been fully expressed in the patient's mind and behavior due to the overriding influence of episodic dyscontrol on her ordinary conduct.
Subject(s)
Brain Injuries, Traumatic/physiopathology , Disruptive, Impulse Control, and Conduct Disorders/physiopathology , Personality Disorders/physiopathology , Female , Humans , Middle AgedABSTRACT
OBJECTIVE: To investigate whether the level of awareness of memory deficits is useful for discriminating between major depressive disorder (MDD) and mild cognitive impairment (MCI) in the elderly. METHODS: Sixty-three consecutively referred patients (38 women and 25 men) with memory concerns comprising three groups (clinical control, MDD and MCI) underwent a memory test (Rey Auditory Verbal Learning Test [RAVLT]) and completed the Memory Assessment Complaints-Questionnaire (MAC-Q). Level of awareness was estimated by the difference between the MAC-Q score and the score on the fifth presentation of the RAVLT. Memory performance, Mini-Mental State Examination (MMSE) and depressive symptoms (Geriatric Depression Scale [GDS]) were also assessed. RESULTS: The control (n=25), MDD (n=16), and MCI (n=22) groups were similar in age, educational level, and MMSE (p > 0.05). Among the groups, the MDD group had the most memory complaints, whereas the MCI group had the worst objective memory performance. Level of awareness was capable of discriminating between MDD and MCI (p < 0.05), but not between MDD and clinical controls (p > 0.05). MDD subjects tended to underestimate their memory functioning as compared to controls (p < 0.05). CONCLUSION: Level of awareness of memory deficits was significantly useful to discriminate between MCI and MDD, which is a common difficulty faced by clinicians. Future studies with larger samples are needed to confirm these findings.
Subject(s)
Awareness , Cognitive Dysfunction/diagnosis , Depressive Disorder, Major/diagnosis , Memory Disorders/diagnosis , Aged , Aged, 80 and over , Analysis of Variance , Case-Control Studies , Cognitive Dysfunction/physiopathology , Depressive Disorder, Major/physiopathology , Diagnosis, Differential , Female , Humans , Male , Memory Disorders/physiopathology , Middle Aged , Neuropsychological Tests , Predictive Value of Tests , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The Barratt Impulsiveness Scale (BIS-11) is a valid and reliable instrument, and one of the most often used tools to assess impulsivity. This study assesses the performance of a large sample of adults by using a version of BIS-11 adapted to Brazilian Portuguese. METHODS: We assessed 3,053 adults from eight Brazilian states. Internal consistencies and performance data were presented for two correction criteria of BIS-11: original and the two-factor score. RESULTS: The associations between age, sex, region, and education and the BIS-11 scores present very small effect sizes. Therefore, we provided a percentile rank parameter for the different BIS-11 subscores considering the whole sample. Given the internal consistency of the two correction systems, we found that only the two-factor system fulfills the psychometric criteria of Cronbach's alpha (cutoff value of at least 0.6). CONCLUSION: Our results support the use of the Brazilian adaptation of BIS-11 in different regions of the country as a measure of impulsivity. Since high impulsiveness is a characteristic of several dysfunctional behaviors, the establishment of normative parameters is of utmost relevance and should be extended to other age ranges and populations in future studies.
Subject(s)
Impulsive Behavior , Psychiatric Status Rating Scales/standards , Self Report/standards , Adolescent , Adult , Aged , Aged, 80 and over , Brazil , Cross-Cultural Comparison , Cultural Characteristics , Educational Status , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Psychometrics/standards , Reference Standards , Reproducibility of Results , Young AdultABSTRACT
Language batteries used to assess the skills of elderly individuals, such as naming and semantic verbal fluency, present some limitations in differentiating healthy controls from patients with amnestic mild cognitive impairment (a-MCI). Deficits in narrative discourse occur early in dementia caused by Alzheimer's disease (AD), and the narrative discourse abilities of a-MCI patients are poorly documented. The present study sought to propose and evaluate parameters for investigating narrative discourse in these populations. After a pilot study of 30 healthy subjects who served as a preliminary investigation of macro- and micro-linguistic aspects, 77 individuals (patients with AD and a-MCI and a control group) were evaluated. The experimental task required the participants to narrate a story based on a sequence of actions visually presented. The Control and AD groups differed in all parameters except narrative time and the total number of words recalled. The a-MCI group displayed mild discursive difficulties that were characterized as an intermediate stage between the Control and AD groups' performances. The a-MCI and Control groups differed from the AD group with respect to global coherence, discourse type and referential cohesion. The a-MCI and AD groups were similar to one another but differed from the Control group with respect to the type of words recalled, the repetition of words in the same sentence, the narrative structure and the inclusion of irrelevant propositions in the narrative. The narrative parameter that best distinguished the three groups was the speech effectiveness index. The proposed task was able to reveal differences between healthy controls and groups with cognitive decline. According to our findings, patients with a-MCI already present narrative deficits that are characterized by mild discursive difficulties that are less severe than those found in patients with AD.
