Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study / Programa de rehabilitación cognitiva para pacientes con esclerosis múltiple: estudio piloto

Introduction In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. Method Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n = 25), and the experimental group (n = 25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. Results Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. Conclusions The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index. (AU)

Introducción En los últimos años se ha observado un interés creciente por la rehabilitación cognitiva en pacientes con esclerosis múltiple. Sin embargo, pocos estudios han analizado su impacto en variables como la reserva cognitiva. Analizamos el efecto de un programa de rehabilitación cognitiva que incluye ejercicios físicos y cognitivos, así como sesiones en grupo enfocadas a mejorar el rendimiento cognitivo, el estado emocional y el índice de reserva cognitiva. Métodos Nuestro estudio incluyó a 50 pacientes con esclerosis múltiple, divididos en 2 grupos: un grupo control (n = 25), en el que los pacientes realizaban ejercicio aeróbico, y un grupo experimental (n = 25), al que se administró un programa integral de rehabilitación cognitiva. Evaluamos a todos los pacientes en 3 momentos diferentes (al inicio, tras el tratamiento, y a largo plazo) con la Batería Neuropsicológica Breve, la Escala de Reserva Cognitiva, el Inventario de Depresión de Beck y una escala para medir la ansiedad rasgo y la ansiedad estado. Resultados Los pacientes del grupo experimental mostraron un mejor rendimiento cognitivo que los controles, con cambios significativos en medidas de velocidad de procesamiento de la información, atención, memoria, índice de reserva cognitiva y estado de ánimo a largo plazo. Conclusión Nuestros resultados demuestran la eficacia del programa de rehabilitación cognitiva para mejorar las funciones cognitiva y emocional de los pacientes con esclerosis múltiple y aumentar el índice de reserva cognitiva. (AU)

Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study.

INTRODUCTION: In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. METHOD: Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. RESULTS: Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. CONCLUSIONS: The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.

Adaptación argentina del Cuestionario de Reserva Cognitiva: CRC-a / Argentinian adaptation of the Cognitive Reserve Questionnaire: CRQ-a

Resumen La reserva cognitiva (RC) se refiere al nivel de adaptabilidad de la cognición frente a cambios cerebrales. Varios estudios la han considerado un factor de protección de la enfermedad de Alzheimer (EA). En la región argentina no se cuenta con un instrumento validado que permita medir este constructo. El objetivo del presente trabajo es adaptar el Cuestionario de Reserva Cognitiva (CRC) a la población argentina, establecer puntajes de corte para determinar desde niveles bajos a superiores de RC y analizar qué variables predicen el puntaje total de la reserva. Las modificaciones introducidas a la adaptación fueron evaluadas a través de un proceso de juicio de expertos. Un total de 177 sujetos sanos completaron el Cuestionario de Reserva Cognitiva en su adaptación argentina (CRC-a). Mediante la medida de cuartiles, se establecieron puntajes de corte para determinar niveles bajos, medios, altos y superiores de la reserva. Se realizó una regresión lineal para evaluar si el sexo, la edad y la escolaridad predicen el nivel de RC. En la adaptación argentina del CRC se modificaron 3 de las 8 dimensiones totales y 16 de los 33 ítems totales con respecto al cuestionario original. La media del puntaje total obtenido por la muestra a partir del cuestionario fue de 15.06 con DS = 3.42. Puntajes menores a 13 reflejaron niveles bajos de RC, puntajes entre 13 y 16, niveles medios, puntajes entre 16 y 20, niveles altos, y puntajes superiores a 20, niveles superiores. La escolaridad resultó ser la única variable de predicción del nivel de RC. Si bien se encontraron diferencias entre grupos respecto a la variable sexo, esta no demostró ser predictiva. El CRC-a es el primer instrumento desarrollado en esta región para medir el nivel de RC. Contar con su validación abriría futuras líneas de investigaciones sobre posibles intervenciones para la prevención de enfermedades, tales como la EA.

Abstract Cognitive reserve (CR) refers to the level of adaptability of cognition after brain changes. It is based on processes that allow the activation of new synaptic connections after neurodegeneration, which permits to better withstand the consequences. This reserve is constituted by the interaction of innate individual characteristics (intrauterine or genetically determined) and the exposure to different life experiences. It begins its development in early stages of life and continues its transformation up to advances ages. The sociodemographic variables reported as the main ones to build the reserve are education, leisure activities, lifestyle, socioeconomic level and intelligence. Several studies have considered it as a protective factor for Alzheimer's Disease (AD). Subjects with high levels of CR have lower prevalence and incidence of AD in comparison to those with low levels of reserve. CR would lead to a late onset of symptoms, despite not having any effect on the underlying pathophysiological process of the disease. The reserve would not prevent AD from developing, but it would compensate the symptoms and, therefore, delay their onset. In some cases, there is such compensation that the symptoms do not manifest. There is no validated instrument available for the Argentinian region that allows to measure this construct. The aim of this study is to adapt the Cognitive Reserve Questionnaire to the Argentinian population, to establish cut-off scores to distinguish between low, medium, high and superior levels of CR and analyze which variables could predict the total reserve score. The modifications introduced in the adaptation were evaluated through an expert judgment process. A total of 177 healthy subjects completed the Cognitive Reserve Questionnaire in its Argentinian adaptation (CRQ-a). Through the measure of quartiles, cut-off scores were established to determine low, medium, high and superior levels of the reserve. A lineal regression was made to evaluate if age, education, and sex might predict the level of CR. Three of the eight total dimensions and 16 of the 33 total items that make up the original questionnaire were modified. The mean of the total score obtained by the sample from the questionnaire was 15.06 with SD = 3.42. Scores under 13 reflected low CR levels, scores between 13 and 16 reflected medium levels, scores between 16 and 20 reflected high levels, and scores above 20 reflected superior levels. Education turned out to be the only predictor variable for the level of CR. Although differences were found between groups of different sex, this variable turned out to be not predictive. The CRQ-a is the first instrument for the Argentinian population to measure the level of the reserve. It allows to quickly explore different dimensions, considered as the most relevant for its formation. These are: formal education, courses, parents' formal education, employment, musical training, languages, reading activity and intellectual games. In patients with AD, is particularly important to have a measure for CR to prepare interventions for those subjects whose reserve levels are perceived as low, aiming to delay and, when possible, prevent the clinical manifestation of the disease. Its validation would open future lines of research on possible interventions for the prevention of diseases such as AD.

