The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States.

Introduction: The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities.It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population. Methods: We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles. Results: This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials. Conclusions: The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities. HIGHLIGHTS: The Brazilian population in the United States is growing but is underrepresented in U.S. health research.Approximately 71% of Brazilian immigrants in the United States are undocumented, with an increased risk for health inequities.Mental health is reported as a central health priority by Brazilian immigrants in the United States.There is a lack of research on Alzheimer's disease and other dementias (ADRD) in Brazilian immigrants in the United States.Epidemiological research is needed to map the prevalence/incidence of mental health conditions and ADRD risk factors among Brazilian immigrants in the United States.

Episodic Memory, Hippocampal Volume, and Function for Classification of Mild Cognitive Impairment Patients Regarding Amyloid Pathology.

BACKGROUND: Previous studies of hippocampal function and volume related to episodic memory deficits in patients with amnestic mild cognitive impairment (aMCI) have produced mixed results including increased or decreased activity and volume. However, most of them have not included biomarkers, such as amyloid-ß (Aß) deposition which is the hallmark for early identification of the Alzheimer's disease continuum. OBJECTIVE: We investigated the role of Aß deposition, functional hippocampal activity and structural volume in aMCI patients and healthy elderly controls (HC) using a new functional MRI (fMRI) ecological episodic memory task. METHODS: Forty-six older adults were included, among them Aß PET PIB positive (PIB+) aMCI (N = 17), Aß PET PIB negative (PIB-) aMCI (N = 15), and HC (N = 14). Hippocampal volume and function were analyzed using Freesurfer v6.0 and FSL for news headlines episodic memory fMRI task, and logistic regression for group classification in conjunction with episodic memory task and traditional neuropsychological tests. RESULTS: The aMCI PIB+ and PIB-patients showed significantly worse performance in relation to HC in most traditional neuropsychological tests and within group difference only on story recall and the ecological episodic memory fMRI task delayed recall. The classification model reached a significant accuracy (78%) and the classification pattern characterizing the PIB+ included decreased left hippocampal function and volume, increased right hippocampal function and volume, and worse episodic memory performance differing from PIB-which showed increased left hippocampus volume. CONCLUSION: The main findings showed differential neural correlates, hippocampal volume and function during episodic memory in aMCI patients with the presence of Aß deposition.

White matter microstructural damage in chronic ischemic stroke affecting the left inferior frontal gyrus: Association with cognitive functions.

Brain ischemia affects the integrity of local white matter and regions that are distant to the primary lesion location. In this study, we analyzed the patterns of white matter microstructural damage and the cognitive performance of 22 patients with left hemisphere stroke. Patients were divided in two groups: one with target lesion affecting the left inferior frontal gyrus (left inferior frontal gyrus, LIFG, n = 11) and the other without ischemic lesion in this region (non-left inferior frontal gyrus, NLIFG, n = 11). Each group was compared with 11 matched healthy controls. Tract-Based Spatial Statistics was used to assess differences in diffusion tensor indices between the groups and for the association of white matter structure with cognitive performance. When compared to Controls, the LIFG showed extensive intra- and interhemispheric disconnection, with surrogate markers for tissue loss with demyelination in the corpus callosum, and microstructural changes that are independent of gross tissue loss in the contralateral hemisphere. The NLIFG group presented discrete alterations in white matter from the ipsilateral hemisphere, with surrogate markers for tissue loss with axonal injury. When LIFG is compared to NLIFG, white matter abnormalities with no gross tissue loss were observed in the corpus callosum and in the contralateral hemisphere. In addition LIFG had worse performance on cognitive functions. In conclusion, our results identify different diffusion profiles for LIFG and NLIFG groups, suggesting more extensive and pronounced white matter damage in the commissural and interhemispheric connections in the LIFG group, in addition to more pronounced cognitive impairment.

Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis.

