In vivo tau is associated with change in memory and processing speed, but not reasoning, in cognitively unimpaired older adults.

The relationship between tau deposition and cognitive decline in cognitively healthy older adults is still unclear. The tau PET tracer 18F-MK-6240 has shown favorable imaging characteristics to identify early tau deposition in aging. We evaluated the relationship between in vivo tau levels (18F-MK-6240) and retrospective cognitive change over 5 years in episodic memory, processing speed, and reasoning. For tau quantification, a set of regions of interest (ROIs) was selected a priori based on previous literature: (1) total-ROI comprising selected areas, (2) medial temporal lobe-ROI, and (3) lateral temporal lobe-ROI and cingulate/parietal lobe-ROI. Higher tau burden in most ROIs was associated with a steeper decline in memory and speed. There were no associations between tau and reasoning change. The novelty of this finding is that tau burden may affect not only episodic memory, a well-established finding but also processing speed. Our finding reinforces the notion that early tau deposition in areas related to Alzheimer's disease is associated with cognitive decline in cognitively unimpaired individuals, even in a sample with low amyloid-ß pathology.

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.

Trends in mortality from Alzheimer's disease in Brazil, 2000-2019.

OBJECTIVE: to analyze trends in mortality rates due to Alzheimer's disease in Brazil and its macro-regions by age and sex, from 2000 to 2019. METHODS: this was a time-series study on mortality from Alzheimer's disease in Brazil and its macro-regions by age and sex; data were obtained from the Mortality Information System; a Prais-Winsten model was used to analyze trends. RESULTS: there were 211,658 deaths in the period analyzed, with an increasing trend in Alzheimer's disease mortality in Brazil in elderly people aged 60-69 years (APC = 4.3; 95%CI 2.9;5.9), 70-79 years (APC = 8.1; 95%CI 4.8;11.5) and ≥ 80 years (APC = 11.3; 95%CI 8.1;14.6) and in all macro-regions, age groups and sexes. CONCLUSION: Brazil and all its macro-regions showed a rising trend in Alzheimer's disease mortality rates, following the global trend.

Tendência de mortalidade por doença de Alzheimer no Brasil, 2000 a 2019 / Tendencias de mortalidad por enfermedad de Alzheimer en Brasil, 2000 a 2019 / Trends in mortality from Alzheimer's disease in Brazil, 2000-2019

Objetivo: analisar as tendências das taxas de mortalidade por doença de Alzheimer no Brasil e nas suas macrorregiões, por faixa etária e sexo, no período de 2000 a 2019. Métodos: estudo de séries temporais sobre mortalidade por doença de Alzheimer no Brasil e suas macrorregiões por faixa etária e sexo; os dados foram extraídos do Sistema de Informação sobre Mortalidade (SIM); o modelo de Prais-Winsten foi utilizado para análise das tendências. Resultados: houve 211.658 óbitos no período analisado, com tendência crescente na mortalidade por doença de Alzheimer no país em idosos de 60-69 anos (VPA = 4,3; IC95% 2,9;5,9), 70-79 anos (VPA = 8,1; IC95% 4,8;11,5) e ≥ 80 anos (VPA = 11,3; IC95% 8,1;14,6), e em todas as macrorregiões, faixas etárias e sexo. Conclusão: o Brasil e todas as suas macrorregiões apresentaram tendência crescente nas taxas de mortalidade por doença de Alzheimer, seguindo a tendência mundial.

Objective: to analyze trends in mortality rates due to Alzheimer's disease in Brazil and its macro-regions by age and sex, from 2000 to 2019. Methods: this was a time-series study on mortality from Alzheimer's disease in Brazil and its macro-regions by age and sex; data were obtained from the Mortality Information System; a Prais-Winsten model was used to analyze trends. Results: there were 211,658 deaths in the period analyzed, with an increasing trend in Alzheimer's disease mortality in Brazil in elderly people aged 60-69 years (APC = 4.3; 95%CI 2.9;5.9), 70-79 years (APC = 8.1; 95%CI 4.8;11.5) and ≥ 80 years (APC = 11.3; 95%CI 8.1;14.6) and in all macro-regions, age groups and sexes. Conclusion: Brazil and all its macro-regions showed a rising trend in Alzheimer's disease mortality rates, following the global trend.

