Improving Recruitment for a Newborn Screening Pilot Study with Adaptations in Response to the COVID-19 Pandemic.

Seven months after the launch of a pilot study to screen newborns for Duchenne Muscular Dystrophy (DMD) in New York State, New York City became an epicenter of the coronavirus disease 2019 (COVID-19) pandemic. All in-person research activities were suspended at the study enrollment institutions of Northwell Health and NewYork-Presbyterian Hospitals, and study recruitment was transitioned to 100% remote. Pre-pandemic, all recruitment was in-person with research staff visiting the postpartum patients 1-2 days after delivery to obtain consent. With the onset of pandemic, the multilingual research staff shifted to calling new mothers while they were in the hospital or shortly after discharge, and consent was collected via emailed e-consent links. With return of study staff to the hospitals, a hybrid approach was implemented with in-person recruitment for babies delivered during the weekdays and remote recruitment for babies delivered on weekends and holidays, a cohort not recruited pre-pandemic. There was a drop in the proportion of eligible babies enrolled with the transition to fully remote recruitment from 64% to 38%. In addition, the proportion of babies enrolled after being approached dropped from 91% to 55%. With hybrid recruitment, the proportion of eligible babies enrolled (70%) and approached babies enrolled (84%) returned to pre-pandemic levels. Our experience adapting our study during the COVID-19 pandemic led us to develop new recruitment strategies that we continue to utilize. The lessons learned from this pilot study can serve to help other research studies adapt novel and effective recruitment methods.

A Year in the COVID-19 Epidemic: Cuba and Uruguay in the Latin American Context.

INTRODUCTION: One year after WHO declared COVID-19 a pandemic, we found it useful to carry out a diagnosis of the situation in Latin America. OBJECTIVE: Examine the prevailing epidemiological panorama in mid-March 2021 in 16 countries in Latin America and the performance, over time, in the two countries with the best responses to their respective epidemics. METHODS: Using morbidity and mortality data, we compared the relative performance of each country under review and identified the two countries with the most successful responses to the pandemic. We used five indicators to analyze the course of each country's performance during the pandemic throughout 2020: prevalence of active cases per million population; cumulative incidence rate in 7 days per 100,000 population; positivity rate over a 7-day period; percentage of recovered patients and crude mortality rate per 1,000,000 population. RESULTS: According to the performance indicators, Cuba was ranked highest, followed by Uruguay. Although figures remained within acceptable margins, both nations experienced notable setbacks in the first weeks of 2021, especially sharp in Uruguay. CONCLUSIONS: Any characterization of the situation is condemned to be short-lived due to the emergence of mutational variants; however, this analysis identified favorable sociodemographic characteristics in both nations, and in their health systems, which may offer possible explanations for the results we obtained.

Evaluation of Aircrew Low-Intensity Threat Laser Eye Protection.

Prototype low-intensity threat laser eye protection (LIT-LEP) spectacles were evaluated for US Coast Guard (USCG) cockpits and night vision goggle compatibility. The impetus for interest in aviation LIT-LEP is driven in part by the fact that easily accessible 0.5-2.0 W high-power laser pointers exceed safety standards for direct on-axis viewing. A repeated-measures experimental design was used to assess LIT-LEP performance relative to a no-LEP control for the following tasks: Near- and far contrast acuity, night vision goggle far-contrast acuity, emissive and non-emissive light source color-vision screening, and USCG multifunctional display color symbol discrimination reaction time and accuracy. Near- and far-contrast acuity results demonstrated good LIT-LEP performance for typical in- and out-of-cockpit lighting conditions. Night vision goggle performance suffered marginally at only one contrast level (85%; 20/30 acuity line). Color vision test results showed good color balance in that S-, M-, and L-cone performance did not demonstrate a clinical diagnostic color defect for emissive or non-emissive light sources when wearing LIT-LEP. Color symbol discrimination reaction-time-task results based on inverse efficiency scores revealed that some non-primary flight display colors exhibited a combination of slower speed and decreased accuracy. The findings will contribute to an acquisition decision as well as guide future LEP designs.

