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1.
Braz. j. otorhinolaryngol. (Impr.) ; 87(1): 94-102, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153582

ABSTRACT

Abstract Introduction The prediction of the impact of olfactory impairment on cognitive decline in older adults has been different among different age groups. Objective This meta-analysis sought to estimate the predictive power of olfactory impairment on cognitive decline during follow-up in older adults of different ages. Material and methods A medical literature search was carried out using these databases for eligible studies: MEDLINE, COCHRANE and EMBASE. Studies recording olfaction and cognition detection at the beginning and end of the follow-up were included in the preliminary screening. The medical records of older adults without cognitive impairment at the beginning of the follow-up were taken into account in this analysis. Raw data was extracted in order to estimate the relative risk and the corresponding 95% confidence interval (95% CI). Subgroup analysis of age was performed to eliminate the effect of age on the results. Statistical heterogeneity was measured using the I 2 index and Cochran's Q test. Results Eight studies were enrolled in this analysis (3237 events and 13165 participants), and the pooled relative risk for the 70-80 years old subgroup was 2.00 (95% CI = 1.79-2.23). Conclusion Relatively, there is a higher risk of cognitive impairment at the end of follow-up in younger adults with olfactory impairment at the beginning of follow-up. The length of follow-up has a little effect on the relative risk.


Resumo Introdução A previsão do impacto do comprometimento olfativo no declínio cognitivo em idosos tem sido distinta entre diferentes faixas etárias. Objetivo Esta metanálise buscou estimar o poder preditivo do comprometimento olfativo no declínio cognitivo durante o seguimento em idosos de diferentes idades. Material e métodos Foi feita uma pesquisa na literatura médica nos seguintes bancos de dados para estudos elegíveis: Medline, Cochrane e Embase. Os estudos que registraram olfação e detecção de cognição no início e no fim do seguimento foram incluídos na triagem preliminar. Os prontuários médicos de idosos sem comprometimento cognitivo no início do seguimento foram considerados nessa análise. Os dados brutos foram extraídos para estimar o risco relativo e o intervalo de confiança de 95% (IC95%) correspondente. A análise de subgrupos da idade foi feita para eliminar o efeito da idade nos resultados. A heterogeneidade estatística foi medida utilizando o índice I2 e o teste Q de Cochran. Resultados Oito estudos foram incluídos nesta análise (3.237 eventos e 13.165 participantes) e o risco relativo combinado para o subgrupo de 70 a 80 anos foi de 2,00 (IC95% = 1,79-2,23). Conclusão Relativamente, existe um risco maior de comprometimento cognitivo no fim do seguimento em adultos mais jovens que se se apresentam com comprometimento olfativo no início do seguimento. A duração do seguimento tem um pequeno efeito no risco relativo.


Subject(s)
Humans , Aged , Aged, 80 and over , Dementia/complications , Dementia/epidemiology , Cognitive Dysfunction/etiology , Cognitive Dysfunction/epidemiology , Olfaction Disorders/etiology , Olfaction Disorders/epidemiology , Smell , Cognition
2.
Article in English | WPRIM | ID: wpr-887723

ABSTRACT

Objective@#Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment.@*Methods@#This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.@*Results@#Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjusted @*Conclusion@#A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.


Subject(s)
Aged , Aged, 80 and over , Alcohol Abstinence , Alcohol Drinking , China , Cognition , Cognitive Dysfunction/epidemiology , Female , Health Behavior , Humans , Longitudinal Studies , Male , Mental Status and Dementia Tests , Risk
3.
Arch. cardiol. Méx ; 90(3): 284-292, Jul.-Sep. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1131045

ABSTRACT

Resumen Introducción: El deterioro cognitivo leve es una alteración de la función cognitiva que no afecta de manera negativa a las actividades diarias de la persona. Factores de riesgo modificables como la hipertensión arterial podrían intervenir en el aceleramiento de este proceso y afectar a personas menores de 65 años. Una detección temprana del deterioro cognitivo leve por medio del Montreal Cognitive Assesment (MoCA) en personas con hipertensión arterial ayudaría a idear medidas para su control eficaz. Materiales y métodos: Se diseñó un estudio de tipo observacional transversal. La población se integra con pacientes hipertensos de 45 a 65 años de Guayaquil. De una base de datos de 570 pacientes, se realizó un llamado a sujetos que cumplieran los criterios de inclusión y exclusión, para la evaluación de la función cognitiva por medio del MoCA. Resultados: El 93.3% de los participantes sometidos a la prueba MoCA presentó un puntaje menor de 26. El promedio del puntaje total fue de 18.9 y el 51.6% de los participantes reveló deterioro cognitivo leve. Se obtuvo una correlación negativa del 40% (-0.40) con una p = 0.0015 entre años con hipertensión arterial y el resultado total de la prueba MoCA. Conclusiones: Por medio del MoCA se pudo cuantificar la magnitud del deterioro cognitivo en estos pacientes. Se identificó que la mayoría de los participantes examinados presentaba un puntaje promedio menor del intervalo normal. Las cifras obtenidas de los valores de correlación de Pearson muestran una actividad tendencial y relación de la hipertensión arterial con el deterioro de la función cognitiva.


Abstract Introduction: Mild cognitive impairment is an alteration of cognitive function that does not negatively affect the daily activities of the person. Modifiable risk factors such as hypertension could be involved in the acceleration of this process affecting people under 65 years of age. Early detection of mild cognitive impairment through the Montreal Cognitive Assessment (MoCA) in people with high blood pressure, would help to formulate strategies for its effective control. Materials and methods: A cross-sectional observational study was designed. The population is hypertensive patients between 45 and 65 years old in Guayaquil. From a database of 570 patients, a call was made to patients who met the inclusion and exclusion criteria, for the evaluation of cognitive function through MoCA. Results: 93.3% of the participants who underwent the MoCA test had a score lower than 26. The average of the total score was 18.9, with 51.6% of the participants suffering from mild cognitive impairment. A negative correlation of 40% (-0.40) was obtained with a p = 0.0015 between years with arterial hypertension and the total result of the MoCA test. Conclusions: Through MoCA, the magnitude of cognitive deterioration in these patients could be quantified. It was detected that the majority of the examined participants had a lower average score of the normal range. The figures obtained from the Pearson correlation values show trend activity, relating arterial hypertension and deterioration of cognitive function.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cognition/physiology , Cognitive Dysfunction/diagnosis , Hypertension/complications , Cross-Sectional Studies , Risk Factors , Ecuador , Cognitive Dysfunction/etiology , Cognitive Dysfunction/epidemiology
4.
Rev. bras. ter. intensiva ; 32(3): 426-432, jul.-set. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1138514

