Levels of nicotine dependence in the elderly and cognitive impairment / Niveles de dependencia de nicotina en ancianos y deterioro cognitivo

Abstract Introduction Health problems in elderly individuals are diverse. The use of cigarettes, a potentially addictive substance, has been increasing in the elderly population age group, affecting the cognitive and elderly domains, and becoming an important global public health problem. Objective This study aimed to investigate the relationship between tobacco consumption by the elderly, as well as different levels of nicotine dependence and cognitive domains of executive functions. Method It is a case-control study composed by 58 individuals aged ≥ 60 years, with 29 participants in the clinical group and 29 in the control group. The case-control sample was paired in subgroups by sex, socioeconomic status, schooling, and sample isonomy with the clinical group. We used the Shapiro-Wilk normality test, the Mann-Whitney test, the student T-test, and the Cohen d-estimator. Results The control group performed better compared to the clinical group with the median grade in the inhibitory control of the executive domain with Cohen's d 1.00 in the five-digit test and Cohen's 1.5 in the Stroop test. The control group compared with the high-grade clinical group presented better performance with Cohen's working memory of 1.56 d, Cohen's inhibition of 1.06 d in the five-digit test, and Cohen's of 1.17 d in the Stroop test. Discussion and conclusion The detection of the level of nicotine dependence is associated with the degree of cognitive impairment in the specific executive domain, which provides a possibility of differential diagnosis, both in the clinical and population contexts, directed at the rehabilitation of executive domains most affected by smoking in the elderly.

Resumen Introducción Los problemas de salud en las personas mayores son diversos. El consumo de tabaco, una sustancia potencialmente adictiva, ha aumentado en el grupo de edad de la población de ancianos, afectando los dominios cognitivos y de ancianos, convirtiéndose en un importante problema de salud pública mundial. Objetivo Este estudio tuvo como objetivo investigar la relación entre el consumo de tabaco en los ancianos, los diferentes niveles de dependencia de la nicotina y los dominios cognitivos de las funciones ejecutivas. Método Es un estudio de casos y controles, compuesto por 58 individuos de ≥ 60 años, con 29 participantes en el grupo clínico y 29 en el control. La muestra de casos y controles se emparejó en subgrupos por sexo, nivel socioeconómico, escolaridad e isonomía de la muestra con el grupo clínico. Se utilizaron la prueba de normalidad Shapiro-Wilk, la prueba de Mann-Whitney, la prueba Student T y el estimador d de Cohen. Resultados El grupo de control se desempeñó mejor en comparación con el grupo clínico con el grado medio en el control inhibitorio del dominio ejecutivo con Cohen's d 1.00 en la prueba de cinco dígitos y Cohen's 1.5 en la prueba de Stroop. En comparación con el grupo clínico de alto grado, el grupo de control presentó un mejor rendimiento con la memoria de trabajo de Cohen de 1.56 d, la inhibición de Cohen de 1.06 d en la prueba de cinco dígitos y la de Cohen de 1.17 d en la prueba de Stroop. Discusión y conclusión La detección del nivel de dependencia de la nicotina se asocia con el grado de deterioro cognitivo en el dominio ejecutivo específico, lo que brinda la posibilidad de un diagnóstico diferencial, tanto en el contexto clínico como en el de la población, dirigido a la rehabilitación de los dominios ejecutivos más afectados por el tabaquismo en los ancianos.

The role of NMDA receptor antagonists, amantadine and memantine, in schizophrenia treatment: a systematic review

Abstract Objective Schizophrenia is a complex and chronic psychiatric disorder. In recent years, studies have found glutamatergic system participation in its etiopathogenesis, especially through aberrant NMDA receptors functioning. Thus, drugs that modulate this activity, as amantadine and memantine, could theoretically be used in its treatment. To perform a systematic literature review about memantine and amantadine use as adjunct in schizophrenia treatment. Methods A systematic review of papers published in English indexed in the electronic database PubMed ® using the terms "memantine", "amantadine" and "schizophrenia" published until October 2016. Results We found 144 studies, 8 selected for analysis due to meet the objectives of this review. Some of these have shown benefits from such drug use, especially in symptoms measured by PANSS and its subdivisions, while others do not. Discussion: The data in the literature about these drugs use for schizophrenia treatment is still limited and have great heterogeneity. Thus, assay with greater robustness are needed to assess real benefits of these drugs as adjuvant therapy.