Tradução, validação cultural e semântica do cognitive reserve index questionnaire (CRIq) o português brasileiro / Cognitive reserve index questionnaire (CRIq) - translation, cultural and semantic validation for Brazilian portuguese

Introdução: A reserva cognitiva pode explicar diferentes respostas do indivíduo após acidentes ou doenças que acometem o sistema nervoso central. É importante ter instrumentos que avaliem tal reserva, não só para serem utilizados quando ocorrem problemas, mas também para avaliar indivíduos de forma profilática, visando o estabelecimento de programas de estimulação cognitiva. Objetivo: Obter a equivalência semântica e cultural do Cognitive Reserve Index questionnaire (CRIq) para o português brasileiro. Método: o questionário foi traduzido por dois tradutores independentes, do italiano para o português brasileiro. Após, foi produzida uma versão única, sintetizada, que foi retrotraduzida para o italiano, novamente por outros dois tradutores, independentes e sem conhecimento das traduções anteriores. A partir das traduções e retrotraduções, foi desenvolvida uma versão semanticamente aceitável para o português, que foi aplicada a 30 pessoas (grupo piloto). A partir desta aplicação foi criada uma nova versão, adaptada culturalmente para o português brasileiro. Resultados: As adaptações foram feitas especialmente na seção que avalia atividades laborativas ao longo da vida (CRIq trabalho) e principalmente no CRI tempo livre. Acredita-se que tais mudanças foram necessárias devido às diferenças culturais no que se refere às atividades realizadas como lazer por italianos e brasileiros. Os resultados obtidos no grupo piloto evidenciaram que houve correlação entre a RC, a idade (r=0,92, p=0,02*) e a escolaridade (r=0,70, p=0,00*). Conclusão: o Cognitive Reserve Index questionaire (CRIq) está traduzido e adaptado para o português brasileiro, sendo uma ferramenta útil para os profissionais que atuam na área, especialmente quando são avaliados indivíduos idosos.(AU)

Introduction: Cognitive reserve can explain the differences among patients' responses after accidents or diseases that affect the central nervous system. It is important to have instruments that assess this reserve, not only to address problems but also to provide individual prophylactic measures through the establishment of cognitive stimulation programs. Objective: To produce the semantic and cultural equivalent of the Cognitive Reserve Index questionnaire (CRIq) in Brazilian Portuguese. Method: The questionnaire was translated by two independent translators, from Italian to Brazilian Portuguese. Afterward, a single, synthesized version was produced and two other independent translators, who were unaware of the previous translations, back-translated it into Italian. From the translations and backtranslations, a semantically acceptable version was produced in Brazilian Portuguese and tested on 30 participants (pilot group). Based on this test, a new version was created that was culturally adapted to Brazilian Portuguese. Results: The section that evaluates work activities throughout life (CRIq work) required the most adaptation, particularly CRIq free time. Such changes may have been necessary due to cultural differences in leisure activities between Italians and Brazilians. The results obtained in the pilot group showed that there was a correlation between CR, age (r = 0.92, p = 0.02 *) and education (r = 0.70, p = 0.00 *). Conclusion: The Cognitive Reserve Index questionnaire (CRIq) has been appropriately translated and adapted into Brazilian Portuguese and may serve as a useful tool for health care professionals, especially those who assess elderly individuals.(AU)

Cognitive Reserve in Older Adults: A Cluster Analysis / Reserva Cognitiva em Adultos Idosos: Uma Análise de Cluster

Abstract Cognitive reserve (CR) is a construct generally associated with neurodegenerative diseases in aging. The aim of this paper was to examine the CR profiles of older adults at different stages of their lifespan and evaluate the importance of: (a) gender and CR; and (b) CR, cognition, and symptoms of depression. A sample of 195 older adults volunteered to participate in the study, and a cluster analysis was carried out on their responses in terms of the Cognitive Reserve Scale. The cluster analysis depicted two different profiles. Furthermore, women had a better CR than men. The results provide an important contribution to understanding the variables related to the CR construct.

Resumo A reserva cognitiva (RC) é um construto geralmente associado a doenças neurodegenerativas no envelhecimento. O objetivo deste estudo foi examinar os perfis de RC em adultos idosos em diferentes estágios da vida, e avaliar o efeito de: (a) gênero e RC; e (b) RC, cognição e sintomas depressivos. A amostra contou com 195 adultos, e uma análise de cluster foi realizada a partir dos escores obtidos na Escala de Reserva Cognitiva. A análise de cluster descreveu dois perfis diferentes. Além disso, as mulheres apresentaram maior RC em comparação aos homens. Os resultados fornecem contribuições importantes para as variáveis relacionadas ao construto da RC.

Cuestionario de reserva cognitiva: análisis psicométrico desde la teoría de respuesta al ítem / Cognitive Reserve Questionnaire: psychometric analysis from the item response theory

Introducción: La reserva cognitiva es la capacidad para tolerar mejor el daño cerebral mediante recursos cognitivos preexistentes y compensatorios. Un método de evaluación es el cuestionario de reserva cognitiva (CRC) de Rami. El objetivo fue realizar un análisis de la calidad informativa del CRC desde la teoría de respuesta al ítem (TRI), con el fin de aportar datos más precisos sobre la fiabilidad de consistencia interna. Se probó, además, la validez convergente con medidas de atención, memoria de trabajo y fluidez. Sujetos y métodos: Participaron 210 argentinos de población general (media edad, 66,8 años). El CRC se administró junto con el test de dígitos y tres tareas de fluidez. Se ajustó un modelo de respuesta graduada desde la TRI con estimación de parámetros de discriminación (a) y dificultad (b), y se elaboró una curva de información del CRC. Se efectuaron correlaciones bivariadas y parciales. Resultados: La TRI indicó una alta discriminación para los ítems del CRC ‘Escolaridad’ y ‘Nivel de ocupación’ (tanto para la versión de ocho ítems como para la versión de seis ítems). En el CRC de ocho ítems se obtuvo una baja discriminación para ‘Formación musical’ y ‘Juegos intelectuales’. En ambas versiones del CRC, la curva indica mayor valor informacional a bajo nivel del constructo. Hubo correlación con el test de dígitos y con las tareas de fluidez, incluso al controlar por edad. Conclusiones: El presente estudio es el primer análisis del CRC desde la TRI, que concluye que el instrumento resulta más confiable cuando se aplica a sujetos con menor reserva. El CRC posee aceptable validez convergente.(AU)