ABSTRACT

RESUMO Objetivo: Avaliar a associação entre a incidência de delirium na unidade de terapia intensiva e qualidade de vida 1 mês após a alta hospitalar Métodos: Trata-se de estudo de coorte prospectivo desenvolvido em unidades de terapia intensiva de dois hospitais de média complexidade durante o período de dezembro de 2015 a dezembro de 2016. Delirium foi identificado por meio da escala Confusion Assessment Method for the Intensive Care Unit. No momento da alta hospitalar, foram avaliadas capacidade funcional e cognição por meio do índice de Barthel e da escala de Mini Exame do Estado Mental, respectivamente. Após 30 dias da alta hospitalar do paciente, por meio de contato telefônico, aplicou-se o questionário World Health Organization Quality of Life-Bref. Resultados: Foram incluídos 216 pacientes. Delirium foi identificado em 127 (58,8%) deles. Os pacientes com delirium apresentaram maior dependência funcional (mediana do índice de Barthel 50,0 [21,2 - 70,0] versus 80,0 [60,0 - 95,0]; p < 0,001) e menor cognição (escore do Mini Exame do Estado Mental 12,9 ± 7,5 versus 20,7 ± 9,8; p < 0,001) na alta hospitalar. Com relação à qualidade de vida, avaliada 1 mês após alta hospitalar, não houve diferença, em nenhum dos domínios, entre os pacientes com e sem delirium. Conclusão: Nossos achados sugerem que os pacientes com delirium na unidade de terapia intensiva não apresentam piora da qualidade de vida 1 mês após a alta hospitalar, apesar de apresentarem maior prejuízo cognitivo e incapacidade funcional no momento da alta hospitalar.


Abstract Objective: To evaluate the association between the incidence of delirium in the intensive care unit and quality of life 1 month after hospital discharge. Methods: This was a prospective cohort study conducted in the intensive care units of two medium-complexity hospitals from December 2015 to December 2016. Delirium was identified using the Confusion Assessment Method for the Intensive Care Unit scale. At the time of hospital discharge, functional capacity and cognition were assessed with the Barthel index and the Mini Mental State Examination, respectively. Thirty days after patient discharge, the World Health Organization Quality of Life-BREF questionnaire was administered by telephone. Results: A total of 216 patients were included. Delirium was identified in 127 (58.8%) of them. Patients with delirium exhibited greater functional dependence (median Barthel index 50.0 [21.2 - 70.0] versus 80.0 [60.0 - 95.0]; p < 0.001) and lower cognition (Mini Mental State Examination score 12.9 ± 7.5 versus 20.7 ± 9.8; p < 0.001) at hospital discharge. There was no difference in any of the quality-of-life domains evaluated 1 month after hospital discharge between patients with and without delirium. Conclusion: Our findings suggest that patients with delirium in the intensive care unit do not have worse quality of life 1 month after hospital discharge, despite presenting greater cognitive impairment and functional disability at the time of hospital discharge.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Quality of Life , Critical Illness/psychology , Delirium/epidemiology , Cognitive Dysfunction/epidemiology , Patient Discharge , Time Factors , Prospective Studies , Surveys and Questionnaires , Cohort Studies , Follow-Up Studies , Intensive Care Units
5.
Rev. méd. Chile ; 148(7): 947-955, jul. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1139396

ABSTRACT

Background: Depression has been previously associated with cognitive impairment in high income country populations. However, its association in the Chilean population has not been investigated. Aim: To investigate the association between depression and cognitive impairment. Material and Methods: Data from 1384 Chilean adults aged > 60 years, participating in the National Health Survey 2009-2010 was analyzed. Cognitive impairment was assessed using the Mini Mental Examination score. The medical diagnosis of depression was self-reported. The association between depression and cognitive impairment was assessed using a logistic regression. Results: Depression was positively associated with cognitive impairment. However, the magnitude of the association was higher in men (Odds ratio (OR) = 4.02 [95% confidence intervals (CI): 1.44; 6.61], p < 0.01]) than in women (OR = 2.23 [95%CI: 1.03; 3.43], p = 0.04). Older adults who were diagnosed for the first time with depression after 65 years of age, showed a stronger association with cognitive impairment (OR = 6.65 [95% CI: 2.39; 10.9], p < 0.01) than those diagnosed before 55 years. Conclusions: Our study confirms the association between depression and cognitive impairment. Further research is needed to elucidate the nature and potential mechanisms that link depression with cognitive impairment.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Depression/epidemiology , Cognitive Dysfunction/epidemiology , Chile/epidemiology , Health Surveys
6.
Arq. neuropsiquiatr ; 78(3): 133-138, Mar. 2020. tab
Article in English | LILACS | ID: biblio-1098078

ABSTRACT

Abstract Cognitive impairment has been described in all phases of a migraine attack and interictally. However, the prevalence and phenotype of such impairment in chronic migraine (CM) have not yet been studied. Objectives: The aim of this study was to evaluate both the prevalence of the objective cognitive deficit in patients with CM and the factors underlying its etiology. Methods: 144 patients with CM and 44 age-matched patients with low-frequency episodic migraine (EM) (a maximum of 4 headache days per month) participated in this study. Neuropsychiatric characteristics were measured with the HADS Hospital Anxiety and Depression Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20). Results: Compared to EM, CM subjects demonstrated higher subjective and objective cognitive impairment across all tests. CM patients had 4 times higher odds of achieving a RAVLT score in the lower quartile range compared to EM (Odds Ratio [OR] 3.8; 95% confidence interval [95%CI] 1.5‒9.6; р=0.005). In the MoCA, CM patients demonstrated the most striking impairment in memory/delayed recall (65.3%), attention (46.5%), abstraction (30.6%), and language (27.1%). Chronic headache and level of education, but not gender, depression or anxiety, were independent predictors of cognitive impairment. Conclusions: Cognitive impairment is prevalent in the CM population during their mildest possible pain and may be caused by a central sensitization. Timely preventive treatment of EM is warranted.


