The comparison of cognitive and functional performance in children and Alzheimer's disease supports the retrogenesis model.

The retrogenesis model states that the progression of brain aging and Alzheimer's disease (AD) deterioration proceeds inversely to human ontogenic acquisition patterns. Our aim was to assess if the progressive decline of cognitive abilities and functional capacity in AD follows an inverse sequence of acquisition compared to normal developmental patterns. One hundred eighty one children ranging in age from 4 to 12 years and 148 adults (cognitively normal, subjects with mild cognitive impairment, and mild-moderately severe AD) were assessed with the same cognitive and functional tools. The statistical analyses showed a progressive and inverse distribution on cognitive, functional, and mental age scores when comparing results of children classified by chronological age and patients by dementia staging. The pattern of cognitive acquisition in children showed a progressive development of overall cognitive function along all age ranges, in addition to a simultaneous acquisition of instrumental and basic daily living activities in the functional domain. AD patients showed a progressive decline in cognitive and functional domains, which concurs with the sequence of impairment reported in this dementia. Our findings provide support to the inverse and progressive pattern of functional and cognitive decline observed in AD patients compared to the developmental acquisition of these capacities in children, as stated by the retrogenesis model. Nonetheless, certain differences should be considered when comparing the sequence of acquisition during ontogenic development with that of progressive loss during the course of AD. Retrogenesis may account for the progressive loss of neocortical-related functions in AD.

Perfil del sujeto con daño cerebral adquirido en fase crónica en un recurso de atención sociosanitaria / Clinical profile in subjects with acquired brain injury in chronic phase in a social and health care center

Introducción. En nuestro país existen escasos recursos dirigidos a la atención del sujeto con daño cerebral adquirido (DCA) en fase posthospitalaria. En este nivel de atención, el Centro de Promoción de la Autonomía Personal de Bergondo se plantea como un recurso sociosanitario para facilitar la integración del sujeto con DCA en su entorno. Objetivos. Describir el perfil clínico de los sujetos integrados en nuestra unidad y valorar los objetivos de recuperación clínica y funcional en fases crónicas del DCA. Pacientes y métodos. Muestra de 105 sujetos admitidos en nuestro centro hasta diciembre de 2010, 86 hombres y 19 mujeres, con una edad media de 32,16 años y un tiempo de evolución más frecuente de menos de cinco años (64,76%). Se recogieron las variables sexo, edad, etiología, tiempo de evolución, diagnóstico de cambio de personalidad, medida de independencia funcional a la admisión, participación previa en programas de rehabilitación y existencia de objetivos de recuperación. Resultados. La principal etiología encontrada fue el traumatismo craneoencefálico (62,5%). El 54,28% recibía rehabilitación física a la admisión, mientras que el 49,52% había participado en intervenciones de neuropsicología. Se identificó a un 42,85% de sujetos con objetivos de recuperación física y a un 78,09% con objetivos en el campo de la neuropsicología. Conclusión. El perfil observado es el de un varón joven con secuelas derivadas de un traumatismo craneoencefálico de menos de cinco años de evolución, que ha recibido una escasa atención en el ámbito de la neuropsicología y que continúa recibiendo tratamientos de fisioterapia (AU)

Introduction. There are few resources for acquired brain injury (ABI) in post-hospitalary phase in our country. At this level of carefulness, Personal Autonomy Promotion Center in Bergondo contemplates like a social and health care resource in order to facilitate community integration in subjects with ABI. Aims. To describe clinical profile in the subjects admitted in our unit, and to assess intervention possibilities with clinicofunctional recovery goals in the chronic phases in ABI. Patients and methods. Sample of 105 subjects admitted in our center until December 2010. 86 men and 19 women, with a mean age of 32.16 years old and a most frequent evolution time of less than 5 years (64.76%). Variables collected were: sex, age, etiology, evolution time, personality changes diagnosis, admission FIM, previous participation in rehabilitation programmes and have recovery goals. Results. The main etiology was traumatic brain injury (62.5%). The 54.28% of the subjects was taking physical rehabilitation at the moment of admission, while the 49.52% had participated in neuropsychological interventions. Physical recovery goals were identified in the 42.85% of the subjects and the 78.09% had goals in neuropsychology field. Conclusion. The clinical profile observed was young man with sequelae caused by a traumatic brain injury suffered in last five years, who has received poor neuropsychological care and that still takes physiotherapy treatment (AU)

[Clinical profile in subjects with acquired brain injury in chronic phase in a social and health care center]. / Perfil del sujeto con daño cerebral adquirido en fase crónica en un recurso de atención sociosanitaria.

INTRODUCTION: There are few resources for acquired brain injury (ABI) in post-hospitalary phase in our country. At this level of carefulness, Personal Autonomy Promotion Center in Bergondo contemplates like a social and health care resource in order to facilitate community integration in subjects with ABI. AIMS. To describe clinical profile in the subjects admitted in our unit, and to assess intervention possibilities with clinico-functional recovery goals in the chronic phases in ABI. PATIENTS AND METHOD: . Sample of 105 subjects admitted in our center until December 2010. 86 men and 19 women, with a mean age of 32.16 years old and a most frequent evolution time of less than 5 years (64.76%). Variables collected were: sex, age, etiology, evolution time, personality changes diagnosis, admission FIM, previous participation in rehabilitation programmes and have recovery goals. RESULTS: The main etiology was traumatic brain injury (62.5%). The 54.28% of the subjects was taking physical rehabilitation at the moment of admission, while the 49.52% had participated in neuropsychological interventions. Physical recovery goals were identified in the 42.85% of the subjects and the 78.09% had goals in neuropsychology field. CONCLUSION: The clinical profile observed was young man with sequelae caused by a traumatic brain injury suffered in last five years, who has received poor neuropsychological care and that still takes physiotherapy treatment.

A preliminary study of the mini-mental state examination in a Spanish child population.

The Mini-Mental State Examination is one of the most widely used screening tests for the adult population in daily neurologic practice. The aim of this study was to describe and to analyze the results of the Mini-Mental State Examination administered to Spanish children and to assess the relationship between Mini-Mental State Examination scores and the child's mental age/intelligence quotient. The study population included 181 children whose ages ranged between 4 and 12 years. The neuropsychologic battery consisted of the Mini-Mental State Examination and Kaufman Brief Intelligence Test. Percentiles were obtained for the Mini-Mental State Examination total score according to age ranges. Performance gradually increased from 4 to 10 years of age when a plateau in the total Mini-Mental State Examination score was reached. At the age of 6 years, results exceeded 24 on average. Pairwise mean comparisons showed statistically significant differences between the age groups (P < .05). Data distribution could be classified in 4 independent groups for the following chronologic ages: 4, 5, and 6 years and from 7 to 12 years of age. The total Mini-Mental State Examination score correlated significantly with the child's chronologic (r = 0.80, P < .001) and mental (r = 0.76, P < .001) ages. This is a preliminary study of the application of the Mini-Mental State Examination in a Spanish child population as well as a first step for the assessment of the usefulness of this instrument as a cognitive screening tool for children's development.