A systematic review and meta-analysis on cognitive frailty in community-dwelling older adults: risk and associated factors.

OBJECTIVES: To identify which factors are associated with cognitive frailty (CF), as well as the impact of CF on the incidence of dementia and mortality. METHODS: A systematic review with meta-analysis was carried out using papers that enrolled a total of 75,379 participants and were published up to January 2020. RESULTS: Of the 558 identified records, 28 studies met the inclusion criteria and were included in the review. The meta-analysis of cross-sectional studies showed that CF has a significant association of having an older age and a history of falls. In longitudinal studies, the analysis showed a significant increase in risk of mortality and dementia for those with CF. DISCUSSION: This is the first systematic review and meta-analysis on CF, which addressed a wide variety of factors associated with the theme and which pointed out some as a potential target for prevention or management with different interventions or treatments, showing the clinical importance of its identification in the most vulnerable and susceptible groups.

Efficacy of Physical Exercise on Cortical Activity Modulation in Mild Cognitive Impairment: A Systematic Review.

OBJECTIVE: To investigate the effects of physical exercise on cortical activity measured via electroencephalogram (EEG) in individuals with mild cognitive impairment (MCI). DATA SOURCES: PubMed, Web of Science, PsycINFO, and SciELO databases were searched using: "physical exercise," "physical activity," "physical therapy," "exercise," "training," "electroencephalogram," "electroencephalography," "EEG," "mild cognitive impairment," "cognitive dysfunction," and "MCI." The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed and the Physiotherapy Evidence Database scale was used to assess the risk of bias of each study. STUDY SELECTION: Original articles, sample including individuals with MCI, physical exercise intervention, use of EEG to measure cortical activity. DATA EXTRACTION: Sample characteristics, physical exercise protocol characteristics, results related to effects of physical exercise on parameters derived from EEG signals, strengths, limitations, and conclusions of the studies were selected by 2 investigators. DATA SYNTHESIS: A total of 365 articles were identified in electronic databases. After the selection stage, 7 studies were included. Although there was a large spectrum of type of exercise (aerobic, resistance, multimodal, exergames, combined exercise with cognitive training), all exercise protocols altered cortical activity in patients with MCI. An exercise session (acute response) causes power reduction of delta band and increases complexity and P300 amplitude in resting-state EEG. After an intervention with an exercise program (chronic response), there was a reduction in the power of delta and theta bands and an increase in beta and alpha bands, as well an increase in complexity in resting-state EEG. CONCLUSIONS: Physical exercise seems to play a role in cortical activity in patients with MCI, suggesting neural plasticity in such individuals.

Apolipoprotein E ε4 allele impairs cortical activity in healthy aging and Alzheimer's disease.

AIM: To investigate the influence of apolipoprotein E (APOE) genotype on cortical activity, using the event-related potential P300 in healthy older adults and individuals with Alzheimer's disease (AD). METHODS: A cohort of 37 healthy older adults and 48 with AD participated in this study and completed an auditory oddball task using electroencephalographic equipment with 21 channels (10-20 system). APOE genotyping was obtained by real-time PCR. RESULTS: AD presented increased P300 latency and lower P300 amplitude, compared to healthy older adults. AD APOE ε4 carriers presented increased P300 latency in F3 (420.7 ± 65.8 ms), F4 (412.0 ± 49.0 ms), C4 (413.0 ± 41.1 ms) and P3 (420.4 ± 55.7 ms) compared to non-carriers (F3 = 382.5 ± 56.8 ms, p < 0.01; F4 = 372.2 ± 56.7 ms, p < 0.01; C4 = 374.2 ± 51.7 ms, p < 0.01; P3 = 384.4 ± 44.4 ms, p < 0.01). Healthy older adults APOE ε4 carriers presented lower Fz amplitude (2.6 ± 1.5 µV) compared to non-carriers (4.9 ± 2.9 µV; p = 0.02). Linear regression analysis showed that being a carrier of APOE ε4 allele remained significantly associated with P300 latency even after adjusting for sex, age, and cognitive grouping. APOE ε4 allele increases P300 latency (95% CI 0.11-0.98; p = 0.02). CONCLUSION: APOE ε4 allele negatively impacts cortical activity in both healthy older adults and AD individuals.

Efficacy of Gene Therapy to Restore Cognition in Alzheimer's Disease: A Systematic Review.