Effects of semantic relations, repetition of words, and list length in word list recall of Alzheimer's patients.

INTRODUCTION: Semantic relations among words and repetition enhance free recall, but it is unknown if these facilitating factors are effective in dementia. METHOD: Alzheimer's patients (MILD-Alz, MOD-Alz) were compared to healthy elderly. Fifteen-word lists were read out to the subjects. In four sets of lists the words in intermediary input positions were semantically related or not, or the midlist words were repeated, or they were repeated and semantically related. RESULTS: The usual third peak of recall of semantically related words was not observed in MOD-Alz, repetition of words did not increase recall of the patients, and the combination of relatedness and repetition benefited only MID-Alz. In a second experiment, with related or unrelated midlist words, and list length shortened from 15 to 9 words, semantic facilitation was observed in mild and moderate Alzheimer s patients, although diminished compared to controls. CONCLUSION: Progression of dementia turns facilitating factors of recall less effective.

Postural Instability and Simulator Seasickness.

BACKGROUND: Motion sickness is a serious issue for many individuals, but the problem is particularly important among military personnel who may regularly experience unusual or extreme motion profiles as a part of their duties. As such, it is important to understand the underlying mechanisms that contribute to motion sickness, which in turn can lead to new and more effective countermeasures. The current study investigated causal etiology by examining the predictions of postural instability theory. Subjects experienced multiple motion profiles while reporting their sickness symptoms. METHODS: Postural instability was directly manipulated by including both an active and passive condition. In the active condition, subjects could actively adapt their posture to the motion profile. In the passive condition, subjects had their feet affixed in place and could not effectively adapt their posture to the motion profiles. Subjects completed both conditions to control for individual differences in motion sickness susceptibility. RESULTS: Active condition subjects had greater postural stability as measured by sample entropy (M = 0.179 Active, M = 0.136 Passive), and sickness symptoms increased with time. Both results provide a methodological check against our manipulation. However, there were no differences in symptoms between active or passive conditions as measured by the simulator sickness questionnaire (M = 16.56 and M = 18.25, respectively), and no relationship between our measure of postural instability and symptomology. DISCUSSION: These results do not support postural instability as the primary causal factor in motion sickness; however, more research is needed to elucidate the mechanisms of motion sickness etiology.Pettijohn KA, Geyer D, Gomez J, Becker WJ, Biggs AT. Postural instability and simulator seasickness. Aerosp Med Hum Perform. 2018; 89(7):634-641.

Un año de epidemia de COVID-19: Cuba y Uruguay en el contexto latinoamericano

RESUMEN Introducción: Transcurrido un año desde que la OMS declaró la diseminación del SARS-COV-2 como una pandemia, consideramos útil realizar un diagnóstico de la situación prevaleciente en la región latinoamericana. Objetivos: Examinar el panorama epidemiológico prevaleciente a mediados del mes de marzo de 2021 en 16 países de la región y el desempeño en el tiempo en los dos países con mejores resultados. Métodos: Con los datos de morbilidad y mortalidad, se realizó una comparación del desempeño relativo de los países considerados y se identificaron las dos naciones con mejores resultados. Para analizar cuantitativamente el derrotero seguido por el proceso epidémico en dichas naciones a lo largo de 2020, se usaron 5 indicadores: tasa de prevalencia de casos activos por millón de habitantes, tasa de incidencia acumulada en 7 días por 100 mil habitantes, tasa de positividad en 7 días, porcentaje de enfermos recuperados y tasa cruda de mortalidad por millón de habitantes. Resultados: Se constató la posición cimera de Cuba en primer lugar, seguido de Uruguay según los indicadores de desempeño considerados. Aunque las cifras se mantienen dentro de márgenes aceptables, se puso de manifiesto el retroceso que ambas naciones han experimentado en las primeras semanas de 2021, especialmente acusado en Uruguay. Conclusiones: Cualquier caracterización de la situación está condenada a ser efímera por la naturaleza mutante de la epidemia; no obstante, el análisis permite identificar que los favorables rasgos sociodemográficos de ambas naciones, así como los de sus sistemas de salud aportan posibles explicaciones para los resultados obtenidos.

