Validity of Zulliger-SC in the cognitive assessment of elderly and long-lived adults / Validade do Zulliger-SC na avaliação cognitiva de adultos idosos e longevos / Validez de Zulliger-SC en la evaluación cognitiva de adultos mayores y longevos

This study sought evidence of validity of the Zulliger method to evaluate cognitive processes in elderly and long-lived adults and to verify the relationship between cognition and external variables. Participated 142 subjects, aged between 18 and 96 years old. The Zulliger Comprehensive System (ZSC), Mini-Mental State Examination and sociodemographic protocols were used as of data collection. The older and long-lived adults presented a significant decrease in mediation (X-%, XA%, P) and abstract reasoning (M) when compared to young and middle-aged adults. Education and socioeconomic status (SES) demonstrated significant and positive correlations with cognitive processes (R, ZF, W, M, DQ+ and Intellectualization). The findings are fundamental to psychological practice and to directing measures for cognitive preservation in human aging. (AU)

Esse estudo buscou evidências de validade do método de Zulliger para avaliar processos cognitivos em adultos idosos e longevos e verificar a relação entre cognição e variáveis externas. Participaram 142 indivíduos, com idades entre 18 e 96 anos. Utilizaram-se para a coleta de dados: Zulliger no Sistema Compreensivo (ZSC), Miniexame de Estado Mental e protocolo sociodemográfico. Adultos mais velhos e longevos apresentaram diminuição significativa na mediação (X-%, XA%, P) e raciocínio abstrato (M), comparados aos adultos jovens e de meia idade. A educação e o nível socioeconômico (NSE) demonstraram correlações positivas e significativas com processos cognitivos (R, ZF, W, M, DQ+ e Intelectualização). Os achados são fundamentais na prática psicológica e para direcionar medidas na preservação cognitiva no envelhecimento humano. (AU)

El presente estudio buscó evidencias de validez del método de Zulliger para evaluar procesos cognitivos en ancianos y longevos y para verificar la relación entre la cognición y las variables externas. Participaron 142 individuos con edades entre 18 y 96 años. Se utilizaron como instrumentos: Zulliger en el Sistema Comprensivo (ZSC), Mini Examen del Estado Mental y protocolos sociodemográficos. Ancianos y longevos presentaron una disminución significativa en la mediación (X-%, XA%, P) y el razonamiento abstracto (M) en comparación con los adultos jóvenes y de mediana edad. La educación y el nivel socioeconómico (NSE) demostraron correlaciones positivas y significativas con los procesos cognitivos (R, ZF, W, M, DQ+ e Intelectualización). Los hallazgos son fundamentales para la práctica psicológica y para dirigir medidas para la preservación cognitiva en el envejecimiento humano. (AU)

Dimensiones para la promoción de la salud cognitiva y prevención de demencias / Dimensions for cognitive health´s promotion and prevention of dementias

En la actualidad existe un aumento exponencial en el número de personas que reciben diagnóstico de demencia cada año. Sin embargo el control de determinados factores de riesgo en la población general podría reducir significativamente la tasa global de pacientes que presentan declive cognitivo o algún tipo de demencia (incluida la enfermedad de Alzheimer). Esta realidad convierte a la promoción de salud cognitiva en un campo prioritario desde el cual deben diseñarse acciones encaminadas a potencias el bienestar cognitivo global con énfasis en el envejecimiento. De esta manera el objetivo de este material es discutir un grupo de premisas y dimensiones que deben considerarse para la concepción, diseño e implementación de programas orientados a la promoción de salud cognitiva y la prevención de demencias. Se propone que el diseño de programas orientados a la promoción de salud cognitiva y la prevención de demencias pueden concebirse partiendo de tres dimensiones principales: a) exploración de creencias y conocimiento general, b) educativo-formativo e c) investigación-implementación. La promoción de salud cognitiva está llamada a convertirse en un importante recurso para reducir el declive cognitivo patológico y el riesgo de padecer demencias. Para alcanzar este objetivo la salud cognitiva y prevención de demencias deben constituir una prioridad dentro de los sistemas de salud (y de los profesionales que los integran), concretándose en el diseño de programas dirigidos a reducir los factores de riesgos relacionados con el deterioro cognitivo patológico, y la implementación de intervenciones en función del bien público(AU)

