Redução da estigmatização e da discriminação das pessoas idosas com transtornos mentais: uma declaração técnica de consenso

This technical consensus statement is jointly produced by the Old Age Psychiatry section of the World Psychiatric Association and the World Health Organization, with the collaboration of several NGOs and the participation of experts from different regions. It is intended to be a tool for (i) promoting debate at all levels on the stigmatization of older people with mental disorders; (ii) outlining the nature, causes and consequences of this stigmatization; and (iii) promoting and suggesting policies, programs and actions to combat this stigmatization.A Organização Mundial da Saúde (OMS) e a Seção de Psiquiatria da Pessoa Idosa da Associação Mundial de Psiquiatria (AMP), em colaboração com um grupo interdisciplinar de representantes das principais associações internacionais e organizações não-governamentais implicadas na saúde mental das pessoas idosas, publicaram três declarações técnicas de consenso sobre a psiquiatria da pessoa idosa (1), a organização dos cuidados em psiquiatria da pessoa idosa (2) e o ensino da psiquiatria da pessoa idosa (3). O Dia Mundial da Saúde 2001, cujo tema foi "Não à exclusão, sim aos cuidados", deu origem a uma nova reunião de consenso sobre o tema da estigmatização e discriminação das pessoas idosas com transtornos mentais. Essa nova reunião foi realizada em Lausanne nos dias 8 e 9 de outubro de 2001 e produziu uma declaração técnica de consenso. O texto inicial foi publicado pela OMS e AMP em inglês. Este artigo apresenta a versão em português desse documento

Memory: a cognitive approach

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Interrater Variability in Pain Assessment of Long-term Care Residents with Dementia

International audiencePurpose: People with dementia are at great risk of their pain being undetected. In long-term care facilities, certified nursing assistants are on the front-line to detect whether a resident with dementia is experiencing pain, but research on certified nursing assistants' abilities to accurately assess pain are scarce. This study aims to examine certified nursing assistants’ pain assessment skills using a simulated standardized video context.Design: A cross-sectional study was conducted.Methods: Fifty certified nursing assistants and 40 individuals with no professional experience in the field of care (controls) watched the same video of an older adult woman with dementia experiencing pain. Afterwards, they completed visual analog scales (pain intensity, affective distress), an observational pain assessment scale (Algoplus), and a set of questionnaires.Results: In both groups, pain intensity assessment and empathic reaction scores showed important interrater variability. Moreover, certified nursing assistants and controls did not differ in detecting the presence of pain or assessing its intensity. But certified nursing assistants displayed lower empathic reactions and dispositions. Certified nursing assistants pain assessment scores decreased with experience and expertise.Conclusions: The practice of pain assessment is challenging for certified nursing assistants in long-term care facilities. Their professional status does not prevent inter-personal inconsistency and tends to lower their empathic dispositions. Personal determinants may interfere with their assessment behaviors and must be considered to enhance pain management for residents with dementia

Familiarité des concepts vivant et non vivant en fonction de l'âge et du genre

Résumé issu de : http://cat.inist.fr/?aModele=afficheN&cpsidt=18690911International audienceNous présentons la familiarité subjective estimée pour 120 concepts appartenant au domaine vivant (animaux, fruits, légumes) et non vivant (véhicules, vêtements, outils) en fonction de l'âge et du genre des participants. Parallèlement à la construction d'une base de concepts contribuant à terme à l'étude en français de l'évolution de l'organisation conceptuelle lors du vieillissement normal et pathologique, nous testons l'hypothèse d'une interaction genre/catégorie. Les résultats montrent l'importance de distinguer les concepts en fonction de ces facteurs dans la construction des tâches expérimentales

Destination Memory and Cognitive Theory of Mind in Alzheimer's Disease

Destination memory, or the ability to remember the destination to whom a piece of information was addressed, is found to be compromised in Alzheimer's disease (AD). Our paper investigated the relationship between destination memory and theory of mind in AD since both destination memory and theory of mind are social abilities that require processing attributes of interlocutors. Mild AD participants and controls were administered tasks tapping destination memory, affective theory of mind, and 1st and 2nd order cognitive theory of mind. Relative to controls, AD participants showed compromise in destination memory and 2nd order cognitive theory of mind, but preserved performance on affective and 1st order cognitive theory of mind. Significant correlations were observed between destination memory, and 1st and 2nd order cognitive theory of mind in AD participants and controls. By demonstrating a relationship between compromises in 2nd order theory of mind and in destination memory, our work highlights links between social cognition and memory functioning in AD

Destination memory and cognitive theory of mind in normal ageing

Destination memory is the ability to remember the destination to which a piece of information has been addressed (e.g., "Did I tell you about the promotion?"). This ability is found to be impaired in normal ageing. Our work aimed to link this deterioration to the decline in theory of mind. Forty younger adults (M age = 23.13 years, SD = 4.00) and 36 older adults (M age = 69.53 years, SD = 8.93) performed a destination memory task. They also performed the False-belief test addressing cognitive theory of mind and the Reading the mind in the eyes test addressing affective theory of mind. Results showed significant deterioration in destination memory, cognitive theory of mind and affective theory of mind in the older adults. The older adults' performance on destination memory was significantly correlated with and predicted by their performance on cognitive theory of mind. Difficulties in the ability to interpret and predict others' mental states are related to destination memory decline in older adults

Diferencias en ansiedad social auto-informada entre estudiantes universitarios chilenos y franceses.