ABSTRACT Introduction: One year after the WHO declared the spread of SARS-COV-2 as a pandemic, we consider it useful to approach a diagnosis of the prevailing situation in the Latin American region. Objectives: To examine the prevailing epidemiological scenario in mid-March 2021 in 16 countries of the region, as well as performance over time in the two countries with best outcomes. Methods: Using morbidity and mortality data, we made a comparison of the relative performance of the countries considered and the two nations with the best results were identified. To quantitatively analyze the course followed by the epidemic process in these nations from the outbreak of COVID-19 until the moment of the analysis, 5 indicators were used: prevalence rate of active cases per million inhabitants, cumulative incidence rate in 7 days per 100.000 inhabitants, positivity rate in 7 days, percentage of recovered patients and crude mortality rate per million inhabitants. Results: The top position of Cuba was shown, followed by Uruguay, according to the performance indicators considered. Although the figures remain within acceptable margins, the setback that both nations have experienced in the first weeks of 2021 was revealed, especially marked in Uruguay. Conclusions: Any characterization of the situation is condemned to be transitory due to the mutant nature of the epidemic. However, the examination of twelve complete months allowed to identify that the favorable socio-demographic characteristics of both nations, as well as those of their health systems, provide possible explanations for the results obtained.

El hospital como dinamizador y difusor de salud regional: la experiencia del Hospital de Tacuarembó, Uruguay / Hospitals as a way to dynamize and disemminate regional health: the case of the Hospital de Tacuarembó, Uruguay / O hospital como habilitador e difusor da saúde regional: a experiência do hospital de Tacuarembó, Uruguai

Resumen: Se describe el desarrollo del Hospital Regional de Tacuarembó (HRT), situado en una ciudad mediana del norte de Uruguay, que lo condujo a convertirse en un referente dinamizador de la salud regional, con una atención médica moderna y eficaz, así como de servicio a la comunidad y a la salud nacional. Todo ello logrado a través de una gestión ambiciosa y optimista en los objetivos, basada en esfuerzos colectivos e individuales así como en apoyos institucionales nacionales y de organismos internacionales. Ese papel dinamizador e influyente a nivel regional, e inclusive nacional, está basado, por una parte, en una gran mejora de su base logística, es decir, el propio hospital, en cuanto a instalaciones, equipamientos y ampliación de las capacidades de atención médica; pero también en un gran apoyo e impulso a la Atención Primaria en Salud, no solo en la ciudad de Tacuarembó, sino a nivel departamental. Además, el HRT ha jugado un papel importante en el control de dos zoonosis parasitarias de importancia nacional: la enfermedad de Chagas y la equinococosis quística. Esa acción dinamizadora ha consistido en plantear al hospital como una "organización de salud", considerando el contexto de un territorio particular junto a los determinantes del sistema nacional de salud. Se puede considerar al HRT como una organización innovadora liderada por "emprendedores sociales" dentro de un marco de emprendimiento social partiendo de un hospital departamental o provincial.

Summary: The study presents the case of the Hospital de Tacuarembó (HRT), located in a medium-size city in the north of Uruguay, which turned into a reference in terms of the dynamization of regional health, offering modern and effective healthcare services, serving the community and contributing to the improvement of national health. All of this was possible as a result of an ambitious and optimistic management of objectives, based on collective and individual effort, as well as relying on the support of national and international bodies. This dynamizing and influential role played by the Hospital de Tacuarembó is based, on the one hand on a great improvement of its logistical base - that is, the hospital itself - in terms of its premises, equipment and upscaling of medical services, and on the other hand on the major support and stimulus to Primary Healthcare Services, not only in the city of Tacuarembó, but also throughout the entire province. Likewise, the HRT has played a significant role in the control of two parasite zoonoses that are extremely important for Uruguay: Chagas disease and cystic echinococcosis. This dynamizing actions have consisted in regarding the hospital as a "health organization" within the context of a certain territory, along with factors defined by the national health system. HRT may be considered as an innovative organization led by "social entrepreneurs" within the framework of social entrepreneurship, stemming from a departmental or province hospital.

