The Anti(auto)nomous Reality in the World of Miroslaw Czyzykiwcz’s Texts

В докладе автор анализирует «Парландо» — сборник оригинальных текстов М. Чижикевича, предназначенных для исполнения на сцене под аккомпанемент гитары или в сопровождении бόльшего числа инструментов. Лингвистическая форма стихов-песен не позволяет рассматривать их как типичные продукты поп-культуры [1]. Сборник стихов, дополненный оригинальными рисунками, полон антиномий на лингвистическом уровне и в то же время оказывается связным на уровне представляемого мира. Это парадокс существования: погруженный в собственное творчество М. Чижикевич балансирует между разрушительным образом жизни и спасительной силой искусства. Анализ «Парландо» направлен на то, чтобы показать богатство литературных средств, использованных автором, и последовательность поэтической программы автора. В соответствии с этим будет проанализирована издательская концепция сборника.In the article the author analyzes “Parlando” — a collection of original texts by Miroslaw Czyzykiewicz, intended for stage performance with guitar accompaniment or accompanied by more than one instrument. The linguistic form given to poems-songs by the author does not allow them to be treated as typical products of pop culture [1]. The collection of poems accompanied by original drawings, full of antinomies on the linguistic level, is at the same time coherent on the level of the presented world. It is the par­adox of existence: immersed in his own work, Czyzykiewicz seems to balance between a self-destructive lifestyle and the saving power of art. The analysis of “Parlando” aims to show the wealth of literary means used by the author and the coherence of the poetry programme that has been consistently implemented for many years. Accordingly, the publishing concept of the collection will be analyzed

Tratamento da doença de Alzheimer: recomendações e sugestões do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

The present recommendations and suggestions on Treatment of Alzheimer's Disease were elaborated by a work group constituted by participants of the IV Meeting of Researchers on Alzheimer's Disease and Related Disorders, sponsored by the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. They comprise topics on pharmacological and non-pharmacological treatment of cognitive impairment and functional decline, as well as of behavioral and psychological symptoms of this dementing disease. Several levels of evidence and of recommendations and suggestions are used for the various proposed drugs, as well as for non-pharmacological treatment, underpinned by a wide national and international bibliographical review.Univ Fed Rio de Janeiro, Setor Neurol Cognit & Comportamento, Inst Neurol Deolindo Couto, Rio de Janeiro, BrazilUniv São Paulo, Fac Med, Grp Neurol Cognit & Comportamento, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilFMUSP, Inst Psiquiatra, Rio de Janeiro, BrazilIPUB, CDA, Rio de Janeiro, BrazilUFRJ, Inst Psiquiatra, Rio de Janeiro, BrazilUERJ, Fac Med, Fac Ciencias Med, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilWeb of Scienc

Early Life Socioeconomic Circumstance and Late Life Brain Hyperintensities : A Population Based Cohort Study

Funding: Image acquisition and image analysis for this study was funded by the Alzheimer's Research Trust (now Alzheimer's Research UK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Acknowledgments The authors would like to thank the participants of the Aberdeen 1936 Birth Cohort (ABC36), without whom this research would not have been possible.Peer reviewedPublisher PD

Validity and Reliability of the Frontotemporal Dementia Rating Scale (FTD-FRS) for the Progression and Staging of Dementia in Brazilian Patients