Objetivo: analizar las tendencias en las tasas de mortalidad por enfermedad de Alzheimer en Brasil y sus macrorregiones por grupo de edad y sexo, de 2000 a 2019. Métodos: estudio de series temporales de mortalidad por enfermedad de Alzheimer en Brasil y sus macrorregiones por grupo de edad y sexo; los datos se obtuvieron del Sistema de Información sobre Mortalidad del Ministerio de Salud de Brasil; se utilizó el modelo Prais-Winsten para analizar tendencias. Resultados: hubo 211.658 óbitos, con tendencia creciente en la mortalidad por enfermedad de Alzheimer en el país, en adultos mayores de 60-69 años (VPA = 4,3; IC95% 2,9;5,9), 70-79 años (VPA = 8,1; IC95%: 4,8;11,5) y ≥ 80 años (VPA = 11,3; IC95% 8,1;14,6) y en todas las macrorregiones, grupos de edad y sexo. Conclusión: Brasil y todas sus macrorregiones mostraron una tendencia creciente en las tasas de mortalidad por enfermedad de Alzheimer siguiendo la tendencia mundial.

Mnemonic strategy training modulates functional connectivity at rest in mild cognitive impairment: Results from a randomized controlled trial.

INTRODUCTION: Mnemonic strategy training (MST) has been shown to improve cognitive performance and increase brain activation in those with mild cognitive impairment (MCI). However, little is known regarding the effects of MST on functional connectivity (FC) at rest. The aim of the present study was to investigate the MST focused on face-name associations effect on resting-state FC in those with MCI. METHODS: Twenty-six amnestic MCI participants were randomized in MST (N = 14) and Education Program (active control; N = 12). Interventions occurred twice a week over two consecutive weeks (ie, four sessions). Resting-state functional magnetic resonance imaging was collected at pre- and post-intervention. Regions of interest (ROIs) were selected based on areas that previously showed task-related activation changes after MST. Changes were examined through ROI-to-ROI analysis and significant results were corrected for multiple comparisons. RESULTS: At post-intervention, only the MST group showed increased FC, whereas the control group showed decreased or no change in FC. After MST, there was an increased FC between the left middle temporal gyrus and right orbitofrontal cortex. In addition, a time-by-group interaction indicated that the MST group showed greater increased FC between the right inferior frontal gyrus and left brain regions, such as fusiform gyrus, temporal pole, and orbitofrontal cortex relative to controls. DISCUSSION: MST enhanced FC in regions that are functionally relevant for the training; however, not in all ROIs investigated. Our findings suggest that MST-induced changes are reflected in task-specific conditions, as previously reported, but also in general innate connectivity. Our results both enhance knowledge about the mechanisms underlying MST effects and may provide neurophysiological evidence of training transfer.

The design, evaluation, and reporting on non-pharmacological, cognition-oriented treatments for older adults: Results of a survey of experts.

INTRODUCTION: Cognitive decline and dementia significantly affect independence and quality of life in older adults; therefore, it is critical to identify effective cognition-oriented treatments (COTs; eg, cognitive training, rehabilitation) that can help maintain or enhance cognitive functioning in older adults, as well as reduce dementia risk or alleviate symptoms associated with pathological processes. METHODS: The Cognitive Intervention Design Evaluation and Reporting (CIDER), a working group from the Non-Pharmacological Interventions Professional Interest Area (NPI-PIA) of the Alzheimer's Association conducted as survey in 2017 with experts in COTs worldwide. The survey's aims were three-fold: (1) determine the common attitudes, beliefs, and practices of experts involved in the COTs research targeting older people; (2) identify areas of relative agreement and disagreement among experts in the field; and (3) offer a critical review of the literature, including recommendations for future research. RESULTS: The survey identified several areas of agreements among experts on critical features of COTs, and on study design and outcome measures. Nevertheless, there were some areas with relative disagreement. Critically, expert opinions were not always supported by scientific evidence, suggesting that methodologic improvements are needed regarding design, implementation, and reporting of COTs. There was a clear consensus that COTs provide benefits and should be offered to cognitively unimpaired older adults, mild cognitive impairment (MCI), and mild dementia, but opinions differed for moderate and severe dementia. In addition, there is no consensus on the potential role of COTs in dementia prevention, indicating that future research should prioritize this aspect. DISCUSSION: Evidence of COTs in older adults is encouraging, but additional evidence is needed to enhance dementia prevention. Consensus building and guidelines in the field are critical to improve and accelerate the development of high-quality evidence for COTs in cognitively unimpaired older adults, and those with MCI and dementia.

