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1.
Braz. j. oral sci ; 21: e227228, jan.-dez. 2022. ilus
Article in English | LILACS, BBO | ID: biblio-1393377

ABSTRACT

Aim: to evaluate the association of the patients' perception about dentist's affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients' adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (ß = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (ß = .41). The trust positively influences the patient's intention to return to that dentist (ß = .82). In addition, the intention to return to the dentist positively influences the patient's satisfaction with life (ß = .49). Conclusions: Affective and cognitive aspects positively influenced the patient's trust in the dentist. The greater the patient's trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient's satisfaction with life


Subject(s)
Humans , Male , Female , Adult , Perception , Patient Satisfaction , Cognition , Affect , Trust/psychology , Dentist-Patient Relations
2.
Rev. Bras. Neurol. (Online) ; 58(2): 11-16, abr.-jun. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1395440

ABSTRACT

Background: Cognitive dysfunctions are frequently found in the 22q11.2 Deletion Syndrome, being an aggravating factor in the impairment of social relationships and communication, strongly impacting the functionality of the individual. Increasing the knowledge regarding cognitive skills may provide contributions to the diagnostic process and the intervention planning. Objectives: To estimate the general, verbal, and non-verbal cognitive functioning of children and adolescents with 22q11.2 Deletion Syndrome. Methods: This is a cross-sectional, descriptive, and case series study regarding 15 individuals between 7-18 years-old diagnosed with 22q11.2 Deletion Syndrome. An assessment of the cognitive functions was performed using the Wechsler Abbreviated Scale of Intelligence (WASI). For data analysis we used a descriptive statistics analysis, having absolute frequencies for variables, and mean, median, standard deviation, minimum and maximum values for numerical variables. Results: In the group analysis, we observed an important cognitive impairment degree. Most of the sampling (n=8; 53.33%) presented a considerably low total intelligence quotient score. Cases showing lower performances also presented greater difficulties regarding Visual Motor and Visuospatial coordination. Regarding the intelligence quotient representative punctuation in the WASI scale, the sample showed a large variability in the results (between 40 and 92 points), with the median total of 83. Conclusions: We observed important dysfunctions, cognitive difficulties, and intellectual, verbal, and non-verbal disabilities in the population studied. These findings indicate the need for an early intervention to assist not only the cognitive aspect, but also the socio-emotional evelopment of children with the 22q11.2 Deletion Syndrome, aiming at their participation in society.


Fundamento: Disfunções cognitivas são frequentemente encontradas na Síndrome de Deleção 22q11.2, sendo um agravante no comprometimento das relações sociais e da comunicação, impactando fortemente na funcionalidade do indivíduo. O aumento do conhecimento sobre as habilidades cognitivas pode trazer contribuições no processo diagnóstico e no planejamento da intervenção. Objetivo: Estimar o funcionamento cognitivo geral, verbal e não verbal de crianças e adolescentes com Síndrome de Deleção 22q11.2. Métodos: Estudo transversal, descritivo, tipo série de casos, com 15 indivíduos entre 7-18 anos com diagnóstico da Síndrome de Deleção 22q11.2. A avaliação das habilidades cognitivas foi realizada com a Escala Wechsler Abreviada de Inteligência (WASI). Para análise dos dados, foi utilizada análise estatística descritiva, com frequências absolutas para variáveis, e média, mediana, desvio padrão, mínima e máximo para variáveis numéricas. Resultados: Na análise do grupo, observou-se um importante grau de comprometimento cognitivo. A maior parte da amostra (n=8; 53,33%) mostrou quociente de inteligência total extremamente baixo. Os casos com desempenhos mais baixos apresentaram maiores dificuldades em relação às habilidades de coordenação visuomotora e visuoespacial. Em relação à pontuação representativa do quociente de inteligência na escala WASI, a amostra apresentou uma grande variabilidade de resultados (entre 40 a 92 pontos), com mediana total de 83 pontos. Conclusões: As dificuldades cognitivas encontradas indicam a necessidade de uma intervenção precoce para auxiliar não só no desenvolvimento cognitivo, mas socioemocional de crianças com a Síndrome de Deleção 22q11.2 visando sua participação na sociedade.

3.
Fisioter. Pesqui. (Online) ; 29(2): 203-209, maio-ago. 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1394345

ABSTRACT

RESUMO A população idosa brasileira possui escolaridade relativamente baixa, quando comparada a outras populações. Na prática clínica, torna-se difícil decidir se alterações mais sutis, observadas nos testes de função executiva (FE) e coordenação motora de idosos, devem-se a um quadro neurológico inicial ou à baixa escolaridade. O objetivo do trabalho foi investigar: (1) possíveis diferenças na coordenação motora e FE de adultos e idosos com escolaridade alta e baixa; e (2) possíveis correlações entre coordenação motora e FE nessa amostra. Foram avaliados 75 indivíduos saudáveis, com idade entre 30 e 89 anos. A FE foi avaliada por meio do trail making test (TMT) e a coordenação motora foi avaliada com o teste de diadococinesia dos membros superiores, que consiste na alternância rápida entre supinação e pronação do antebraço (direito, esquerdo, de ambos os antebraços em fase, e ambos em antifase). A análise de variância investigou possíveis influências da idade e da escolaridade na FE e coordenação motora. O teste de correlação de Pearson investigou possíveis relações entre FE e diadococinesia. Idosos com escolaridade baixa foram significativamente mais lentos na parte B (cognitivo-motora) e no delta (cognitiva) do TMT. Todos os grupos foram mais lentos na condição antifase, sobretudo os idosos com escolaridade baixa. Encontramos apenas correlações fracas entre FE e coordenação motora. A idade e a escolaridade influenciaram na FE e na coordenação motora; porém, os testes de FE e coordenação motora não apresentaram correlação quando esses dois fatores foram corrigidos estatisticamente.


RESUMEN La población anciana brasileña tiene un bajo nivel educativo en comparación con otras poblaciones. En la práctica clínica es difícil decidir si las alteraciones más sutiles, observadas en pruebas de función ejecutiva (FE) y coordinación motora en ancianos, son provenientes de una condición neurológica inicial o de un bajo nivel educativo. El objetivo de este estudio fue examinar: (1) posibles diferencias en la coordinación motora y la FE de adultos y ancianos con altos y bajos niveles educativos; y (2) posibles correlaciones entre coordinación motora y FE en esta muestra. Se evaluaron a 75 individuos sanos, con edades entre 30 y 89 años. Para la FE se aplicó la Prueba de creación de senderos (TMT en inglés), y la coordinación motora se evaluó con la prueba de diadococinesia de miembros superiores, que consiste en una alternancia rápida entre supinación y pronación del antebrazo (derecho, izquierdo, ambos antebrazos en fase y ambos en antifase). El análisis de varianza analizó las posibles influencias de la edad y la educación en la FE y la coordinación motora. La prueba de correlación de Pearson evaluó las posibles relaciones entre FE y diadococinesia. Los ancianos con bajo nivel educativo fueron significativamente más lentos en la parte B (cognitivo-motora) y delta (cognitiva) de la TMT. Todos los grupos fueron más lentos en la condición antifase, especialmente los ancianos con bajo nivel educativo. Se encontró únicamente correlaciones débiles entre FE y coordinación motora. La edad y el nivel educativo influyeron en la FE y la coordinación motora; sin embargo, las pruebas de FE y de coordinación motora no mostraron correlación cuando estos dos factores fueron corregidos estadísticamente.