OBJECTIVE: A 4.5-year follow-up study was conducted to characterize baseline verbal episodic memory (VEM) and its behavior and to assess the effects of relapsing-remitting multiple sclerosis (RRMS) on this domain. METHODS: Twenty-nine patients with RRMS underwent two neuropsychological assessments performed an average of 4.5 years apart. Twenty-six control participants underwent a single neuropsychological assessment. A significance level of p < 0.005 was adopted to denote a significant difference between the groups on the Mann Whitney and Wilcoxon paired statistical analyses. RESULTS: No statistical difference was found in the results of the VEM tests between the first and second neuropsychological assessments of the patients. However, a statistical difference was evident between the patient and control groups in the results of the VEM tests. CONCLUSION: The patient group showed changes in the VEM relative to the control group. After approximately 4.5 years of disease, the patient performance on the VEM stabilized or improved.

Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis / Análise longitudinal da memória episódica verbal em pacientes com esclerose múltipla remitente-recorrente

ABSTRACT Objective: A 4.5-year follow-up study was conducted to characterize baseline verbal episodic memory (VEM) and its behavior and to assess the effects of relapsing-remitting multiple sclerosis (RRMS) on this domain. Methods: Twenty-nine patients with RRMS underwent two neuropsychological assessments performed an average of 4.5 years apart. Twenty-six control participants underwent a single neuropsychological assessment. A significance level of p < 0.005 was adopted to denote a significant difference between the groups on the Mann Whitney and Wilcoxon paired statistical analyses. Results: No statistical difference was found in the results of the VEM tests between the first and second neuropsychological assessments of the patients. However, a statistical difference was evident between the patient and control groups in the results of the VEM tests. Conclusion: The patient group showed changes in the VEM relative to the control group. After approximately 4.5 years of disease, the patient performance on the VEM stabilized or improved.

RESUMO Objetivo: Neste estudo, propomos a caracterização da Memória Episódica Verbal (MEV) basal e o seu comportamento após o período de 4,5 anos de doença, a fim de avaliar o efeito da EMRR neste domínio. Métodos: Vinte e nove pacientes com EMRR foram submetidos a duas avaliações neuropsicológicas realizadas entre um intervalo de tempo médio de 4,5 anos. Vinte e seis controles foram submetidos à avaliação neuropsicológica única. Considerou-se nível de significância p <0,005 para delinear diferença significante entre os grupos nas análises estatísticas Mann Whitney e Wilcoxon pareado. Resultados: Não houve diferença estatística nos resultados dos testes de MEV entre a primeira e segunda avaliação neuropsicológica realizada pelos pacientes. Houve discrepância estatística nos resultados dos testes de MEV entre o grupo dos pacientes e controles. Conclusão: O grupo de pacientes apresentou alterações de MEV quando comparado aos controles. Após 4,5 anos aproximadamente os pacientes estabilizaram ou melhoraram seu desempenho em MEV.

The protective effects of high-education levels on cognition in different stages of multiple sclerosis.

BACKGROUND: Low-education attainment is associated with worse cognitive performance in multiple sclerosis (MS) patients, and possibly with a lower cognitive reserve and/or increased inflammatory activity. Cognitive reserve refers to the capability of a source of intellectual enrichment in attenuating a negative effect of a disease-related factor; while the inflammatory activity is often related to T2-lesion load (T2-LL) increase. OBJECTIVE: To disentangle the effects of cognitive reserve and an increased T2-LL in MS-patients with low-education levels. METHODS: The study included 136 MS patients and 65 healthy-controls, divided in low-education (12 years or less of school education without obtaining any technical superior degree) and high-education (more than 12 years of school education with technical or superior degree) groups. An extensive battery of neuropsychological tests was applied examining intelligence quotient and six cognitive domains. Test results were z-scored and subjects with z-scores ≤ -1.5 in two or more domains were considered cognitively impaired. To test the factors associated with worse cognitive performance, regression models were applied using average cognition as target; education level, Expanded Disability Status Scale (EDSS), T2-LL, disease duration, age of disease onset, age and gender as predictors. We also tested the correlation between T2-LL and cognition in the groups. To investigate the role of education level as a source of intellectual enrichment/cognitive reserve in different stages of MS, we sub-divided the MS patients in three groups according to the disease duration (less than 5 years, between 5 and 10 years and more than 10 years). RESULTS: Worse average cognition was associated with low-education level, higher T2-LL and male gender. A higher frequency of cognitively impaired patients was observed in MS patients with low-education level, in all stages of the disease. In patients with a disease duration shorter than five years, there was a lower correlation between worse average cognition and T2-LL in the high-education level group, compared to the patients with low-education level; in MS patients with longer disease duration, we observed a stronger correlation between lesion burden and cognitive impairment in both groups. CONCLUSION: Education attainment is a source of intellectual enrichment and can enhance the cognitive reserve in MS patients. The protective effect of a high-education level was stronger in patients with less than five years of disease, suggesting a stronger role of cognitive reserve in short-term disease. In long-term disease we observed a greater impact of increased inflammatory activity on cognition.