BACKGROUND: Alzheimer's disease (AD) is the main cause of dementia and it is a progressive neurogenerative disease characterized by the accumulation of neurofibrillary tangles and senile plaques. There is currently no cure; however, some treatments are available to slow down the progression of the disease, including gene therapy, which has been investigated to have great potential for the treatment of AD. OBJECTIVE: The aim of this review was to identify the efficacy of gene therapy to restore cognition in AD. METHODS: A systematic review was carried out using papers published up to May 2020 and available in the Web of Science, Scopus, and Medline/PUBMED databases. Articles were considered for inclusion if they were original researches that investigated the effects of gene therapy on cognition in AD. The methodological quality of the selected studies was evaluated using the Risk of Bias Tool for Animal Intervention Studies (SYRCLE's Rob tool) and the Jadad Scale. RESULTS: Most preclinical studies obtained positive results in improving memory and learning in mice that underwent treatment with gene therapy. On the other hand, clinical studies have obtained inconclusive results related to the delivery methods of the viral vector used in gene therapy. CONCLUSION: Gene therapy has shown a great potential for the treatment of AD in preclinical trials, but results should be interpreted with caution since preclinical studies presented limitations to predict the efficacy of the treatment outcome in humans.

Home-Based Exercise for People With Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

BACKGROUND: Exercise performed at home could be a useful therapy for people with chronic kidney disease. This systematic review and meta-analysis aimed at describing the characteristics, main findings, methodological quality, and adherence rate reported in the existent randomized controlled trials that have provided information regarding the impact of home-based exercise programs on people with chronic kidney disease. METHODS: Electronic databases (MEDLINE/PubMed, SPORTDiscus, Scopus, and CENTRAL) were searched up to April 2021, using the keywords: "Exercise"; "Home"; "Kidney Disease." Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was adopted. Jadad scale and Cochrane's tool were used to assess the methodological quality and risk of bias. RESULTS: Out of the 14 studies finally selected, 11 were included in the meta-analysis and most presented high methodological quality. The meta-analysis showed significant effects of home-based exercise on fitness and quality of life, but a little impact on renal function. Although exercise performed at home was mostly feasible and safe, adherence was not high and a considerable number of dropouts were observed. CONCLUSION: Home-based exercise has positive effects on the fitness' level and on the quality of life on people with chronic kidney disease. Future studies are needed to identify whether exercise performed at home is a better physical therapy option than center-based exercise.

A Systematic Review of Altered P300 Event-Related Potential in Apolipoprotein E4 (APOE4) Carriers.

BACKGROUND: Apolipoprotein ε4 allele (APOE4) is the strongest genetic risk factor for Alzheimer's disease and seems to be related to cognitive decline and damaged event-related potential P300, which is a sensitive measure to assess cognitive processing. OBJECTIVE: This research aims to critically review the existing scientific evidence regarding the association between APOE4 and P300. METHODS: A systematic review was carried out up to January 2020 on the following databases: Web of Science, Scopus and Medline/PubMed. Articles were considered for inclusion if they are original research that provided information regarding the association between APOE4 and P300, available in English, Spanish, or Portuguese, and available in full text. The methodological quality of the studies selected was evaluated using the quality assessment tool for observational cohort and cross-sectional studies recommended by Cochrane. RESULTS: Out of 993 studies, 14 met the inclusion criteria. The results obtained showed that APOE4 is related to a longer P300 latency. However, the data supplied do not allow us to confirm if this relationship also occurs in amplitude measures. Moreover, it was observed that APOE genotype may influence P300 in different ages, from younger individuals to demented older people. CONCLUSION: Evidence shows that APOE4 negatively influences cortical activities related to cognitive functions, as indicated by P300.

ADAM10: Biomarker of mild cognitive impairment but not of cognitive frailty.