ABSTRACT Brazilian older adults present a relatively low schooling level when compared with other populations. In clinical practice, defining if more subtle alterations observed in executive function (EF) and motor coordination tests in older adults are due to an initial neurological condition or low schooling level is difficult. This study aimed to evaluate the possible differences in motor coordination and EF between adults and older adults with high and low schooling level as well as the possible correlations between motor coordination and EF in this sample. A total of 75 healthy individuals (aged from 30 to 89 years) were evaluated. EF was assessed by the trail making test (TMT) whereas motor coordination was assessed by the upper limb diadochokinetic test, which is the rapid alternation between supination and pronation of the forearms (right, left, both performing in-phase movements, and both performing anti-phase movements). Analysis of variance showed that age and schooling level possibly influenced EF and motor coordination. Possible relationships between EF and diadochokinesis were calculated by Pearson's correlation. Older adults with low schooling level were significantly slower on the TMT part B (cognitive and motor) and delta TMT (cognitive). All groups were slower performing the anti-phase movement, especially those with low schooling level. Results showed only weak correlations between EF and motor coordination. Age and schooling level influenced executive function and motor coordination. However, the EF and motor coordination tests presented no correlation when these two factors were statistically corrected.

4.
Interdisciplinaria ; 39(2): 119-133, ago. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1385921

ABSTRACT

Abstract Deaf students show a significant delay in their understanding of numeracy and measurement concepts as well as verbal problem solving. There is still no consensus about the origin of this delay but several studies have shown that deaf people show differences in basic numerical skills and executive function (EF), which could underlie the differences in the way they learn and develop their cognitive abilities. Children have the innate ability to estimate and compare numerosities without using language or numerical symbols. The ability to discriminate large numerosities depends on the approximate number system (ANS), a cognitive system believed to be governed by a neural circuit within the intraparietal sulcus. Researchers hypothesize that the ANS underlies the development of arithmetic and there is data supporting the contribution of the ANS for math achievements. Little is known about the approximate number system of deaf children at early ages. Deaf and hearing preschool children were compared in terms of specific cognitive functions shown to be important for success in mathematics. Executive functions and symbolic and nonsymbolic magnitude comparison abilities of 7 deaf children and 14 hearing children aged 4-7 years (M = 69.90 months, SD = 11.42), were compared. To do so, neuropsychological assessments for school-aged children were adapted into Portuguese Sign Language. Significant group differences were found in abstract counting as well as in symbolic and nonsymbolic magnitude comparisons. These findings suggest that deaf children are less competent in these early numeracy skills than are their hearing peers.


Resumen La cognición de los sordos ha sido objeto de numerosos estudios que buscan comprender cómo los niños y adultos sordos procesan la información. Dichos estudios han demostrado que las personas sordas muestran diferencias en las habilidades numéricas y la función ejecutiva (FE), lo que podría ser la base de las diferencias conocidas en la forma en que las personas sordas aprenden y desarrollan sus habilidades cognitivas. Se han encontrado diferencias entre estudiantes sordos y oyentes en varias áreas de razonamiento numérico, en matemática y en la eficiencia en el procesamiento de representaciones numéricas como la comparación de magnitud. En las tareas de comparación de magnitud, los resultados dependían de si se estaban haciendo comparaciones simbólicas (números arábigos) o no simbólicas (puntos). En un estudio, los niños sordos fueron más lentos que sus compañeros oyentes en las tareas de comparación de magnitud simbólica, pero no en las tareas no simbólicas. Sin embargo, en un estudio más reciente, también se encontraron diferencias en las tareas no simbólicas. Se considera que la capacidad para comparar y discriminar grandes numerosidades depende del sistema numérico aproximado (ANS, Approximate Number System), un sistema cognitivo que se cree está gobernado por un circuito neuronal dentro del surco intraparietal. Los investigadores plantean la hipótesis de que el ANS subyace en cierta medida al desarrollo de la aritmética. Hay algunos datos que apoyan esta hipótesis: por ejemplo, las diferencias individuales en la agudeza del ANS se correlacionan positivamente con las habilidades numéricas y los logros futuros en matemática. Por otro lado, se ha encontrado un deterioro en la agudeza del ANS en niños con discapacidades de aprendizaje matemático. En consecuencia, los investigadores han propuesto que el ANS contribuye a la aparición de conceptos numéricos que los niños requieren para la competencia básica en el conteo y las comparaciones de magnitud simbólica. Otros han sugerido que la asociación entre la agudeza en la comparación de magnitud no simbólica y el rendimiento en matemática está moderada por factores de dominio general como las funciones ejecutivas (FE), en particular el control inhibitorio. En general, no está claro si existen diferencias en la agudeza de comparación de magnitud simbólica y no simbólica en niños sordos más pequeños y en qué medida se relacionan con las FE. El estudio actual examina la agudeza de las representaciones numéricas simbólicas y no simbólicas en niños sordos en edad preescolar e investiga la posible influencia del funcionamiento ejecutivo en estas habilidades matemáticas básicas. Se recolectaron datos de 21 niños portugueses del área de Lisboa, siete de los cuales eran sordos congénitamente y 14 tenían audición normal; los niños tenían entre 4 y 7 años de edad (M = 69.9 meses, DT = 11.42). Se seleccionaron tareas para medir lo siguiente: (a) FE, (b) memoria de trabajo, (c) lenguaje y (d) habilidades numéricas tempranas. Se empleó la tarea Shape School Task para evaluar FE. Se administró la versión portuguesa de la tarea de tapping de bloques de Corsi para evaluar la amplitud visuoespacial. Se desarrolló una tarea de comparación de puntos para examinar la capacidad de los niños de decidir instantáneamente cuál de las dos matrices de puntos es más grande utilizando el software Panamath. Se utilizaron dos tareas para evaluar la capacidad de los niños para producir palabras numéricas en un contexto cardinal y el Numeracy Screener para medir su capacidad para comprender la magnitud numérica simbólica. Los resultados indicaron que los niños sordos mostraron retrasos en las capacidades de comparación de magnitud simbólica y no simbólica. En las FE solo se encontraron diferencias en una tarea que implicaba una combinación de conmutación e inhibición; por lo demás, su función ejecutiva era comparable a la de los niños no sordos.

