ABSTRACT
ABSTRACT Mini-Mental State Examination (MMSE) results are strongly influenced by educational level. The Brief Cognitive Screening Battery (BCSB) is an alternative assessment tool that provides more accurate results in individuals with less education. Objective: Our aim was to compare the MMSE and BCSB as screening tests. Methods: The MMSE and BCSB were assessed in 112 participants by two evaluators blind to the other test's result. Participants were classified according to their level of education. The influence of education level was analyzed using the Kruskal-Wallis and multiple comparison tests. Results: Scores of the MMSE (p < 0.0001) and the clock-drawing test (p < 0.0001) were influenced by education level but the delayed recall test score was not (p = 0.0804). The verbal fluency test (p = 0.00035) was influenced only by higher educational levels. It took three minutes less to apply the MMSE than to apply the BCSB (p < 0.0001). Conclusions: These findings suggest that the delayed recall test and the verbal fluency test of the BCSB are better than the MMSE and clock-drawing test as tools for evaluating cognition in people with limited education.
Resumo Os resultados do Mini-Exame de Estado Mental (MEEM) são consideravelmente influenciados pelo nível de escolaridade. A Bateria Breve de Rastreio Cognitivo (BBRC) é uma ferramenta de rastreamento cognitivo alternativa que fornece resultados mais acurados em indivíduos com menor nível de escolaridade. Objetivo: Comparar o MEEM e a BBRC como testes de rastreamento cognitivo. Métodos: 112 participantes foram submetidos ao MEEM e a BBRC por 2 avaliadores cegos para o resultados do outro teste. Os participantes foram classificados de acordo o nível de escolaridade. A influência do nível de escolaridade foi analisada utilizando o teste de Kruskal-Wallis e o teste de comparações múltiplas. Resultados: As pontuações do MEEM (p < 0,0001) e do teste do desenho do relógio (p < 0,0001) foram influenciadas pelo nível de escolaridade, porém o teste de memória tardia não sofreu influência do nível de escolaridade (p = 0,0804). O teste de fluência verbal (p = 0,00035) foi influenciado apenas pelos níveis educacionais mais altos. A aplicação do MEEM levou 3 minutos a menos que a da BBRC (p < 0,0001). Conclusão: Os achados desse estudo sugerem que o teste de memória tardia e o teste de fluência verbal da BBRC são mais adequados que o MEEM e o teste do desenho do relógio como ferramentas para avaliação cognitiva em populações com menor nível educacional.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Cognition Disorders/diagnosis , Educational Status , Mental Status and Dementia Tests , Neuropsychological Tests , Mental Recall , Reference Values , Speech Disorders/diagnosis , Speech Disorders/psychology , Time Factors , Brazil , Cross-Sectional Studies , Cognition Disorders/psychology , Statistics, NonparametricABSTRACT
Abstract Objectives: To explore the socioeconomic, demographic and psychosocial factors associated with cognitive performance in elderly caregivers from Brazil. Methods: We evaluated 351 Brazilian elderly caregivers attending primary healthcare services regarding sociodemographic and care variables. Addenbrooke's Cognitive Examination-Revised (ACE-R) domains of orientation/attention, memory, verbal fluency, language and visuospatial were used as dependent variables in the Tobit model. Results: Literacy and family income were positively associated with all ACE-R domains. Age, gender, time of care (days/week) were negatively associated with some cognitive domains. Moreover, receiving emotional help and the level of hope were positively associated with specific domains. Discussion: The results may be useful for planning interventions aimed at elderly caregivers in order to prevent deficits in the different cognitive domains.
RESUMO Objetivos: explorar os fatores socioeconômicos, demográficos e psicossociais associados ao desempenho cognitivo em idosos cuidadores do Brasil. Métodos: Avaliamos 351 idosos cuidadores da atenção primária à saúde em relação a variáveis sociodemográficas e de contexto do cuidado. Os domínios da Escala Cognitiva de Addenbrooke Revisada (ACE-R) - orientação/atenção, memória, fluência verbal, linguagem e visuo-espacial - foram utilizados como variáveis dependentes no modelo de Tobit. Resultados: Alfabetização e renda familiar foram positivamente associados a todos os domínios ACE-R. A idade, o sexo, o tempo de atendimento (dias/semana) foram associados negativamente com alguns domínios cognitivos. Além disso, receber ajuda emocional e nível de esperança foram positivamente associados a domínios específicos. Discussão: os resultados podem ser úteis para o planejamento de intervenções voltadas para cuidadores idosos, a fim de prevenir déficits nos diferentes domínios cognitivos.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Caregivers/psychology , Cognition/classification , Socioeconomic Factors , Stress, Psychological/psychology , Time Factors , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Cognition Disorders/prevention & control , Cognition Disorders/psychology , Sex Distribution , Hope , Neuropsychological TestsABSTRACT