Resumo: Descreve-se o desenvolvimento do Hospital Regional de Tacuarembó (HRT), localizado em uma cidade de médio porte do norte do Uruguai, o que o tornou uma referência dinâmica de saúde regional, com atendimento médico moderno e eficaz, além de atendimento à comunidade e a saúde nacional. Tudo isto alcançado através de uma gestão ambiciosa e otimista dos objectivos, baseada no esforço coletivo e individual, bem como no apoio institucional nacional e de organismos internacionais. Este papel dinâmico e influente a nível regional, e mesmo nacional, está baseado, por um lado, numa grande melhoria da sua base logística, ou seja, do próprio hospital, ao nível das instalações, equipamentos e ampliação das capacidades de assistência médica; mas também num grande apoio e dinamização da Atenção Primária à Saúde (APS) não só na cidade de Tacuarembó mas também a nível departamental. Além disso, o HRT tem desempenhado um papel importante no controle de duas zoonoses parasitárias de importância nacional: a doença de Chagas e a equinococose cística. Essa dinâmica de ação consistiu em considerar o hospital como uma "organização de saúde", considerando o contexto de um determinado território e os determinantes do sistema nacional de saúde. O HRT pode ser considerado uma organização inovadora liderada por "empreendedores sociais" dentro de um quadro de empreendedorismo social a partir de um hospital departamental ou provincial.

A longitudinal study of a neuropsychological rehabilitation program in Alzheimer's disease.

UNLABELLED: Our aim was to study the duration of benefits derived from a neuropsychological rehabilitation program (NRP) for dementia patients. METHOD: The participants in this study were three patients diagnosed as probable Alzheimer's disease in the initial-to-moderate phase; the three were taking anticholinesterases. They were submitted to a neuropsychological evaluation (NE) before the NRP and then reevaluated after 12 and 24 months of treatment. The aim of our intervention was to do practical work with implicit and explicit residual memory by training them in everyday life activities, and using compensatory strategies and their intact cognitive abilities. RESULTS: Analysis of quantitative NE data (descriptive measures) after the first year of NRP showed cognitive improvement, functional stabilization and fewer behavioral problems. However, this improvement did not continue in the second year, and the disease maintained its characteristic progression.

Applicability of the abbreviated neuropsychologic battery (NEUROPSI) in Alzheimer disease patients.

NEUROPSI is a brief neuropsychologic battery developed to briefly assess a wide spectrum of cognitive functions. The aim of this study was to examine the applicability of a Portuguese version of this battery and verify the efficacy in detecting cognitive impairment in Alzheimer disease (AD) patients. NEUROPSI was applied to 75 elderly people, 25 patients with probable AD in mild stage (AD1), 25 patients in moderate stage (AD2), and 25 healthy elderly persons (control group), matched with the AD patients for age and schooling. Before testing all participants were applied the Mini-Mental State Examination. Results showed significant differences in total scores of the tests; NEUROPSI (P<0.001) and Mini-Mental State Examination (P<0.001), and the control group scored highest in both of the tests followed by groups AD1 and AD2. Differences were also found between the initial phase and the moderate phase. Results indicate that NEUROPSI is an efficient instrument for detecting AD patients in the initial stage of the disease.

Involution of categorical thinking processes in Alzheimer's disease: Preliminary results.

Alzheimer's disease (AD) is a degenerative brain disorder characterized by progressive losses in cognitive functions, including memory. The sequence of these losses may correspond to the inverse order of the normal sequence of ontogenetic cognitive acquisitions, a process named retrogenesis. One of the acquisitions that improve in normal development is the ability to retrieve previously acquired categorical knowledge from semantic memory in order to guide associative thinking and memory processes; consequently, children become able to associate verbal stimuli in more complex taxonomic ways and to use this knowledge to improve their recall. OBJECTIVE: In this study, we investigated if AD-related deterioration of semantic memory involves a decrease in categorical thinking processes with progression of the disease, according to the retrogenesis hypothesis. METHODS: We compared the performance of AD patients at mild and moderate stages, and of groups of 7, 10 and 14-year-old children in tasks of free association along with recall tasks of perceptually and semantically related stimuli. RESULTS: ANOVAS showed a decrease in taxonomic associations and an increase in diffuse associations between mild and moderate stages, corresponding to the inverse order shown by the child groups. At the moderate AD stage, the pattern was similar to that of 7-year-old children. Both groups of patients performed worse than child groups in recall tasks. CONCLUSIONS: These results corroborate the hypothesis of an involution of the processes of categorical associative thinking in the course of the disease.