5.
Interdisciplinaria ; 39(2): 181-198, ago. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1385925

ABSTRACT

Resumen El trastorno del espectro autista (TEA) es un trastorno del neurodesarrollo, cuyas dificultades radican en las esferas social y comportamental. Al presente se ha estimado que aproximadamente uno entre 59 niños presentó esta condición, que es más frecuente en hombres. El nivel depende de la severidad de las alteraciones; el nivel 1 corresponde a lo que anteriormente se conocía como síndrome de Asperger. El objetivo de este trabajo es determinar la relación entre cognición social (CS) y el funcionamiento ejecutivo (FE) en una muestra de niños con trastorno del espectro autista nivel 1. Para esto, se desarrolló una metodología observacional, transversal, analítico-correlacional con diseño de dos grupos independientes, TEA (n = 39) y control (n = 39) de entre 8 y 16 años, todos escolarizados. Para la evaluación de las FE se utilizaron los test de clasificación de tarjetas, fluidez verbal y dígitos en regresión de la Evaluación Neuropsicológica Infantil (ENI), y para la evaluación de la CS se usaron el test de falsas creencias de primer y segundo orden, el test de expresiones faciales, las historias extrañas de Happé, el test de metidas de pata (faux pas) y el test de la mirada para niños. Este estudio encontró que los test de CS -las historias extrañas de Happé y el test de las miradas- logran discriminar a ambos grupos y confirman que los sujetos TEA tienen alteración en la teoría de la mente (ToM) emocional y, asimismo, sugiere revisar la evaluación del funcionamiento ejecutivo para delinear mejor la interacción entre FE y CS en el TEA. Para ello, se recomienda ampliar la medición de las FE de dominio más emocional y delinear nuevas estrategias para comprender la interacción entre los dominios cognitivo y social, y avanzar en la intervención neurocognitiva y en el pronóstico en este síndrome.


Abstract Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The level varies depending on the impact and persistence of the symptoms in the person's daily life. Some level 3 cases have a full dependence on their caregivers, while level 1, the other side of the spectrum, includes what used to be known as Asperger's Syndrome (AS), who usually have a normal IQ and high language skills. The prevalence varies depending on the country and type of methodology for the estimation; at present it has been estimated that approximately 1 in 59 children presented this condition according to the study of the Centers for Disease Control and Prevention (CDC). In Colombia, a high prevalence of the disorder has been found: from 1/87 to 1/91 according to the screening instrument. The objective of this work is to determine the relationship between social cognition (SC), that focuses on how people process, store, and apply information about other people and social situations, and executive functioning (EF), that are skills we use every day to learn, work and manage daily life, in a sample of children with level 1 Autism Spectrum Disorder. An observational, cross-sectional, correlational analytical methodology was designed with two independent groups, ASD (n = 39) and control (n = 39) between 8 and 16 years of age, all of them enrolled in school. Both groups were assessed by neurodevelopmental experts to determine the presence or absence of ASD symptoms. For the components of the EF, the card classification subtests, regression digit span and phonological fluency of the Infant Neuropsychological Assessment (ENI) were used to evaluate the capacity for abstraction, the formation of concepts and the change of cognitive strategies in response to the changes that occur in environmental contingencies, as well as the initiation, efficient organization of verbal recovery, inhibition and self-monitoring. For the SC, the first and second order false beliefs were used to evaluate the ability of subjects to infer that someone has a belief that is different from their own and a third party; the Facial Expressions Test, to assess facial emotional recognition; and advanced tests such as Happé's Strange Stories, the Faux Pas test and Reading the mind in the eyes test to assess understanding of covert language, detection of lies or deception, and attribution of cognitive emotions through inference from beliefs or intentions of others. This study found that the SC test, Happé's strange stories and Reading the mind in the eyes test were able to discriminate both groups and confirm that ASD subjects have an alteration in emotional Theory of Mind. Although no differences were found in EF between the two groups, the hypothesis that there are alterations in EF in ASD is not rejected; on the contrary, the importance of carrying out a complete evaluation with sensitive instruments is emphasized, it suggests reviewing the evaluation of executive functioning to better delineate the interaction between EF and SC in ASD, expanding the measurement of EF of more emotional domain including some "hot" EF measures; outlining new strategies to understand the interaction between the cognitive and social domains, advancing neurocognitive intervention and prognosis in this syndrome. In future phases of this line of research, a better choice of instruments should be considered, including the Theory of Mind Inventory-2 (ToMi-2), a questionnaire filled out by caregivers that allows obtaining information on factors and domains evaluated by the applied tests that also has a pragmatic subscale.

6.
Distúrb. comun ; 34(2): e55278, jun. 2022. ilus
Article in Portuguese | LILACS | ID: biblio-1396702

ABSTRACT

Introdução: a literatura relata a associação entre o desequilíbrio e o comprometimento cogntivo, porém não é clara sobre quais habilidades cognitivas estão envolvidas com o sistema vestibular. Objetivo: avaliar quais habilidades cognitivas então envolvidas na avaliação e reabilitação vestibular em indivíduos jovens adultos e idosos. Estratégia de pesquisa: trata-se de uma revisão integrativa de literatura realizada entre julho e outubro de 2020, os artigos foram selecionados por meio das principais bases de dados da saúde MEDLINE via PubMed, LILACS via Portal Regional da BVS; Cochrane, Scopus, Web of Science, e CINAHL acesso via Portal CAPES, utilizando os descritores "Cognition" OR "Cognitive Dysfunction" AND "Vestibular Function Tests" AND "Vertigo" AND "Vestibular Rehabilitation" e seus correlatos em português e espanhol. Critérios de seleção: Foram incluídos artigos publicados até 2020 que investigaram a cognição com avaliação e reabilitação vestibular (tradicional e/ou com tecnologias) em indivíduos acima de 18 anos. Foram excluídos artigos que não possuíam texto completo disponível ou que utilizaram outra forma de tratamento. Resultados: dos 6965 artigos resultantes da busca inicial, 16 foram incluídos na presente revisão por satisfazerem os critérios de inclusão. Destes, 12 são estudos transversais, e quatro, estudos longitudinais. Conclusão: observou-se relação entre disfunção vestibular uni e bilateral com a memória de trabalho, funções executivas, navegação espacial e atenção. Nos estudos que realizaram a reabilitação vestibular encontrou-se melhora das habilidades cognitivas em geral, capacidade visuoespacial, atenção, funções executivas, memória de trabalho espacial, aumento do ganho do reflexo vestíbulo-ocular, do controle postural e uma diminuição do sofrimento psicológico.


Introduction: The literature reports an association between imbalance and cognitive impairment. However, it is not yet clear which cognitive skills are involved with the vestibular system. Objective: To evaluate which cognitive skills are involved in vestibular assessment and rehabilitation in young and older adults. Research strategy: This is an integrative review of the literature, conducted between July and October 2020. The articles were selected through search in the main health databases - MEDLINE via PubMed, LILACS via Regional Portal of VHL, Cochrane, Scopus, Web of Science, and CINAHL, accessed via Portal CAPES, using the following descriptors "Cognition" OR "Cognitive Dysfunction" AND "Vestibular Function Tests" AND "Vertigo" AND "Vestibular Rehabilitation", and their equivalent terms in Portuguese and Spanish. Selection criteria: Articles published until 2020, investigating cognition with vestibular assessment or traditional and/or technology rehabilitation in subjects aged 18 years or older were included. Articles not available in full text or that used other types of treatment were excluded. Results: 16 out of the 6,965 articles initially retrieved met the inclusion criteria and were included in this review; 12 of them are cross-sectional, and four longitudinal studies. Conclusion: There was a relationship between uni- and bilateral vestibular dysfunction and working memory, executive functions, spatial navigation, and attention. The studies that conducted vestibular rehabilitation found improved overall cognitive skills, visuospatial capacity, attention, executive functions, spatial working memory, increased vestibulo-ocular reflex, postural control gains, and diminished psychological suffering.