Objective: To compare social skills and related executive functions among bipolar disorder (BD) patients with a family history of mood disorders (FHMD), BD patients with no FHMD and healthy control (HCs). Methods: We evaluated 20 euthymic patients with FHMD, 17 euthymic patients without FHMD, and 31 HCs using the Social Skills Inventory (SSI) and a neuropsychological battery evaluating executive function, inhibitory control, verbal fluency and estimated intelligence. Results: Both BD groups had lower SSI scores than controls. Scores for one subfactor of the social skills questionnaire, conversational skills and social performance, were significantly lower among patients with FHMD than among patients without FHMD (p = 0.019). Both groups of BD patients exhibited significant deficits in initiation/inhibition, but only BD patients with FHMD had deficits in verbal fluency, both compared to HC. There were no associations between social skills questionnaire scores and measures of cognitive function. Conclusion: Euthymic BD patients have lower social skills and executive function performance than HC. The presence of FHMD among BD patients is specifically associated with deficits in conversational and social performance skills, in addition to deficits in verbal fluency. Both characteristics might be associated with a common genetically determined pathophysiological substrate.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Bipolar Disorder/psychology , Cognition , Cognition Disorders/psychology , Mood Disorders/psychology , Executive Function , Social Skills , Verbal Behavior/physiology , Bipolar Disorder/genetics , Remission Induction , Case-Control Studies , Cognition Disorders/genetics , Intelligence , Neuropsychological TestsSubject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Body Image/psychology , Cognition , Psychology , Cognition Disorders/psychology , Depression/psychology , Amnesia/psychologyABSTRACT
ABSTRACT Purpose To verify indicators of cognitive development, receptive language skills and adaptive behavioral patterns in toddlers with Williams syndrome (WS). Methods The sample comprised 8 children of both sex, aged between 48 and 72 months with WS. Instruments of data collection were Denver Developmental Screening Test II; Peabody Picture Vocabulary Test; Vineland Adaptive Behavior Scale; Child Behavior Checklist for Ages 1½-5and 6 to 18; Columbia Mental Maturity Scale (CMMS), and Behavior Problems Inventory-01. Results The major developmental impairments were associated with fine motor skills and personal care abilities. Deficits in receptive language and communication skills were reported according to the PPVT and Denver II, respectively. The caregivers reported behavioral and emotional problems associated to anxiety and depression, and attention problems scales of CBCL. Conclusion The toddlers demonstrated deficits in adaptive functioning and behavioral, motor and cognitive difficulties such as inattention and hyperactivity, stereotypies and aggressive behavior.
RESUMO Objetivo Verificar indicadores de desenvolvimento cognitivo, habilidades de linguagem receptiva e padrões comportamentais adaptativos em pré-escolares com Síndrome de Williams (SW). Método A amostra foi composta por 8 crianças de ambos os sexos, com idade entre 48 e 72 meses com SW. Os instrumentos de coleta de dados utilizados foram Denver Developmental Screening Test II; Peabody Picture Vocabulary Test; Escala de comportamento adaptativo Vineland; Child Behavior Checklist (CBCL) para as idades 1½-5 e 6 a 18; Inventário de Problemas de Comportamento (BPI-01) e Escala de Maturidade Mental Columbia. Resultados Os principais prejuízos de desenvolvimento foram associados a habilidades motoras finas e habilidades de cuidados pessoais. Os déficits em linguagem receptiva e habilidades de comunicação foram relatados de acordo com o PPVT e Denver II, respectivamente. Os cuidadores relataram problemas comportamentais e emocionais associados às escalas de ansiedade e depressão e de problemas de atenção do CBCL. Conclusão Os pré-escolares demonstraram déficits no funcionamento adaptativo e dificuldades comportamentais, motoras e cognitivas, como desatenção e hiperatividade, estereotipias e comportamento agressivo.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Social Behavior , Adaptation, Psychological , Williams Syndrome/psychology , Language Development , Developmental Disabilities/psychology , Cognition Disorders/psychology , Williams Syndrome/genetics , Intelligence Tests , Language Tests , Neuropsychological TestsABSTRACT
ABSTRACT Motor function, cognition, functional independence and quality of life have been described in myelomeningocele patients, but no study has investigated their relationships. We aimed to investigate the relationships between motor function, cognition, functional independence, quality of life, age, and lesion level in myelomeningocele patients, and investigate the influence of hydrocephalus on these variables. We assessed 47 patients with the Gross Motor Function Measure (motor function), Raven's Colored Progressive Matrices (cognition), Pediatric Evaluation of Disability Inventory (functional independence) and the Autoquestionnaire Qualité de vie Enfant Imagé (quality of life). Spearman's correlation tests determined relationships between the variables. The Friedman ANOVAs determined the influence of hydrocephalus. Motor function was strongly related to mobility and lesion level, and moderately related to cognition, self-care and social function. Cognition and quality of life were moderately related to functional independence. Age correlated moderately with functional independence and quality of life. Hydrocephalus resulted in poorer motor/cognitive outcomes and lower functional independence.