Nowadays, there is an exponential increase in the number of people diagnosed with dementia every year. However, control of certain risk factors in general population could significantly reduce the overall rate of patients with cognitive decline or some form of dementia (including Alzheimer's disease). This reality turns cognitive health´s promotion into a priority field from which actions should be designed to encourage the overall cognitive wellbeing with an emphasis in aging. The objective of this paperwork is to discuss a group of premises and dimensions that must be considered for the conception, design and implementation of programs oriented to cognitive health´s promotions and the prevention of dementias. It is proposed that the design of programs oriented to the promotion of cognitive health and the prevention of dementias can be conceived from three main dimensions: a) exploration of beliefs and general knowledge, b) educational-formative and c) research-implementation. The promotion of cognitive health is called to become an important resource to reduce pathological cognitive decline and the risk of dementias. To achieve this goal, Cognitive Health and Dementia Prevention must be a priority within the health systems (and the professionals that integrate them), focusing on the design of programs aimed to reduce the risk factors related to pathological cognitive impairment , and the implementation of interventions in function of the public good(AU)

Determinantes del estado de salud de la población y su influencia en el desarrollo de los trastornos cognitivos / Determinants of the health status of the population and its influence on the development of cognitive disorders

Introducción: Ante el envejecimiento acelerado de la población cubana los trastornos cognitivos se han convertido en creciente problema y un reto para nuestro sistema de salud. Objetivo: Describir la influencia de las determinantes del estado de salud de la población en el desarrollo de los trastornos cognitivos. Fuente de datos: Se consultaron 113 artículos en la Biblioteca Virtual Scielo y en las bases de datos Medline, Google Scholar, Cochrane y PubMed, en idioma Inglés y Español. Se seleccionaron 40, publicados en revistas nacionales e internacionales de gran impacto, por autores considerados expertos en esta temática. Síntesis de los datos: Además de factores biológicos y genéticos, existen determinantes psicosociales como el nivel educacional y los estilos de vida que pudieran incidir en la aparición y desarrollo de las demencias. Entre estos últimos, aparecen los hábitos tóxicos, las relaciones sociales, antecedentes de depresión, nivel socioeconómico y otros. Conclusiones: La influencia de los determinantes del estado de salud de la población en el desarrollo de los trastornos cognitivos, es notable. Es necesario el estudio de estos determinantes y su contribución a la puesta en marcha de estrategias de intervención comunitaria que ayuden, sobre todo, a la población más vulnerable a tener una mejor calidad de vida(AU).

Introduction: The accelerated aging of the Cuban population is an alert to the high prevalence of dementias and other chronic diseases. Objective: To describe the influence of health status determinants of the population in the development of cognitive disorders. Data source: 113 articles in the Scielo Virtual Library and in Medline, Google Scholar, Cochrane and PubMed databases were consulted, both in English and Spanish. 38 of the selected were published in national and international magazines of great impact, by authors considered experts in this subject. Synthesis of data: In addition to biological and genetic factors, there are other psychosocial determinants such as education and lifestyles that may have an impact on the onset and development of dementia. Among the latter are toxic habits, social interactions, sleep, and depressive states. These states may be considered as a psychological reaction to incipient cognitive worsening or as an early manifestation of dementia. Conclusions: The influence of population´s health status determinants in the development of cognitive disorders is remarkable. Given the accelerated aging of the Cuban population, cognitive disorders become a growing health problem. More research is needed and the results of this may contribute to a better understanding of the epidemiological behavior of these disorders. It is necessary, through intersectoral work, the implementation of community intervention strategies that help above all most vulnerable population to have a better life quality(AU)