A doença de Alzheimer (DA) é uma doença degenerativa do cérebro caracterizada por perdas progressivas nas funções cognitivas, incluindo memória. A seqüência destas perdas pode corresponder à ordem inversa da seqüência normal das aquisições na ontogênese, um processo conhecido como retrogênesis. Uma das aquisições que melhoram no desenvolvimento normal é a habilidade de recuperar conhecimento categórico previamente adquirido da memória semântica de forma a organizar o pensamento associativo e a memória imediata; como conseqüência, as crianças tornam-se capazes de associar estímulos verbais de formas mais complexas, taxonômicas, e de usar este conhecimento para melhorar sua recordação. OBJETIVO: Neste estudo, investigamos se a deterioração cognitiva associada à DA envolve uma redução dos processos de pensamento categórico ao longo da progressão da doença, considerando a hipótese da retrogênesis. MÉTODO: Comparamos o desempenho de pacientes com DA nos estágios inicial e moderado e de grupos de crianças com 7, 10 e 14 anos de idade em tarefas de associação livre e recordação de estímulos semântica e perceptivamente associados. RESULTADOS: ANOVAS mostraram uma redução das associações taxonômicas e um aumento de associações difusas entre os estágios inicial e moderado, correspondendo à ordem inversa mostrada pelos grupos de crianças. No estágio moderado, o padrão foi similar ao das crianças de 7 anos. Os dois grupos de pacientes apresentaram pior desempenho que as crianças nas tarefas de memória. CONCLUSÕES: Os resultados corroboram a hipótese de uma involução dos processos de pensamento associativo categórico no curso da doença.

Neuropsychological rehabilitation program and behavioral disturbances in early-stage Alzheimer patients.

Alzheimer's disease (AD) is the most frequent cause of dementia and cholinesterase inhibitors are the available treatment in the mild stage. However cognitive rehabilitation has shown satisfactory results when combined with pharmacological treatment. Behavioral alteration is common in AD patients, which burdens caregivers and raises the risk of institutionalization. Providing caregivers guidance may enable them to assure better quality of life for patient and caregiver and lower institutionalization rates. OBJECTIVE: To evaluate the effects of a neuropsychological rehabilitation program (NRP) combined with pharmacological treatment in early stage AD patients. METHODS: We studied 12 AD patients (6 women), average age 75.42 (6.22) with 9.58 (5.6) years education in use of stable doses of cholinesterase inhibitors. Cognitive performance was evaluated using Mini-Mental State Examination (MMSE) and Alzheimer´s Disease Assessment Scale-cognitive (ADAS-Cog). Caregivers responded to Neuropsychiatric Inventory (NPI) and Functional Activities Questionnaire (FAQ) at initial evaluation (T1), and after 8 months of rehabilitation program (T2). The program comprised two sessions every week and family guidance every fortnight. RESULTS: MMSE (T1:23.25 (1.82)/T2:23.42 (2.81); ADAS-Cog (T1:17.11 (6.73)/T2:21.2 (8.59); NPI (T1:23.42 (23.38)/T2:19.83 (17.73); FAQ (T1:10.67 (7.24)/T2: 13.92 (6.92). CONCLUSIONS: These results show the importance of providing guidance and support for caretakers. Study limitations were the small number of patients and absence of a control group with only drug treatment to compare with combined pharmacological and rehabilitation treatments.