Introducción: la literatura reporta la asociación entre desequilibrio y deterioro cognitivo, pero no está claro qué habilidades cognitivas están involucradas con el sistema vestibular. Objetivo: evaluar qué habilidades cognitivas están involucradas en la evaluación y rehabilitación vestibular en adultos jóvenes y ancianos. Estrategia de búsqueda: se trata de una revisión integradora de la literatura realizada entre julio y octubre de 2020, los artículos fueron seleccionados a través de las principales bases de datos en salud MEDLINE vía PubMed, LILACS vía Portal Regional BVS; Acceso a Cochrane, Scopus, Web of Science y CINAHL a través del Portal CAPES, utilizando los descriptores "Cognición" O "Disfunción cognitiva" Y "Pruebas de función vestibular" Y "Vértigo" Y "Rehabilitación vestibular" y sus correlatos en portugués y español. Criterios de selección: Se incluyeron artículos publicados hasta 2020 que investigaban la cognición con valoración vestibular y rehabilitación (tradicional y / o con tecnologías) en mayores de 18 años. Se excluyeron los artículos que no tenían el texto completo disponible o que usaban otra forma de tratamiento. Resultados: de los 6965 artículos resultantes de la búsqueda inicial, 16 se incluyeron en esta revisión por cumplir con los criterios de inclusión. De estos, 12 son estudios transversales y cuatro estudios longitudinales. Conclusión: hubo relación entre la disfunción vestibular uni y bilateral con la memoria de trabajo, funciones ejecutivas, navegación espacial y atención. En estudios que realizaron rehabilitación vestibular se encontró una mejora en las habilidades cognitivas en general, capacidad visuoespacial, atención, funciones ejecutivas, memoria de trabajo espacial, aumento de ganancia en el reflejo vestibular-ocular, control postural y una disminución del malestar psicológico.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Vestibular Diseases/diagnosis , Vestibular Diseases/rehabilitation , Cognition , Vestibular Function Tests , Vertigo , Cognitive Dysfunction
7.
Interdisciplinaria ; 39(1): 77-90, jun. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1360481

ABSTRACT

Resumen En la actualidad, existe mayor interés sobre los estudios acerca de la cognición implícita y su función en la conducta. Los modelos explicativos actuales de la psicopatología tienen como limitante la escasa consideración de los procesos cognitivos automáticos en la conducta psicopatológica, como la relacionada con el consumo de sustancias. En este estudio, se revisa al sesgo atencional en los trastornos por consumo y sus implicaciones en la psicopatología, la medición del fenómeno y su aplicación para la intervención. El sesgo atencional hacia las señales críticas de sustancias o drogas es un mecanismo disfuncional de la atención selectiva que opera frecuentemente a nivel automático o implícito y en el que la asignación y focalización de la atención es desproporcionada en el tiempo, entre un estímulo específico (imagen o palabra relacionada con una droga) versus un estímulo neutro. Atrae la atención de la persona al estímulo crítico del que, posteriormente, resulta difícil de desacoplarse y facilita otros procesos cognitivos subsecuentes al consumo. Se presenta evidencia de la incidencia del sesgo atencional en el consumo, el curso, la gravedad, el craving (necesidad intensa de consumo), la abstinencia, la recaída y la probabilidad de fracaso en el tratamiento. Además, explica sobre el fenómeno del consumo, desde la cognición implícita, el inconsciente y la neurociencia cognitiva. Finalmente, en este estudio, se revisan propuestas de intervención sobre los problemas de consumo con técnicas de modificación del sesgo atencional complementarias a los tratamientos cognitivo-conductuales actuales. Se considera necesario explorar sobre esta línea de investigación y su relación con los trastornos por consumo de sustancias dentro de la región.


Abstract The objective of this work is to investigate attentional bias as an automatic cognitive process and its implications in substance use disorders. Cognitive processes are fundamental in the formulation of the different explanatory models about psychopathology. Of the various cognitive processes, attention is a significant determinant, because although it fulfils various activities such as orientation and wakefulness, it is cognitive control that arouses relevant interest for it. This is due to the fact that it fulfills a task of linking between signal uptake and the achievement of other cognitive processes that intervene in the behavioral response mechanism. When a cognitive process like attention is markedly altered it will trigger impaired sequential cognitive functioning, along with the emission of disturbing behavior. Psychology considers that cognitive processes operate consciously (voluntarily) and automatically (implicitly); that is, in a dual way in which these processes such as attention maintain a continuum of coordinated gradual variations that regulate behavior. Failure to consider automatic cognitive processes is a notorious limitation for current explanatory models of psychopathological behavior (including compulsive substance use); given that many of these underlying cognitive processes are often not considered to influence higher mental processes and therefore behavior, without the individual necessarily being aware of this. In fact, this can help to understand pathological behaviors that for the investigator or the professional of psychology can be incomprehensible or paradoxical. Among the various underlying and altered processes, the attentional bias towards critical signals associated with substances has investigative relevance. Since it is a dysfunctional mechanism of selective attention, which operates frequently at an automatic level and in which the allocation and focus of attention are disproportionate in time, between a specific stimulus (image or word related to a drug) versus a neutral stimulus. And it attracts a person's focus of attention to the critical stimulus, from which it later becomes difficult to decouple. This later facilitates other altered cognitive processes subsequent to consumption. The generation of an attentional bias towards a specific signal has its origin in the association between the signal and the behavior, which can be avoidant (recurrent in phobias) or attractive (frequent in substance or food consumption) and that is conditioned until becoming an automatic process of difficult voluntary control. Although it is true that attention bias may be present in all individuals, the evidence reveals the marked and recurrent presence in various pathologies such as mood disorders (depressive), anxiety, food intake, phobias, of personality among others. And also included in substance use disorders. The findings show that attention bias has an impact on substance use, course, the severity of the disorder, craving, withdrawal, relapse, and the probability of treatment failure. Working with an attentional bias for specific signals on substances can generate difficulty, in the case of evaluation because it is assessed through software that usually measures the eye-hand reaction time or eye movement when faced with neutral and critical signals, which can be a limitation for the usual clinic; while at the intervention level, it is required to formulate bias retraining processes that require continuous exercise as a complementary technique to the usual cognitive-behavioral treatment. It is considered necessary to explore this line of research and its relationship with substance use disorders within the region.

8.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 44(3): 271-278, May-June 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1374606

ABSTRACT

Objectives: To investigate the patterns of impairment in decision-making abilities and their relationship with cognitive and clinical symptoms in people with Alzheimer's disease. We hypothesized that decision-making abilities would not be impaired at the same level and would be related to impairment of global cognition and other clinical symptoms of the disease. Methods: Using a cross-sectional design, we included a consecutive sample of 102 people with Alzheimer's disease and their respective caregivers. We investigated the relationship between decision-making capacity and quality of life (QoL), disease awareness, mood, functionality, neuropsychiatric symptoms, and cognition. Results: Different levels of impairment were observed in the participants' decision-making abilities. Understanding, appreciation, and reasoning were correlated, but expressing a choice was only correlated with appreciation. Deficits in understanding were related to impaired disease awareness, lower self-reported QoL, and lower comprehension of spoken language. Better appreciation was related to better orientation and lower age. Better reasoning was related to better orientation and better self-reported QoL. Deficits in expressing a choice were related to lower self-reported QoL. Conclusion: The pattern of impairment in decision-making abilities was not linear. Each decision-making ability was related to different cognitive and clinical deficits. Therefore, cognitive functioning is an insufficient criterion for judging an individual's decision-making ability.