Mild cognitive impairment (MCI) associated with physical frailty gave rise to the new concept of cognitive frailty. Previous studies have suggested that MCI may represent a condition that precedes Alzheimer's disease (AD), in view of its higher conversion rate to dementia, when compared with the conversion rate of cognitively healthy older adults. Therefore, and considering that MCI represents a reversible condition, the identification of biomarkers for this condition is imperative to early diagnosis. Accordingly, this study aimed to assess whether the platelet and plasma levels of ADAM10 could be related with the concomitant conditions of MCI and physical frailty, in order to support a new blood-based biomarker for the construct of cognitive frailty. Sixty-one adults aged 60 years or older participated in this study. The results showed that ADAM10 levels are reduced in platelets (p < 0.05) and increased in plasma (p < 0.05) of older adults with MCI compared to healthy controls, regardless of the physical frailty condition. The analysis of the ROC curve of ADAM10 in platelets showed sensitivity and specificity of 72.7 and 73.9%, respectively, to correct differentiate between participants with preserved cognition from those with MCI. For plasma samples, ADAM10 presented 62.5 and 90.0%, sensitivity and specificity respectively, to differentiate the aforementioned conditions. Together with other clinical criteria blood ADAM10 could be a relevant, low-invasive, low-cost and fast processing biomarker tool to help in the early and accurate diagnosis of MCI, however this marker was not able to identify cognitive frailty.

Adherence, Adhesion, and Dropout Reasons of a Physical Activity Program in a High Social Vulnerability Context.

BACKGROUND: One of the most important health determinants is social vulnerability, which can interfere in the practice of physical activity (PA). This study aimed at analyzing adherence to a PA program in a high social vulnerability context. METHODS: A longitudinal study with a 6-month intervention period was conducted. The program offered monitored walks associated with behavioral change educational campaigns. Sociodemographic characteristics, occupation, PA level, noncommunicable chronic diseases, participants' frequency of participation in the program, and intervention dropout reasons were evaluated. Descriptive and survival analyses were accomplished. RESULTS: Among the 106 participants, 88.0% were female and 21.7% were older adults. The most mentioned participation reasons were health improvement (23.0%), weight loss (19.0%), disease control (17.0%), and social living (12%). The mean frequency of participation in the program was 27.4%. Dropout rate was 52.7%. The main reported reasons for dropping out were work hours (27.8%), health problems (25.9%), personal reasons (22.2%), and lack of time (11.1%). Factors associated with remaining in the program were being older adults and presenting body mass index <25 kg/m2. CONCLUSIONS: Results showed that in a high social vulnerability context, adherence to PA programs is low, and adult-life-related commitments and high levels of obesity are factors associated with lower adherence.

Relationship between cognitive processing, language and verbal fluency among elderly individuals.

Some cognitive dimensions, such as attention, memory and executive functions, may decline with age, while other functions remain intact or even improve due to greater life experience. OBJECTIVE: to analyze the relationship between cognitive processing, language and verbal fluency among elderly individuals seen by primary healthcare services located in a city in the interior of São Paulo, Brazil. METHODS: a cross-sectional study with a quantitative method was conducted. A total of 149 elderly individuals were assessed through previously scheduled interviews. Data collection included a questionnaire on sociodemographic data and the Addenbrooke's Cognitive Examination - Revised (ACE-R). Cognitive processing (P300) was assessed using a device that captures potentials elicited in auditory tasks. Descriptive analysis and Spearman's correlation were performed with the level of significance established at 5%. RESULTS: a negative correlation was found between language and P300 latency, while a positive correlation was found between verbal fluency and P300 amplitude. Comprehension and naming tasks showed a negative correlation with latency. The repetition task revealed a positive correlation with P300 amplitude. CONCLUSION: although more extensive testing is needed, these findings suggest that language correlates with P300 latency, whereas verbal fluency correlates with P300 amplitude.

As dimensões cognitivas, como atenção, memória e funções executivas, podem diminuir com a idade, enquanto outras funções permanecem ou até melhoram devido a uma maior experiência de vida. OBJETIVO: analisar a relação entre processamento cognitivo, linguagem e fluência verbal em idosos atendidos em serviços de atenção básica localizados em um município do interior de São Paulo, Brasil. MÉTODOS: estudo transversal, método quantitativo. Um total de 149 idosos foram avaliados por meio de entrevistas previamente agendadas. A coleta de dados incluiu um questionário abordando dados sociodemográficos e o Exame Cognitivo de Addenbrooke - Revisado (ACE-R). O processamento cognitivo (P300) foi avaliado por meio de um dispositivo que capta potenciais elicitados em tarefas auditivas. A análise descritiva e a correlação de Spearman foram realizadas com o nível de significância estabelecido em 5%.\. RESULTADOS: foi encontrada correlação negativa entre a linguagem e a latência do P300 e uma correlação positiva entre a fluência verbal e a amplitude do P300. Tarefas de compreensão e nomeação apresentaram uma correlação negativa com a latência. A tarefa de repetição revelou correlação positiva com a amplitude do P300. CONCLUSÃO: embora testes mais extensos sejam necessários, esses achados sugerem que a correlação de linguagem com a latência e fluência do P300 está correlacionada com a amplitude do P300.