Intervenção fonológica em escolares de risco para dislexia: revisão de literatura / Phonologic intervention in school kids on risk of dyslexia: Literature review

A meta do presente estudo foi, por meio de uma revisão de literatura, sistematizar pesquisas já realizadas sobre a contribuição de instruções fônicas na capacidade em desenvolver a consciência fonológica por intermédio do trabalho interventivo, auxiliando na aquisição das habilidades necessárias para o aprendizado da leitura e escrita em escolares de risco para dislexia. Empregou-se a pesquisa literária pela análise de artigos publicados em revistas científicas com referência à temática de intervenção fonológica em escolares de risco para dislexia. Os resultados dos estudos demonstraram que o treino de instrução fônica dá suporte ao desenvolvimento da leitura e escrita em crianças de risco para dislexia.

The goal of the present study was to systematize, by a literature review, researches previously done about the contribution of phonic instructions in the capacity of developing the phonologic consciousness by interventional work, assisting the acquirement of necessary skills to learn lecture and writing in school kids on risk of dyslexia. The literature review consisted in analyzing articles that were published in scientific journals, which referred to the thematics of phonologic intervention in school kids on risk of dyslexia. The results of the study inferred that the phonic instruction training gives support to the development of lecture and writing in kids on risk of dyslexia.

Impact of sociodemographic variables on executive functions.

Executive functions (EFs) regulate human behavior and allow individuals to interact and act in the world. EFs are sensitive to sociodemographic variables such as age, which promotes their decline, and to others that can exert a neuroprotective effect. OBJECTIVE: To assess the predictive role of education, occupation and family income on decline in executive functions among a sample with a wide age range. METHODS: A total of 925 participants aged 18-89 years with 1-28 years' education were submitted to assessment of executive functions using the Card Sorting Test (CST), Phonemic Verbal Fluency (FAS) Task and Semantic Verbal Fluency (SVF) Task. Data on income, occupation and educational level were collected for the sample. The data were analyzed using Linear Regression, as well as Pearson's and Spearman's Correlation. RESULTS: Age showed a significant negative correlation (p<0.001) with performance on the CST, FAS and SVF, whereas education, income and occupation were positively associated (p<0.001) with the tasks applied. After application of the multivariate linear regression model, a significant positive relationship with the FAS was maintained only for education (p<0.001) and income (p<0.001). The negative relationship of age (p<0.001) and positive relationship of both education (p<0.001) and income (p<0.001and p=0.003) were evident on the CST and SVF. CONCLUSION: Educational level and income positively influenced participants' results on executive function tests, attenuating expected decline for age. However, no relationship was found between occupation and the cognitive variables investigated.