9.
Säo Paulo med. j ; 140(3): 422-429, May-June 2022. tab
Article in English | LILACS | ID: biblio-1377396

ABSTRACT

ABSTRACT BACKGROUND: Falls among older people have a negative impact on health and therefore constitute a public health problem. Cognitive decline can also accompany the aging process, and both conditions lead to significant increases in morbidity and mortality in this population. Objective: To analyze the cognitive performance of older people, classified as non-fallers, sporadic fallers and recurrent fallers, and investigate the relationship between falls and cognition. DESIGN AND SETTING: Cross-sectional study conducted in the interior of the state of São Paulo, Brazil. METHODS: Evaluations on 230 older people were conducted. They were divided into three groups: non-fallers, sporadic fallers (one fall) and recurrent fallers (two or more falls). The Mini-Mental State Examination, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Brief Cognitive Screening Battery (BCSB), Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) similarities subtest and digit span test were applied. RESULTS: In multinomial logistic regression, being a recurrent faller was significantly associated with lower scores in the CERAD word list (odds ratio, OR = 0.92; 95% confidence interval, CI, 0.86-0.98; P = 0.01), in CERAD constructive praxis (OR = 0.88; 95% CI, 0.79-0.98; P = 0.02), in BCSB figure list memory (OR = 0.94; 95% CI, 0.89-0.99; P = 0.02) and in verbal fluency (OR = 0.89; 95% CI, 0.81-0.97; P = 0.01). Recurrent fallers also had lower scores in these same tests, compared with sporadic fallers. CONCLUSION: Cognitive impairment, especially in the domains of memory and executive functioning, can influence occurrences of recurrent falls.


Subject(s)
Humans , Aged , Accidental Falls , Alzheimer Disease , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Cognition , Independent Living
10.
Int. j. cardiovasc. sci. (Impr.) ; 35(3): 364-372, May-June 2022. tab
Article in English | LILACS | ID: biblio-1375640

ABSTRACT

Abstract Background: Among the various pathologies that affect the elderly, Heart Failure (HF) stands out. Recently, an attempt has been made to verify the existence of cognitive impairment associated with HF. Objectives: To compare the cognitive performance of elderly people with heart failure with that of age-matched individuals without this pathology. Check the existence of marked impairment in some cognitive functions in the clinical group. Methods: The sample consisted of 78 elderly people, whose inclusion criterion was the presence of HF and no HF (control group); age over 60 years, both sexes, and any level of education. The control group consisted of 37 individuals (with a median age of 68 years - Interquartile range of 12) and the HF group, with 41 individuals (with a median age of 67 years - Interquartile range of 11). The subjects were matched in terms of education level, with a predominance of elderly people with 0 to 4 years of education (65.9% in the Clinical Group and 59.5% in the Control Group). Eleven neuropsychological tests covering cognitive functions were used: attention, language, memory, mood, and executive function. Statistical analysis was performed using SPSS software, version 23, with a significance level of 5%. The Chi-square test and the Mann-Whitney test were applied. Results: The results showed significant differences between the groups, mainly in executive functions, which include the ability to plan, switch, and recall previously stored information. Conclusion: Our study showed differences between the cognitive performance of elderly people with HF and elderly people without HF. The main alteration was found in the so-called executive functions, attention, and memory.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Attention , Aging , Executive Function , Cognitive Dysfunction , Heart Failure , Memory , Anxiety , Cross-Sectional Studies , Depression , Nervous System Diseases , Neuropsychology
11.
Rev. Bras. Neurol. (Online) ; 58(1): 5-11, jan.-mar. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1377962

ABSTRACT

Objetivo: Comparar os domínios da função cognitiva com a capacidade funcional para as atividades básicas de vida diária de centenários. Métodos: Trata-se de um estudo descritivo com 66 idosos com 100 anos ou mais de idade, 45 do sexo feminino e 21 do masculino, com média de idade 102,14 ± 2,71 anos, residentes na Grande Florianópolis/SC. Foram avaliados os domínios da função cognitiva (Mini Exame do Estado Mental- MEEM) e a capacidade funcional (escala de Katz) dos centenários. Os dados foram tratados por meio do Kruskal-Wallis e o post hoc de Bonferroni, com nível de significância de 5%. Também analisou-se com o modelo de regressão multinominal, com intervalo de confiança de 95%. Resultados: Houve diferença significativa entre os centenários MF (Mais Funcional) e Mf (Menos Funcional) em todos os domínios do MEEM: orientação temporal (p<0,001), orientação espacial (p<0,002), memória imediata (p<0,001), atenção e cálculo (p<0,013), memória e evocação (p<0,012) e linguagem (p<0,001) e, os Mf e com FI nos domínios do MEEM memória imediata (p<0,004) e linguagem (p<0,004). Conclusão: Os domínios da função cognitiva estão relacionados à capacidade funcional, ou seja, centenários que apresentam uma boa funcionalidade nas atividades da vida diária básica, possuem uma boa função cognitiva, no que diz respeito a orientação temporal e espacial, memória, cálculo, evocação e linguagem.


Objective: To verify the relationship between the domains of cognitive function and functional capacity for basic activities of daily living in centenarians. Methods: This is a descriptive study with 66 elderly aged 100 years or more, 45 females and 21 males, mean age 102.14 ± 2.71 years, residents in Greater Florianópolis/SC. The domains of cognitive function (Mini Mental State Examination - MMSE) and functional capacity (Katz scale) of the centenarians were evaluated. The data were treated by Kruskal-Wallis and Bonferroni post hoc, with a 5% significance level. Results: There was significant difference between MF and Mf centenarians in all domains of MMSE: temporal orientation (p<0.001), spatial orientation (p<0.002), immediate memory (p<0.001), attention and calculation (p<0.013), memory and recall (p<0.012) and language (p<0.001) and, Mf (More Functional) and with FI (Less Functional) in the domains of MMSE immediate memory (p<0.004) and language (p<0.004). Conclusion: the domains of cognitive function are related to functional capacity, that is, centenarians who have good functionality have good cognitive function, with respect to temporal and spatial orientation, memory, calculation, evocation and language.

12.
Rev. Nac. (Itauguá) ; 14(1): 58-74, Junio 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1372734

ABSTRACT

RESUMEN La obesidad y el sobrepeso en adultos mayores se asocia con un mayor riesgo de enfermedades cognitivas, lo que contribuye a la disminución del rendimiento funcional. El objetivo de esta revisión es analizar el efecto del ejercicio en la memoria de adultos mayores con obesidad o sobrepeso. La metodología utiliza las palabras MESH: Población = envejecido, sobrepeso, obesidad; Intervención = ejercicio; Comparación = grupo control; Resultado = memoria; Diseño: ensayo clínico aleatorio. Buscando hasta diciembre de 2021 en: PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE Y MEDLINE. Se identifican 6.832 artículos. Se analizan cinco estudios, con 214 participantes. El índice de masa corporal medio es 28,6 ± 1,1 kg/m2 y el Mini mental medio inicial es 23,6 ± 2,1 puntos. La intervención con ejercicio es de doce a veintiséis semanas. En el modelo de efectos aleatorios el ejercicio mejora el Mini mental medio en MD = 2,6 puntos (1,7 a 3,4) p < 0,01. Heterogeneidad (87,7 %). El ejercicio mejora la función cognitiva (memoria) en adultos mayores con sobrepeso u obesidad.