Effects of Physical Exercise on the P300 of Elderly With Alzheimer's Disease.

BACKGROUND: Evidence regarding the benefits of physical activity on the mental processing information of patients with Alzheimer's disease assessed objectively is scarce and can be observed through event-related potentials, such as the P300. The aim of the study was to identify the effects of physical exercises on mental processing information in the elderly with Alzheimer's disease through neurophysiological measures (P300 amplitude and latency) and reaction time. METHODS: A total of 31 patients with Alzheimer's disease participated in this study: 14 in functional exercise (FE) group and 17 in social gathering (SG) group who carried out three 1-hour sessions per week of FE and SG activities, respectively, for a 12-week period. All groups performed an auditory oddball task. A healthy elderly control group also participated. RESULTS: Significant (P < .05) improvements were observed as a reduction of reaction time after intervention in the FE group (pre = 421.5 ms and post = 360.9 ms). Also, an increase of P300 amplitude at central midline (pre = 5.9 µV and post = 6.9 µV) and parietal midline (pre = 4.7 µV and post = 5.7 µV) was observed in the FE. Finally, a decrease in the P300 latency at frontal midline (pre = 377 ms and post = 367 ms) was observed in the SG after the intervention. CONCLUSION: Physical exercise decreases reaction time and suggests a recovery in cortical activity, whereas SG activities could probably facilitate information processing.

Cognitive, functional and physical activity impairment in elderly with Alzheimer's disease.

Alzheimer's Disease (AD) is a progressive degenerative disorder that negatively affects quality of life of patients and family members. OBJECTIVE: The aim of this study is to compare the cognition, level of physical activity and functioning of elderly individuals with mild AD and those without dementia. METHODS: The study comprised 24 elderly with mild AD (mean age = 76.9 ± 5.3 years) and 30 elderly without dementia (mean age = 74.1 ± 5.6 years). The following instruments were applied to evaluate cognitive functions: MMSE; Frontal Assessment Battery; Clock Drawing Test; Corsi Blocks, and Verbal Paired Associates. Event-related potential P300 was used to evaluate cognitive processing. The Modified Baecke Questionnaire For Older Adults was applied to evaluate the level of physical activity together with use of a pedometer for 7 consecutive days. For the evaluation of the functioning, the Direct Assessment of Functional Status-Revised scale and functional tests were used. RESULTS: There was a significant difference between the groups in level of physical activity and functioning, except on the test evaluating flexibility. CONCLUSION: Elderly with AD had cognitive, functional and physical activity deficits which can manifest even in the early stages of the disease.

A doença de Alzheimer é um processo neurodegenerativo e progressivo que afeta, negativamente, a qualidade de vida do paciente e de seus familiares. OBJETIVO: Comparar a cognição, nível de atividade física capacidade funcional de idosos no estágio leve da doença de Alzheimer e de idosos sem demência. MÉTODOS: Participaram deste estudo 24 idosos no estágio leve da doença de Alzheimer (média de idade = 76,9 ± 5.3 anos) e 30 idosos sem demência (média de idade = 74,1 ± 5,6 anos). Foram utilizados os seguintes instrumentos de avaliação cognitiva: MEEM, Bateria de Avaliação Frontal, Teste do Desenho do Relógio, Blocos de Corsi e Pares Verbais Associados. Além disso, foi realizado o exame eletroencefalográfico P300 para avaliar o tempo de processamento de informação. Para quantificar o nível de atividade física foi utilizado o Questionário Baecke Modificado para Idosos e o pedômetro, que foi utilizado por 7 dias consecutivos. A funcionalidade foi avaliada através da escala Direct Assessment of Functional Status-Revised, juntamente com testes funcionais que avaliaram os componentes da capacidade funcional. RESULTADOS: Foram encontradas diferenças significativas entre os grupos para o nível de atividade física e funcionalidade motora, com exceção da avaliação da flexibilidade. CONCLUSÃO: Idosos com doença de Alzheimer apresentam prejuízos cognitivos, funcionais e de nível de atividade física, os quais encontram-se alterados nos estágios iniciais da doença.

On the use of the P300 as a tool for cognitive processing assessment in healthy aging: A review.