Treino Cognitivo para Idosos: Uma Revisão Sistemática dos Estudos Nacionais / Entrenamiento cognitivo para ancianos: una revisión sistemática de estudios nacionales / Cognitive training for elderly: a systematic review of Brazilian research

Este artigo de revisão sistemática sobre treino cognitivo para idosos saudáveis objetivou analisar 23 estudos nacionais em seus aspectos metodológicos e quanto às evidências de eficácia das intervenções. Os estudos foram publicados entre os anos 2000 e 2015. Uma busca foi feita nas bases SciELO, PubMed e PsycInfo utilizando-se os termos (português e inglês): "treino cognitivo", "estimulação cognitiva", "envelhecimento", "idoso" e "brasileiro". Em uma segunda etapa, as referências dos artigos encontrados foram consultadas para identificar quaisquer estudos pertinentes adicionais. A quase totalidade dos estudos utilizou a modalidade coletiva de intervenção (n = 20). O número de sessões com os participantes variou de 2 a 48 encontros. Em relação às habilidades cognitivas que foram alvo de intervenção, 60,8% dos estudos (n = 14) tiveram como foco o treino de memória episódica. Como medidas cognitivas, 90,4% dos estudos (n = 20) incluíram escalas de domínio comum (não restritas a psicólogos). No tocante aos resultados, 47,6% dos estudos (n = 10) identificaram efeitos de treino para pelo menos uma medida cognitiva utilizada. Conclui-se que o panorama nacional em treino cognitivo para idosos destaca-se por uma tendência a intervenções coletivas e voltadas à estimulação da memória episódica. Discute-se a importância de um avanço na área em relação à ampliação das pesquisas e à testagem da eficácia das intervenções padronizadas para o contexto brasileiro.(AU)

This systematic review about cognitive training for healthy elderly adults aimed to analyze 23 Brazilian studies regarding their methodological aspects and the evidence of effectiveness of interventions. The studies were published between 2000 and 2015. A search was performed in Scielo, PubMed and PsycInfo databases using the terms (Portuguese and English): cognitive training, cognitive stimulation, aging, elderly, and Brazilian. In a second step, the references of retrieved articles were consulted to identify any additional relevant studies. Almost all studies used the group intervention modality (n = 20). The number of sessions with participants ranged from 2 to 48 meetings. Regarding the cognitive skills that were targeted for intervention, 60.8% of the studies (n = 14) were focused on episodic memory training. For cognitive measures, 90.4% of the studies (n = 20) included common domain scales (not restricted to psychologists). Regarding the results, 47.6% of studies (n = 10) identified training purposes for at least one cognitive measure used. In conclusion, the national scene in cognitive training for older adults stands out for a tendency for collective interventions aimed at stimulating episodic memory. The present article argues for the importance of testing the effectiveness of interventions protocols.(AU)

Este artículo de revisión sistemática sobre entrenamiento cognitivo para ancianos con buena salud, realizó un análisis de 23 estúdios brasilenõs, publicados entre 2000 y 2015, sobre los aspectos metodológicos y evidencias de eficacia de las intervenciones. Se realizó una búsqueda en las bases Scielo, PubMed y PsycInfo utilizando los términos (portugués e inglés): entrenamiento cognitivo, estimulación cognitiva, envejecimiento, anciano y brasileño. En una segunda etapa, se consultaron las referencias de los artículos encontrados para identificar los estudios pertinentes adicionales. Casi todos los estudios utilizaron la modalidade colectiva de intervención (n = 20). El número de sesiones con los participantes osciló entre 2-48 reuniones. En cuanto a las habilidades cognitivas que fueron objeto de intervención, el 60,8% de los estudios (n = 14) se centraron en el entrenamiento de la memoria episódica. Como medidas cognitivas, 90,4% de los estudios (n = 20) incluyeron escalas de dominio común (no restringidas a psicólogos) y 47,6% de los estudios (n = 10) identificaron efectos de entrenamiento para por lo menos una medida cognitiva utilizada. Se concluye, que el panorama nacional en entrenamiento cognitivo para ancianos se destaca por una tendência a intervenciones colectivas y dirigidas a estimulación de la memoria episódica. Se discute la importancia de un avance en el área, con relación a la ampliación de las investigaciones y la comprobación de la eficacia de las intervenciones estandarizadas para el contexto brasileño.(AU)