ABSTRACT Obesity and overweight in older adults are associated with an increased risk of cognitive diseases, contributing to decreased functional performance. The objective of this review is to analyze the effect of exercise on memory in older adults with obesity or overweight. The methodology uses the words MESH: Population = aged, overweight, obesity; Intervention = exercise; Comparison = control groups; Result = Memory; Design: randomized controlled trial. Searching until December 2021 in PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE, and MEDLINE. Six thousand eight hundred thirty-two items are identified. We analyzed five studies with 214 participants. The mean body mass index is 28.6 ± 1.1 kg/m2, and the initial average Mini mental is 23.6 ± 2.1 points. The intervention with exercise is from twelve to twenty-six weeks. In the random-effects model, exercise improves the mean Mini Mental by MD = 2.6 points (1.7 to 3.4) p < 0.01. Heterogeneity (87.7 %). Exercise improves cognitive function (memory) in older adults who are overweight or obese.

13.
Dement. neuropsychol ; 16(2): 135-152, Apr.-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1384670

ABSTRACT

ABSTRACT. Studies show that aging is accompanied by losses in cognitive functions and that interventions can increase performance and/or support the maintenance of cognitive skills in the elderly. Objective: The objective of this study was to carry out a systematic review of long-term studies involving cognitive training (CT) in older adults without dementia and/or with mild cognitive impairment (MCI). Methods: A systematic review of controlled studies was published in scientific journals from 2000 onward, with duration ≥6 months, CT intervention, cognitively normal (CN) or MCI participants aged ≥60 years, and assessments using cognitive and/or neuropsychological tests. Results: A total of 32 studies were reviewed, comprising 10 on study protocols, 14 in CN older adults (no MCI and/or dementia), and 8 in older adults with MCI or at risk for dementia. Conclusions: The studies reported improvements in cognitive performance for some motor abilities, among older participants of CT with or without booster sessions, including multimodal interventions or otherwise.


RESUMO. Estudos mostram que o envelhecimento é acompanhado por perdas nas funções cognitivas, e que as intervenções podem gerar um aumento no desempenho e/ou apoiar a manutenção de habilidades cognitivas em idosos. Objetivo: Realizar uma revisão sistemática de pesquisas com longa duração que ofereceram treino cognitivo (CT) em idosos sem demência e/ou com comprometimento cognitivo leve (MCI). Métodos: Revisão sistemática de estudos controlados, publicados em periódicos científicos a partir de 2000, com duração ≥6 meses, CT na intervenção, participantes ≥60 anos, saudáveis ou com MCI, avaliações por testes cognitivos e/ou neuropsicológicos. Resultados: Foram selecionados 32 estudos, sendo dez protocolos de pesquisa, 14 com idosos sem MCI e/ou sem demência e oito com idosos com MCI ou risco de demência. Conclusões: Foram relatados benefícios no desempenho cognitivo, incluindo habilidades motoras, de idosos que participaram de CT, com ou sem sessões de reforço, incluindo ou não intervenções multimodais.

14.
Rev. colomb. psiquiatr ; 51(2): 133-145, abr.-jun. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1394983

ABSTRACT

RESUMEN Introducción: El tratamiento del trastorno afectivo bipolar (TAB) con litio se ha relacionado con menos deterioro cognitivo y menores cambios en la anatomía estructural cerebral comparado con otros tratamientos. Sin embargo, los estudios son heterogéneos y son pocos los que evalúan si estos efectos están relacionados. El objetivo de este estudio es evaluar y relacionar el desempeno cognitivo y la neuroanatomía estructural en pacientes tratados con y sin litio. Métodos: Estudio de corte trasversal que incluyó a 48 sujetos con TAB I: 22 tratados con litio y 26 sin litio. Se evaluó el desempeno en las pruebas neuropsicológicas Wechsler III (WAIS III), TMTAyB (Trial Making Test), prueba de aprendizaje verbal de California (TAVEC), prueba de Figura compleja de Rey y prueba de clasificación de tarjetas de Wisconsin. Se evaluaron estructuras cerebrales obtenidas por resonancia magnétiva (RM) cerebral. Se calculó la diferencia de medias estandarizada (DME) entre ambos grupos, con ajuste por variables de confusión mediante puntuación de propensión, y se empleó el coeficiente de correlación de Spearman (p) para evaluar la relación existente entre el desempeno cognitivo y las regiones neuroanatómicas. Resultados: Respecto al grupo sin litio, el grupo con litio tuvo menos errores perseverativos en el Wisconsin (DME = -0,69) y mayores áreas corticales derecha e izquierda (DME = 0,85 y DME = 0,92); mayor superficie en el cíngulo anterior izquierdo (DME = 1,32), la corteza orbi-tofrontal medial derecha (DME = 1,17), el giro frontal superior derecho (DME = 0,82), los giros precentrales derecho e izquierdo (DME = 1,33 y DME = 0,98); mayor volumen de la amígdala derecha (DME = 0,57), el hipocampo derecho (DME = 0,66), el putamen derecho (DME = 0,87) y el tálamo derecho (DME = 0,67). En el grupo con litio, se encontró una correlación con dichos errores y el espesor del giro precentral izquierdo (p = -0,78), el volumen del tálamo derecho (p = -0,44) y la amígdala derecha (p = 0,6). Conclusiones: El grupo con litio tuvo mejor flexibilidad cognitiva y mayor dimensión en algunas regiones corticales frontales y subcorticales. Además, hubo correlación moderada a alta entre el desempeno en esta función ejecutiva y el espesor del giro precentral derecho, y los volúmenes del tálamo y la amígdala derecha. Estos hallazgos podrían indicar un efecto neuroprotector del litio


ABSTRACT Introduction: Lithium treatment of bipolar disorder (BD) has been associated with less impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. Methods: Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propen-sity score, and the Spearman correlation coefficient (p) was used to assess the relationship between cognitive performance and neuroanatomical regions. Results: Compared to the group without lithium, the group with lithium had fewer perse-verative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amyg-dala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD=.67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (p = -0.78), the volume of the right thalamus (p =-0.44), and the right amygdala (p = 0.6). Conclusions: Thelithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.

15.
J. bras. psiquiatr ; 71(2): 117-125, abr.-jun. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1386079

ABSTRACT

OBJECTIVE: Cognitive, neuropsychiatric and functional deficits are core symptoms of dementia. Non- -pharmacological interventions, such as music therapy, when used in conjunction with pharmacological treatment, have the potential to alleviate these symptoms. The purpose of this preliminary study is to examine the active music therapy on cognition and neuropsychiatric symptoms in the elderly with mild and moderate dementia. METHODS: The initial sample consisted of outpatients with dementia (N = 15) and their family members or caregivers (N = 15). Two dyads did not complete the assessments before intervention and were excluded from the analysis. Thirteen females (N = 13) comprised the final sampled and were diagnosed with Alzheimer's disease (N = 10), vascular dementia (N = 2) and mixed dementia (N = 1), at mild (N = 11) and moderate (N = 2) dementia stage. Participants were enrolled in an open-label trial of active music therapy group, set to take place once weekly for 60 minutes over a period of 12 weeks. RESULTS: Participants experienced a slight improvement on cognition measured with Mini-Mental State Examination (p = 0.41), although without statistical significance and a statistically significant decrease in anxiety (p = 0.042) in post-intervention. There were no significant effects on quality of life and caregiver burden. CONCLUSIONS: Active music therapy is a promising intervention with good acceptance among participants. More studies with larger sample sizes are needed to confirm its effects and efficacy in cognitive and neuropsychiatric symptoms in dementia.