Metamemory and aging: Psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire for elderly / Metamemória e envelhecimento: propriedades psicométricas da versão brasileira do questionário multifatorial de memória para idosos

ABSTRACT Metamemory measures provide subjective memory information and are relevant to investigate memory ability in aging. However, there is a lack of metamemory instruments available in Brazil. Objective: The aim of this study was to examine the psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire (MMQ), which evaluates different dimensions of subjective memory functioning, such as Feelings, Abilities and Strategies used in everyday life. Methods: The MMQ was translated into Portuguese and administered to 30 Brazilian elderly subjects. The participants underwent cognitive tests, mood scales and metamemory instruments. Results: Analyses revealed good internal consistency (Cronbach's a coefficient ranged from 0.75 to 0.89) and test-retest validity for each MMQ dimensions (positive correlations between two applications ranged from 0.75 to 0.8). Convergent validity evidence for the MMQ was confirmed by significant positive correlations (0.47 to 0.68) with dimensions of the Metamemory in Adulthood scale (MIA) (i.e., the Ability, Control, Self-efficacy and Strategy dimensions). Discriminant validity revealed no associations between the MMQ and cognitive performance, suggesting a weak metamemory-objective memory correspondence. Moreover, there was a negative correlation between MMQ-Ability subscale scores and mood symptoms (-0.63 for anxious symptoms, and -0.54 for depressive symptoms); and the Brazilian MMQ was comparable with MMQ translations to other languages. Conclusion: The Brazilian MMQ exhibits good psychometric properties and appears promising for clinical and research purposes. Additional studies are needed to further examine the psychometric properties of the Brazilian MMQ in a larger sample.

RESUMO Medidas de metamemória fornecem informações acerca da memória subjetiva e são relevantes para se compreender a habilidade de memória no envelhecimento. Todavia, há uma falta de instrumentos de metamemória disponíveis no Brasil. Objetivo: O presente trabalho teve como objetivo examinar as propriedades psicométricas da versão brasileira do Questionário Multifatorial de Memória (MMQ), que avalia diferentes aspectos da memória subjetiva, como Sentimentos, Habilidade e Estratégias usadas na vida diária. Métodos: O MMQ foi traduzido para o Português e administrado em 30 idosos brasileiros. Os participantes realizaram testes cognitivos, escalas de humor e questionários de metamemória. Resultados: Análises revelaram boa consistência interna (coeficiente a de Cronbach's variou de 0.75 a 0.89) e validade teste-reteste para cada dimensão do MMQ (correlações positivas entre as duas aplicações variou de 0.75 a 0.8). Validade convergente do MMQ foi identificada através de correlações positivas (0.47 a 0.68) com as dimensões do Metamemory In Adulthood Questionnaire (MIA) (i.e., Habilidade, Controle, Autoeficácia e Estratégia). Validade discriminante revelou ausência de associação entre MMQ e performance cognitiva, sugerindo uma fraca correspondência entre metamemória e memória objetiva. Além disto, observou-se uma correlação negativa entre os escores da subscala MMQ-Habilidade e sintomas do humor (-0.63 para sintomas ansiosos, e -0.54 para sintomas depressivos); e o MMQ Brasileiro se mostrou comparável a traduções do MMQ em outros idiomas. Conclusão: O MMQ Brasileiro apresenta boas propriedades psicométricas e parece ser promissor para o uso clínico e de pesquisa. Estudos adicionais são necessários para investigar caracteristicas psicométricas do MMQ Brasileiro em uma amostra maior.

Metamemory and aging: Psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire for elderly.

Metamemory measures provide subjective memory information and are relevant to investigate memory ability in aging. However, there is a lack of metamemory instruments available in Brazil. OBJECTIVE: The aim of this study was to examine the psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire (MMQ), which evaluates different dimensions of subjective memory functioning, such as Feelings, Abilities and Strategies used in everyday life. METHODS: The MMQ was translated into Portuguese and administered to 30 Brazilian elderly subjects. The participants underwent cognitive tests, mood scales and metamemory instruments. RESULTS: Analyses revealed good internal consistency (Cronbach's a coefficient ranged from 0.75 to 0.89) and test-retest validity for each MMQ dimensions (positive correlations between two applications ranged from 0.75 to 0.8). Convergent validity evidence for the MMQ was confirmed by significant positive correlations (0.47 to 0.68) with dimensions of the Metamemory in Adulthood scale (MIA) (i.e., the Ability, Control, Self-efficacy and Strategy dimensions). Discriminant validity revealed no associations between the MMQ and cognitive performance, suggesting a weak metamemory-objective memory correspondence. Moreover, there was a negative correlation between MMQ-Ability subscale scores and mood symptoms (-0.63 for anxious symptoms, and -0.54 for depressive symptoms); and the Brazilian MMQ was comparable with MMQ translations to other languages. CONCLUSION: The Brazilian MMQ exhibits good psychometric properties and appears promising for clinical and research purposes. Additional studies are needed to further examine the psychometric properties of the Brazilian MMQ in a larger sample.