RESUMO Função motora, cognição, independência funcional e qualidade de vida foram descritos em pacientes com mielomeningocele (MMC), mas sua correlação não foi investigada. Esse estudo investigou correlações entre função motora, cognição, independência funcional, qualidade de vida, idade, nível de lesão em pacientes com MMC e a influência da hidrocefalia nessas variáveis. Quarenta e sete pacientes foram avaliados com a Medida de Função Motora Grossa, Matrizes Progressivas de Raven, Inventário de Avaliação Pediátrica de Incapacidade e Autoquestionnaire Qualité de vie Enfant Imagé. Testes de Spearman investigaram as correlações. ANOVAS de Friedman investigaram a influência da hidrocefalia. A função motora correlacionou-se fortemente com mobilidade e nível de lesão e moderadamente com cognição, auto-cuidado e função social. Cognição e qualidade de vida correlacionaram-se moderadamante com independência funcional. Idade correlacionou moderadamente com independência funcional e qualidade de vida. Hidrocefalia associou-se a piores desfechos motores/cognitivos e menor independência funcional.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Quality of Life/psychology , Meningomyelocele/psychology , Cognition/physiology , Cognition Disorders/psychology , Hydrocephalus/complications , Motor Skills/physiology , Psychiatric Status Rating Scales , Age Distribution , Statistics, Nonparametric , Disability Evaluation , Independent LivingABSTRACT
Objectives: Brain maturation differs depending on the area of the brain and sex. Girls show an earlier peak in maturation of the prefrontal cortex. Although differences between adult females and males with schizophrenia have been widely studied, there has been less research in girls and boys with psychosis. The purpose of this study was to examine differences in verbal and visual memory, verbal working memory, auditory attention, processing speed, and cognitive flexibility between boys and girls. Methods: We compared a group of 80 boys and girls with first-episode psychosis to a group of controls. Results: We found interactions between group and sex in verbal working memory (p = 0.04) and auditory attention (p = 0.01). The female controls showed better working memory (p = 0.01) and auditory attention (p = 0.001) than males. However, we did not find any sex differences in working memory (p = 0.91) or auditory attention (p = 0.93) in the psychosis group. Conclusions: These results are consistent with the presence of sex-modulated cognitive profiles at first presentation of early-onset psychosis.
Subject(s)
Humans , Male , Female , Child , Adolescent , Schizophrenia/physiopathology , Sex Factors , Cognition Disorders/physiopathology , Schizophrenic Psychology , Case-Control Studies , Prefrontal Cortex , Cognition Disorders/psychology , Memory, Short-Term , Neuropsychological TestsABSTRACT
ABSTRACT Multiple sclerosis (MS) may present with a cognitive impairment as disabling as the physical disabilities. Therefore, routine cognitive evaluation is pivotal. Valid and reliable neuropsychological tests are essential in follow-up and to define future therapeutic interventions. Objectives To investigate the correlation between the disabilities of MS patients and their cognitive impairment assessed by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Methods Forty patients with definitive diagnoses of MS were selected. The correlation coefficient (r) between the Expanded Disability Status Scale (EDSS) and the neuropsychological tests of BICAMS were calculated. Results The correlation was clinically substantial and significant with r = 0.55 (p < 0.01) in the Symbol Digit Modalities Test (SDMT), 0.54 (p < 0.01) in the Brief Visuospacial Memory Test (BVMT) and 0.40 (p < 0.05) in the California Verbal Learning Test (CVLT). Conclusion BICAMS has easy and satisfactory application and evaluation for routine visits and presents a significant correlation with the EDSS. Its use may be indicated for screening and monitoring of cognitive impairment in patients with MS.
RESUMO A esclerose múltipla (EM) pode apresentar um déficit cognitivo (DC) tão devastador quanto suas debilidades físicas. Uma avaliação cognitiva rotineira é essencial e testes neuropsicológicos (TNs) validados e confiáveis são fundamentais no acompanhamento e definição de futuras intervenções terapêuticas. Objetivos Investigar a correlação entre o estado de incapacidade física de pacientes com EM e o comprometimento cognitivo, avaliado pelo Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Métodos Foram calculados coeficientes de correlação (r) entre a Expanded Disability Status Scale (EDSS) e resultados dos testes do BICAMS em quarenta pacientes com diagnóstico definitivo de EM. Resultados A correlação foi clinicamente substancial e significativa, com r = 0.55 (p < 0.01, no Symbol Digit Modalities Test (SDMT), 0.54 (p < 0.01) no Brief Visuospacial Memory Test (BVMT) e 0.40 (p < 0.05) no California Verbal Learning Test (CVLT). Conclusão O BICAMS é de fácil e satisfatória aplicação e avaliação em visitas de rotina e apresenta uma correlação significativa com a EDSS. Seu uso pode ser indicado como rotina no acompanhamento do (DC) em portadores de EM.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Young Adult , Brief Psychiatric Rating Scale/standards , Cognition Disorders/psychology , Multiple Sclerosis, Relapsing-Remitting/psychology , Disability Evaluation , Brazil , Cognition Disorders/diagnosis , Multiple Sclerosis, Relapsing-Remitting/diagnosis , Educational Status , Language , Neuropsychological Tests/standardsABSTRACT
Objective: To assess cognitive performance and psychosocial functioning in patients with bipolar disorder (BD), in unaffected siblings, and in healthy controls. Methods: Subjects were patients with BD (n=36), unaffected siblings (n=35), and healthy controls (n=44). Psychosocial functioning was accessed using the Functioning Assessment Short Test (FAST). A sub-group of patients with BD (n=21), unaffected siblings (n=14), and healthy controls (n=22) also underwent a battery of neuropsychological tests: California Verbal Learning Test (CVLT), Stroop Color and Word Test, and Wisconsin Card Sorting Test (WCST). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chi-square test; multivariate analysis of covariance was used to examine differences in neuropsychological variables. Results: Patients with BD showed higher FAST total scores (23.90±11.35) than healthy controls (5.86±5.47; p < 0.001) and siblings (12.60±11.83; p 0.001). Siblings and healthy controls also showed statistically significant differences in FAST total scores (p = 0.008). Patients performed worse than healthy controls on all CVLT sub-tests (p < 0.030) and in the number of correctly completed categories on WCST (p = 0.030). Siblings did not differ from healthy controls in cognitive tests. Conclusion: Unaffected siblings of patients with BD may show poorer functional performance compared to healthy controls. FAST scores may contribute to the development of markers of vulnerability and endophenotypic traits in at-risk populations.