Influence of schooling and age on cognitive performance in healthy older adults

Few studies have examined the influence of a low level of schooling on age-related cognitive decline in countries with wide social and economic inequalities by using the Cambridge Automated Neuropsychological Test Battery (CANTAB). The aim of the present study was to assess the influence of schooling on age-related cognitive decline using unbiased cognitive tests. CANTAB allows cognitive assessment across cultures and education levels with reduced interference of the examiner during data acquisition. Using two-way ANOVA, we assessed the influences of age and education on test scores of old adults (61–84 years of age). CANTAB tests included: Visual Sustained Attention, Reaction Time, Spatial Working Memory, Learning and Episodic Memory. All subjects had a minimum visual acuity of 20/30 (Snellen Test), no previous or current history of traumatic brain/head trauma, stroke, language impairment, chronic alcoholism, neurological diseases, memory problems or depressive symptoms, and normal scores on the Mini Mental State Examination (MMSE). Subjects were grouped according to education level (1 to 7 and ≥8 years of schooling) and age (60–69 and ≥70 years). Low schooling level was associated with significantly lower performance on visual sustained attention, learning and episodic memory, reaction time, and spatial working memory. Although reaction time was influenced by age, no significant results on post hoc analysis were detected. Our findings showed a significantly worse cognitive performance in volunteers with lower levels of schooling and suggested that formal education in early life must be included in the preventive public health agenda. In addition, we suggest that CANTAB may be useful to detect subtle cognitive changes in healthy aging.

Valoración del estado cognitivo en el adulto mayor: áreas más afectadas / Assessment of cognitive status in the elderly: most affected areas

Introducción: La alteración del estado cognitivo vuelve al adulto mayor dependiente, limita su autocuidado y genera cuidados a largo plazo. Objetivo: Valorar el estado cognitivo del adulto mayor, identificar las capacidades cognitivas más afectadas según género, edad y escolaridad. Metodología: Se realizó un estudio descriptivo transversal no probabilístico con enfoque cuantitativo en una casa de rehabilitación y reposo en México D.F. La población fue de 78 adultos mayores de 60 años (41 mujeres y 37 hombres). Se valoró el estado cognitivo con ayuda del (Mini-Mental) cuyo objetivo es establecer un diagnóstico presuntivo de las funciones cognitivas. Se utilizaron cuatro variables: estado cognitivo, género, edad y escolaridad. Resultados: De las 78 personas el 47.4% fueron hombres y el 52.6% mujeres, el 40.5% tienen de 60 a 69 años, el 32.1% obtuvo un título universitario, el 23.1% de la población mostro deterioro severo, el 44.9% deterioro leve. Las áreas más afectadas fueron: abstracción (cálculo) con 46.2% de deterioro severo, memoria a corto plazo con 47.4% de deterioro severo y lenguaje con 11.5% de deterioro. Conclusiones: Evaluar y detectar alteraciones cognitivas permitirá concientizar a la familia, buscar modelos de atención y cuidado fortaleciendo el bienestar del adulto mayor.

Introduction: Altered mental state becomes the elderly dependent, limited self-care and generates long-term care. Objective: To assess the cognitive status of the elderly and identify the cognitive abilities most affected by gender, age and education. Methodology: A cross-sectional study of non-probabilistic descriptive quantitative approach was conducted in a rehabilitation and rest house in Mexico DF. The sample was 78 adults over 60 years, 41 women and 37 men. We made an assessment of cognitive status using the Minimental which objective to establish a diagnosis of cognitive functions. Were considered four variables: Cognitive status, gender, age and education. Results: Of the 78 people found that 47.4% were male and 52.6% female, 40.5% was found in the group of 60-69 years, 32.1% of seniors earned a university degree in 23.1% of the population severe deterioration was observed, 44.9% mild deterioration. The Areas with more impairment were the area of abstraction (calculation) 46.2% had severe deterioration in the area of short-term memory 47.4% severe cognitive impairment was found and in the language area was 11.5%. Conclusions: Evaluate and detect cognitive impairment will allow awareness to the family, look for models of care and attention to strengthen the welfare of the elderly.