Medidas de metamemória fornecem informações acerca da memória subjetiva e são relevantes para se compreender a habilidade de memória no envelhecimento. Todavia, há uma falta de instrumentos de metamemória disponíveis no Brasil. OBJETIVO: O presente trabalho teve como objetivo examinar as propriedades psicométricas da versão brasileira do Questionário Multifatorial de Memória (MMQ), que avalia diferentes aspectos da memória subjetiva, como Sentimentos, Habilidade e Estratégias usadas na vida diária. MÉTODOS: O MMQ foi traduzido para o Português e administrado em 30 idosos brasileiros. Os participantes realizaram testes cognitivos, escalas de humor e questionários de metamemória. RESULTADOS: Análises revelaram boa consistência interna (coeficiente a de Cronbach's variou de 0.75 a 0.89) e validade teste-reteste para cada dimensão do MMQ (correlações positivas entre as duas aplicações variou de 0.75 a 0.8). Validade convergente do MMQ foi identificada através de correlações positivas (0.47 a 0.68) com as dimensões do Metamemory In Adulthood Questionnaire (MIA) (i.e., Habilidade, Controle, Autoeficácia e Estratégia). Validade discriminante revelou ausência de associação entre MMQ e performance cognitiva, sugerindo uma fraca correspondência entre metamemória e memória objetiva. Além disto, observou-se uma correlação negativa entre os escores da subscala MMQ-Habilidade e sintomas do humor (-0.63 para sintomas ansiosos, e -0.54 para sintomas depressivos); e o MMQ Brasileiro se mostrou comparável a traduções do MMQ em outros idiomas. CONCLUSÃO: O MMQ Brasileiro apresenta boas propriedades psicométricas e parece ser promissor para o uso clínico e de pesquisa. Estudos adicionais são necessários para investigar caracteristicas psicométricas do MMQ Brasileiro em uma amostra maior.

Cognitive Effects of Intentional Weight Loss in Elderly Obese Individuals With Mild Cognitive Impairment.

CONTEXT: Obesity in midlife is a risk factor for dementia, but it is unknown if caloric restriction-induced weight loss could prevent cognitive decline and therefore dementia in elderly patients with cognitive impairment. OBJECTIVE: To evaluate the cognitive effect of intentional weight loss in obese elderly patients with mild cognitive impairment (MCI), considering the influence of age, apolipoprotein E (APOE) genotype, physical activity, biochemical markers, and diet. DESIGN: Single-center, prospective controlled trial. SETTING: Academic medical center. PARTICIPANTS: Eighty obese patients with MCI, aged 60 or older (68.1 ± 4.9 y, body mass index [BMI] 35.5 ± 4.4 kg/m(2), 83.7% women, 26.3% APOE allele ϵ4 carriers). INTERVENTION: Random allocation to conventional medical care alone (n = 40) or together with nutritional counselling (n = 40) in group meetings aiming to promote weight loss through caloric restriction for 12 months. OUTCOME MEASUREMENTS: clinical data, body composition, neuropsychological tests (main outcome), serum biomarkers, APOE genotype, physical performance, dietary recalls. RESULTS: Seventy-five patients completed the follow-up. BMI, on average, decreased 1.7 ± 1.8 kg/m(2) (P = .021), and most of the cognitive tests improved, without difference between the groups. In analysis with linear generalized models, the BMI decrease was associated with improvements in verbal memory, verbal fluency, executive function, and global cognition, after adjustment for education, gender, physical activity, and baseline tests. This association was strongest in younger seniors (for memory and fluency) and in APOE allele ϵ4 carriers (for executive function). Changes in homeostasis model assessment-estimated insulin resistance, C-reactive protein, leptin and intake of energy, carbohydrates, and fats were associated with improvement in cognitive tests. CONCLUSIONS: Intentional weight loss through diet was associated with cognitive improvement in patients with MCI.