Subject(s)
Humans , Male , Female , Middle Aged , Bipolar Disorder/psychology , Cognition/physiology , Cognition Disorders/psychology , Siblings/psychology , Verbal Learning , Case-Control Studies , Cross-Sectional Studies , Multivariate Analysis , Cognition Disorders/physiopathology , Endophenotypes , Learning Disabilities/diagnosis , Memory Disorders/diagnosisABSTRACT
La cantidad de personas que ascienden a la tercera edad aumentó en 700 millones en la década del 90, a nivel mundial. Para el año 2025 se estima que existirán cerca de 2 mil millones de ancianos. El cuidado de su salud reviste vital importancia para todas las sociedades; por ello, en el presente trabajo se propone una herramienta matemático computacional para medir la ejercitación de la atención y la percepción en el ambiente diario del adulto mayor. Ambas funciones poseen una estrecha relación con la capacidad psicológica de la memoria; además, se considera que su afectación puede provocar pérdida de validismo, dependencia y discapacidad, una vez que se ha iniciado el deterioro cognitivo. La propuesta es aplicada en la ciudad de Pinar del Río, Cuba a través de test experimentales y diferentes tipos de análisis mediante medios de cómputo en una muestra de personas de la tercera edad, con una capacidad moderadamente razonable(AU)
The number of old persons increased in 700 millions in the 90's at world level. This number will increase to nearly 2 thousand more million in 2025. The carefulness of their healthy becomes an important issue for all societies; that is why, in this research, it is presented a computational tool to measure the assistance and the perception in the daily environment of the elderly people. Both functions have a close relationship with the psychological capacity of the memory; moreover, it is considered that their damage can provoke loss of skills, dependence and disabilities, once the cognitive deterioration has begun. The proposal is applied in the pinar del río, cuba, through experimental tests and different types of analysis by means of computational in a sample of elderly people with a moderately reasonable capacity(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Medical Informatics Applications , Software Design , Aged/psychology , Cognition Disorders/psychology , Mental Status and Dementia Tests/standards , CubaABSTRACT
ABSTRACT Tests evaluating the attentional-executive system are widely used in clinical practice. However, proximity of an objective cognitive test with real-world situations (ecological validity) is not frequently investigated. The present study evaluate the association between measures of the Five Digit Test (FDT) and the Oral Trails Test (OTT) with self-reported cognitive failures in everyday life as measured by the Cognitive Failures Questionnaire (CFQ). Brazilian adults from 18-to-65 years old voluntarily performed the FDT and OTT tests and reported the frequency of cognitive failures in their everyday life through the CFQ. After controlling for the age effect, the measures of controlled attentional processes were associated with cognitive failures, yet the cognitive flexibility of both FDT and OTT accounted for by the majority of variance in most aspects of the CFQ factors. The FDT and the OTT measures were predictive of real-world problems such as cognitive failures in everyday activities/situations.
RESUMO Testes que avaliam o sistema atencional-executivo são amplamente adotados no contexto clínico. Contudo, a proximidade de uma medida cognitiva objetiva com situações reais (validade ecológica) são pouco investigadas. O presente estudo objetiva avaliar a associação entre o Teste dos Cinco Dígitos (FDT) e o Oral Trails Test (OTT) com falhas cognitivas do dia a dia relatadas no Questionário de Falhas Cognitivas (CFQ). Sessenta adultos brasileiros, de 18 a 65 e cinco anos, realizaram o FDT e o OTT e reportaram a frequência das falhas cognitivas por meio do CFQ. Controlando o efeito da idade, as medidas de processos atencionais controlados foram associadas com as falhas cognitivas, sendo que o componente de flexibilidade cognitiva do FDT e do OTT explicou a maior parte da variância das falhas. O FDT e o OTT foram preditores de problemas reais do dia a dia, como as falhas cognitivas.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Attention , Activities of Daily Living/psychology , Cognition Disorders/psychology , Cognition/physiology , Surveys and Questionnaires/standards , Cognition Disorders/diagnosis , Psychometrics , Reproducibility of Results , Self Report , Stroop Test/standardsABSTRACT
A Síndrome de Turner é uma condição genética que resulta da deleção do segundo cromossomo sexual (45, X). Todavia, alguns indivíduos apresentam uma mistura de linhagens celulares, que é conhecida como mosaicismo. Nas mulheres com a deleção completa existe uma discrepância cognitiva entre habilidades verbais e não-verbais, sendo estas últimas as mais afetadas. Entretanto, acredita-se que a heterogeneidade genética é uma das responsáveis por variações no fenótipo cognitivo desses indivíduos. Assim, o objetivo do estudo foi investigar diferenças nas habilidades verbais e não-verbais, avaliadas pelas Escalas de Inteligência Wechsler, em 5 mulheres com Síndrome de Turner e diferentes cariótipos. O estudo revelou que a variação cariotípica refletiu em diferenças no perfil cognitivo das participantes. Tais resultados são importantes, uma vez que influenciam diretamente os métodos de avaliação e intervenção de uma população específica, além de indicar como tal variação genética atua sobre a cognição.