Funções executivas regulam o comportamento humano e permitem ao indivíduo interagir e agir no mundo. Elas são sensíveis a variáveis sociodemográficas como a idade, que promove seu declínio, e a outras que podem ter ação neuroprotetora. OBJETIVO: Avaliar o papel preditivo da escolaridade, atividade ocupacional e renda familiar sobre o declínio das funções executivas em uma amostra de ampla variação de idade. MÉTODOS: 925 participantes saudáveis com idades de 18 a 89 anos e escolaridade de 1 a 28 anos foram submetidos ao exame de funções executivas com uma Tarefa de Classificação de Cartas (TCC) e de Fluência Verbal nominal (FVN) e semântica (FVS). Foram obtidas a renda, atividade ocupacional e escolaridade da amostra. Os dados foram analisados com Regressão Linear, Correlação Pearson e Spearman. RESULTADOS: Idade apresentou correlação significativa (p<0,001) negativa com o desempenho em TCC, FVN e FVS, enquanto educação, renda e ocupação se relacionaram de forma positiva (p<0,001) com as tarefas utilizadas. Após modelo de regressão linear multivariada, apenas educação (p<0,001)e renda (p<0,001) mantiveram relação significativa positiva com FVN. A relação negativa da idade (p<0,001) e positiva de educação (p<0,001) e renda (p<0,001 e p=0,003) foi evidente em TCC e FVS. CONCLUSÃO: Escolaridade e renda influenciaram positivamente os resultados dos participantes nos testes de função executiva, tendo um efeito contrário ao declínio esperado para a idade. Por outro lado a ocupação não manteve relação com as variáveis cognitivas.

Impact of sociodemographic variables on executive functions / Impacto das variáveis sociodemográficas nas funções executivas

ABSTRACT Executive functions (EFs) regulate human behavior and allow individuals to interact and act in the world. EFs are sensitive to sociodemographic variables such as age, which promotes their decline, and to others that can exert a neuroprotective effect. Objective: To assess the predictive role of education, occupation and family income on decline in executive functions among a sample with a wide age range. Methods: A total of 925 participants aged 18-89 years with 1-28 years' education were submitted to assessment of executive functions using the Card Sorting Test (CST), Phonemic Verbal Fluency (FAS) Task and Semantic Verbal Fluency (SVF) Task. Data on income, occupation and educational level were collected for the sample. The data were analyzed using Linear Regression, as well as Pearson's and Spearman's Correlation. Results: Age showed a significant negative correlation (p<0.001) with performance on the CST, FAS and SVF, whereas education, income and occupation were positively associated (p<0.001) with the tasks applied. After application of the multivariate linear regression model, a significant positive relationship with the FAS was maintained only for education (p<0.001) and income (p<0.001). The negative relationship of age (p<0.001) and positive relationship of both education (p<0.001) and income (p<0.001 and p=0.003) were evident on the CST and SVF. Conclusion: Educational level and income positively influenced participants' results on executive function tests, attenuating expected decline for age. However, no relationship was found between occupation and the cognitive variables investigated.

RESUMO Funções executivas regulam o comportamento humano e permitem ao indivíduo interagir e agir no mundo. Elas são sensíveis a variáveis sociodemográficas como a idade, que promove seu declínio, e a outras que podem ter ação neuroprotetora. Objetivo: Avaliar o papel preditivo da escolaridade, atividade ocupacional e renda familiar sobre o declínio das funções executivas em uma amostra de ampla variação de idade. Métodos: 925 participantes saudáveis com idades de 18 a 89 anos e escolaridade de 1 a 28 anos foram submetidos ao exame de funções executivas com uma Tarefa de Classificação de Cartas (TCC) e de Fluência Verbal nominal (FVN) e semântica (FVS). Foram obtidas a renda, atividade ocupacional e escolaridade da amostra. Os dados foram analisados com Regressão Linear, Correlação Pearson e Spearman. Resultados: Idade apresentou correlação significativa (p<0,001) negativa com o desempenho em TCC, FVN e FVS, enquanto educação, renda e ocupação se relacionaram de forma positiva (p<0,001) com as tarefas utilizadas. Após modelo de regressão linear multivariada, apenas educação (p<0,001)e renda (p<0,001) mantiveram relação significativa positiva com FVN. A relação negativa da idade (p<0,001) e positiva de educação (p<0,001) e renda (p<0,001 e p=0,003) foi evidente em TCC e FVS. Conclusão: Escolaridade e renda influenciaram positivamente os resultados dos participantes nos testes de função executiva, tendo um efeito contrário ao declínio esperado para a idade. Por outro lado a ocupação não manteve relação com as variáveis cognitivas.