Resumo O comprometimento cognitivo foi descrito em todas as fases de um ataque de enxaqueca, de maneira intermitente. Entretanto, a prevalência e o fenótipo desse comprometimento na enxaqueca crônica (EC) não foram estudados. Objetivos: O objetivo deste estudo foi avaliar a prevalência do déficit cognitivo objetivo em pacientes com EC e fatores subjacentes à sua etiologia. Métodos: 144 pacientes com CM e 44 pacientes pareados por idade com enxaqueca episódica (EE) de baixa frequência (máximo de 4 dias de dor de cabeça por mês) foram incluídos. As características neuropsiquiátricas foram medidas pela Hospital Anxiety and Depression Scale (HADS). A função cognitiva foi avaliada por meio da Montreal Cognitive Assessment (MoCA), o Digit Symbol Substitution Test (DSST), o Rey Auditory Verbal Learning Test (RAVLT) e o Perceived Deficits Questionnaire (PDQ-20). Resultados: Em comparação com a EE, os indivíduos com EC demonstraram um comprometimento cognitivo subjetivo e objetivo maior em todos os testes. Os pacientes com CM tiveram 4 vezes mais chances de alcançar um escore RAVLT na faixa quartil inferior, em comparação com EE (Odds Ratio [OR] 3,8; intervalo de confiança de 95% [IC95%] 1,5‒9,6; p=0,005). No MoCA, os pacientes com EC demonstraram o maior prejuízo na memória/atraso na recordação (65,3%), atenção (46,5%), abstração (30,6%) e linguagem (27,1%). Dor de cabeça crônica e nível de escolaridade, mas não o sexo, depressão ou ansiedade, foram preditores independentes de comprometimento cognitivo. Conclusões: O comprometimento cognitivo é prevalente na população com enxaqueca crônica mesmo durante uma dor muito leve e pode ser causado pela sensibilização central. O tratamento preventivo oportuno da enxaqueca episódica se faz necessário.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cognitive Dysfunction/etiology , Headache/epidemiology , Migraine Disorders/epidemiology , Anxiety/epidemiology , Severity of Illness Index , Prevalence , Cross-Sectional Studies , Depression/physiopathology , Depression/epidemiology , Cognitive Dysfunction/psychology , Cognitive Dysfunction/epidemiology , Migraine Disorders/classification , Migraine Disorders/psychology
7.
Rev. cuba. med ; 59(1): e1314, ene.-mar. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139037

ABSTRACT

Introducción: Las quejas sobre la función cognitiva han aumentado en la población más envejecida del municipio Habana del Este, provincia La Habana, donde se desconoce la frecuencia y causas de este incremento. Objetivo: Determinar la prevalencia y los factores de riesgo de deterioro cognitivo leve en personas mayores de 85 años o más. Métodos: Se realizó un estudio descriptivo y transversal en personas mayores de un área de salud durante el período 2019-2020. El universo estuvo conformado por 51 personas de 85 años o más. Se tomó una muestra de 47, los cuales cumplieron con los criterios de inclusión y exclusión. Se les aplicó un modelo de recogida de información anónimo, pruebas neuropsicológicas y exámenes complementarios con el propósito de elevar la precisión del diagnóstico. Los datos fueron validados estadísticamente mediante el chi cuadrado, la prueba exacta de Fisher, la regresión de Poisson y estadígrafo de Woolf. Resultados: La prevalencia de deterioro cognitivo leve en personas mayores de 80 años o más fue de 74,5 por ciento, encontrándose significativamente influenciada por el género femenino (OR 6,67; IC 95 por ciento1,09-52,01). Un mayor nivel educacional fue asociado con menor riesgo de deterioro cognitivo leve (OR 10,13; IC 95 por ciento 1,83-63,53). Conclusiones: En la población estudiada, el deterioro cognitivo leve constituye un problema de salud. El mayor nivel educacional mostró su efecto protector, se identificó asociación entre el género femenino y el declinar cognitivo(AU)


Introduction: Complaints about cognitive function have increased in the eldest population from Habana del Este municipality, Havana province, where the frequency and causes of such increase are unknown. Objective: To determine the prevalence and risk factors of mild cognitive impairment in elderly older than 85 years. Methods: A descriptive and cross-sectional study was conducted in the elderly from a health area from 2019 to 2020. Fifty one persons aged over 85 made up the universe. Forty seven subjects who met the inclusion and exclusion criteria made the sample. An anonymous information collection model, neuropsychological tests and complementary examinations were applied to them in order to rise the diagnosis precision. Data were statistically validated using chi square, Fisher's exact test, Poisson regression and Woolf statistician. Results: The prevalence of mild cognitive impairment in persons older than 80 years was 74.5 percent. Women accounted the higher number (OR 6.67, 95 percent CI 1.09-52.01). Higher educational level was associated with lower risk of mild cognitive impairment (OR 10.13, 95 percent CI 1.83-63.53). Conclusions: In the studied population, mild cognitive impairment constitutes a health problem. The higher educational level showed protective effect, an association between female gender and cognitive decline was identified(AU)


Subject(s)
Humans , Male , Female , Aged, 80 and over , Risk Factors , Cognitive Dysfunction/etiology , Cognitive Dysfunction/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies
8.
Arq. neuropsiquiatr ; 78(1): 2-8, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088988

ABSTRACT

Abstract The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. Objective: To analyze the association between cognitive impairment and the criteria for frailty. Methods: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled 'Variables associated to cognition in elderly caregivers' involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. Results: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. Conclusion: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.


Resumo A associação entre comprometimento cognitivo e fragilidade tem sida estudada em idosos e os critérios de fragilidade e níveis de fragilidade podem também apresentar influência na função cognitiva. Objetivo: Analisar a associação entre comprometimento cognitivo e os critérios de fragilidade em idosos. Métodos: O estudo analisou transversalmente dados de 667 idosos (≥60 anos) do estudo 'Variables associated to cognition in elderly caregivers' conduzido com usuários da atenção primária a saúde de áreas urbanas e rurais. Comprometimento cognitivo foi definido em função dos escores no Miniexame do Estado Mental baseado na escolaridade e a fragilidade e pré-fragilidade foi operacionalizada segundo os critérios do Cardiovascular Health Study. Foram realizados modelos de regressão multinominal para analisar a associação entre níveis de fragilidade e comprometimento cognitivo. Resultados: Proporções semelhantes de mulheres (54,8%) e homens (45,2%) participaram do estudo (média de idade: 71 anos). Comprometimento cognitivo, pré-fragilidade e fragilidade foram encontrados em 34, 54 e 24% dos participantes, respectivamente. Concomitante comprometimento cognitivo e fragilidade foi evidenciado em 13%. As chances de apresentar comprometimento cognitivo aumentaram em 330% (Odds Ratio [OR]: 4.3; intervalo de confiança de 95% [IC95%] 2.4‒7.7; p<0.001) entre indivíduos frágeis e 70% (OR: 1.7; IC95% 1.0‒2.8; p=0.033) entre indivíduos pré-frágeis em comparação com indivíduos robustos/não-frágeis. Após controle da idade, escolaridade, local de residência e dependência funcional, os critérios de lentidão e fadiga foram significativamente associados ao comprometimento cognitivo. Conclusão: Os idosos mais frágeis têm maior probabilidade de apresentar comprometimento cognitivo comparados a adultos idosos pré-frágeis ou robustos. A prevalência de comprometimento cognitivo e fragilidade é consistente com os dados relatados na literatura e fornece suporte para futuras investigações sobre a fragilidade cognitiva.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Frail Elderly/psychology , Cognitive Dysfunction/etiology , Frailty/complications , Frailty/psychology , Severity of Illness Index , Brazil/epidemiology , Activities of Daily Living/psychology , Geriatric Assessment , Prevalence , Cross-Sectional Studies , Risk Factors , Analysis of Variance , Age Factors , Sex Distribution , Age Distribution , Independent Living , Cognitive Dysfunction/epidemiology , Frailty/epidemiology , Mental Status and Dementia Tests
9.
Einstein (Säo Paulo) ; 18: eAO4752, 2020. tab
Article in English | LILACS | ID: biblio-1039735