Turner syndrome is a genetic condition that results from deletion of the second sex chromosome (45, X). However some individuals exhibit a mixture of cells, which is known as mosaicism. In women with complete deletion there is a cognitive discrepancy between verbal and non-verbal skills, the latter being the most affected. Nevertheless, it is believed that genetic heterogeneity is one of the points responsible for variations in the individuals' cognitive phenotype. Thus, this study aimed to investigate differences in verbal and non-verbal abilities, evaluated by the Wechsler Intelligence scales, in 5 Turner syndrome women with different karyotypes. The study revealed that karyotype variation reflected in differences in the participants' cognitive profile. Such results are important since they directly influence the methods of assessment and intervention of a specific population, as well as indicating how such genetic variation impacts on cognition.
Subject(s)
Humans , Female , Child , Adult , Turner Syndrome/psychology , Cognition Disorders/psychology , MosaicismABSTRACT
Este estudo teve por objetivo verificar a relaçaÌo entre apoio social de idosos com alteraçoÌes cognitivas que residem em diferentes contextos de vulnerabilidade social e a presença de crianças vivendo no mesmo domiciÌlio. Trata-se de um estudo descritivo, transversal, que avaliou 85 idosos residentes em diferentes contextos de vulnerabilidade social, e que apresentaram resultado no Mini Exame do Estado Mental abaixo da nota de corte. Todos os cuidados eÌticos foram observados. Foram aplicados instrumento de caracterizaçaÌo sociodemograÌfica e familiar, Mini Exame do Estado Mental e o Medical Outcomes Study (MOS). Os resultados revelaram bons niÌveis de apoio social recebidos pelos idosos e correlaçaÌo estatisticamente significativa entre a dimensaÌo de apoio emocional e a presença de crianças no domiciÌlio (t=2,16, sendo p<0,01). Esses resultados possibilitam conhecer melhor a relaçaÌo entre idosos e crianças ao revelar que o contato intergeracional favorece a percepçaÌo de apoio social satisfatoÌrio pelos idosos.
The aim of this study was to investigate the relationship between social support to elderly patients with cognitive alterations in different contexts of social vulnerability and the presence of children living in the same household. A descriptive, cross-sectional study assessed 85 elderly individuals in different contexts of social vulnerability; all of them presented results below the cut-off point in the mini mental state examination. All ethical guidelines were respected. A sociodemographic and family characterization tool, the mini mental state examination, and the Medical Outcomes Study (MOS) were applied. The results showed good levels of social support received by elderly individuals and a statistically significant correlation between the extent of emotional support and the presence of children in the household (t=2.16, p<0.01). These results enable a better understanding on the relationships between elderly people and children by evidencing that intergenerational contact favors the perception of satisfactory social support by the elderly.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Child , Family , Intergenerational Relations , Social Support , Cognition Disorders/psychology , Geriatric NursingABSTRACT
Objective: Evidence suggests that early-onset obsessive-compulsive disorder (OCD) is an etiologically distinct subtype of OCD. The objective of the present work was to search for neurocognitive endophenotypes of early-onset OCD based on assessments of attention, memory, and executive function in patients with the disorder and their unaffected siblings. Methods: We compared the performance of 40 adult patients with early-onset OCD, 40 of their unaffected siblings, and 40 unrelated healthy controls on a neuropsychological battery designed for this study. We searched for associations among test performance, demographic variables (age, sex and years of education) and clinical symptoms of early-onset OCD. Results: Patients performed significantly worse than healthy controls on the Tower of Hanoi, and the Stroop and Wisconsin tests, indicating impairments in planning, mental flexibility and inhibitory control. The performance of the unaffected first-degree siblings of patients with early-onset OCD on the Stroop and Wisconsin tests also differed from that of healthy controls. Symptom severity in early-onset OCD was strongly correlated with performance on the Tower of Hanoi. Conclusions: Our findings support the existence of specific executive function deficits in patients with early-onset OCD. Relatives presented an intermediate phenotype between patients and controls, suggesting that executive functions such as mental flexibility and response inhibition may be considered candidate endophenotypes of early-onset OCD. .