OBJETIVO: Distúrbios cognitivos, comportamentais e funcionais são sintomas nucleares na demência. Intervenções não farmacológicas, como a musicoterapia, quando usadas em conjunto com o tratamento farmacológico, têm o potencial de aliviar esses sintomas. O objetivo deste estudo preliminar é examinar a musicoterapia ativa na cognição e nos sintomas neuropsiquiátricos em idosos com demência leve e moderada. MÉTODOS: A amostra inicial foi composta por pacientes ambulatoriais com demência (N = 15) e seus familiares ou cuidadores (N = 15). Duas duplas não completaram as avaliações antes da intervenção e foram excluídas da análise. Treze mulheres (N = 13) compuseram a amostra final e foram diagnosticadas com doença de Alzheimer (N = 10), demência vascular (N = 2) e demência mista (N = 1), nos estágios leve (N = 11) e moderado (N = 2). Os participantes foram inscritos em um estudo aberto de grupo de musicoterapia ativa, programado para ocorrer uma vez por semana, com duração de 60 minutos, durante o período de 12 semanas. RESULTADOS: Os participantes experimentaram uma discreta melhora cognitiva medida pelo Miniexame do Estado Mental (p = 0.41), embora sem significância estatística, e uma diminuição estatisticamente significativa na ansiedade (p = 0.042) na pós-intervenção. Não houve efeitos significativos na qualidade de vida e sobrecarga do cuidador. CONCLUSÕES: A musicoterapia ativa é uma intervenção promissora, com boa aceitação entre os participantes. Mais estudos com amostras maiores são necessários para confirmar seus efeitos e eficácia em sintomas cognitivos e neuropsiquiátricos na demência.


Subject(s)
Humans , Female , Middle Aged , Aged , Aged, 80 and over , Dementia/diagnosis , Dementia/therapy , Music Therapy , Behavioral Symptoms , Treatment Outcome , Cognition , Mental Status and Dementia Tests
16.
Ciênc. Saúde Colet. (Impr.) ; 27(6): 2269-2278, jun. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1374992

ABSTRACT

Resumo O objetivo deste artigo é estimar a prevalência de comprometimento cognitivo e analisar sua associação com o controle da pressão arterial em idosos hipertensos. Trata-se de um estudo transversal realizado com 383 idosos hipertensos no estado do Piauí, Brasil. Foram coletados dados sociodemográficos, clínicos, realizada aferição da pressão arterial e avaliação da função cognitiva utilizando o teste Montreal Cognitive Assessment (MoCA). Utilizou-se regressão de Poisson com variância robusta. A prevalência de comprometimento cognitivo foi de 74,4%, sendo maior na faixa etária entre 80 anos ou mais de idade e naqueles com menor escolaridade. A prevalência de pressão arterial não controlada foi de 61,6%, com maior proporção entre os idosos com comprometimento cognitivo. Observou-se associação entre o comprometimento cognitivo e pressão arterial não controlada (RPAjustada: 3,98; IC95% = 2,51-6,33). A associação significativa entre função cognitiva e controle pressórico sugere que comprometimento cognitivo é um importante fator de risco para pressão arterial não controlada em pessoas idosas. A inclusão de medidas de rastreamento para possíveis déficits cognitivos podem ser úteis para melhor monitoramento da elevação dos níveis pressóricos entre idosos hipertensos.


Abstract This article aims to estimate the prevalence of cognitive impairment and analyze its association with blood pressure control in elderly hypertensive individuals. Cross-sectional study of 383 elderly hypertensive individuals in the state of Piauí, Brazil. The authors collected sociodemographic and clinical data, performed blood pressure measurement, and assessed cognitive function using the Montreal Cognitive Assessment (MoCA) test. Poisson regression with robust variance was used. Overall prevalence of cognitive impairment was 74.4%, higher in the age group 80 years and over and among older persons with less schooling. Prevalence of uncontrolled blood pressure was 61.6%, with a higher proportion in the elderly with cognitive impairment. An association was observed between cognitive impairment and uncontrolled blood pressure (aPR: 3.98; 95%CI = 2.51-6.33). The significant association between cognitive function and blood pressure control suggest that cognitive impairment is an important risk factor for uncontrolled blood pressure in older persons. The inclusion of screening measures for possible cognitive deficits may be useful for better monitoring blood pressure levels among elderly hypertensive individuals.

17.
Nursing (Säo Paulo) ; 25(287): 7540-7552, abr.2022. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1372419

ABSTRACT

Objetivo: Avaliar a cognição e presença de dor em idosos após AVE que residem no interior de Coari, Amazonas. Método: Trata-se de um estudo transversal e observacional realizado com 50 idosos pós-AVE no município de Coari, Amazonas. A coleta de dados foi realizada no período de outubro e dezembro de 2019 até janeiro de 2020. Resultados: No MEEM, 78,0% (39) apresentam grave déficit cognitivo demonstrando estarem abaixo da nota de corte para analfabetos (≥20). Sobre o teste de fluência verbal, a maioria dos idosos apresentaram dificuldades de linguagem e memória e não conseguiram no tempo estipulado falar e/ou lembrar de nomes de frutas e animais. 72% (36) dos idosos relataram sentir dor, maioria apresentou dor de intensidade moderada a forte 68,0% (34). Os locais mais referidos de dor foram os membros inferiores 26,0% (13). Conclusão: Após o AVE os idosos deste estudo apresentaram consideráveis alterações cognitivas e piora da dor.(AU)


Objective: To evaluate cognition and presence of pain in elderly people after CVA living in the countryside of Coari, Amazonas. Method: This is a cross-sectional and observational study conducted with 50 post-CVA elderly in the municipality of Coari, Amazonas. Data collection was performed in the period from October and December 2019 to January 2020. Results: In the MMSE, 78.0% (39) present severe cognitive deficit demonstrating to be below the cutoff score for illiterate (≥20). On the verbal fluency test, most of the elderly presented language and memory difficulties and were unable in the stipulated time to speak and/or remember names of fruits and animals. 72% (36) of the elderly reported feeling pain, majority presented pain of moderate to strong intensity 68.0% (34). The most referred sites of pain were the lower limbs 26.0% (13). Conclusion: After the CVA, the elderly in this study presented considerable cognitive changes and worsening of pain.(AU)