Boston Naming Test (BNT) original, Brazilian adapted version and short forms: normative data for illiterate and low-educated older adults.

BACKGROUND: The aims of this study were (1) to describe and compare the performance of illiterate and low-educated older adults, without evidence of cognitive impairment, on different versions of the Boston Naming Test (BNT) original, Brazilian adapted, abbreviated 30-item (even and odd) and 15-item from the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) battery; (2) to compare performance on the original versus adapted versions of the BNT. METHODS: A total of 180 healthy older adults (60 years or older) were stratified according to educational level (0, 1-2, and 3-4 years), and age (60-69, 70-79, and ≥ 80 years). The protocol comprised the following instruments: Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), Functional Activities Questionnaire (FAQ), Geriatric Depression Scale (GDS), and the BNT. RESULTS: The illiterate participants had poorer performance than the educated participants. The performance of the two educated groups was similar on all versions of the BNT. A higher number of correct responses were observed on the adapted BNT than on the original BNT in all three education groups. CONCLUSIONS: The adapted BNT appears to be the most suitable for use in the low-educated Brazilian population. The present study provided normative data for low-educated elderly on several different versions of the BNT, which may be helpful in diagnosing naming deficits among elderly in these strata of the population.

Instrução fônica como intervenção no processo da leitura e escrita em estudantes com deficiência intelectual / Phonics instruction as intervention in the process of reading and writing in students with intellectual disability

A meta do presente estudo foi, por meio de uma revisão de literatura, sistematizar pesquisas já realizadas sobre a contribuição de instruções fônicas na capacidade em desenvolver a leitura e escrita em estudantes com deficiência intelectual. Empregou-se a pesquisa literária por meio da análise de artigos publicados em revistas científicas tanto nacionais quanto internacionais com referência à temática de intervenção fonológica no processo de leitura em deficientes intelectuais. Os resultados dos estudos demonstraram que o treino de instrução fônica dá suporte ao desenvolvimento da leitura em crianças com deficiência intelectual de diferentes etiologias.

The goal of this study was, through a literature review, systematize previous studies on the contribution of phonic instructions on the ability to develop reading in students with intellectual disabilities. Literary research was employed by the analysis of articles published in scientific journals both national and international with reference to phonological intervention theme in the reading process intellectually disabilities. The results of the studies have shown that phonics instruction training supports the development of reading in children with intellectual disabilities of different etiologies.

Cognitive Rehabilitation of Dementia in Adults with Down Syndrome: A Review of Non-Pharmacological Interventions.

BACKGROUND: There is a close genetic relationship between Alzheimer's disease (AD) and Down syndrome (DS), AD being the most severe mental disorder affecting ageing individuals with DS. The objective of the present study was to evaluate the efficacy of cognitive rehabilitation interventions in DS patients with AD by means of a critical literature review. SUMMARY: Because AD is progressive and irreversible, treatment is aimed at delaying and reducing the cognitive and functional decline in order to preserve or improve quality of life. The effects that pharmacological treatments and cognitive interventions have on elderly individuals with AD are well documented. Recent clinical trials have investigated the use of pharmacological treatment in DS patients with AD, generating preliminary results that have been unfavourable. KEY MESSAGES: There is a clear lack of studies addressing the efficacy of cognitive rehabilitation interventions in DS patients with AD, and there is an urgent need for studies providing evidence to inform decisions regarding the appropriate choice of treatment strategies.