Subject(s)
Adult , Female , Humans , Male , Young Adult , Cognition Disorders/genetics , Cognition Disorders/psychology , Endophenotypes , Obsessive-Compulsive Disorder/genetics , Obsessive-Compulsive Disorder/psychology , Case-Control Studies , Educational Status , Executive Function , Family Health , Neuropsychological TestsABSTRACT
Objective To investigate the adequacy of the neuropsychological test battery proposed by the International Study of Postoperative Cognitive Dysfunction to evaluate this disorder in Brazilian elderly patients undergoing surgery under general anesthesia. Methods A neuropsychological assessment was made in patients undergoing non-cardiac surgery under general anesthesia, aged over 65 years, literate, with no history of psychiatric or neurological problems and score on the Mini Mental State Examination at or above the cutoff point for the Brazilian population (>18 or >23) according to the schooling level of the subject. Eighty patients were evaluated by a trained team of neuropsychologists up to 24 hours before elective surgery. Results Among the patients evaluated, one was excluded due to score below the cutoff point in the Mini Mental State Examination and two did not complete the test battery, thus remaining 77 patients in the study. The mean age was 69±7.5 years, and 62.34% of the subjects had ±4 years of study. The subjects had significantly lower averages than expected (p<0.001) for normative tables on neuropsychological tests. Conclusion The study demonstrated the applicability of the instruments in the Brazilian elderly and low schooling level population, but suggested the need to determine cutoff points appropriate for these individuals, ensuring the correct interpretation of results. This battery is relevant to postoperative follow-up evaluations, favoring the diagnosis of postoperative cognitive dysfunction in patients undergoing different types of surgery and anesthetic techniques. .
Objetivo Investigar a adequação da bateria neuropsicológica proposta pelo International Study of Postoperative Cognitive Dysfunction para a avaliação de disfunção cognitiva pós-operatória em pacientes idosos brasileiros submetidos à cirurgia sob anestesia geral. Métodos Foi realizada uma avaliação neuropsicológica em pacientes submetidos a cirurgias não cardíacas sob anestesia geral, com idade >65 anos, alfabetizados, sem histórico de problemas psiquiátricos ou neurológicos e com pontuação no Miniexame do Estado Mental igual ou superior ao ponto de corte para a população brasileira (>18 ou >23) de acordo com a escolaridade do sujeito. Oitenta pacientes foram avaliados por equipe treinada de neuropsicólogos até 24 horas antes da cirurgia de caráter eletivo. Resultados Dentre os pacientes avaliados, um foi excluído por apresentar pontuação abaixo do ponto de corte no Miniexame do Estado Mental e dois não completaram a bateria de testes, permanecendo 77 pacientes no estudo. A média de idade foi de 69±7,5 anos, com 62,34% dos sujeitos, com ±4 anos de estudo. Os sujeitos apresentaram médias significativamente inferiores ao esperado (p<0,001) para tabelas normativas nos testes neuropsicológicos. Conclusão O estudo demonstrou a aplicabilidade dos instrumentos na população brasileira idosa e de baixa escolaridade, mas sugeriu a necessidade de determinação de pontos de corte adequados a essa população, garantindo a correta interpretação de resultados. Tal bateria é relevante para avaliações de seguimento pós-cirúrgico, favorecendo o diagnóstico de disfunção cognitiva pós-operatória em pacientes submetidos a diferentes tipos de cirurgia e técnicas anestésicas. .
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Anesthesia, General/psychology , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Neuropsychological Tests/standards , Postoperative Complications/psychology , Age Factors , Anesthesia, General/adverse effects , Brazil , Cognition Disorders/etiology , Educational Status , Postoperative Period , Reproducibility of Results , Sex Factors , Statistics, Nonparametric , Time FactorsABSTRACT
Magnesium and its alloys have recently been used in the development of lightweight, biodegradable implant materials. However, the corrosion properties of magnesium limit its clinical application. The purpose of this study was to comprehensively evaluate the degradation behavior and biomechanical properties of magnesium materials treated with micro-arc oxidation (MAO), which is a new promising surface treatment for developing corrosion resistance in magnesium, and to provide a theoretical basis for its further optimization and clinical application. The degradation behavior of MAO-treated magnesium was studied systematically by immersion and electrochemical tests, and its biomechanical performance when exposed to simulated body fluids was evaluated by tensile tests. In addition, the cell toxicity of MAO-treated magnesium samples during the corrosion process was evaluated, and its biocompatibility was investigated under in vivo conditions. The results of this study showed that the oxide coating layers could elevate the corrosion potential of magnesium and reduce its degradation rate. In addition, the MAO-coated sample showed no cytotoxicity and more new bone was formed around it during in vivo degradation. MAO treatment could effectively enhance the corrosion resistance of the magnesium specimen and help to keep its original mechanical properties. The MAO-coated magnesium material had good cytocompatibility and biocompatibility. This technique has an advantage for developing novel implant materials and may potentially be used for future clinical applications.
Subject(s)
Adult , Female , Humans , Middle Aged , Cognition Disorders/psychology , Hospitals , Personnel, Hospital/psychology , Stress, Psychological/psychology , Cognition Disorders/epidemiology , Finland/epidemiology , Surveys and QuestionnairesABSTRACT
Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS) who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI). The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9%) of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients. .