O efeito da exposição ao calor sobre o desempenho cognitivo de idosos: um estudo controlado / The effect of heat exposure on the cognitive performance of older adults: a controlled trial

Introdução: Concomitante ao processo de envelhecimento populacional, estão ocorrendo mudanças climáticas, sendo a principal delas o aquecimento global. O envelhecimento leva a mudanças tanto nos mecanismos de termorregulação quanto no desempenho cognitivo. Embora inúmeros estudos tenham avaliado o efeito do calor sobre a cognição de adultos jovens, este é um tema praticamente inexplorado na população geriátrica. Objetivos: Avaliar o efeito da exposição ao calor sobre o desempenho cognitivo de idosos saudáveis e identificar fatores que expliquem as variações na susceptibilidade ao estresse térmico nesta população. Casuística e Métodos: 68 idosos com bom desempenho físico e cognitivo realizaram uma bateria de testes neuropsicológicos em duas condições ambientais: 24oC (controle) e 32oC (calor). Através de cinco testes selecionados da Bateria Neuropsicológica Automatizada de Testes de Cambridge (CANTAB), foram avaliados diferentes aspectos do desempenho cognitivo com foco principal em memória, atenção e velocidade de processamento. Um escore composto global de desempenho cognitivo foi criado usando a medida mais representativa de cada um desses testes. Antes e após cada uma das sessões de testes, foram aferidos o peso corporal, a temperatura axilar, a temperatura auricular, a frequência cardíaca e a pressão arterial. Por meio da análise de variância para medidas repetidas (ANOVA), verificou-se a interação entre o efeito da temperatura na cognição (avaliada pelo escore composto global) e características sociodemográficas (idade, sexo, educação, cor), frequência de exercício físico e umidade relativa registrada durante o protocolo de exposição ao calor. Adicionalmente, foi também desenvolvido um modelo de regressão linear multivariada a fim de identificar variáveis independentes que explicariam a susceptibilidade ao estresse pelo calor. Resultados: A idade média da amostra foi de 73,28 anos. 42,9% dos indivíduos relataram praticar atividade física quatro ou mais...

Introduction: Concomitantly to the process of population aging, major climate changes are taking place, among which global warming is regarded as the most important. Aging leads to changes in temperature control mechanisms and is associated with a subtle and progressive decline in cognitive functions. Although a great deal of studies have evaluated the effect of heat on the cognitive performance of young adults, to the best of our knowledge, no studies have directly investigated the effects of warm environments on the cognitive functioning of older adults. Objectives: To evaluate the effect of heat exposure on the cognitive performance of healthy older adults and to identify factors that would explain variations in susceptibility to heat stress in that population. Methods: 68 older adults with both good physical and cognitive performance were requested to take a series of neuropsychological tests under two environmental conditions: at 24oC and 32oC. Five tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered to measure different aspects of cognitive functioning while focusing on memory, attention and processing speed. A global composite score of cognitive performance was created, using the most representative measures of each one of those five tests. Before and after each session, measures of auxiliary temperature, tympanic temperature, blood pressure, heart rate, and body weight were obtained. Interaction analysis was carried out using repeated measures analysis of variance (ANOVA) in order to check whether the effect of temperature on cognition, assessed by the global composite score, was modified by sociodemographic characteristics (age, gender, education, race), frequency of physical activity or relative humidity registered during the heat protocol. In addition, a multiple linear regression model has been fitted to identify independent variables that would explain susceptibility to heat stress Results: The mean age...