INTRODUCTION: Cognitive reserve is the ability to better tolerate brain damage through pre-existing and compensatory cognitive resources. One assessment method is the Rami CRQ-Cognitive Reserve Questionnaire. The objective was to carry out an analysis of the informative quality of the CRQ from the item response theory (IRT), in order to provide more precise data on the reliability of internal consistency. Convergent validity was also tested with measures of attention, working memory, and fluency. SUBJECTS AND METHODS: 210 Argentines from the general population (mean age, 66.8 years) participated. The CRQ was administered together with the digits test and three fluency tasks. A graded response model was fitted from IRT with estimation of discrimination parameters (a) and difficulty (b), and a CRQ information curve was created. Bivariate and partial correlations were made. RESULTS: The IRT indicated high discrimination for the CRQ items ‘Education’ and ‘Occupation level’ (both for the 8-item version and the 6-item version). In the CRQ of 8 items, low discrimination was obtained for ‘Musical training’ and ‘Intellectual games’. In both versions of the CRQ, the curve indicates greater informational value at a low level of the construct. There was a correlation with the digits test and with fluency tasks, even when controlling for age. CONCLUSIONS: This study is the first analysis of CRQ from IRT, concluding that the instrument is more reliable when applied to subjects with less reserve. The CRQ has acceptable convergent validity.(AU)

Reserva cognitiva. Propuesta de una nueva hipótesis conceptual / Cognitive reserve. A proposal for a new conceptual hypothesis

Introducción: Actualmente, se observa una falta de consenso en la definición del concepto de reserva cognitiva, los elementos que la conforman y la relación entre ellos, a pesar del notable aumento de los estudios relacionados con ésta. Materiales y método. Se plantea un modelo conceptual multidominio de dos factores: reserva general y reserva específica de dominio. A su vez, la reserva específica de dominio quedaría dividida en cuatro áreas: cognitiva, conductual, emocional y social. Resultados: El modelo planteado parece dar una explicación más amplia del constructo, con nuevos elementos de estudio que se deben tener en consideración. Conclusiones: Con esta propuesta, se pretende aportar una nueva perspectiva al estudio de la reserva cognitiva y abrir nuevas líneas de investigación tanto a nivel clínico como académico para demostrar su viabilidad.(AU)

INTRODUCTION: Currently, there is a lack of consensus on the definition of the concept of cognitive reserve, the elements that make it up and the relationship between them, despite the notable increase in the number of studies conducted on the subject. MATERIALS AND METHODS: A multi-domain conceptual model with two factors is proposed: general reserve and domain-specific reserve. The domain-specific reserve, in turn, would be divided into four areas: cognitive, behavioural, emotional and social. RESULTS: The proposed model seems to provide a more comprehensive explanation of the construct, with new elements of study to be taken into consideration. CONCLUSIONS: This proposal aims to introduce a new perspective into the study of cognitive reserve and to open up new lines of clinical and academic research with the aim of demonstrating its feasibility.(AU)

Reserva cognitiva y prevalencia de deterioro cognitivo desde una farmacia rural / Cognitive reserve and prevalence of cognitive impairment in a rural pharmacy

JUSTIFICACIÓN: la edad es el factor de riesgo más importante en el desarrollo de deterioro cognitivo (DC). En España, en municipios de menos de 1000 habitantes, tres de cada diez personas superan los 65 años. Las poblaciones rurales se diferencian de las urbanas por estar más envejecidas debido a la despoblación. Este hecho implica que el envejecimiento de las zonas rurales constituya un problema de primer orden, siendo prioridad a distintos niveles administrativos. La reserva cognitiva (RC) juega un papel fundamental en la prevención de DC. La escasez de población y falta de recursos dificultan el desarrollo de programas y actividades que incrementen la RC.OBJETIVOS: estudiar la prevalencia de deterioro cognitivo y factores de riesgo asociados en una población rural aislada desde la farmacia comunitaria (FC).MATERIAL Y MÉTODOS: estudio observacional-transversal en personas mayores de 50 años no institucionalizadas que viven en una población no superior a 400 habitantes. Se diseñó un cuestionario had-hoc estructurado en tres bloques con las variables a estudiar. 1. Factores sociodemográficos (edad, sexo, estado civil); 2. Tests de cribado de deterioro cognitivo: Memory Impairment Screening (MIS), Short Portable Mental State Questionnaire (SPMSQ) y Fluidez Verbal Semántica (FVS); 3. Estilo de vida: BMI (kg/m2), MEditerranean Diet Adherence Screener, MEDAS-14, International Physical Activity Questionnaire (IPAQ) y Cuestionario de Reserva Cognitiva de Rami (CRC). Mediante entrevista personal en la zona de atención personalizada de la farmacia. Dicho estudio fue aprobado por el comité de ética (CEI21/222). Todos los pacientes firmaron el consentimiento informado. Los resultados fueron analizados estadísticamente.RESULTADOS/DISCUSIÓN: participaron 47 pacientes: edad media 66,62 (DE=11,81), 65,96 % mujeres (31) y 34,04 % hombres (16). Se detectaron 16 pacientes (34 %) en riesgo de deterioro cognitivo. (AU)

El rol de las actividades del tiempo libre en la reserva cognitiva en adultos mayores / The Role of Leisure Activities in the Cognitive Reserve of Seniors / O papel das atividades de lazer na reserva cognitiva em idosos