Performance of a sample of patients with Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD) and healthy elderly on a lexical decision test (LDT) as a measure of pre-morbid intelligence / Desempenho de uma amostra de pacientes com Comprometimento Cognitivo Leve (CCL), doença de Alzheimer (DA) e idosos saudáveis em Teste de Decisão Lexical (TDL) como medida de QI pré-mórbido

Objective:The objective of this study was to describe the performance of healthy elderly patients with aging-related pathologies (MCI) and patients with AD on a lexical decision test.Methods:The study included 38 healthy elderly subjects, 61 MCI and 26 AD patients from the Neurology Department of the Hospital das Clinicas, Behavioral and Cognitive Neurology Group. The neuropsychological instruments included the episodic memory test (RAVLT), subtests from the WAIS-III (Matrix Reasoning and Vocabulary) to determine estimated IQ, the Boston naming test (BNT) and Lexical Decision Test (LDT).Results:All groups differed on the MMSE, as expected according to their pathologies, memory tests, naming and estimated IQ. For the vocabulary and the LDT - measures of crystalized intelligence no differences were found.Conclusion:The LDT demonstrated that lexical decision can be used as a measure of pre-morbid IQ among the individuals assessed in a Brazilian sample.

Objetivo:O objetivo deste artigo é descrever o desempenho de idosos saudáveis, idosos com patologias relacionadas ao envelhecimento (CCL) e de idosos com DA, em teste de decisão lexical.Métodos:Participaram 38 idosos saudáveis, 61 CCL e 26 DA, atendidos no Setor de Neurologia do Hospital das Clínicas (GNCC) e do Centro de Referência em Distúrbios Cognitivos (CEREDIC). Os instrumentos neuropsicológicos incluíram teste de memória episódica (RAVLT), Subtestes do WAIS-III (Vocabulário e Raciocínio Matricial) para estabelecer QI estimado, teste de nomeação (BNT) e o Teste de Decisão Lexical (TDL).Resultados:Todos os grupos diferiram quanto ao MEEM, de acordo com o esperado para as patologias, para os testes de memória, para a nomeação e o QI estimado. No caso do vocabulário e do TDL - medidas de inteligência cristalizada não apresentaram diferença.Conclusão:O TDL permitiu que se mostrasse que a decisão lexical pode ser uma medida de QI pré-mórbido nos indivíduos avaliados em uma amostra da população brasileira.

Cognitive and Functional Impairment in Stroke Survivors with Basilar Artery Occlusive Disease.

BACKGROUND: Despite growing literature on posterior vascular disease, specific information about the cognitive and functional profiles of patients with basilar artery occlusion disease (BAOD) is scarce. The aims of this study were (1) to compare the cognitive statuses of BAOD survivors versus healthy controls and (2) to correlate the functional capacity outcomes with the cognitive profiles of BAOD patients. METHODS: Comprehensive cognitive and functional assessments were carried out in 28 patients with BAOD and 27 age- and education level-matched healthy controls. RESULTS: Compared to matched controls, patients presented impairments in selective, sustained, and set-shifting attention, processing speed, visuospatial skills, mental flexibility, and monitoring rules. There were significant deficits in verbal episodic memory (immediate and delayed recall) and visuospatial episodic memory (immediate and delayed recall and recognition). Functional capacity outcomes were significantly related to the cognitive test results. Seventy-five percent of patients had a Modified Rankin Scale score of 0 or 1. CONCLUSIONS: Our results indicate good functional outcomes in a selected group of BAOD survivors, despite the presence of subnormal performance on some cognitive tests, including tests of attention, executive function, and long-term memory.

Performance of a sample of patients with Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD) and healthy elderly on a lexical decision test (LDT) as a measure of pre-morbid intelligence.

OBJECTIVE: The objective of this study was to describe the performance of healthy elderly patients with aging-related pathologies (MCI) and patients with AD on a lexical decision test. METHODS: The study included 38 healthy elderly subjects, 61 MCI and 26 AD patients from the Neurology Department of the Hospital das Clinicas, Behavioral and Cognitive Neurology Group. The neuropsychological instruments included the episodic memory test (RAVLT), subtests from the WAIS-III (Matrix Reasoning and Vocabulary) to determine estimated IQ, the Boston naming test (BNT) and Lexical Decision Test (LDT). RESULTS: All groups differed on the MMSE, as expected according to their pathologies, memory tests, naming and estimated IQ. For the vocabulary and the LDT - measures of crystalized intelligence no differences were found. CONCLUSION: The LDT demonstrated that lexical decision can be used as a measure of pre-morbid IQ among the individuals assessed in a Brazilian sample.