A doença de Alzheimer é a demência mais freqüente, o tratamento disponível específico, no estágio leve é com droga anticolinesterásico. Por outro lado a reabilitação cognitiva tem apresentado resultados satisfatórios quando associado ao tratamento farmacológico. É comum alteração de comportamento em pacientes com DA, o que contribui para uma maior sobrecarga do cuidador aumentando o risco de institucionalização. Cuidadores orientados sobre a doença pode permitir uma melhor qualidade de vida para ambos diminuindo a taxa de institucionalização. OBJETIVOS: Avaliar os efeitos de um programa de reabilitação neuropsicológica (PRN) associado ao tratamento farmacológico de pacientes em fase leve da DA. MÉTODOS: 12 pacientes com DA (6 mulheres) com idade média de 75.42 (6.22) e 9.58 (5.6) anos de escolaridade e dose estável de anticolinesterásicos foram avaliados com o Mini-Exame do Estado Mental (MEEM) e Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog) e os cuidadores responderam NPI e FAQ na avaliação inicial (T1) e depois de 8 meses do PRN (T2). O PRN foi composto por duas sessões semanais e Orientação Familiar a cada 15 dias. RESULTADOS: MMSE (T1:23.25 (1.82)/T2: 23,42 (2,81); ADAS-Cog (T1:17.11 (6,73)/T2: 21.2 (8,59); NPI (T1:23,42 (23.38)/T2:19.83 (17,73); FAQ (T1:10,67 (7.24)/T2: 13,92 (6.92). CONCLUSÕES: Estes resultados nos mostram a importância do trabalho desenvolvido com cuidadores, propiciando orientação e suporte. Limitações aos resultados podem estar presentes pelo número reduzido de pacientes, ausência de um grupo controle que permitisse a comparação do tratamento farmacológico isolado com tratamento farmacológico e reabilitação em conjunto.

Effects of semantic relations, repetition of words, and list length in word list recall of Alzheimer's patients / Efeitos da relação semântica, repetição de palavras e extensão das listas na recordação de pacientes com doença de Alzheimer

INTRODUCTION: Semantic relations among words and repetition enhance free recall, but it is unknown if these facilitating factors are effective in dementia. METHOD: Alzheimer's patients (MILD-Alz, MOD-Alz) were compared to healthy elderly. Fifteen-word lists were read out to the subjects. In four sets of lists the words in intermediary input positions were semantically related or not, or the midlist words were repeated, or they were repeated and semantically related. RESULTS: The usual third peak of recall of semantically related words was not observed in MOD-Alz, repetition of words did not increase recall of the patients, and the combination of relatedness and repetition benefited only MID-Alz. In a second experiment, with related or unrelated midlist words, and list length shortened from 15 to 9 words, semantic facilitation was observed in mild and moderate Alzheimer´s patients, although diminished compared to controls. CONCLUSION: Progression of dementia turns facilitating factors of recall less effective.

INTRODUÇÃO: Relacionamento semântico e repetição facilitam a recordação livre mas não se sabe se esses fatores continuam efetivos na demência. MÉTODO: O desempenho de pacientes com doença de Alzheimer (MILD-Alz e MOD-Alz) foi comparado com o de idosos sadios na recordação livre de listas de 15 palavras, utilizando quatro diferentes conjuntos de listas que continham ou não palavras relacionadas nas posições intermediárias, palavras repetidas, ou ainda palavras repetidas e semanticamente relacionadas. RESULTADOS: O terceiro pico usual na recordação das palavras semanticamente relacionadas não foi observado em MOD-Alz; a repetição não aumentou a recordação dos pacientes; a combinação de relacionamento e repetição beneficiou apenas MILD-Alz. Em outro experimento, com palavras intermediárias relacionadas ou não, e em que a extensão das listas foi reduzida para 9 palavras, observou-se facilitação semântica em MILD-Alz e MOD-Alz. CONCLUSÃO: A progressão da demência diminui a eficácia de fatores facilitadores da recordação.