ABSTRACT

ABSTRACT Objective To evaluate the epidemiological profile of patients seen at a dementia outpatient clinic. Methods A retrospective study conducted by medical record review searching data on sex, race, age, schooling level, and diagnosis of patients seen from 2008 to 2015. Results A total of 760 patients were studied, with a predominance of female (61.3%; p<0.0001). The mean age was 71.2±14.43 years for women and 66.1±16.61 years for men. The most affected age group was 71 to 80 years, accounting for 29.4% of cases. In relation to race, 96.3% of patients were white. Dementia was diagnosed in 68.8% of patients, and Alzheimer's disease confirmed in 48.9%, vascular dementia in 11.3%, and mixed dementia in 7.8% of cases. The prevalence of dementia was 3% at 70 years and 25% at 85 years. Dementia appeared significantly earlier in males (mean age 68.5±15.63 years). As to sex distribution, it was more frequent in women (59.6%) than in men (40.4%; p<0.0001; OR=2.15). People with higher schooling level (more than 9 years) had a significantly younger age at onset of dementia as compared to those with lower schooling level (1 to 4 years; p=0.0007). Conclusion Most patients seen in the period presented dementia, and Alzheimer was the most prevalent disease. Women were more affected, and men presented young onset of the disease. Individuals with higher schooling level were diagnosed earlier than those with lower level.


RESUMO Objetivo Avaliar o perfil epidemiológico dos pacientes atendidos em um ambulatório de demência. Métodos Estudo retrospectivo realizado pela revisão de prontuários com busca de dados sobre sexo, raça, idade, escolaridade e diagnóstico de pacientes atendidos de 2008 a 2015. Resultados Foram estudados 760 pacientes, com predomínio do sexo feminino (61,3%; p<0,0001). A média de idade foi 71,2±14,43 anos, para as mulheres, e de 66,1±16,61 anos, para os homens. A faixa etária mais acometida foi de 71 a 80 anos, representando 29,4% dos casos. Em relação à etnia, 96,3% dos pacientes eram brancos. O quadro de demência foi diagnosticado em 68,8% dos pacientes, tendo sido a doença de Alzheimer confirmada em 48,9% dos casos, demência vascular em 11,3% e mista em 7,8%. A prevalência de demência foi de 3% aos 70 anos e de 25% aos 85 anos. O quadro demencial apareceu significativamente mais cedo no sexo masculino (média de idade 68,5±15,63 anos). A distribuição entre os sexos mostrou demência mais frequente em mulheres (59,6%) do que em homens (40,4%; p<0,0001; RC=2,15). Pessoas com maior escolaridade (acima de 9 anos) apresentaram idade de aparecimento da demência significativamente menor que aquelas de menor escolaridade (1 a 4 anos; p=0,0007). Conclusão Os pacientes atendidos no período apresentaram demência na maioria dos casos, sendo Alzheimer a doença mais prevalente. Mulheres foram mais acometidas, entretanto homens apresentaram a doença mais precocemente. Indivíduos com maior escolaridade foram diagnosticados mais cedo que aqueles com menor escolaridade.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Outpatients/statistics & numerical data , Dementia/epidemiology , Cognitive Dysfunction/epidemiology , Brazil/epidemiology , Medical Records , Prevalence , Retrospective Studies , Hospitals, Private/statistics & numerical data , Sex Distribution , Age Distribution , Dementia/diagnosis , Educational Status , Alzheimer Disease/diagnosis , Alzheimer Disease/epidemiology , Cognitive Dysfunction/diagnosis , Middle Aged
10.
Rev. cuba. enferm ; 36(2): e3244, abr.-jul.2020. tab
Article in English | LILACS, BDENF, CUMED | ID: biblio-1280253

ABSTRACT

Introduction: The decreasing of cognitive function can cause the elderly depends on their daily activities and affect the quality of life among elderly. Objective: This study want to examine the cognitive function status and quality of life among elderly at Nursing Home of Jember, Indonesia. Methods: The study was conducted a cross-sectional design during October December 2018. Among 82 of elderly involved using convenience sampling. Short Portable Mental Status Questionnaire and World Health Organization Quality of Life-BREF were performed to measure congnitive function and quality of life, respectively. Data were analyzed using Chi square test. Results: Among 82 of elderly identified intact intellectual functioning status (43,90 percent) and severe cognitive impairment (2,40 percent). Meanwhile, 70,70 percent and 8,50 percent elderly were moderate and low of quality of life, respectively. Furthermore, cognitive function significantly related to quality of life (X2= 8,685; p-value= 0,003). The elderly who have intact cognitive function was prevent for decreasing quality of life (OR= 0,210; 95 percent CI= 0.071-0.621). Conclusions: Cognitive function is related to quality of life among elderly. Therefore, health promotion program, including physical activity could develop in nursing home to improve the cognitive function and quality of life among elderly(AU)