Changes in patterns of performance for the cognitive functions of memory, processing speed, and focused attention are expected in old age. OBJECTIVE: The main goal of this systematic review was to analyze the use of ERP in healthy elderly in studies evaluating the P300 components. METHODS: A systematic review was carried out based on recommendations for nursing research on the databases LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. RESULTS: 26 studies involving 940 healthy elderly were identified, most of which sought to identify and determine the influence of age on the P300. CONCLUSION: Although there is consensus in the literature that P300 latency is significantly longer in elderly with psychiatric disorders compared to healthy elderly, it was not possible to conclude P300 associations with gender, education and other cognitive tests.

São esperadas mudanças nos padrões de desempenho nas funções cognitivas de memória, velocidade de processamento e atenção concentrada durante o processo de envelhecimento. OBJETIVO: O objetivo principal desta revisão sistemática é analisar o uso de ERP em idosos saudáveis nos estudos que avaliaram os componentes do P300. MÉTODOS: Realizou-se uma revisão sistemática com recomendações de estudo para enfermagem nos bancos de dados LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. RESULTADOS: Foram identificados 26 estudos com 940 idosos saudáveis, a maioria procurava identificar e encontrar a influência da idade no P300. CONCLUSÃO: Embora haja consenso na literatura de que em idosos com transtornos psiquiátricos a latência P300 é significativamente maior, em relação aos idosos saudáveis não foi possível concluir as associações P300 com gênero, escolaridade e outros testes cognitivos.

Relationship between cognitive processing, language and verbal fluency among elderly individuals / Relação entre processo cognitivo, linguagem e fluência verbal entre idosos individuais

ABSTRACT Some cognitive dimensions, such as attention, memory and executive functions, may decline with age, while other functions remain intact or even improve due to greater life experience. Objective: to analyze the relationship between cognitive processing, language and verbal fluency among elderly individuals seen by primary healthcare services located in a city in the interior of São Paulo, Brazil. Methods: a cross-sectional study with a quantitative method was conducted. A total of 149 elderly individuals were assessed through previously scheduled interviews. Data collection included a questionnaire on sociodemographic data and the Addenbrooke's Cognitive Examination - Revised (ACE-R). Cognitive processing (P300) was assessed using a device that captures potentials elicited in auditory tasks. Descriptive analysis and Spearman's correlation were performed with the level of significance established at 5%. Results: a negative correlation was found between language and P300 latency, while a positive correlation was found between verbal fluency and P300 amplitude. Comprehension and naming tasks showed a negative correlation with latency. The repetition task revealed a positive correlation with P300 amplitude. Conclusion: although more extensive testing is needed, these findings suggest that language correlates with P300 latency, whereas verbal fluency correlates with P300 amplitude.

RESUMO As dimensões cognitivas, como atenção, memória e funções executivas, podem diminuir com a idade, enquanto outras funções permanecem ou até melhoram devido a uma maior experiência de vida. Objetivo: analisar a relação entre processamento cognitivo, linguagem e fluência verbal em idosos atendidos em serviços de atenção básica localizados em um município do interior de São Paulo, Brasil. Métodos: estudo transversal, método quantitativo. Um total de 149 idosos foram avaliados por meio de entrevistas previamente agendadas. A coleta de dados incluiu um questionário abordando dados sociodemográficos e o Exame Cognitivo de Addenbrooke - Revisado (ACE-R). O processamento cognitivo (P300) foi avaliado por meio de um dispositivo que capta potenciais elicitados em tarefas auditivas. A análise descritiva e a correlação de Spearman foram realizadas com o nível de significância estabelecido em 5%./ Resultados: foi encontrada correlação negativa entre a linguagem e a latência do P300 e uma correlação positiva entre a fluência verbal e a amplitude do P300. Tarefas de compreensão e nomeação apresentaram uma correlação negativa com a latência. A tarefa de repetição revelou correlação positiva com a amplitude do P300. Conclusão: embora testes mais extensos sejam necessários, esses achados sugerem que a correlação de linguagem com a latência e fluência do P300 está correlacionada com a amplitude do P300.

Physical exercise modulates peripheral levels of brain-derived neurotrophic factor (BDNF): a systematic review of experimental studies in the elderly.