ABSTRACT
BACKGROUND: Prose memory tests exhibit ecological validity, but the influence of non-memory functions on immediate recall in elderly subjects with memory complaints has not been fully investigated. This study examined (1) whether the ability to immediately recall a story can distinguish among clinical controls, amnesic mild cognitive impairment (MCI) and dementia due to Alzheimer's disease (AD) and (2) which cognitive functions contribute to immediate recall performance. METHODS: A total of 73 consecutive volunteers (50 women and 23 men) aged 47-88 (mean age = 71.85 ± 9.41) and with a mean schooling level of 12.51 (SD = 4.09) participated in the experiment. All individuals were seeking specialized evaluation because of memory complaints. Diagnoses were made by considering clinical, neuropsychological, and MRI assessments collected by a multidisciplinary team of neurologists, neuropsychologists, and speech-language therapists. A total of 26 individuals were classified as clinical controls; 27 as MCI patients; and 20 as having AD dementia. All individuals in the AD group had a Clinical Dementia Rating (CDR) ≤ 1. RESULTS: Immediate recall was only able to distinguish AD subjects from MCI patients and clinical controls (p > 0.05). Stepwise multiple linear regression analysis revealed that mental status (MMSE), semantic memory (WAIS-III vocabulary) and episodic memory (RAVLT primacy) explained approximately 62% of the variance in immediate recall. CONCLUSIONS: Understanding the value and limitations of immediate story recall in distinguishing between MCI and AD may help clinicians in better choosing cognitive tests to diagnose MCI.
Subject(s)
Aging , Alzheimer Disease/psychology , Cognitive Dysfunction/diagnosis , Memory, Short-Term/physiology , Aged , Aged, 80 and over , Cognition , Female , Humans , Linear Models , Male , Middle Aged , Neuropsychological Tests , Psychiatric Status Rating ScalesABSTRACT
BACKGROUND Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. OBJECTIVE Perform psychometric analysis of a functional impairment scale (FIE). METHODS A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach’s alpha and Spearman-Brown were calculated. RESULTS Family analysis revealed four components: a) “family life”, b) “self-perception”, c) “performance” and d) “social life”. Adults’ analysis revealed two components: a) “family life, social life and self-perception” and b) “performance”. Children showed the domains: a) “performance and social life”, b) “self-perception” and c) “family life” components. Cronbach’s alpha were above 0.9 in all components. DISCUSSION Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups. .
Subject(s)
Humans , Male , Female , Attention Deficit Disorder with Hyperactivity/diagnosis , Interviews as Topic , Family RelationsABSTRACT
INTRODUCTION: Brain tumors are the most common solid tumors and the second largest group of neoplasms diagnosed in childhood. Treatment includes surgery, radiotherapy, and chemotherapy. However, radiotherapy can cause complications, e.g., cognitive deficits. CASE DESCRIPTION: We describe the case of a child diagnosed with a brain tumor evaluated before and after radiotherapy to investigate cognitive decline after treatment. The results showed a decline in Intelligence Quotient (IQ) scores and reversal of the predominance of verbal and nonverbal skills. After radiotherapy, the subject showed slowness, academic deficits, and difficulties learning new information. COMMENTS: Even though the post-treatment evaluation showed scores compatible with the average, comparison between pre- and post-treatment evaluations demonstrated the impact of radiotherapy on the subject's cognitive profile. These results highlight the importance of evaluating patients who undergo radiotherapy before and after treatment and understanding neuropsychological scores associated with the subjects' complaints (AU)
INTRODUÇÃO: Tumores cerebrais são os tumores sólidos mais comuns e o segundo maior grupo de neoplasias diagnosticadas na infância. O tratamento inclui cirurgia, radioterapia e quimioterapia. No entanto, a radioterapia pode causar complicações, como, por exemplo, déficits cognitivos. DESCRIÇÃO DO CASO: Descrevemos o caso de uma criança diagnosticada com tumor cerebral e avaliada antes e após tratamento com radioterapia para investigar declínio cognitivo pós-tratamento. Os resultados demonstraram um declínio nos escores de Quociente de Inteligência (QI) e uma reversão da predominância em habilidades verbais e não verbais. Após a radioterapia, o sujeito demonstrou lentidão, déficits acadêmicos e dificuldade para aprender novas informações. COMENTÁRIO: Embora a avaliação pós-tratamento tenha mostrado escores compatíveis com a média, a comparação entre as avaliações pré e pós-tratamento evidenciaram o impacto da radioterapia sobre o perfil cognitivo do paciente. Esses resultados salientam a importância de avaliar pacientes tratados com radioterapia antes e após o tratamento e de entender os escores neuropsicológicos associados às queixas dos pacientes (AU)