Introducción: La disminución de la función cognitiva puede causar que los ancianos dependan de sus actividades diarias y afecten su calidad de vida. Objetivo: Examinar el estado de la función cognitiva y la calidad de vida entre los ancianos del Hogar de Ancianos de Jember, Indonesia. Métodos: Estudio de diseño transversal durante octubre y diciembre de 2018. En 82 personas de la tercera edad involucradas, se usó una muestra de conveniencia. Se realizó un breve cuestionario portátil sobre el estado mental y calidad de vida-BREF de la Organización Mundial de la Salud para medir la función cognitiva y la calidad de vida. Los datos se analizaron mediante la prueba de Chi cuadrado. Resultados: De los 82 ancianos se identificó el estado de funcionamiento intelectual intacto en 43,90 por ciento y deterioro cognitivo severo en 2,4 por ciento. Mientras, el 70,7 por ciento y el 8,5 por ciento de los ancianos tenían moderada y baja calidad de vida, respectivamente. Además, la función cognitiva se relacionó significativamente con la calidad de vida (X2 = 8,685; valor p = 0,003). Las personas de edad avanzada que tenían una función cognitiva intacta evitaron la disminución de la calidad de vida (OR = 0,210; IC del 95 por ciento = 0,071-0,621). Conclusiones: La función cognitiva está relacionada con la calidad de vida entre los ancianos. Por lo tanto, el programa de promoción de la salud, incluida la actividad física, podría desarrollarse en un hogar de ancianos para mejorar la función cognitiva y la calidad de vida entre los ancianos(AU)


Subject(s)
Humans , Aged , Quality of Life , Activities of Daily Living , Cognitive Dysfunction/epidemiology , Homes for the Aged , Cross-Sectional Studies , Surveys and Questionnaires , Health Promotion
11.
Rev. eletrônica enferm ; 22: 1-8, 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1141560

ABSTRACT

Objetivou investigar associações entre o declínio cognitivo de idosos longevos em contexto ambulatorial e variáveis sociodemográficas, desempenho funcional, doenças crônicas, número de hospitalizações e acesso aos serviços de saúde. Foram entrevistados idosos longevos (80 anos e mais) residentes no Distrito Federal, avaliados em contexto ambulatorial por questionários padronizados e pelo Miniexame do Estado Mental (MEEM). Nas análises bivariadas, o declínio cognitivo esteve associado à faixa etária (85 anos e mais), possuir uma ou mais limitações nas atividades básicas de vida diária (ABVD), residir em arranjos domiciliares bi e trigeracionais e ter maior número de hospitalizações no último ano. No modelo logístico múltiplo, permaneceram associados ao declínio cognitivo em longevos as ABVD e as hospitalizações no último ano. Por tratar-se de uma população com maior demanda assistencial de saúde, torna-se necessário delinear medidas de prevenção e a promoção de cuidados de longa duração.


The aim was to investigate associations between the cognitive decline of very old adults in outpatient settings and sociodemographic variables, functional performance, chronic diseases, number of hospitalizations and access to health services. Very old adults (80 years and over) residing in the Federal District were interviewed, evaluated in an outpatient setting by means of standardized questionnaires and the Mini-Mental State Examination (MMSE). In bivariate analyzes, cognitive decline was associated with the age group (85 years and over), having one or more limitations in basic activities of daily living (BADL), living in bi and tri-generational household arrangements and having a higher number of hospitalizations in the prior year. In the multiple logistic model, BADL and hospitalizations in the prior year remained associated with cognitive decline in very old adults. As it is a population with a greater demand for health care, it is necessary to outline measures of preventive and promotion of long-term care.


Subject(s)
Humans , Male , Female , Aged, 80 and over , Cognitive Dysfunction/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Activities of Daily Living , Logistic Models , Cross-Sectional Studies , Comprehensive Health Care , Ambulatory Care , Mental Status and Dementia Tests , Health Services Accessibility , Hospitalization
12.
Arch. Clin. Psychiatry (Impr.) ; 46(6): 151-155, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1054917

ABSTRACT

Abstract Background Cognitive impairment and frailty are important problems affecting the elderly population. Frail elderly present worse overall cognitive performance. Objective The aim of this study was to investigate general and domain-specific cognitive performance among non-frail, pre-frail, and frail elderly persons. Methods This is a cross-sectional study in which 267 elderly persons living in São Carlos, SP were divided into three groups according to the frailty criteria defined by Fried et al. Cognitive performance was evaluated with a battery of cognitive tests covering domains such as memory, attention, language, and executive functioning. A multinomial logistic regression analysis adjusted for age, gender, and education was performed to evaluate the association between performance in cognitive domains and levels of frailty. Results Frailty was significantly associated with lower scores on the global cognitive test (RRR = 0.86; IC 95% 0.78-0.96; p < 0.01), word list memory (RRR = 0.92; IC 95% 0.86-0.99; p = 0.02), and figure list recognition (RRR = 0.78; IC 95% 0.62-0.99; p = 0.04). Pre-frailty was associated with lower scores on the word list memory (RRR = 0.92; IC 95% 0.86-1.00; p = 0.04) and naming test (RRR = 0.82; IC 95% 0.69-0.99; p = 0.03). Discussion Frailty syndrome can influence general cognition and specific domains such as memory and language. Prospective studies will be fundamental to evaluate the causal relation between frailty and cognition.


Subject(s)
Humans , Male , Female , Aged , Cognitive Dysfunction/epidemiology , Frailty/epidemiology , Logistic Models , Prevalence , Cross-Sectional Studies , Frail Elderly , Cognition , Self Report , Cognitive Dysfunction/complications , Frailty/complications , Neuropsychological Tests
13.
Ciênc. Saúde Colet ; 24(11): 4355-4366, nov. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1039513

ABSTRACT

Resumo Com o objetivo de efetuar o rastreio do perfil cognitivo dos residentes em Estruturas Para Idosos no Concelho de Miranda do Corvo, avaliaram-se 174 participantes recorrendo ao Mini-Mental State Examination (MMSE) (n=96) e ao diagnóstico de demência reportado nos prontuários dos pacientes (n=78). Verificou-se, através do MMSE, que 41,7% dos inquiridos apresentavam pontuações sugestivas de déficit cognitivo. Adicionando a este resultado o diagnóstico de demência reportado nos prontuários dos pacientes, a percentagem subiu para 67,8% (n=118). A comparação dos nossos resultados com os obtidos a nível nacional revelou que essa percentagem foi significativamente superior (p<0,001). A escolaridade foi um fator preditivo da pontuação do MMSE (p=0,001). Conclui-se que a elevada prevalência de suspeita de déficit cognitivo e de demência revelada no nosso estudo deve remeter para a reflexão sobre a adequação dos cuidados prestados e sobre a ausência/escassez de programas de estimulação cognitiva nas estruturas residenciais para idosos. Nesse sentido, torna-se imperativo implementar avaliação cognitiva regular e instituir programas de intervenção que promovam a conservação e melhoria do funcionamento cognitivo em pessoas idosas institucionalizadas de zonas desfavorecidas.


