How many items from a word list can Alzheimer's disease patients and normal controls recall? Do they recall in a similar way?

Abstract The serial position effect occurs when individuals are asked to recall a list of information that exceeds normal attention span. Alzheimer's disease (AD) patients show lower scores on word span recall tests when compared to healthy aging subjects, younger individuals or depressed patients. Objective: To evaluate the immediate free recall and the serial position effect of a 10-word list, emotionally neutral in tone, in Alzheimer's disease (AD) patients and two age-groups of healthy controls. Methods: The free word recall test was applied in a sample of 44 mild AD outpatients and 168 >50 year and 173 ≤50 year-old healthy controls. The span of recalled words and order of recollection of each item was recorded. Scores for serial position effect were analyzed. MMSE scores were recorded for all participants. Descriptive statistics and the ANOVA with Tukey test were performed. Results: The controls scored significantly better than AD patients on the MMSE and word span (p=0.0001). Older controls word span mean ±SD was 5.65±1.75, younger controls was 5.99±1.27, and AD patients was 2.86±1.42. The best recalled item in all groups was the first item of the list. Primacy was observed across the three groups, although AD patients presented lower scores. Recency was diminished among AD patients compared to control groups. Conclusions: Primacy effect was observed in AD patients as well as in both normal control groups. Recency effect was presented by the normal control groups but was extremely poor among AD patients. The first item was universally best retrieved

Effect of successful aging on mortality in older individuals: The PALA study

ABSTRACT The definition of successful aging and identification of predictors have been extensively reviewed, less attention however, has been given to the role of this condition on mortality. Objective: To evaluate the effect of aging status (normal or successful) on mortality in a South Brazilian population-based cohort, adjusted for sociodemographic and clinical variables, and to report the mortality rate and causes of death in this population. Methods: The baseline sample comprised 345 community-dwelling, independent and healthy Southern Brazilian older individuals who were followed for 12 years. Clinical, socio-demographic, functional and cognitive variables were assessed at baseline and during the follow-up. At baseline, 214 participants fulfilled criteria for successful aging, and 131 for normal aging. The main outcome was death. Results: The Cox regression model showed an increased risk for mortality in subjects with normal aging (HR=1.9; p=0.003) adjusted by age (HR=1.1; p<0.001) and by sex (HR=1.9; p=0.002). The overall mortality rate was 41% and the rate was significantly lower among successful than normal agers (p=0.001). The main causes of death were cardiovascular disease and cancer. Conclusion: Our main finding was an increased risk of mortality among normal in comparison with successful aging subjects, emphasizing the impact of the heterogeneity of the healthy aging process on mortality

Validity of the Brazilian version of the Neuropsychiatric Inventory Questionnaire (NPI-Q)

The NPI-Q (Neuropsychiatry Inventory-Questionnaire) was developed to facilitate the evaluation of neuropsychiatric symptoms. This study evaluated the internal consistency, the test-retest reliability of the Brazilian NPI-Q version and its convergent validity with the original NPI. Method The NPI-Q and the NPI were administered to 64 caregivers of dementia patients. Thirteen informants were asked to complete a second NPI-Q form. Results The internal consistency of the Brazilian NPI-Q version was 0.67 for the severity scale and 0.81 for the distress scale. The test-retest reliability of the total NPI-Q severity and the distress scales were 0.97 and 0.92, respectively (p < 0.001). There were significant correlations between the total NPI-Q severity score and the NPI (r = 0.75) and between the total NPI-Q distress score and the total NPI standard distress (r = 0.74). Conclusion The Brazilian NPI-Q version showed evidence of good psychometric properties and can be used in general clinical practice

General psychiatric or depressive symptoms were not predictive for mortality in a healthy elderly cohort in Southern Brazil

Abstract General psychiatric symptoms may interfere with the ability of individuals to take care of their health, to get involved with activities and develop social abilities, thereby increasing risk of death. Objective: To evaluate general psychiatric symptoms as predictive factors for mortality in a community elderly cohort in Southern Brazil. Methods: 345 healthy elderly, aged ³60 years, from the catchment area of Hospital de Clinicas de Porto Alegre were followed from 1996. Data for the present study were drawn from the period 1996-2004. General psychiatric symptoms (Self-Reporting Questionnaire - SRQ), depressive symptoms (Montgomery-Asberg depressive rating scale), and Mini Mental State Examination scores at baseline were included in the study. Socio-demographic, medical conditions, and functional capacity were also analyzed. The outcome was vital status at follow-up obtained from family members, hospital records and checked against official death registers. Results: Of the 345 baseline individuals, 246 were followed-up. The global mortality rate over the study period was 36.9% (N=90). Those who deceased during the period were older (73.5±7.5), more dependent overall, and more cognitively impaired than the living elderly (univariate analyses). In the logistic regression, only age (OR=0.93; p=0.003) and functional capacity (OR=0.22; p=0.007) remained significant in the final equation. Conclusion: Psychiatric symptoms presented no association with mortality in the present sample. Older age and functional incapacity were risk factors for mortality

Brain-Derived Neurotrophic Factor Serum Levels and Hippocampal Volume in Mild Cognitive Impairment and Dementia due to Alzheimer Disease

Background/Aims: Hippocampal atrophy is a recognized biomarker of Alzheimer disease (AD) pathology. Serum brain-derived neurotrophic factor (BDNF) reduction has been associated with neurodegeneration. We aimed to evaluate BDNF serum levels and hippocampal volume in clinical AD (dementia and mild cognitive impairment [MCI]). Methods: Participants were 10 patients with MCI and 13 with dementia due to AD as well as 10 healthy controls. BDNF serum levels were determined by ELISA and volumetric measures with NeuroQuant®. Results: MCI and dementia patients presented lower BDNF serum levels than healthy participants; dementia patients presented a smaller hippocampal volume than MCI patients and healthy participants. Discussion: The findings support that the decrease in BDNF might start before the establishment of neuronal injury expressed by the hippocampal reduction