A longitudial study of a neuropsychological rehabilitation program in Alzheimer's disease

OBJETIVO: Estudar a duração do beneficio de um programa de reabilitação neuropsicológica (PRN) dirigido a pacientes demenciados. MÉTODO: Participaram deste estudo, três pacientes com diagnóstico de provável doença de Alzheimer em fase inicial a moderada. Todos faziam uso de anti-colinesterásicos e passaram por uma avaliação neuropsicológica (AN) antes de começar o PRN e reavaliação após 12 e 24 meses do tratamento. O alvo de nossa intervenção foi trabalhar de forma prática a memória explicita residual e implícita, através do treino das atividades da vida diária, uso de estratégias compensatórias e habilidades cognitivas ainda preservadas. RESULTADOS: A análise dos dados quantitativos (medidas descritivas) da AN mostrou, que após o primeiro ano do PRN houve uma melhora cognitiva, estabilização funcional e redução dos problemas comportamentais nos pacientes. No entanto, observamos que essa melhora não se estendeu para o segundo ano, mostrando a doença sua característica progressiva.

Avaliaçäo neuropsicologica nas fases incial e moderada da demência do tipo Alzheimer / Neuropsychological assesment in initial and moderate phases od Alzheimer's disease

No presente trabalho, tentamos obter dados a respeito de testes neuropsicológicos que possam auxiliar o processo diagnóstico da DA. Utilizamos uma nova Bateria de Avaliação Neuropsicológica Breve (NEUROPSI) e outros testes de avaliação neuropsicológica, com suficiente sensibilidade para diagnosticar as fases inicial e moderada da doença. Também estudamos o uso de diferentes estratégias de recordação, incluindo o uso de figuras com conteúdo emocional para verificar se pacientes com DA ainda se beneficiam destas estratégias para aumentar a recordação. Metodologia : Participaram deste estudo um total de 49 voluntários de ambos os sexos, 30 com DA e 19 idosos saudáveis . Os pacientes com DA foram subdivididos em dois grupos, fase inicial (l5) e moderada (l5) a classificação foi feita de acordo aos critérios da Escala Clinica de Demência (CDR) e o Exame do Estado Mental (Mini Mental), todos os grupos foram pareados de acordo a idade e escolaridade. No primeiro experimento avaliamos estes pacientes com a bateria NEUROPSI, e outros testes de aplicação simples. No segundo, avaliamos os processos de memória declarativa através do estudo da curva de posição serial e da Escala Wechsler de Memória. No terceiro, avaliamos a memória para estímulos visuais cognitivos nas fases inicial e moderada da DA ., Os resultados do uso de com conteúdo emocional através de tarefas de reconhecimento. Resultados : O NEUROPSI foi sensível o suficiente para detectar e identificar déficits cognitivos nas fases inicial e moderada da DA . Os resultados do uso de estratégias de recordação mostraram que pacientes com DA em fase inicial ainda guardam habilidades mnemônicas consideráveis que podem eventualmente servir de base para algum tipo de treinamento em reabilitação neuropsicológica visando a manutenção das funções cognitivas residuais. Pacientes com DA não se beneficiaram do uso do conteúdo emocional para ampliar a recordação

Neuropsicologia do envelhecimento cognitivo normal e patológico e sua relação com a deficiência mental / Neuropsychology of normal cognitive aging mental and pathologic and her relation with mental deficiency

A compreensão do envelhecimento cognitivo em portadores de deficiência mental (DM) é um desafio a enfrentar, pois os modelos de envelhecimento cognitivo normal e patológico atualmente estudados, nos permitirão identificar as semelhanças e diferenças entre estas populações, o que servirá de base na adaptação de nossos instrumentos e procedimentos diagnósticos a fim de detectar mudanças cognitivas que existem nos estágios pré-clínicos do envelhecimento cognitivo patológico nesta população

Uma visão neuropsicológica no tratamento do idoso / Neuropsychological view of aged treatment

A contribuição da Neuropsicologia no auxílio diagnóstico de doenças neurológicas que atinge a terceira idade (a maioria delas degenerativa) tornou-se necessária, inclusive na intervenção terapêutica, pois um plano de tratamento em fases precoces pode fazer diferença no retardo da progressão da doença. Por se tratar de um tema bastante amplo, nos restringiremos apenas a expor aspectos básicos da Avaliação Neuropsicológica (AN) na função diagnóstica e terapêutica