Objetivo Avaliar como a melhora da depressão grave através da psicoterapia afeta a função cognitiva de pacientes com esclerose múltipla (EM) diagnosticados com depressão e disfunção cognitiva. Método Foram aplicados a pacientes com EM o “Brief Repeatable Battery of Neuropsychological Test” e o ınventário de depressão de beck (BDI). Os pacientes com depressão e disfunção cognitiva foram submetidos a psicoterapia de grupo por 3 meses. Depois desse período, foram reaplicados os mesmos testes. Resultados Depressão e disfunção cognitiva foram detectadas conjuntamente em 15 (13,9%) dos pacientes. Embora os pacientes se tivessem recuperado ao fim dos 3 meses de psicoterapia de grupo, somente através do BDI e do “Paced Auditory Test” foi possível detectar uma recuperação significativa. Conclusão Psicoterapia de grupo pode diminuir o comprometimento cognitivo em pacientes com EM. .
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cognition Disorders/therapy , Cognition/physiology , Depressive Disorder/therapy , Multiple Sclerosis/psychology , Psychotherapy, Group/methods , Analysis of Variance , Cognition Disorders/psychology , Depressive Disorder/psychology , Neuropsychological Tests , Sex Factors , Statistics, Nonparametric , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: Patients presenting upper gastrointestinal obstruction, difficulty or inability in swallowing, may need nutritional support which can be obtained through gastrostomy and jejunostomy. AIM: To describe the methods of gastrostomy and jejunostomy video-assisted, and to compare surgical approaches for video-assisted laparoscopy and laparotomy in patients with advanced cancer of the esophagus and stomach, to establish enteral nutritional access. METHODS: Were used the video-assisted laparoscopic techniques for jejunostomy and gastrostomy and the same procedures performed by laparotomies. Comparatively, were analyzed the distribution of patients according to demographics, diagnosis and type of procedure. RESULTS: There were 36 jejunostomies (18 by laparotomy and 17 laparoscopy) and 42 gastrostomies (21 on each side). In jejunostomy, relevant data were operating time of 132 min vs. 106 min (p=0.021); reintroduction of diet: 3.3 days vs 2.1 days (p=0.009); discharge: 5.8 days vs 4.3 days (p= 0.044). In gastrostomy, relevant data were operative time of 122.6 min vs 86.2 min (p= 0.012 and hospital discharge: 5.1 days vs 3.7 days (p=0.016). CONCLUSION: The comparative analysis of laparotomy and video-assisted access to jejunostomies and gastrostomies concluded that video-assisted approach is feasible method, safe, fast, simple and easy, requires shorter operative time compared to laparotomy, enables diet start soon in compared to laparotomy, and also enables lower length of stay compared to laparotomy. .
RACIONAL: Enfermos que apresentam obstrução digestiva alta, com dificuldade ou impossibilidade de deglutição, podem necessitar suporte nutricional provisório ou permanente16, que pode ser obtido através de gastrostomias e jejunostomias. OBJETIVO: descrever os métodos de gastrostomia e jejunostomia videoassistidas, bem como comparar os acessos cirúrgicos por laparotomia e por laparoscopia videoassistida, em pacientes portadores de neoplasias avançadas de esôfago e estômago, para estabelecimento de acesso nutricional enteral. MÉTODOS: Foram utilizadas as técnicas laparoscópics video-assistidas para a jejunostomia e gastrostomia e os mesmo procedimentos realizados por laparotomia. Foram analisados comparativamente a distribuição dos pacientes quanto à demografia, diagnóstico e tipo de procedimento. RESULTADOS: Foram 36 jejunostomias (18 por laparotomia e 17 por laparoscopia) e 42 gastrostomias (21 de cada lado). Na jejunostomia os dados relevantes foram: tempo operatório de 132 min vs 106 min (p=0,021); reintrodução da dieta: 3,3 dias vs 2,1 dias (p=0,009); alta hospitalar: 5,8 dias vs 4,3 dias (p=0,044). Na gastrostomia os dados relevantes foram: tempo operatório de 122,6 min vs 86,2 min (p=0,012 e alta hospitalar: 5,1 dias vs 3,7 dias (p=0,016). CONCLUSÃO: A análise comparativa das vias de acesso laparotômica e videoassistida para jejunostomias e gastrostomias conclui que a via videoassistida é método factível, segura, rápida, simples e fácil, necessita menor tempo operatório em relação à laparotomia, possibilita início de dieta mais rapidamente na jejunostomia em relação à laparotomia, e possibilita menor tempo de internação em relação à laparotomia. .
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cognition Disorders/epidemiology , Cognition Disorders/psychology , Diet , Education , Feeding Behavior , Cohort Studies , United Kingdom/epidemiology , Health Behavior , Neuropsychological Tests , Surveys and Questionnaires , Socioeconomic Factors , VegetablesABSTRACT
Los resultados contradictorios de las investigaciones respecto a la capacidad de las personas con esquizofrenia, para percibir sus déficits cognitivos, podrían explicarse por factores metodológicos, en especial, por diferencias en los instrumentos empleados y las funciones evaluadas. Esta investigación reporta los resultados obtenidos comparando directamente, el desempeño cognitivo, con el reporte subjetivo de dificultades cotidianas derivadas del mismo. Método: Participaron 57 personas con diagnóstico de esquizofrenia, entre 18 y 55 años, clínicamente estables y con un déficit cognitivo demostrado. El funcionamiento cognitivo fue evaluado con la batería CogState, mientras que la percepción de los pacientes fue registrada con la Escala Subjetiva para Investigar la Cognición en la Esquizofrenia (SSTICS). Se correlacionó específicamente, los desempeños en cada función cognitiva con los ítems correspondientes de la escala. Resultados: Los puntajes reportados en la escala SSTICS, indican un grado de dificultad leve a moderado, en todos los funciones evaluadas, sin diferencias por edad o género. El análisis de correlación entre la batería Cogstate y la escala SSTICS, sólo muestra una asociación directa, estadísticamente significativa, entre las preguntas referidas a dificultades en la vida diaria y las evaluaciones de atención y resolución de problemas. Al examinar por funciones cognitivas específicas y puntación total en la SSTICS, no se encuentran asociaciones significativas. Discusión: La falta de correlación entre el desempeño en la batería Cogstate y la autoevaluación en la encuesta SSTICS, podría explicarse por la falta de percepción de los pacientes de sus déficits cognitivos...