Cognitive Behavioral Therapies in older adults with depression and cognitive deficits: a systematic review.

OBJECTIVES: The objective of this study is to investigate the effectiveness of cognitive behavioral therapies (CBTs) in improving depressive symptoms, disability, and cognition in older adults with depression and cognitive deficits. DESIGN: It was performed a systematic search for articles published between 1994 and February 2014 in the MEDLINE/Pubmed, PsycINFO, and SCIELO. The studies should have provided information about benefits after CBTs to older adults with depression and cognitive deficits. RESULTS: Cognitive behavioral therapy focused on problem solving is the main approach studied, having better effectiveness than supportive therapy in randomized clinical trials. Significant improvements in mood and disability were consistent, although evidence of changes in cognitive measures is controversial, less studied, and limited. Nevertheless, improvements in executive functions, processing speed, and changes in patients' perspectives of problem solving skills, such as generating alternatives and decision-making, were described. Also, it would be necessary that future studies more often evaluate cognitive status of depressed elders, as well as cognitive changes after psychotherapy. It should be emphasized that there is a lack of studies in this field, and more approaches in CBTs need to be investigated to this population. CONCLUSION: Older adults with depression and cognitive deficits can benefit from CBTs. Improvements in mood and disability are more consistent than changes in cognition, which are little studied after CBTs. It is necessary more studies in the field, as well as, to investigate more approaches in CBTs to older adults with depression and cognitive deficits.

Cognitive screening for dementia in primary care: a systematic review.

BACKGROUND: Identifying dementia in primary care could minimize the impact of a late intervention; however, it shows high rates of misdiagnosis. One of the reasons seems to be the lack of knowledge of adequate cognitive screening instruments. This is a systematic review of the available instruments for the primary care context. METHOD: For this systematic review, articles were collected according to the following combined key terms: "cognitive screening" and "dementia" and "primary care" and "review". Studies should be reviews focusing on cognitive screening instruments best used in primary care setting. RESULTS: Thirteen reviews were selected. In total, it was considered 34 cognitive screening instruments. Half of the instruments can be applied in an adequate time-limit for primary care context. Memory is the most commonly assessed cognitive function (91%). Almost half of the tests are mentioned to have influence of education or cultural factors (44%). CONCLUSION: Tests such as 6CIT, AMT, GPCOG, Mini-Cog, MIS, MoCA, and STMS seem to be good alternatives to the use of the Mini-Mental State Examination when considering factors such as application time, sensitivity, specificity, and number of studies. However, there is a wide range of tests with different characteristics, therefore it is recommended that the professional gets some expertise in a few number of instruments in order to be able to choose which to use, or use in combination, depending on the setting and the profile of the patient.

Cognitive intervention in amnestic Mild Cognitive Impairment: a systematic review.

Mild Cognitive Impairment (MCI) represents a transitional state between normal aging and early dementia and is commonly associated with memory impairment (amnestic or A-MCI). Several studies have investigated therapeutic approaches to A-MCI, including cholinestherase inhibitors (I-ChEs), although this practice is still controversial. Thus, there is a current need to determine the effects of cognitive interventions either in combination with I-ChEs or alone. To assess the efficacy of such treatments, neuropsychological instruments and self-evaluated scoring of memory, mood, daily life activities and quality of life are employed. Recently, some studies have used functional magnetic resonance imaging (fMRI) in order to understand the neurobiological effects of these interventions. The aim of this systematic review is to investigate the effectiveness of cognitive interventions on the enhancement of learning abilities as well as their impacts on cognitive measurements of mood, everyday functioning and functional neuroimaging. This review also focused on the methodological aspects of such studies and attempted to introduce new perspectives on cognitive interventions in this population. The authors concluded that a-MCI patients are capable to learn new information and memory strategies. Although findings in standardized neuropsychological tests are limited, non-standardized cognitive measures and subjective measures show significant changes. Furthermore, fMRI reveals changes in the patterns of brain activation and increase of connectivity.