Abstract This study aimed to screen the cognitive profile elderly people living in long-term care institutions in the municipality of Miranda do Corvo by evaluating 174 participants with the Mini Mental State Examination (MMSE) (n=96) and the clinical dementia diagnosis (n=78). According to the MMSE, 41.7% of respondents had scores suggestive of cognitive impairment. The percentage rose to 67.8% (n=118) by adding the diagnosis of dementia reported in individual medical records to this result. The comparison of our results with those obtained nationwide showed that this proportion was significantly higher (p<0.001). The educational level was a predictive factor for MMSE scores (p=0.001). We can conclude that the high prevalence of suspected cognitive impairment and dementia revealed in our study should lead us to reflect on the quality of care provided and on the lack/scarcity of cognitive stimulation programs in long-term care institutions for seniors. Thus, it is imperative to implement regular cognitive assessment and to apply intervention programs for the preservation and improvement of the cognitive functioning of institutionalized elderly of deprived areas.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Mass Screening , Cognition/physiology , Dementia/diagnosis , Cognitive Dysfunction/diagnosis , Portugal , Prevalence , Cross-Sectional Studies , Long-Term Care , Dementia/epidemiology , Cognitive Dysfunction/epidemiology , Mental Status and Dementia Tests , Homes for the Aged
14.
J. bras. nefrol ; 41(3): 375-383, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040259

ABSTRACT

Abstract Introduction: In the last decades, there was an expressive increase in the number of elderly patients with chronic kidney disease starting hemodialysis. Thus, our goal was to evaluate the profile of the elderly in chronic hemodialysis and to compare the cognition and quality of life of the younger elderly with those of the very elderly. Methods: Patients on hemodialysis for at least 3 months, who were 65 years of age or older when they started dialysis were invited to participate, and stratified according to age (under or over 80 years). The participants answered a clinical-epidemiological questionnaire and underwent cognitive tests (Mini Mental State Exam [MMSE], clock drawing test [CDT] and verbal fluency test [VFT]) and a quality of life assessment 36- Item Short Form Health Survey). Results: Of the 125 eligible patients, 124 agreed to participate. The mean age was 76 ± 6 years (28% ≥ 80 years), 56% were men and 55% had ≥ 8 years of schooling. Depression was suggested in 38%. The prevalence of cognitive deficit was 38%, 70% and 30%, by MEEM, CDT and VFT, respectively. The prevalence of any deficit was higher among the very elderly (94% vs. 72%, p = 0.007). Quality of life scores were similar between the two age groups, except for the functional capacity domain, worse in the group with ≥ 80 years (p = 0.033). Conclusion: Elderly patients on chronic hemodialysis have a high prevalence of cognitive deficits, especially the very elderly, but this group does not have a worse quality of life, except for functional capacity.


Resumo Introdução: Nas últimas décadas, houve um aumento expressivo no número de pacientes idosos com doença renal crônica iniciando hemodiálise. Assim, nosso objetivo foi avaliar o perfil de idosos em hemodiálise crônica e comparar a cognição e a qualidade de vida dos idosos com as de muito idosos. Métodos: Pacientes em hemodiálise havia pelo menos 3 meses, que tinham 65 anos ou mais quando começaram o tratamento dialítico foram convidados a participar, e estratificados de acordo com a idade (menores ou maiores de 80 anos). Os participantes responderam a um questionário clinico-epidemiológico e foram submetidos a testes cognitivos (miniexame do estado mental [MEEM], teste do relógio [TDR] e teste de fluência verbal [TFV]) e a uma avaliação de qualidade de vida 36-Item Short Form Health Survey). Resultados: Dos 125 pacientes elegíveis, 124 concordaram em participar. A idade média foi de 76 ± 6 anos (28% ≥ 80 anos), 56% eram homens e 55% tinham ≥ 8 anos de escolaridade. Depressão foi sugerida em 38%. A prevalência de déficit cognitivo foi 38%, 70% e 30%, pelo MEEM, TDR e TFV, respectivamente. A prevalência de qualquer déficit foi maior entre os muito idosos (94% vs. 72%, p = 0,007). Os escores de qualidade de vida foram semelhantes entre os dois grupos etários, exceto pelo domínio da capacidade funcional, pior no grupo com ≥ 80 anos (p = 0.033). Conclusão: Os pacientes idosos em hemodiálise crônica apresentam elevada prevalência de déficit cognitivo, especialmente os muito idosos, mas esse grupo não possui pior qualidade de vida, exceto pelo aspecto da capacidade funcional.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Quality of Life , Geriatric Assessment/methods , Renal Dialysis , Cognition , Cognitive Dysfunction/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Age Factors , Depression , Neuropsychological Tests
15.
Rev. méd. Chile ; 147(8): 1013-1023, ago. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058637

ABSTRACT

Background: The risk factors for the development of cognitive impairment are not well known. Aim: To identify socio-demographic, lifestyle and health-related factors associated with cognitive impairment in older Chilean adults. Material and Methods: Data analysis of 1,384 participants ≥ 60 years who participated in the National Health Survey of Chile 2009-2010. Sociodemographic, lifestyle and health-related factors were used as exposure variables of interest. Cognitive impairment was assessed using an abbreviated version of the Mini Mental test and defined as a score < 13 points of a maximum of 19. A logistic regression was used to identify factors associated with cognitive impairment. Results: In this sample, the prevalence of cognitive impairment was 11.6 [95% confidence intervals (CI): 8.8; 15.2]. The factors associated with cognitive impairment were age (Odds ratio (OR) for > 76 years: 4.89, p < 0.01), male sex (OR: 2.42, p = 0.02), lower education (OR: 21.6, p < 0.01), physical inactivity (OR: 2.07, p = 0.02), sedentary behavior (OR: 2.23, p = 0.01), sleeping > 9/hours/day (OR: 2.98, p = 0.01), consumption of < 5 portions/day of fruit and vegetables (OR: 2.02, p = 0.05), having an unhealthy lifestyle (OR: 6.10, p = 0.0001), being underweight (OR: 3.67, p < 0.01), obesity (OR: 3.32, p = 0.03), having hearing impairment (OR: 2.26, p = 0.02), having a visual impairment (OR: 3.89, p < 0.01), a history of depression (OR: 3.03, p = 0.01) and having a physical disability (OR: 5.63, p < 0.01). Conclusions: We identified 14 factors associated with cognitive impairment. Although some of these factors were non-modifiable such as age and sex, most of them could be modified by implementing prevention programs aiming to improve lifestyle behaviors in older adults in Chile.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Cognitive Dysfunction/etiology , Cognitive Dysfunction/epidemiology , Socioeconomic Factors , Chile/epidemiology , Sex Factors , Anthropometry , Nutritional Status , Cross-Sectional Studies , Risk Factors , Age Factors , Sex Distribution , Age Distribution , Disability Evaluation , Food Preferences , Mental Status and Dementia Tests , Life Style
16.
Arch. Clin. Psychiatry (Impr.) ; 46(3): 72-79, May.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011151