UNLABELLED: The objective of this study was to conduct a systematic review of studies that analyzed the effect of physical exercise on the peripheral levels of BDNF in elderly individuals. METHOD: We conducted a search in PsycINFO, Biological Abstracts, Pubmed, Web of Science, and Science Direct from 1990 to 2011, using the following keywords: "physical exercise", "physical activity", "physical therapy", "training", "BDNF", "neuroplasticity", "neurotrophins", "neuroplasticity proteins", "aged", "older", "elderly". The articles were considered for inclusion in the review if they were studies with elderly, assessed peripheral (serum and/or plasma) BDNF and evaluated an acute exercise or chronic exercise (training). RESULTS: Five randomized controlled trial and one randomized non-controlled trial studies were analyzed. Five out of six studies reported a significantly higher BDNF response to aerobic acute exercise and to aerobic or strength training program in healthy elderly and elderly with different pathologies. CONCLUSION: It was not possible to establish a recommendation protocol for the type and intensity of physical exercise required to produce an increase in levels BDNF. However, physical exercise, particularly, moderate-intensity exercises seem to be more effective to promote increase the peripheral levels of BDNF in the elderly.

Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer's disease: a controlled trial.

AIM: The objective of the present study was to investigate the effect of a multimodal exercise intervention on frontal cognitive functions and kinematic gait parameters in patients with Alzheimer's disease. METHODS: A sample of elderly patients with Alzheimer's disease (n=27) were assigned to a training group (n=14; aged 78.0±7.3 years) and a control group (n=13; aged 77.1±7.4 years). Multimodal exercise intervention includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week for 16 weeks, and the control participants maintained their regular daily activities during the same period. The frontal cognitive functions were evaluated using the Frontal Assessment Battery, the Clock Drawing Test and the Symbol Search Subtest. The kinematic parameters of gait-cadence, stride length and stride speed were analyzed under two conditions: (i) free gait (single task); and (ii) gait with frontal cognitive task (walking and counting down from 20--dual task). RESULTS AND DISCUSSION: The patients in the intervention group significantly increased the scores in frontal cognitive variables, Frontal Assessment Battery (P<0.001) and Symbol Search Subtest (P<0.001) after the 16-week period. The control group decreased the scores in the Clock Drawing Test (P=0.001) and increased the number of counting errors during the dual task (P=0.008) after the same period. CONCLUSION: The multimodal exercise intervention improved the frontal cognitive functions in patients with Alzheimer's disease.

Cognitive, functional and physical activity impairment in elderly with Alzheimer's disease / Comprometimento cognitivo, funcional e de nível de atividade física de idosos com doença de alzheimer: prejuízos na doença de alzheimer

ABSTRACT Alzheimer's Disease (AD) is a progressive degenerative disorder that negatively affects quality of life of patients and family members. Objective: The aim of this study is to compare the cognition, level of physical activity and functioning of elderly individuals with mild AD and those without dementia. Methods: The study comprised 24 elderly with mild AD (mean age = 76.9 ± 5.3 years) and 30 elderly without dementia (mean age = 74.1 ± 5.6 years). The following instruments were applied to evaluate cognitive functions: MMSE; Frontal Assessment Battery; Clock Drawing Test; Corsi Blocks, and Verbal Paired Associates. Event-related potential P300 was used to evaluate cognitive processing. The Modified Baecke Questionnaire For Older Adults was applied to evaluate the level of physical activity together with use of a pedometer for 7 consecutive days. For the evaluation of the functioning, the Direct Assessment of Functional Status-Revised scale and functional tests were used. Results: There was a significant difference between the groups in level of physical activity and functioning, except on the test evaluating flexibility. Conclusion: Elderly with AD had cognitive, functional and physical activity deficits which can manifest even in the early stages of the disease.

RESUMO A doença de Alzheimer é um processo neurodegenerativo e progressivo que afeta, negativamente, a qualidade de vida do paciente e de seus familiares. Objetivo: Comparar a cognição, nível de atividade física capacidade funcional de idosos no estágio leve da doença de Alzheimer e de idosos sem demência. Métodos: Participaram deste estudo 24 idosos no estágio leve da doença de Alzheimer (média de idade = 76,9 ± 5.3 anos) e 30 idosos sem demência (média de idade = 74,1 ± 5,6 anos). Foram utilizados os seguintes instrumentos de avaliação cognitiva: MEEM, Bateria de Avaliação Frontal, Teste do Desenho do Relógio, Blocos de Corsi e Pares Verbais Associados. Além disso, foi realizado o exame eletroencefalográfico P300 para avaliar o tempo de processamento de informação. Para quantificar o nível de atividade física foi utilizado o Questionário Baecke Modificado para Idosos e o pedômetro, que foi utilizado por 7 dias consecutivos. A funcionalidade foi avaliada através da escala Direct Assessment of Functional Status-Revised, juntamente com testes funcionais que avaliaram os componentes da capacidade funcional. Resultados: Foram encontradas diferenças significativas entre os grupos para o nível de atividade física e funcionalidade motora, com exceção da avaliação da flexibilidade. Conclusão: Idosos com doença de Alzheimer apresentam prejuízos cognitivos, funcionais e de nível de atividade física, os quais encontram-se alterados nos estágios iniciais da doença.