Objetivo: Evaluar la cognición y la presencia de dolor en ancianos después del ACV que viven en el campo de Coari, Amazonas. Método: Se trata de un estudio transversal y observacional realizado con 50 ancianos post-CVA en el municipio de Coari, Amazonas. La recogida de datos se realizó en el periodo comprendido entre octubre y diciembre de 2019 y enero de 2020. Resultados: En el MMSE, el 78,0% (39) presentan un déficit cognitivo severo demostrando estar por debajo de la puntuación de corte para analfabetos (≥20). En la prueba de fluidez verbal, la mayoría de los niños presentaban dificultades de lenguaje y memoria y no conseguían, en el tiempo estipulado, decir y/o memorizar nombres de frutas y animales. El 72% (36) de los ancianos dijeron sentir dolor, la mayoría presentó dolor de intensidad moderada a fuerte 68,0% (34). Los lugares de dolor más referidos fueron las extremidades inferiores 26,0% (13). Conclusión: Tras el ACV, los ancianos de este estudio presentaron considerables cambios cognitivos y empeoramiento del dolor(AU)


Subject(s)
Pain , Aged , Cognition , Stroke
18.
Rev. colomb. psiquiatr ; 51(1): 35-40, ene.-mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1388974

ABSTRACT

ABSTRACT Background and objectives: Rather than focusing on the extensively studied social perception and recognition impairments in people with schizophrenia, this study focuses on the type of social information considered relevant by people with schizophrenia, and how they use it to arrive at conclusions about social situations. Methods: Participants included 50 outpatients with schizophrenia from the Hospital del Salvador at Valparaíso, Chile, and 50 healthy comparators matched by age and gender. Subjects completed the Social Information Preference Test (SIPT), which presents scenes depicting ambiguous social situations with faces, thoughts, and facts about the scene hidden from view. Participants were required to select a limited number of these items and then choose between possible interpretations of the scene (positive, neutral, or negative). Additionally, they are asked to provide a feeling of certainty in their answers, using a 7-point visual analogue scale. Results: People with schizophrenia, as well as controls had a strong preference for knowing the thoughts of the characters. Both groups were least likely to choose emotional expressions. Patients were significantly less likely to choose object/information than controls. Both groups showed a high certainty in their responses and no tendency to choose negative interpretations. Limitations: compensated clinical status of the patients may have influenced the results. Conclusions: The results of this study suggest that, despite difficulties perceiving clues about the mental state of others, people with schizophrenia use this information to make sense of social situations, and apparently, they do not have problems in understanding social interactions.


RESUMEN Objetivos: En lugar de los impedimentos en la percepción social, ampliamente estudiada en personas con esquizofrenia, centramos nuestra investigación en el tipo de información social considerada relevante por las personas con esquizofrenia y cómo la usan para llegar a conclusiones sobre situaciones sociales. Métodos: Se incluyó a 50 pacientes ambulatorios con esquizofrenia del Hospital del Salvador en Valparaíso, Chile, y 50 comparadores sanos, emparejados por edad y sexo. Los sujetos completaron la Prueba de Preferencia de Información Social (SIPT), que presenta escenas con situaciones sociales ambiguas en las que rostros, pensamientos y hechos sobre la escena están ocultos a la vista. Los participantes deben seleccionar un pequeño número de estos elementos y luego elegir entre posibles interpretaciones (positiva, neutral o negativa). Además, se les pide que proporcionen una sensación de certeza en sus respuestas, utilizando una escala analógica visual de 7 puntos. Resultados: Tanto las personas con esquizofrenia como los comparadores mostraron una fuerte preferencia por conocer los pensamientos de los personajes. La opción menos preferida por ambos grupos fue las expresiones emocionales, mientras que los pacientes escogieron menos objeto/información que los controles. Ambos grupos mostraron una alta certeza en sus respuestas y no se observó una tendencia a elegir interpretaciones negativas. Limitaciones: el estado clínico compensado de los pacientes puede haber influido en los resultados. Conclusiones: Los resultados de este estudio indican que, a pesar de las dificultades para percibir pistas sobre el estado mental de los demás, las personas con esquizofrenia usan esta información para dar sentido a las situaciones sociales y, aparentemente, no presentan problemas para comprender las interacciones sociales.

19.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388419

ABSTRACT

RESUMEN Introducción Antecedentes: La anorexia nerviosa (AN) y la bulimia nerviosa (BN) son enfermedades mentales graves y crónicas que afectan a un alto porcentaje de la población. Un número creciente de estudios han informado de alteraciones neuropsicológicas en esta población, que aparentemente contribuyen a la aparición y progresión del trastorno, y que repercuten en la eficacia del tratamiento y la recuperación. Metodología: El objetivo de esta Revisión Narrativa es resumir los hallazgos relativos al perfil neuropsicológico de las mujeres con AN y BN en diferentes fases de tratamiento. Resultados: La evidencia disponible sugiere que las mujeres con AN y BN presentan un perfil de déficits de cognición ejecutiva y social. Estos resultados son consistentes con la evidencia de los hallazgos de neuroimagen de alteraciones cerebrales estructurales en las áreas frontales y en los circuitos frontales-subcorticales. Conclusiones: El conocimiento de los perfiles neuropsicológicos de las mujeres con AN y BN ofrece información clave para entender la presentación clínica de esta población y los retos en la adherencia y beneficio del tratamiento. Los estudios futuros deberían explorar la eficacia de las intervenciones dirigidas a las deficiencias neuropsicológicas y cómo contribuyen al tratamiento habitual.


Background: Anorexia nervosa (AN) and bulimia nervosa (BN) are severe and chronic mental health illnesses that affect a high percentage of the population. A growing number of studies have reported neuropsychological impairments in this population, apparently contributing to the onset and progression of the disorder, and impacting on treatment efficacy and recovery. Methodology: This Narrative Review aimed to summarize findings regarding the neuropsychological profile of women with AN and BN at different treatment phases. Results: Available evidence suggests that women with AN and BN present a profile of executive and social cognition deficits. These results are consistent with evidence from neuroimaging findings of structural brain alterations in frontal areas and frontal-subcortical circuits. Conclusions: Knowledge about the neuropsychological profiles of AN and BN women offers key information to understand the clinical presentation of this population and challenges in adhering and benefiting from treatment. Future studies should explore the efficacy of interventions targeting neuropsychological impairments and how they contribute to treatment as usual.

20.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 44(1): 41-45, Jan.-Feb. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1360174

ABSTRACT

Objective: To analyze the association between physical fitness, cognitive function, and depressive symptoms among older adults in long-term care facilities (LTCFs). Methods: Seventy-six institutionalized male and female elderly individuals (65 years and older) living in LTCFs participated of this study. Physical fitness (aerobic capacity and strength), cognitive functions (global cognition, short-term and working and semantic memories, and executive function), and depressive symptoms were assessed. Linear regression and contingency analyses were performed. Significance was accepted at p-values ≤ 0.05. Results: Aerobic capacity predicted 32% of variance in global cognition (p < 0.01) and 25% of variance in semantic fluency/executive function (p < 0.01). Low levels of upper limb strength, lower limb strength, and aerobic capacity were associated with semantic fluency/executive function (OR = 1.38, p = 0.01, OR = 1.26, p = 0.03, and OR = 1.07, p = 0.01, respectively) and depressive symptoms (OR = 1.06, p < 0.01). Conclusion: Poor physical fitness is associated with cognition and depressive symptoms in institutionalized older adults. Low levels of strength and aerobic fitness increase the odds of presenting with impaired semantic fluency and executive function, possibly denoting an increased risk of developing dementia.

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