Introduction: Few studies on instruments for staging frontotemporal dementia (FTD) have been conducted.  Objective: The objective of this study was to analyze the factor structure, internal consistency, reliability, and convergent validity of the Brazilian version of the Frontotemporal Dementia Rating Scale (FTD-FRS).  Methods: A total of 97 individuals aged 40 years and above with >2 years’ education took part in the study, 31 patients diagnosed with behavioral variant FTD (bvFTD), 8 patients with primary progressive aphasia, 28 with Alzheimer disease, 8 with mild cognitive impairment, and a control group of 22 healthy subjects. The FTD-FRS was completed by family members or caregivers, and Neurologists completed the 8-item Clinical Dementia Rating for Frontotemporal Lobar Degeneration (CDR-FTLD) scale (6 original domains plus Language and Behavior). The Alzheimer disease and FTD patients had equivalent disease severity level.  Results: The internal consistency of the FTD-FRS, estimated by Cronbach α, was 0.975 whereas test-retest reliability was 0.977. Scree plot and exploratory factor (Varimax rotation) analyses revealed the existence of 4 factors, with eigenvalues >1, which together explained 77.13% of the total variance with values of 1.28 to 17.52. The domains of the Brazilian version of the FTD-FRS scale correlated with the domains of the CDR-FTLD.  Conclusions: The present study is the first to document the factorial structure of the FTD-FRS and its convergent validity with the CDR-FTLD. These tools are key to determine dementia severity in FTD. The Brazilian FTD-FRS demonstrated adequate psychometric properties for use in Brazil. This instrument may contribute to disease staging in FTD and may help to document intervention-related changes

Apathy and functional disability in behavioral variant frontotemporal dementia

Background Behavioral variant frontotemporal dementia (bvFTD) has profound consequences on patients and their families. In this multicenter study, we investigated the contribution of cognitive and neuropsychiatric factors to everyday function at different levels of overall functional impairment. Methods In a retrospective cross-sectional study, 109 patients with bvFTD from 4 specialist frontotemporal dementia centers (Australia, England, India, and Brazil) were included. The measures administered evaluated everyday function (Disability Assessment for Dementia [DAD]), dementia staging (Clinical Dementia Rating [CDR]), general cognition (Addenbrooke’s Cognitive Examination–revised [ACE-R]), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). Patients were then subdivided according to functional impairment on the DAD into mild, moderate, severe, and very severe subgroups. Three separate multiple linear regression analyses were run, where (1) total DAD, (2) basic activities of daily living (BADL), and (3) instrumental activities of daily living (IADL) scores were dependent variables; ACE-R total score and selected NPI domains (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) were used as independent variables. Age, sex, education, and country of origin were controlled for in the analyses. Results Cognitive deficits were similar across the mild, moderate, and severe subgroups but significantly worse in the very severe subgroup. NPI domain scores (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) did not differ across the DAD subgroups. In the multiple regression analyses, a model including ACE-R and NPI apathy explained 32.5% of the variance for total DAD scores. For IADL, 35.6% of the variance was explained by the ACE-R only. No model emerged for BADL scores. Conclusions Cognitive deficits and apathy are key contributors to functional disability in bvFTD but factors underlying impairment in BADLs remain unclear. Treatments targeting reduction of disability need to address apathy and cognitive impairment to ensure greater efficacy, especially in regards to IADLs

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

Introduction: Older caregivers living in rural areas may be exposed to three vulnerable conditions, i.e., those related to care, their own aging, and their residence context. Objective: To analyze the association of burden and frailty with cognition performance in older caregivers in rural communities. Method: In this cross-sectional survey, 85 older caregivers who cared for dependent elders were included in this study. Global cognition (Addenbrooke's Cognitive Examination – Revised; Mini Mental State Examination), burden (Zarit Burden Interview) and frailty (Fried's frailty phenotype) were assessed. All ethical principles were observed. Results: Older caregivers were mostly women (76.7%); mean age was 69 years. Cognitive impairment was present in 15.3%, severe burden in 8.2%, frailty in 9.4%, and pre-frailty in 52.9% of the older caregivers. More severely burdened or frail caregivers had worse cognitive performance than those who were not, respectively (ANOVA test). Caregivers presenting a high burden level and some frailty degree (pre-frail or frail) simultaneously were more likely to have a reduced global cognition performance. Conclusion: A significant number of older caregivers had low cognitive performance. Actions and resources to decrease burden and physical frailty may provide better cognition and well-being, leading to an improved quality of life and quality of the care provided by the caregivers