On the use of the P300 as a tool for cognitive processing assessment in healthy aging: A review / O uso do p300 como ferramenta para avaliação do processamento cognitivo em envelhecimento saudável

ABSTRACT Changes in patterns of performance for the cognitive functions of memory, processing speed, and focused attention are expected in old age. Objective: The main goal of this systematic review was to analyze the use of ERP in healthy elderly in studies evaluating the P300 components. Methods: A systematic review was carried out based on recommendations for nursing research on the databases LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. Results: 26 studies involving 940 healthy elderly were identified, most of which sought to identify and determine the influence of age on the P300. Conclusion: Although there is consensus in the literature that P300 latency is significantly longer in elderly with psychiatric disorders compared to healthy elderly, it was not possible to conclude P300 associations with gender, education and other cognitive tests.

RESUMO São esperadas mudanças nos padrões de desempenho nas funções cognitivas de memória, velocidade de processamento e atenção concentrada durante o processo de envelhecimento. Objetivo: O objetivo principal desta revisão sistemática é analisar o uso de ERP em idosos saudáveis nos estudos que avaliaram os componentes do P300. Métodos: Realizou-se uma revisão sistemática com recomendações de estudo para enfermagem nos bancos de dados LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. Resultados: Foram identificados 26 estudos com 940 idosos saudáveis, a maioria procurava identificar e encontrar a influência da idade no P300. Conclusão: Embora haja consenso na literatura de que em idosos com transtornos psiquiátricos a latência P300 é significativamente maior, em relação aos idosos saudáveis não foi possível concluir as associações P300 com gênero, escolaridade e outros testes cognitivos.

Balance, executive functions and falls in elderly with Alzheimer's disease (AD): a longitudinal study.

Elderly individuals with AD are more susceptible to falls, which might be associated with decrements in their executive functions and balance, among other things. We aimed to analyze the effects of a program of dual task physical activity on falls, executive functions and balance of elderly individuals with AD. We studied 21 elderly with probable AD, allocated to two groups: the training group (TG), with 10 elderly who participated in a program of dual task physical activity; and the control group (CG), with 11 elderly who were not engaged in regular practice of physical activity. The Clock Drawing Test (CDT) and the Frontal Assessment Battery (FAB) were used in the assessment of the executive functions, while the Berg Balance Scale (BBS) and the Timed Up-and-Go (TUG)-test evaluated balance. The number of falls was obtained by means of a questionnaire. We observed a better performance of the TG as regards balance and executive functions. Moreover, the lower the number of steps in the TUG scale, the higher the scores in the CDT, and in the FAB. The practice of regular physical activity with dual task seems to have contributed to the maintenance and improvement of the motor and cognitive functions of the elderly with AD.

P300 latency and amplitude in Alzheimer's disease: a systematic review.

UNLABELLED: The P300 plays a key role as a method for monitoring and evaluating dementia, including Alzheimer's disease. OBJECTIVE: The goal of this study was to search for articles which analyzed P300 latency and amplitude values in Alzheimer's disease. METHODS: We searched in the following databases: Web of Science, Pub Med, Psyc Info, Medline, Biological Abstracts and Scielo using the following keywords: speed of information processing, processing speed, information processing, aged, older, elderly, older people, alzheimer dementia, alzheimer disease, Alzheimer and cross-references of selected articles. RESULTS: We found eight studies matching the inclusion criteria. These studies showed that there is a consensus on a P300 latency increase of elderly patients with Alzheimer's disease compared with subjects without the disease. However, it appears that, with respect to the P300 amplitude, there is still no consensus; however, it may be related to different methodological variables adopted in the reviewed studies. CONCLUSION: There is a need to standardize the variables involved in P300 measurement for senior citizens with Alzheimer's disease in order to be able to compare P300 latency and amplitude values for this population.