La participación en actividades de ocio puede prevenir el deterioro cognitivo. El objetivo del presente trabajo es analizar a través de un modelo de ecuaciones estructurales, el peso relativo que tiene la participación en actividades del tiempo libre en cuatro dominios cognitivos: memoria episódica verbal, lenguaje, funciones ejecutivas y funciones atencionales en adultos mayo-res autoválidos. Para ello, se llevó a cabo un análisis de senderos, utilizando el procedimiento de ecuaciones estructurales (sem) en 167 participantes mayores (m= 72.34 años, de= 5.07 años) independientes en actividades de la vida diaria. Todos fueron evaluados con cuestionario de datos sociodemográficos, cuestionario de participación social y una batería neuro-psicológica de pruebas de uso frecuente en el ámbito clínico para memoria, lenguaje, funciones atencionales y funciones ejecutivas. Los resultados obtenidos indican que el factor de actividades muestra efectos significativos sobre el factor de funciones ejecutivas (ß = .45, p < .001, R2 = .20), también sobre el factor de memoria (ß = .38, p < .001, R2 = .14), al igual que con el factor de lenguaje (ß = .45, p < .001, R2 = .20) y el factor funciones atencionales (ß = .44, p = .03, R2 = .20). Estos resultados concuerdan con los de otros estudios que indican que las actividades de ocio podrían desempeñaron papel diferencial e importante en la construcción de la reserva cognitiva a lo largo del ciclo de vida, conformando un posible factor de protección cognitiva en el proceso de envejecimiento

Participation in cognitively demanding leisure activities can prevent cognitive decline. The objective of the present work is to analyze through a structural equation model (sem) the relative weight that partici-pation in leisure time activities has in three cognitive domains: episodic verbal memory, language execu-tive functions, and attentional functions in self-validated seniors. A path analysis was carried out using the semin 167 elderly participants (m=72.34 years, sd=5.07 years), independent in activities of daily living. All the participants were evaluated with a sociodemographic data questionnaire, a social participation questionnaire, and a neuropsychological battery of neuropsycho-logical tests frequently used in the clinical setting for memory, language, attentional functions, and executive functions. The results obtained indicate that the activities factor shows significant effects on the executive functions factor (ß=.45, p<.001, R2=.20), also on the memory factor (ß=.38, p<.001, R2=.14), as well as on the language factor (ß=.45, p<.001, R2=.20) and the attentional functions factor (ß=.44, p=.03, R2=.20). These results coincide with those of other studies that indicate that leisure activities could play a differential and important role in the construction of cognitive reserve throughout the life cycle, forming a possible cognitive protection factor in the aging process.

A participação em atividades de lazer pode prevenir o declínio cognitivo. O objetivo do presente trabalho é analisar, por meio de um modelo de equações estruturais, o peso relativo que a participação em atividades de lazer exerce em quatro domínios cognitivos: memória verbal episódica, linguagem, funções executivas e funções atencionais em idosos autovalidados. Foi realizada uma análise de trilha por meio do procedimento de equações estruturais (sem) em 167 idosos (m= 72.34 anos, dp = 5.07 anos), independentes nas atividades de vida diária. Todos os participantes foram avaliados com: questionário de dados sociodemográficos, questionário de participação social e uma bateria neurop-sicológica de testes neuropsicológicos frequentemente utilizados em âmbito clínico para: memória, linguagem, funções atencionais e funções executivas. Os resultados obtidos indicam que o fator atividade apresenta efeitos significativos sobre o fator funções executivas (ß = 0.45, p < 0.001, R2 = 0.20), também sobre o fator memória (ß = 0.38, p < 0.001, R2 = 0.14), assim como no fator linguagem (ß = 0.45, p < 0.001, R2 = 0.20) e sobre o fator funções atencionais (ß = 0.44, p < 0.03, R2 = 0.20). Estes resultados são corroborados por outros estudos que indicam que as atividades de lazer podem desempenhar um papel diferencial e importante na construção da reserva cognitiva ao longo do ciclo vital, constituindo um possível fator de proteção cognitiva no processo de envelhecimento.

O impacto das atividades cognitivas no desempenho no Mini-Mental de idosos octogenários de São João del Rei/MG: um estudo piloto / The impact of cognitive activities in the Mini-Mental performance of octogenarian elderly in the city of São João del Rei/MG: a pilot study

O aumento da população idosa mundial em torno de 600% nos últimos 50 anos trouxe vários desafios. O principal é a adoção de políticas que possam oferecer um envelhecimento saudável, preservando a autonomia dos sujeitos. Entre essas estratégias, a estimulação cognitiva é uma que possui baixo custo operacional e pode otimizar as funções que ainda se encontram preservadas. O objetivo desse estudo piloto retrospectivo foi avaliar o impacto protetivo das práticas de estimulação cognitiva em octogenários da cidade de São João del Rei. Para tanto foram aplicados dois instrumentos de avaliação: o Mini-Mental e um Questionário de Práticas Cognitivas. Os resultados preliminares indicam uma tendência de as práticas cognitivas impactarem positivamente no desempenho no Mini-Mental dos octogenários (p<0.01). Tais resultados têm implicações diretas, sobretudo nas estratégias de baixo custo a serem implementadas com o objetivo de se construírem reservas cognitivas na população recém adentrada na 3ª idade, visando uma maior autonomia na 4ª idade.

The increase in the world's elderly population of around 600% in the last 50 years has brought many challenges. The main one is adopting policies that can offer healthy aging, preserving the subjects' autonomy. Among these strategies, the cognitive stimulation is one that has a low operational cost and can optimize the functions which are still preserved. This retrospective pilot study aimed at evaluating the impact of cognitive stimulation practices on octogenarian elderly in the city of São João del Rei. Therefore, two evaluation instruments were applied: Mini-Mental and a Cognitive Practice Questionnaire. The preliminary results indicate a tendency that the cognitive practices impact positively on the octogenarians' cognitive performance(p<0.01). Such results have direct implications especially on the low-coststrategies to be implemented aiming at building cognitive reserves in the population of the recent 3rd age viewing a bigger autonomy in the 4th age.