Comprometimento cognitivo leve e reabilitação neuropsicológica: uma revisão bibliográfica / Mild cogntive impairment and neuropsychological rehabilitation: a systematic review

O Comprometimento Cognitivo Leve (CCL) é frequentemente definido como a zona de transição entre o envelhecimento saudável e a demência, sendo comuns déficits de memória. Assim, a Reabilitação Neuropsicológica (RN) pode ser uma importante intervenção, envolvendo aspectos cognitivos, comportamentais e emocionais, buscando a melhora da qualidade de vida do idoso. A presente revisão bibliográfica investigou os benefícios da RN para os idosos com CCL. Por meio das bases de dados MEDLINE e PsycINFO foram encontrados 15 estudos, publicados entre 2002 e maio de 2009. Como resultado das intervenções realizadas foi descrita melhora das funções cognitivas, tais como memória episódica e operacional, praxia construtiva, aprendizado psicomotor, raciocínio e velocidade de processamento. Além disto, houve benefícios funcionais e emocionais, tais como melhora do bem estar, da autoconfiança, da percepção sobre a própria memória, nos relacionamentos sociais e no humor. Todavia, houve controvérsias entre os estudos e limitações metodológicas importantes, sendo necessárias pesquisas com amostras maiores, desenhos experimentais controlados e randomizados, maior consenso sobre os intrumentos utilizados e mais acompanhamento a longo prazo dos benefícios alcançados.(AU)

Mild Cognitive Impairment (MCI) is often conceptualized as a transitional stage between healthy aging and dementia, and is usually associated with memory lapses. Neuropsychological Rehabilitation (NR) – dealing with cognitive, behavioral and emotional aspects - can be a useful intervention, capable of improving quality of life. This systematic review aimed to investigate the benefits of NR to elderly people with MCI. The literature was searched using key terms in the MEDLINE and PsycINFO databases and 15 studies were identified, all of them published from 2002 until May 2009. Cognitive benefits were described, such as episodic and working memory, constructive praxis, psychomotor learning, reasoning and processing speed. Furthermore, there were functional and emotional gains, such as improved well-being, self-confidence, perception of their own memory, social relations and mood. However, there were some controversial issues between studies and methodological limitations. Thus, large samples and robust experimental design (controlled and randomized studies) are needed, as well as higher consensus about the cognitive and functional measures and longer term follow-up.(AU)

Comprometimento cognitivo leve e reabilitação neuropsicológica: uma revisão bibliográfica / Mild cogntive impairment and neuropsychological rehabilitation: a systematic review

O Comprometimento Cognitivo Leve (CCL) é frequentemente definido como a zona de transição entre o envelhecimento saudável e a demência, sendo comuns déficits de memória. Assim, a Reabilitação Neuropsicológica (RN) pode ser uma importante intervenção, envolvendo aspectos cognitivos, comportamentais e emocionais, buscando a melhora da qualidade de vida do idoso. A presente revisão bibliográfica investigou os benefícios da RN para os idosos com CCL. Por meio das bases de dados MEDLINE e PsycINFO foram encontrados 15 estudos, publicados entre 2002 e maio de 2009. Como resultado das intervenções realizadas foi descrita melhora das funções cognitivas, tais como memória episódica e operacional, praxia construtiva, aprendizado psicomotor, raciocínio e velocidade de processamento. Além disto, houve benefícios funcionais e emocionais, tais como melhora do bem estar, da autoconfiança, da percepção sobre a própria memória, nos relacionamentos sociais e no humor. Todavia, houve controvérsias entre os estudos e limitações metodológicas importantes, sendo necessárias pesquisas com amostras maiores, desenhos experimentais controlados e randomizados, maior consenso sobre os intrumentos utilizados e mais acompanhamento a longo prazo dos benefícios alcançados.

Mild Cognitive Impairment (MCI) is often conceptualized as a transitional stage between healthy aging and dementia, and is usually associated with memory lapses. Neuropsychological Rehabilitation (NR) – dealing with cognitive, behavioral and emotional aspects - can be a useful intervention, capable of improving quality of life. This systematic review aimed to investigate the benefits of NR to elderly people with MCI. The literature was searched using key terms in the MEDLINE and PsycINFO databases and 15 studies were identified, all of them published from 2002 until May 2009. Cognitive benefits were described, such as episodic and working memory, constructive praxis, psychomotor learning, reasoning and processing speed. Furthermore, there were functional and emotional gains, such as improved well-being, self-confidence, perception of their own memory, social relations and mood. However, there were some controversial issues between studies and methodological limitations. Thus, large samples and robust experimental design (controlled and randomized studies) are needed, as well as higher consensus about the cognitive and functional measures and longer term follow-up.