ABSTRACT

Abstract Background Mild Cognitive Impairment (MCI) is a disorder in which the patient presents a cognitive decline, but without negative impact on the activities of daily living. Objective To carry out a systematic review of published studies that analyzed the prevalence of Mild Cognitive Impairment (MCI) in older adults living in the community, and the criteria used for the diagnosis of this disorder. Methods A search was carried out in May 2017 using the descriptors: "epidemiology" or "prevalence", "mild cognitive impairment", and "community" in the PubMed, PsycInfo, SciELO, Web of Science, and Scopus databases. Two independent researchers extracted and documented the data. We used a random effect model to calculate pooled prevalence of MCI for overall studies and for each subgroup divided by diagnostic criteria. Results We found initially 1996 articles, and we selected 35 studies. The prevalence of MCI in the selected studies ranged from 0.5% to 41.8%. The overall pooled prevalence of MCI was 17.3% (CI 95%, 13.8-20.8), with significant heterogeneity between estimates (I2 = 99.6%). Discussion The standardization of the diagnostic criteria for MCI, as well as the tests used in the cognitive evaluation, could allow the comparison between the studies and would be an important step in the researches of this area.


Subject(s)
Humans , Aged , Aged, 80 and over , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/epidemiology , Residence Characteristics , Prevalence
17.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(1): 9-17, mar. 2019. tab
Article in Spanish | LILACS | ID: biblio-1004378

ABSTRACT

RESUMEN Introducción: Estudios previos han asociado la pérdida auditiva con un acelerado deterioro cognitivo durante el envejecimiento; no obstante, esta asociación no ha sido estudiada en adultos mayores chilenos. Objetivo: Investigar la asociación entre la discapacidad auditiva y la sospecha de deterioro cognitivo a través del cuestionario Mini Mental State Examination (MMSE, versión abreviada) en esta población. Material y método: Se incluyeron 1.384 adultos mayores de 60 años de la encuesta nacional de salud 2009-2010. Un puntaje <13 puntos en el MMSE se consideró sospecha de deterioro cognitivo. La discapacidad auditiva se determinó a través de un cuestionario de tamizaje autorreportado de tres preguntas. La asociación entre estas dos variables se investigó mediante análisis de regresión logística. Resultados: Se identificó una asociación significativa entre el MMSE alterado y cada una de las discapacidades auditivas estudiadas. A su vez, existió una tendencia a aumentar en 59% la probabilidad de desarrollar deterioro cognitivo en la medida que aumentaron las discapacidades auditivas (OR: 1,59 [95% IC: 1,38 a 1,82], p <0,0001). Conclusión: La disminución de la percepción auditiva es un factor de riesgo para el desarrollo de deterioro cognitivo y posteriormente demencia. La creación de políticas públicas, orientadas al tamizaje temprano en población de riesgo, podría ser una solución efectiva para prevenir las consecuencias asociadas con esta condición.


ABSTRACT Introduction: Hearing loss has been associated with an accelerated cognitive impairment during ageing. However, this association has not been investigated in older Chilean adults. Aim: To investigate the association between hearing impairment and cognitive impairment, using the Mini-Mental State Examination (MMSE, abridged version), in the Chilean population. Material and methods: 1,384 older adults aged ≥60 years, from 2009-2010 Chilean national health survey, were included. <13 points in the MMSE were considered suspicion of cognitive impairment. Hearing impairment was determined through a questionnaire including 3 domains. The association between cognitive and hearing loss was investigated using logistic regression. Results: An association between MMSE and each hearing disabilities studied was identified. As hearing impairments increased, the odd for cognitive impairment incremented by 59% (OR: 1.59 [95% IC: 1.38 a 1.82], p <0.0001). Conclusion: Hearing loss is a risk factor to develop cognitive impairment, which could translate into a high risk of dementia. Public politics implementation, focused in an early screening, could be an effective approach to prevent the complications associated with this hearing loss in older adults.


Subject(s)
Humans , Male , Female , Dementia/etiology , Cognitive Dysfunction/etiology , Hearing Loss/complications , Chile/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Dementia/epidemiology , Cognitive Dysfunction/epidemiology
18.
J. bras. nefrol ; 41(1): 112-123, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002412

ABSTRACT

Abstract Introduction: There is evidence in the literature that cognitive impairment is more prevalent in individuals with chronic kidney disease (CKD) than in the general population. The Montreal Cognitive Assessment (MoCA) is an instrument with a good application profile for cognitive evaluation of patients with CKD-like impairments. The objective of this study is to perform a systematic review of MoCA use in the context of CKD. Method: The keywords "Montreal Cognitive Assessment", "Kidney Disease" and "Chronic Kidney Disease" were used to search the databases. The inclusion criteria were: a) empirical articles; b) approach to cognitive impairment in CKD; c) papers in Portuguese and English. Results: The studies were mostly cross-sectional, published in medical journals, with research carried out mostly in Europe. About 45% of the studies had samples of less than 150 participants and variations in the prevalence of cognitive impairment were found ranging from 28.9% to 74.6%. The cutoff point for the identification of the impairment presented variation between the studies. Discussion: The results' analysis demonstrates the need for more complete studies on MoCA scoring and adaptation in its different versions. We recommend to the health professionals who will use the results in the clinical setting that the interpretation of the results be made in the light of studies more related to the context lived by the patients. Conclusions: The instrument is efficient to be used in several stages and treatment modalities of the disease. We point to the need to adapt a cut-off point for the instrument in the different translations of the instrument.