La reserva cognitiva como factor modulador del impacto de la cirugía sobre la memoria visual y la denominación en pacientes con epilepsia del lóbulo temporal / Cognitive reserve as a modulating factor in the impact of surgery on visual memory and naming in temporal lobe epilepsy patients

Introducción:La cirugía de la epilepsia del lóbulo temporal (ELT) es un procedimiento eficaz que produce cambios cognitivos. Se han propuesto factores moduladores de dichos cambios, pero permanece sin esclarecer la influencia de la reserva cognitiva. Objetivo: Examinar el efecto del cociente intelectual (CI) sobre los cambios posquirúrgicos en medidas de fluencia verbal, denominación y memoria verbal y visual en una muestra de pacientes con ELT. Pacientes y métodos: Sesenta y cuatro pacientes adultos con ELT farmacorresistente (edad media ± desviación típica: 39,16 ± 11,67) fueron sometidos a una evaluación neuropsicológica antes y un año después de la cirugía. Resultados: Los pacientes con un CI alto presentaron un mejor funcionamiento de la memoria visual inmediata antes de la cirugía que los que tenían un CI medio, así como ausencia de cambios posquirúrgicos. Los pacientes con un CI manipulativo alto presentaron mejor denominación antes de la cirugía que los que tenían un CI manipulativo medio, así como un empeoramiento posquirúrgico significativo. Tanto antes como después de la cirugía, los pacientes con un CI alto presentaron mejor fluencia verbal fonémica y semántica y memoria verbal a corto y largo plazo que los que tenían un CI medio. Conclusiones: El CI es un factor relevante en la evolución de la memoria visual inmediata y de la denominación tras la cirugía en pacientes con ELT. La cirugía no repercute en la ventaja que tienen los pacientes con un CI alto en fluencia verbal y memoria verbal, lo que sugiere que la reserva cognitiva tiene un efecto positivo sobre la función cognitiva, incluso tras la cirugía de la ELT.(AU)

Introduction: Temporal lobe epilepsy (TLE) surgery is an effective procedure that produces cognitive changes. Factors modulating such changes have been proposed, but the influence of cognitive reserve remains unclear. Objective: To examine the effect of intellectual quotient (IQ) on postsurgical changes in verbal fluency, naming, and verbal and visual memory in a sample of patients with TLE. Patients and methods: 64 adult patients with drug-resistant TLE (mean age ± SD: 39.16 ± 11.67) underwent a neuropsychological evaluation before and one year after surgery. Results: Patients with high IQ showed better immediate visual memory before surgery than those with medium IQ, as well as an absence of postsurgical changes. Patients with high manipulative IQ had better naming before surgery than those with medium manipulative IQ, as well as a significant postsurgical worsening. Both before and after surgery, patients with high IQ showed better phonemic and semantic verbal fluency and short- and long-term verbal memory than those with medium IQ. Conclusions: IQ is a relevant factor in the evolution of immediate visual memory and naming after surgery in patients with TLE. Surgery does not impact on the advantage of high IQ patients in verbal fluency and verbal memory, suggesting that cognitive reserve has a positive effect on cognitive function, even after TLE surgery.(AU)

Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study.

INTRODUCTION: In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. METHOD: Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. RESULTS: Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. CONCLUSIONS: The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.

Efecto moderador de la creatividad en el rendimiento en memoria cotidiana en personas mayores / Moderating effect of creativity on everyday memory performance in the elderly

Antecedentes: la sociedad envejece a pasos agigantados y propone un reto importante al conjunto de profesionales, ya que una de las mayores preocupaciones en el transcurso de los años es la pérdida de funciones cognitivas como la memoria. Con base en ello, es relevante conocer qué estrategias pueden ayudar a preservar la capacidad mnésica de las personas mayores sanas. Objetivo: analizar el efecto moderador del constructo creatividad en la memoria cotidiana, así como el de la edad en una muestra de personas mayores sanas. Métodos: Participaron 106 personas mayores sanas y voluntarias provenientes de diferentes ciudades de España. Se les aplicó la prueba de creatividad CREA y la de memoria cotidiana RBMT. Resultados: La creatividad modera la pérdida de memoria en las personas mayores, en tanto que, por cada unidad de análisis de creatividad, aumenta la memoria. Lo contrario ocurre con la edad, al aumentar esta, la memoria disminuye. No se ha observado que la edad y la creatividad tengan un efecto de interacción conjunta sobre la memoria, actuando las dos por separado. Implicaciones: la creatividad puede ser incrementada en los programas de ocio y de intervención en psicoestimulación en el envejecimiento, ya que promover un contexto de actividades que fomenten la creatividad puede ser muy ventajoso para prevenir problemas de memoria en adultos mayores sanos. Se necesitan más estudios que ahonden en esta relación y el tipo de actividades concretas creativas que pueden ser beneficiosas y efectivas (AU)

Background: The society ages at a rapid pace proposing an important challenge to the group of professionals, since one of the biggest concerns over the years is the loss of cognitive functions such as memory. Based on this, it is relevant to know what strategies can help to preserve the mnemonic capacity of healthy elderly people. Objective: to analyze the moderator effect of the creativity construct in the daily memory, as well as the age effect in a sample of healthy elderly people. Methods 106 healthy and voluntary elderly people from different cities of Spain participated. The CREA creative test and the RBMT daily memory test were applied. Results: Creativity moderates memory loss in older people, while for each unit of creativity analysis, memory increases. The opposite happens with age, as it increases, memory decreases. It has not been found that age and creativity have a joint interaction effect on memory, acting both separately. Implications: creativity can be increased in leisure programs and intervention in psychostimulation in aging, since promoting a context of activities that promote creativity can be very advantageous to prevent memory problems in healthy older adults. More studies are needed that deepen this relationship and the type of concrete creative activities that can be beneficial and effective (AU)

Aspectos psicosociales, nutricionales, aptitud y actividad física en seis centros de jubilados de la Ciudad de Buenos Aires / Psychosocial and nutritional aspects, physical fitness and activity in six retirement centers of Buenos Aires City