The contradictory results of investigations into the ability of persons with schizophrenia, to perceive their cognitive deficits, could be explained by methodological factors, especially, differences in the instruments used and the functions evaluated. This study reports the results obtained by directly comparing, cognitive performance, and subjective report of daily difficulties arising from the same in a group of people with schizophrenia. Methods: 57 participants with a diagnosis of schizophrenia, between 18 and 55 years, clinically stable and with a demonstrated cognitive deficit. Cognitive performance was evaluated with the CogState battery, while the perception of patients was registered with the SSTICS scale. The performance in each cognitive function was specifically, correlated with the corresponding items of the scale. Results: The scores reported in the SSTICS scale, indicate a degree of mild to moderate difficulty, in all the functions assessed, without differences by age or gender. The analysis of correlation between the Cogstate battery and SSTICS scale, only shows a direct, statistically significant association, between the questions referring to difficulties in daily life and evaluations of attention and resolution of problems. Examining specific cognitive functions and the total score in the SSTICS, did not yield any significant associations. Discussion: The lack of correlation between the performance in the Cogstate battery and self-evaluation in the SSTICS scale, could be explained by the lack of perception of patients of their cognitive deficits...
Subject(s)
Humans , Male , Adult , Female , Young Adult , Middle Aged , Neuropsychological Tests , Schizophrenic Psychology , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Cognition Disorders/psychology , Self ConceptABSTRACT
Objetivos Avaliar a mobilidade funcional e sua relação com a capacidade cognitiva em pacientes com diabetes tipo 2 (DM2) entre 50 e 65 anos de idade, e com menos de 10 anos de diagnóstico. Materiais e métodos Estudo observacional, analítico e transversal envolvendo indivíduos não diabéticos e pacientes com DM2 com controle glicêmico inadequado, selecionados por amostra de conveniência. Em ambos os grupos, foram aplicados questionário estruturado, avaliação cognitiva com Miniexame do Estado Mental (MEEM) e teste do relógio (TDR), além da avaliação de mobilidade funcional pelo teste Timed Up & GO (TUG). Resultados No TUG os pacientes com DM2 apresentaram tempo médio de 11,27 segundos versus 9,52 segundos nos controles (p = 0,013). A associação entre declínio cognitivo e dismobilidade foi positiva nos indivíduos com DM2 (p = 0,037). No subgrupo que apresentou dismobilidade e declínio cognitivo associados, 18% eram portadores de DM2 e 1,6% era do grupo sem DM2 (p < 0,01). Conclusões Pacientes com DM2 apresentaram pior mobilidade funcional e desempenho cognitivo, favorecendo a hipótese de que o DM2 influencia a mobilidade funcional e capacidade cognitiva antes do aparecimento de complicações vasculares ou neuropáticas. Esses dados sugerem que a hiperglicemia é um fator agravante no desempenho de atividades que exijam funções mentais como atenção, orientação e memória de trabalho. Arq Bras Endocrinol Metab. 2014;58(9):946-52 .
Objectives The aim of the present study was to evaluate the functional mobility and its relationship to cognitive ability in patients with type 2 diabetes (T2DM), age between 50 and 65 years and under 10 years of diagnosis. Materials and methods An observational, analytical and cross-sectional study, involving no diabetic and type 2 diabetic individuals with inadequate glycemic control, selected by convenience sampling. In both groups, were administered structured questionnaire and cognitive assessment with Mini-Mental State Examination (MMSE) and the clock drawing test (CDT), besides assessment of functional mobility by the Timed Up & Go (TUG). Results In TUG, DM2 patients presented a mean time of 11.27 seconds versus 9.52 seconds (p = 0.013). The association between cognitive decline and decrease of mobility was positive in individuals with T2DM (p = 0.037). In the subgroup that showed decrease of mobility and associated cognitive decline, 18% were patients with DM2 and 1.6% were individuals without T2DM (p < 0.01). Conclusions Patients with T2DM presented worse functional mobility and cognitive performance, supporting the hypothesis that DM2 influence functional mobility and cognitive ability, regardless of neuropathic or vascular complications. These data suggest that hyperglycemia is an aggravating factor in the performance of activities requiring mental functions such as attention, working memory and orientation. Arq Bras Endocrinol Metab. 2014;58(9):946-52 .