Menor performance das funções executivas prediz maior consumo de álcool e tabaco em adolescentes / Lower performance of executive functions predicts higher alcohol and tobacco consumption among adolescents

RESUMO Objetivo O estudo propôs-se a avaliar diferentes domínios das funções executivas em adolescentes como preditores ao uso de álcool e cigarro. Métodos Utilizou-se um delineamento transversal. A amostra foi composta por 239 adolescentes com idade média de 15,34 (±2,32). Os testes Alcohol Use Disorders Identification Test (AUDIT) e Fagerstrom Test for Nicotine Dependence (FTND) avaliaram o uso de álcool e cigarro respectivamente. O Self-Reporting Questionnaire (SRQ-20) foi utilizado para rastreio de saúde mental. Os testes Iowa Gambling Task (IGT), Wisconsin Card Sorting Test (WCST) e Continuous Performance Task (CPT) avaliaram os domínios executivos. Foi utilizado o estimador Odds Ratio adjusted (ORa). Resultados Os modelos logísticos ajustados demonstraram associação entre os domínios controle inibitório (ORa = 1.043; IC de 95% = 1,013-1,069; p = 0,001), flexibilidade cognitiva (ORa = 1.069; IC de 95% = 1,01-1,11; p = 0,001) e a tomada de decisão (ORa = 1.025; IC de 95% = 0,258-0,867; p < 0,014) e o uso de álcool. Também houve associação entre os domínios controle inibitório (ORa = 1.053; IC de 95% = 1,017-1,041; p = 0,003) e flexibilidade cognitiva (ORa =1.047; IC 95% = 1,004-1,250; p = 0,001) e o uso de cigarro. A faixa dos 14 aos 16 anos com 1,065 (ORa = 1.065; IC de 95% = 1,05-1,95; p = 0,010) razão de chances maiores para o uso de álcool e 1,067 (ORa = 1.067; IC de 95% = 0,156-1,453; p = 0,016) razão de chances para o uso de cigarro. Conclusão Os domínios cognitivos das funções executivas são fatores preditores associados ao uso de álcool e cigarro por adolescentes. Adolescentes com piores desempenhos nos domínios das funções executivas possuem maiores chances de fazer o uso de álcool ou cigarro.

ABSTRACT Objective The study proposes to evaluate different domains of executive functions in adolescents as predictors of alcohol and cigarette use. Methods A cross-sectional design was used. The sample consisted of 239 adolescents with a mean age of 15.34 (±2.32). The Alcohol Use Disorders Identification Test (AUDIT) and Fagerstrom Test for Nicotine Dependence (FTND) evaluated alcohol and cigarette use respectively. Self-Reporting Questionnaire (SRQ-20) for mental health screening. The Iowa Gambling Task (IGT), Wisconsin Card Sorting Test (WCST) and Continuous Performance Task (CPT) assessed executive domains. The adjusted Odds Ratio (ORa) was used. Results Adjusted logistic models showed an association between the inhibitory control domains (ORa = 1.043; 95% CI = 1.013-1.069; p = 0.001), cognitive flexibility (ORa = 1.069; 95% CI = 1.01-1.11; p = 0.001), and decision making (ORa = 1.025; 95% CI = 0.258-0.867; p < 0.014) and alcohol use. There was also an association between the inhibitory control domains (ORa = 1.053; 95% CI = 1.017-1.041; p = 0.003), and cognitive flexibility (ORa = 1.047; 95% CI = 1.004-1.250; p = 0.001), and tobacco use. The range from 14 to 16 years old with 1.065 (ORa = 1.065; 95% CI = 1.05-1.95; p = 0.010) was higher odds ratio for alcohol use, and 1.067 (ORa = 1.067; 95% CI = 0.156-1.453; p = 0.016) odds ratio for cigarette use. Conclusion The cognitive domains of executive functions are predictive factors associated with the use of alcohol and cigarettes by adolescents. Adolescents with worse performance in executive functions are more likely to use alcohol or cigarettes.