INTRODUCCIÓN: El estado nutricional, la actividad física (AF) y las variables psicosociales plantean nuevos desafíos en los adultos mayores (AM). El objetivo fue explorar y describir aspectos psicosociales, nutricionales, aptitud y AF en AM que asisten a centros de jubilados de la Ciudad Autónoma de Buenos Aires (CABA). MÉTODOS: Se realizó un estudio exploratorio, observacional, transversal y cuantitativo con una muestra no probabilística de AM de ambos sexos, auto-válidos, en seis comunas de CABA durante 2017-2018. Se evaluó edad, sexo, índice de nivel socioeconómico (NSE), valoración sociofamiliar, cuestionario de reserva cognitiva e índice de bienestar de Pemberton, estado nutricional por Mini Nutritional Assessment, antropometría por índice de masa corporal, aptitud física por fuerza muscular y funcionalidad, gasto energético y nivel de AF por acelerometría. RESULTADOS: En una muestra de 150 AM de 74±7 años, el 90% (n=135) eran mujeres. El 48% pertenecía a un NSE bajo. Hubo presencia de riesgo social en el 50%, bienestar en el 97,6% y reserva cognitiva satisfactoria en el 53,6%. El 53,7% presentó sobrepeso/ obesidad con predominio en cuartil 1, y hubo 10,2% con riesgo o malnutrición. La debilidad muscular prevaleció en el tercer y cuarto cuartil. De los 57 AM que usaron acelerómetro, la mayoría tenía AF sedentaria y bajo gasto energético. DISCUSIÓN: La muestra explorada mostró riesgo/ problema social, exceso de peso y sedentarismo

Reserva cognitiva e os diferentes perfis de ganho cognitivo em idosos: uma scoping review / Cognitive reserve and the different cognitive gain profiles in the aged: a scoping review / Reserva cognitiva y los perfiles diferentes de ganancia cognitiva en los ancianos: una escopulación de revisión

O objetivo desse estudo foi verificar diferentes perfis de ganho cognitivo em idosos para a reserva cognitiva. Trata-se de uma scoping review, utilizando-se PubMed, Medline, Web of Science, Science Direct, Lilacs, SciELO, PsycInfo, PsycNet e AgeLine como base de dados; restringiu-se à busca entre o ano de 2008 e 2018. Identificou-se 2295 estudos e 51 foram elegíveis para a revisão. Dentre os 51 estudos selecionados, encontrou-se nove perfis diferentes para manutenção cognitiva, sendo que cinco estudos não especificaram o perfil. Como conclusão, os perfis encontrados representaram relevância para a teoria de reserva cognitiva e forneceram esclarecimentos de como fatores individuais e de vida diária podem fazer o cérebro mais resiliente no envelhecimento e na velhice; no entanto, esses fatores individuais e o modo como eles contribuem para o desenvolvimento da reserva cognitiva e da manutenção da cognição ainda permanecem obscuros na literatura.

The objective of this study was to verify different profiles of cognitive gain in the elderly for cognitive reserve. This is a scoping review, using PubMed, Medline, Web of Science, Science Direct, Lilacs, SciELO, PsycInfo, PsycNet and AgeLine as a database; the search was restricted between 2008 and 2018. 2295 studies were identified and 51 were eligible for the review. Among 51 studies selected, 9 different profiles were found for cognitive maintenance, and 5 studies did not specify the profile. Conclusion: The profiles found were relevant to cognitive reserve theory and provide insights into how individual factors and daily life can make the brain more resilient in aging and old age. However, those individual factors and how they contribute to development of cognitive reserve and maintenance of cognition still remain obscure in the literature.

El objetivo de este estudio fue verificar diferentes perfiles de ganancia cognitiva en ancianos para la reserva cognitiva. Se trata de una escopulación de revisión, utilizando PubMed, Medline, Web of Science, Science Direct, Lilacs, SciELO, PsycInfo, PsycNet y AgeLine como base de datos, restringiendo entre el año 2008 y el 2018. Se identificaron 2295 estudios y 51 fueron elegibles para la revisión. De los 51 estudios seleccionados, se encontraron 9 perfiles diferentes para el mantenimiento cognitivo, siendo que 5 estudios no especificaron el perfil. Conclusión: Los perfiles encontrados representaron relevancia para la teoría de reserva cognitiva y proporciona aclaraciones de cómo factores individuales y de vida diaria pueden hacer el cerebro más resistente en el envejecimiento y en la vejez, sin embargo, estos factores individuales y de cómo contribuyen al desarrollo de la reserva cognitiva y del mantenimiento de la cognición, todavía permanecen obscuras en la literatura.

Promotores de reserva cognitiva en adultos mayores con alto riesgo de demencia cortical / Promoters of Cognitive Reserve in the Elderly with High Risk of Cortical Dementia

Introducción: La reserva cognitiva constituye un elemento central para entender cómo responde el cerebro a la neuropatología durante el ciclo vital. Objetivo: Comprender los factores promotores de reserva cognitiva desde la experiencia de vida de adultos mayores sin deterioro cognitivo y con alto riesgo de demencia cortical. Métodos: Estudio cualitativo, con base en método Grounded Theory. Se realizan entrevistas semiestructuradas en profundidad a siete adultos mayores. En el análisis, se aplica la técnica de comparación constante según modelo de Glasser y Straus, utilizando Atlas ti/7. Resultados: Desde el análisis axial surgen cinco categorías interrelacionadas: actividad mental, experiencias gratificantes, cuidados, eventos traumáticos y características de personalidad. Se aprecia un patrón constante de experiencias vitales mentalmente estimulantes, relacionado principalmente a actividades de cuidado y experiencias gratificantes, no asociadas a educación formal. Conclusiones: Se distingue un proceso dinámico que involucra experiencias y eventos de vida cotidiana, tanto personales como ambientales, ocupacionales y del estilo de vida, que operan secuencialmente durante el ciclo vital; estos factores podrían incidir significativamente en los mecanismos neurobiológicos y actuar como promotores de reserva cognitiva. Se obtiene un modelo de promotores de reserva cognitiva que podría utilizarse en programas de salud cognitiva para contrarrestar la neuropatología(AU)