OBJETIVO: O objetivo deste artigo é descrever o desempenho de idosos saudáveis, idosos com patologias relacionadas ao envelhecimento (CCL) e de idosos com DA, em teste de decisão lexical. MÉTODOS: Participaram 38 idosos saudáveis, 61 CCL e 26 DA, atendidos no Setor de Neurologia do Hospital das Clínicas (GNCC) e do Centro de Referência em Distúrbios Cognitivos (CEREDIC). Os instrumentos neuropsicológicos incluíram teste de memória episódica (RAVLT), Subtestes do WAIS-III (Vocabulário e Raciocínio Matricial) para estabelecer QI estimado, teste de nomeação (BNT) e o Teste de Decisão Lexical (TDL). RESULTADOS: Todos os grupos diferiram quanto ao MEEM, de acordo com o esperado para as patologias, para os testes de memória, para a nomeação e o QI estimado. No caso do vocabulário e do TDL ­ medidas de inteligência cristalizada não apresentaram diferença. CONCLUSÃO: O TDL permitiu que se mostrasse que a decisão lexical pode ser uma medida de QI pré-mórbido nos indivíduos avaliados em uma amostra da população brasileira.

Executive function and depressive symptoms of retardation in nonelderly stroke patients.

The depression-executive dysfunction syndrome, a late-onset depression of vascular origin with executive dysfunction and psychomotor retardation, has also been described after stroke. We verified whether this syndrome also occurs in nonelderly stroke patients by investigating the association between domains of depressive symptoms with executive functions in 87 first-ever ischemic stroke patients. The retardation domain of the 31-item Hamilton Rating Scale for Depression was associated with decreased performance on verbal fluency (assessed with FAS). The association was maintained for younger patients (aged <60 years) after adjusting for confounders. This result supports the clinical presentation of depression-executive dysfunction syndrome in younger stroke patients. Confirmation of this finding, its neural correlates, and clinical implication deserve further investigation.

Performance of an adult Brazilian sample on the Trail Making Test and Stroop Test / Desempenho de uma amostra de adultos Brasileiros no Traill making test e Stroop Test

OBJECTIVE: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. METHODS: We recruited 1447 healthy subjects aged ?18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. RESULTS: Among the participants, mean intellectual efficiency was 103.20 (SD:12.0), age 41.0 (SD:16.4) years and education 11.9 (SD:5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correlation. Gender was not found to be significant on the multiple linear regression model, but age and education maintained their interference. CONCLUSION: Gender did not have the major impact on attentional tasks observed for age and education, both of which should be considered in the stratification of normative samples.

OBJETIVO: Os testes de atenção Trail Making Test (TMT) e Stroop Test (ST) são largamente usados na prática clínica e em pesquisas. O objetivo deste estudo foi fornecer informação normativa para a população brasileira de adultos e estudar a interferência de gênero, idade e educação no TMT parte A e B e no ST cartão A, B e C. MÉTODOS: Recrutamos 1447 sujeitos saudáveis com idade ?18 anos, nível educacional de 0-25 anos, falantes nativos do Português (Brasil). Os sujeitos foram avaliados pelos subtestes do Wechsler Adult Intelligence Scale-III Raciocínio Matricial e Vocabulários, além do TMTA, TMTB e ST A, B e C. RESULTADOS: Entre os participantes a média de eficiência intelectual foi de 103,20 (SD:12,0), de idade 41,0 (SD:16,4) anos e de escolaridade 11,9 (SD: 5,6) anos. Houve diferenças significantes por gênero em TMTA (p=0,002), TMTB (p=0,017) e STC (p=0,024). Idade se correlacionou de modo positivo com todos os testes de atenção, enquanto a escolaridade correlacionou-se de modo negativo. Após o modelo de regressão linear múltipla o gênero não manteve correlação significativa, mas idade e escolaridade mantiveram sua interferência. CONCLUSÃO: O gênero não mostrou grande impacto nas tarefas atencionais como a idade e escolaridade que devem, portanto, ser consideradas na estratificação de amostras normativas.