Resumo Introdução: Há evidências na literatura de que o comprometimento cognitivo se apresenta com maior prevalência em indivíduos com Doença Renal Crônica (DRC) do que na população em geral. O Montreal Cognitive Assessment (MoCA) é um instrumento com bom perfil de aplicação para avaliação cognitiva de pacientes com comprometimentos similares aos da DRC. O objetivo deste estudo é realizar uma revisão sistemática sobre a aplicação do MoCA no contexto da DRC. Método: Foram utilizadas as palavras-chave "Montreal Cognitive Assessment", "Kidney Disease" e "Doença Renal Crônica" nas bases de dados. Os critérios de inclusão foram: a) artigos empíricos; b) abordagem do comprometimento cognitivo na DRC; c) trabalhos em língua portuguesa e inglesa. Resultados: Os estudos foram em sua maioria transversais, publicados em periódicos médicos, com pesquisas realizadas majoritariamente na Europa. Cerca de 45% das pesquisas tiveram amostras inferiores a 150 participantes e foram encontradas variações na prevalência de comprometimento cognitivo variando de 28,9% até 74,6%. O ponto de corte para identificação do comprometimento apresentou variação entre os estudos. Discussão: A análise de resultados demonstra a necessidade de estudos mais completos sobre pontuação e adaptação do MoCA em suas diferentes versões. Recomenda-se aos profissionais de saúde que utilizarão os resultados em âmbito clínico que a interpretação dos resultados seja realizada por estudos mais relacionados ao contexto vivido pelos pacientes. Conclusões: O instrumento demonstra-se eficiente para ser utilizado em diversos estágios e modalidades de tratamento da doença. Aponta-se a necessidade da adaptação de um ponto de corte para o instrumento nas diferentes traduções do instrumento.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Renal Insufficiency, Chronic/complications , Cognitive Dysfunction/etiology , Cognitive Dysfunction/epidemiology , Mental Status and Dementia Tests , Prevalence , Cross-Sectional Studies , Cognitive Dysfunction/diagnosis
19.
J. bras. nefrol ; 41(1): 29-37, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002428

ABSTRACT

ABSTRACT Introduction: Chronic kidney disease (CKD) is an independent risk factor for several unfavorable outcomes including cardiovascular disease (CVD), particularly in the elderly, who represent the most rapidly growing segment of the end-stage kidney disease (ESKD) population. Portugal has the highest European unadjusted incidence and prevalence rates of ESKD. In 2012, we started to follow a cohort of elderly CKD patients, we describe their baseline characteristics, risk profile, and cardiovascular disease burden. Methods: All CKD patients aged 65 years and older referred to our department during 2012 were enrolled. Baseline data included: demographic, CKD stage, medication, comorbid conditions. Estimated glomerular filtration rate (eGFR) was calculated by the CKD-EPI formula. Results: A total of 416 patients, 50% referred by primary care physicians, aged 77 ± 7 years, 52% male, with a median eGFR of 32 mL/min/1.73m2 participated in the study. Fifty percent had diabetes (DM), 85% dyslipidemia, 96% hypertension; 26% were current/former smokers, and 24% had a body mass index > 30 kg/m2. The prevalence of CVD was 62% and higher in stage 4-5 patients; in diabetics, it gradually increased with CKD progression (stage 3a < stage 3b < stage 4-5) (39, 58, 82%; p < 0.001). Conclusions: At baseline, our CKD elderly cohort had a higher burden of CVD. The prevalence of CVD was greater than in other European CKD cohorts. Lower level of eGFR was associated with a greater burden of CVD and was more pronounced in diabetics, highlighting the importance of strategically targeting cardiovascular risk reduction in these patients.


RESUMO Introdução: Doença renal crônica (DRC) é fator de risco independente para vários desfechos desfavoráveis, incluindo doença cardiovascular (DCV), particularmente em idosos, o segmento de crescimento mais rápido da população com doença renal terminal (DRT). Portugal tem a maior incidência europeia não-ajustada e a maior prevalência de DRT. Neste artigo caracterizamos uma coorte de idosos com DRC, referenciados para a nefrologia, com particular ênfase para o risco e carga de doença cardiovascular. Métodos: Foram incluídos todos os pacientes com DRC com 65 anos ou mais encaminhados ao nosso departamento em 2012. Os dados basais incluíram: demografia, estágio da DRC, medicação e comorbidades. A taxa de filtração glomerular (TFGe) foi calculada pela fórmula CKD-EPI. Resultados: Metade dos 416 pacientes incluídos foram encaminhados por médicos da atenção primária; sua idade era 77 ± 7 anos; 52% eram homens; a TFGe mediana era de 32 mL /min/1,73 m2. Metade tinha diabetes (DM), 85% dislipidemia, 96% hipertensão; 26% eram fumantes atuais/ antigos; 24% tinham índice de massa corporal > 30 kg/m2. A prevalência de DCV foi de 62%, sendo maior entre pacientes nos estágios 4-5; em diabéticos, aumentou gradualmente com a progressão da DRC (estágio 3a < estágio 3b < estágio 4-5) (39%, 58%, 82%; p < 0,001). Conclusões: A coorte de idosos com DRC apresentava inicialmente maior carga de DCV. A prevalência de DCV foi maior que em outras coortes europeias com DRC. Níveis menores de TFGe foram associados a carga maior de DCV e foram mais pronunciados entre diabéticos, destacando a importância de objetivar estrategicamente a redução do risco cardiovascular nesses pacientes.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aging/physiology , Cardiovascular Diseases/epidemiology , Renal Insufficiency, Chronic/epidemiology , Kidney Failure, Chronic/epidemiology , Portugal/epidemiology , Cardiovascular Diseases/etiology , Body Mass Index , Comorbidity , Incidence , Prevalence , Risk Factors , Follow-Up Studies , Longitudinal Studies , Creatinine/blood , Diabetes Mellitus/epidemiology , Renal Insufficiency, Chronic/complications , Dyslipidemias/epidemiology , Cognitive Dysfunction/epidemiology , Glomerular Filtration Rate , Hypertension/epidemiology , Kidney Failure, Chronic/etiology
20.
Ciênc. Saúde Colet ; 24(1): 247-252, ene. 2019.
Article in Portuguese | LILACS | ID: biblio-1039456

ABSTRACT

Resumo Este texto apresenta um panorama do envelhecimento no Brasil e informações que fundamentam a necessidade de se criarem instrumentos para lidar com o aumento acelerado da população idosa e, particularmente, com os que perdem sua autonomia física, cognitiva, mental/emocional e social. São mostrados exemplos de políticas públicas criadas por países da União Europeia, em particular pela Espanha, para proteger os mais vulneráveis e dar apoio a suas famílias, em especial, aos cuidadores informais. Todo o processo de proteção aos mais longevos é pensado como uma solidariedade social em que o Estado e os entes subnacionais, a sociedade, as famílias e a própria pessoa idosa participam.


Abstract This text presents an overview of aging in Brazil and information that highlights the need to create instruments to deal with the exponential increase of the elderly population, particularly those who lose their physical, cognitive, mental/emotional, and social autonomy. Examples of public policies created by European countries, notably Spain, show how they act to protect the most vulnerable individuals and provide support to their families, especially to the informal caregivers. The whole process of protection for the long-lived is perceived as a form of social solidarity in which the State and sub-national entities, society, the families and the elderly people themselves participate.


Subject(s)
Humans , Aged , Public Policy , Aging/psychology , Caregivers/psychology , Social Support , Brazil , Personal Autonomy , Cognitive Dysfunction/epidemiology
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