Introduction: Cognitive reserve constitutes an element central to understanding how the brain responds to neuropathology during the life cycle. Objective: To understand the factors that promote cognitive reserve from the life experience of the elderly without cognitive deterioration and with high risk of cortical dementia. Methods: Qualitative study, methodologically based on grounded theory. In-depth semi-structured interviews are conducted on seven elderlies. In the analysis, the constant comparison technique is applied according to the model by Glaser and Strauss, using ATLAS-Ti 7. Results: Five interrelated categories emerge from the axial analysis: mental activity, gratifying experiences, care, traumatic events, and personality traits. There is a constant pattern of mentally-stimulating life experiences, mainly related to care activities and gratifying experiences, not associated with formal education. Conclusions: A dynamic process is distinguished that involves experiences and events of daily life, both personal and environmental, occupational and related to lifestyle, which operate sequentially during the life cycle. These factors could significantly influence neurobiological mechanisms and act as promoters of cognitive reserve. A model of cognitive reserve promoters is obtained that could be used in cognitive health programs to counteract neuropathology(AU)

Reserva Cognitiva: revisión de su conceptualización y relación con la Enfermedad de Alzheimer / Cognitive Reserve: a revision of its conceptualization and its relation with Alzheimer´s Disease

Introducción: La reserva cognitiva permite la activación de conexiones sinápticas adicionales y nuevas redes neurales frente a demandas del ambiente. Objetivo: Delimitar qué variables contribuyen a la formación de la reserva cognitiva y establecer su expresión en el desarrollo de la Enfermedad de Alzheimer. Metodología: Revisión bibliográfica sistemática y evaluativa de tipo cualitativa. Resultados: La educación, actividades de ocio, estilo de vida, estatus socioeconómico e inteligencia son las principales variables que aportan a la formación de la reserva cognitiva. Sujetos con alta reserva tienen menor prevalencia e incidencia de demencia. Aquellos que lleguen a desarrollar la enfermedad lo harán a una edad más tardía y con mayor severidad de síntomas. Conclusión: Las variables que contribuyen a la formación de la reserva cognitiva son, principalmente, variables socio-ambientales. La reserva se considera factor de protección frente a la enfermedad. Además, atrasaría la aparición de la demencia, logrando, en algunos casos, que nunca se llegue a desarrollar la enfermedad(AU)

Introduction: Cognitive reserve allows the activation of additional synaptic connections and new neural networks against environmental demands. Objective: Establish the variables that contribute to the formation of cognitive reserve and its expression in relation with Alzheimer´s Disease. Method: Systematic and evaluative review of qualitative type. Results: Education, leisure activities, lifestyle, socioeconomic status and intelligence are the main variables which contribute to the formation of cognitive reserve. Subjects with high reserve have lower prevalence and incidence of dementia. Those who develop Alzheimer´s Disease will do so at a later age and with more severe symptoms. Conclusions: The variables which contribute to the formation of cognitive reserve are, mainly, socio-environmental variables. The reserve is considered a protective factor against disease. It delays the onset of dementia avoiding, in some cases, the development of the pathology(AU)

Reserva Cognitiva e Abertura à Experiência em idosos sem demência: um estudo correlacional / Cognitive reserve and openness to experience in non-demented elderly people: a correlational study / Reserva cognitiva y apertura a la experiencia en ancianos sin demencia: un estudio correlacional

O objetivo deste artigo foi investigar acerca da Reserva Cognitiva (RC) e da Abertura à Experiência (AE) em idosos sem demência. Trata-se de uma pesquisa de campo, descritiva, correlacional e quantitativa, da qual participaram 31 idosos divididos em dois grupos: Saudável e Comprometimento Cognitivo Leve (CCL). Houve correlação moderada, positiva e significativa (r = 0,463; p < 0,01) entre RC e AE. Percebeu-se que os idosos saudáveis (M = 0,53; DP = 0,10) apresentaram significativamente [t = (29) 3,785; p < 0,01] maior índice de RC em comparação aos idosos com CCL (M = 0,39; DP = 0,11). Os dados confirmaram que existe associação entre RC e AE, e que idosos saudáveis apresentam maior RC, comparados a idosos com CCL. Este estudo possibilitou conhecer possíveis relações e diferenças subjacentes ao processo de aquisição das reservas cognitivas e de fatores relativos a AE, podendo contribuir para que mais pesquisas sejam feitas, buscando maiores evidências no campo da ciência.

El objetivo de este trabajo fui investigar la Reserva Cognitiva (RC) y la Apertura a la Experiencia (AE) en ancianos sin demencia. Es una investigación de campo, descriptiva, correlacional y cuantitativa. Los participantes fueron 31 ancianos divididos en dos grupos: ancianos cognitivamente saludables (GS) y ancianos con deterioro cognitivo leve (DCL). Existió una correlación moderada, positiva y significativa (r = 0.463; p < 0.01) entre RC y AE. El GS (M = 0.53; SD = 0.10) presentó significativamente [t = (29) 3,785; p <0.01] mayor índice RC comparado con el DCL (M = 0.39; SD = 0.11). Los datos confirmaron que existió una asociación entre RC y AE, y que los ancianos cognitivamente sanos tuvieron una RC más alta en comparación con los ancianos con DCL. Este estudio permitió conocer las posibles relaciones y diferencias subyacentes al proceso de adquisición de reservas cognitivas y factores relacionados con la AE y puede contribuir a una mayor investigación, buscando mayor evidencia en el campo de la ciencia.

This paper aimed to analyze the relationship between Cognitive Reserve (CR) and Openness to Experience (OE) in non-demented elderly people. Descriptive, correlational and quantitative research was undertaken. The sample consisted of thirty-one elderly people divided into two groups: healthy and Mild Cognitive Impairment (MCI). There was a moderate, positive and significant correlation (r = 0.463; p < 0.01) between CR and OE. It was found that the healthy controls (M = 0.53; SD = 0.10) present significantly [t = (29) 3,785; p < 0.01] higher CR compared to the elderly with MCI (M = 0.39; SD = 0.11). The data confirm that there was an association between CR and OE and that healthy controls have higher CR compared to the MCI group. This study allowed to know possible relationships and differences underlying the acquisition process of cognitive reserves and factors related to OE and may contribute to further research, seeking more evidence in the field of science.