Performance of an adult Brazilian sample on the Trail Making Test and Stroop Test.

OBJECTIVE: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. METHODS: We recruited 1447 healthy subjects aged ≥18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. RESULTS: Among the participants, mean intellectual efficiency was 103.20 (SD: 12.0), age 41.0 (SD: 16.4) years and education 11.9 (SD: 5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correlation. Gender was not found to be significant on the multiple linear regression model, but age and education maintained their interference. CONCLUSION: Gender did not have the major impact on attentional tasks observed for age and education, both of which should be considered in the stratification of normative samples.

OBJETIVO: Os testes de atenção Trail Making Test (TMT) e Stroop Test (ST) são largamente usados na prática clínica e em pesquisas. O objetivo deste estudo foi fornecer informação normativa para a população brasileira de adultos e estudar a interferência de gênero, idade e educação no TMT parte A e B e no ST cartão A, B e C. MÉTODOS: Recrutamos 1447 sujeitos saudáveis com idade ≥18 anos, nível educacional de 0-25 anos, falantes nativos do Português (Brasil). Os sujeitos foram avaliados pelos subtestes do Wechsler Adult Intelligence Scale-III Raciocínio Matricial e Vocabulários, além do TMTA, TMTB e ST A, B e C. RESULTADOS: Entre os participantes a média de eficiência intelectual foi de 103,20 (SD: 12,0), de idade 41,0 (SD: 16,4) anos e de escolaridade 11,9 (SD: 5,6) anos. Houve diferenças significantes por gênero em TMTA (p=0,002), TMTB (p=0,017) e STC (p=0,024). Idade se correlacionou de modo positivo com todos os testes de atenção, enquanto a escolaridade correlacionou-se de modo negativo. Após o modelo de regressão linear múltipla o gênero não manteve correlação significativa, mas idade e escolaridade mantiveram sua interferência. CONCLUSÃO: O gênero não mostrou grande impacto nas tarefas atencionais como a idade e escolaridade que devem, portanto, ser consideradas na estratificação de amostras normativas.

Atividade física, envelhecimento e o desempenho no teste de fluência verbal categoria animais / Physical activity, aging and performance on verbal fluency testing in the animals category

A cognição em idosos é caracterizada por um declínio natural e gradual nas suas diversas funções cognitivas. Diversos estudos têm mostrado que a atividade física regular pode contribuir retardando essa perda. O objetivo deste estudo foi avaliar o desempenho de sujeitos idosos saudáveis engajados em atividade física regular em medida de função executiva – teste de fluência verbal categoria animais. Para isso, 14 sujeitos com idade entre 60 e 85 e 1 a 4 anos de escolaridade foram avaliados através de uma bateria de testes de rastreio – MEEM, HAD, um teste de cognição geral – WAIS-III, uma entrevista semidirigida e o teste de fluência verbal. Sujeitos engajados em atividade física mostraram desempenho melhor na medida de função executiva em comparação com normas propostas para nossa população. Esse resultado está de acordo com outros achados que mostram um efeito positivo da atividade física sobre o funcionamento cognitivo de sujeitos idosos saudáveis(AU)

Cognition in the elderly is characterized by a natural and gradual decline in its various functions. Several studies have shown that regular physical activity can help to slow the loss. The objective of this study has been to evaluate the performance of healthy, elderly subjects engaged in regular physical activity as a measure of executive function through verbal fluency testing, category of animals. To this end, 14 subjects between the ages of 60 and 85, and having 1 to 4 years of schooling, were assessed by a battery of screening tests, i.e., MMSE, HAD, a test of general cognition - WAIS-III, a semi-directed interview and testing verbal fluency. Subjects engaged in physical activity showed the best performance measure of executive function compared with the proposed standards for our population. This result is consistent with other findings that show a positive effect of physical activity on cognitive functioning in healthy elderly subjects(AU)