Social engagement as a measurement of cognitive reserve and how it relates to different cognitive skills in college students / Compromisso social como medida de reserva cognitiva e sua relação com diferentes processos cognitivos em jovens universitários / Compromiso social como medida de reserva cognitiva y su relación con distintos procesos cognitivos en jóvenes universitarios

Abstract Greater social engagement is commonly associated with more efficient cognitive processing, as it improves cognitive reserve. The aim of this research is to assess the relationship between social engagement (in the dimensions of social contact, support and conflict) and certain cognitive skills (cognitive flexibility, planning, verbal fluency, processing speed, and verbal comprehension) in young college students. This cross-sectional rank correlation study was carried out in a sample of 49 college students. Spearman's rank correlation coefficient showed relationship between: social contact and verbal fluency (r = -.299, p = .037); social support and planning (r = .368, p = .009); and social conflict and processing speed (r = .306, p = .032). The results outline a measurable relationship between social engagement and certain cognitive skills, even when said results are not entirely conclusive. Thus, the need for more detailed studies on these processes becomes clear.

Resumo A literatura científica indica que um maior compromisso social está relacionado com um pensamento cognitivo mais eficiente, devido ao fato de que tal compromisso aumenta a reserva cognitiva. Levando isso em consideração, o objetivo da presente pesquisa foi identificar a relação existente entre o compromisso social (em suas dimensões de contato, apoio e conflito social) e alguns processos cognitivos (como flexibilidade mental, planejamento, fluidez verbal, velocidade de processamento e compreensão verbal) em jovens universitários. Para tanto, realizou-se um estudo correlacional com um desenho transversal em uma amostra de 49 estudantes. A análise de correlação de Spearman revelou correlações entre contato social e fluidez verbal (r = -.299, p = .037), apoio social e planejamento (r = .368, p = .009) e conflito social e velocidade de processamento (r = .306, p = .032). Esses resultados constituem uma associação entre o compromisso social e algumas funções cognitivas. Apesar dos resultados não serem completamente conclusivos, fica clara a necessidade de um estudo mais detalhado desses processos.

Resumen La literatura científica indica que un mayor compromiso social se relaciona con un procesamiento cognitivo más eficiente, debido a que dicho compromiso incrementa la reserva cognitiva. Teniendo esto en cuenta, el objetivo de la presente investigación fue identificar la relación existente entre el compromiso social (en sus dimensiones de contacto, apoyo y conflicto social) y algunos procesos cognitivos (como flexibilidad mental, planeación, fluidez verbal, velocidad de procesamiento y comprensión verbal) en jóvenes universitarios. Para esto, se realizó un estudio correlacional con un diseño transversal en una muestra de 49 estudiantes. El análisis de correlación de Spearman reveló correlaciones entre contacto social y fluidez verbal (r = -.299, p = .037), apoyo social y planeación (r = .368, p = .009), y conflicto social y velocidad de procesamiento (r = .306, p = .032). Estos resultados perfilan una asociación entre el compromiso social y algunas funciones cognitivas. A pesar de que los resultados no son del todo concluyentes, queda claro que se necesita de un estudio más detallado de estos procesos.

Anatomic and neuropsychological findings in low-educated cognitively intact elderly from a Brazilian cohort / Achados Anatômicos e Neuropsicológicos de Idosos Cognitivamente Saudáveis com Baixa Escolaridade em uma Coorte Brasileira

ABSTRACT In elderly individuals, low educational level may represent a risk factor for the development of dementia and a proxy of cognitive reserve. Objective: This study examined the cognitive and neuroanatomic correlates of high versus low educational levels in cognitively healthy community-dwelling older adults in Brazil. Methods: Fifty-three older adults (mean age: 68±5.3 years) were divided into a "low education" group [LE; 1-4 years of education (N=33)] and "high education" group [HE; >11 years of education (N=20)]. Both groups completed a comprehensive neuropsychological battery and underwent in vivo structural MRI close to the time of testing. Results: Higher educational level increased the chance of having better scores on neuropsychological tests, including verbal and visual delayed recall of information, verbal learning, category fluency, global cognition, and vocabulary. Better scores on these tests were observed in the HE group relative to the LE group. Despite this, there were no group differences between MRI measures. Conclusion: Older adults with higher educational levels showed better scores on neuropsychological measures of cognition, highlighting the need for education-adjusted norms in developing countries. Given the absence of differences in structural anatomy between the groups, these findings appear to be best explained by theories of cognitive reserve.

RESUMO Sabe-se que baixos níveis de educação são comuns em países em desenvolvimento. Em indivíduos idosos, em particular, baixos níveis de educação podem representar um fator de risco para o desenvolvimento de demência. Objetivo: Este estudo examina os correlatos cognitivos e neuroanatômicos de escolaridade alta versus baixa, em idosos cognitivamente saudáveis,vivendo em comunidade no Brasil. Métodos: Cinquenta e três idosos (média de idade: 68±5,3) foram divididos em um grupo de "baixa escolaridade" [LE; 1-4 anos de escolaridade (N=33)] e um grupo de "alta escolaridade" [HE; >11 anos de escolaridade (N=20)]. Ambos os grupos completaram uma bateria neuropsicológica abrangente e foram submetidos à RM estrutural in vivo próximo à testagem. Resultados: O nível educacional aumentou a chance de se obter melhores pontuações em testes neuropsicológicos, incluindo evocação verbal e visual da informação, aprendizagem verbal, fluência de categoria, cognição global e vocabulário. Escores mais altos foram encontrados no grupo HE, em detrimento do LE. Apesar disso, não houve diferenças entre os grupos nas medidas de ressonância magnética in vivo. Conclusão: Idosos com maiores níveis de escolaridade apresentaram melhores pontuações nas medidas neuropsicológicas da cognição, destacando a necessidade de normas ajustadas à educação nos países em desenvolvimento. Não havendo diferenças na anatomia estrutural entre os grupos, os achados parecem ser melhor explicados pelas teorias da "reserva cognitiva".