This study compares the results of 85 Chilean and 174 French undergraduates who responded to the Liebowitz Social Anxiety Scale (LSAS). French men scored significantly higher in the LSAS than Chilean men. No differences were found between women from both countries. The results are discussed in terms of cross-cultural differences such as individualism and collectivism.Neste trabalho se comparam as pontuações de 85 estudantes universitários chilenos e 174 franceses que responderam à Escala de Ansiedade Social de Liebowitz (LSAS). Os homens franceses apresentaram pontuações significativamente superiores que os homens chilenos no LSAS. Nenhuma diferença foi observada entre as mulheres de ambos países. Os resultados se discutem em termos de diferenças culturais taos como o individualiste e o coletivismo.En este trabajo se comparan las puntuaciones de 85 estudiantes universitarios chilenos y 174 franceses que respondieron a la Escala de Ansiedad Social de Liebowitz (LSAS). Los hombres franceses presentaron puntuaciones significativamente superiores que los hombres chilenos en la LSAS. Ninguna diferencia fue observada entre las mujeres de ambos países. Los resultados se discuten en términos de diferencias culturales tales como el individualismo y el colectivismo

Prise de décision dans le vieillissement normal et neurodégénératif

International audienceSavoir prendre de bonnes décisions (dans son intérêt ou celui de ses proches) relève d’une faculté indispensable à notre adaptation, notre autonomie, voire notre survie. Pour autant, cette aptitude n’est pas aisée car la prise de décision est une faculté complexe, composite, qui s’avère particulièrement sensible aux effets de l’avancée en âge. Deux modalités de prise de décision sont distinguées : la prise de décision sous ambiguïté, lorsque la probabilité du résultat est ignorée et la prise de décision sous risque, lorsque les conséquences et leurs probabilités sont connues. Cette revue de la littérature présente les effets du vieillissement normal et pathologique sur ces deux modalités décisionnelles. Dans le vieillissement cérébral/cognitif dit normal, la diminution des aptitudes en prise de décision s’explique principalement par le déclin exécutif lié à l’âge, la modalité prise de décision sous risque paraissant mieux préservée. Au cours du vieillissement cérébral/cognitif dit pathologique, la localisation des lésions anatomiques joue un rôle prégnant sur le type de troubles décisionnels. Ainsi, les lésions frontales et/ou sous-corticofrontales conduisent à une prise de risque majeure, surtout en condition ambiguë. Les lésions frontales affectent le rôle des renforcements utiles à la prise de décision sous ambiguïté, en entravant la connaissance de la probabilité du résultat. Les dysfonctionnements exécutifs et la dégradation du système de récompense altèrent la prise de décision sous risque, empêchant l’anticipation des conséquences et la connaissance des probabilités sur le résultat. Les lésions temporales ou temporofrontales affectent les deux conditions décisionnelles. Ici, l’altération de la prise de décision sous ambiguïté paraît liée aux difficultés à apprendre par « feed-back » afin d’estimer correctement la probabilité du résultat. La détérioration de la prise de décision sous risque s’explique par l’incapacité à apprécier correctement les probabilités des conséquences. Ces données soulignent la complexité et la variété des mécanismes et des processus mis en jeu lors des activités de prise de décision. Elles permettent aussi d’expliquer les dissociations observées en fonction de type de lésions cérébrales relevées dans la cadre du vieillissement normal et pathologique

Inhibitory deterioration may contribute to hallucinations in Alzheimer’s disease

International audienceINTRODUCTION: Although delusions and hallucinations are relatively common symptoms in individuals with Alzheimer's disease (AD), very little is known regarding underlying mechanisms. We examined whether these manifestations could be underpinned by psychological distress and executive impairments. METHODS: Thirty-one participants with probable mild AD and 33 healthy older adults were administered a neuropsychological and clinical battery assessing delusions, hallucinations, anxiety, depression, episodic memory and executive functions (shifting, updating and inhibition). RESULTS: Prevalence of delusions and hallucinations were significantly higher in AD participants compared to control participants. Further, hallucinations in AD participants were significantly correlated with poor inhibition, with the latter uniquely predicting the former, as compared to other variables. In addition, hallucinations in AD participants were associated with depression, a relationship that was further mediated by inhibition. CONCLUSION: Hallucinations in individuals with AD seem to be related to difficulties suppressing irrelevant thoughts, resulting in these irrelevant thoughts becoming confused with ongoing reality

Emotion and Destination Memory in Alzheimer's Disease

Research shows beneficial effect of emotion on self-related information in patients with Alzheimer's Disease (AD). Our paper investigates whether emotion improves destination memory (e.g., did I tell you about the manuscript?), which is thought to be self-related (e.g., did I tell you about the manuscript?). To this aim, twenty-seven AD patients and thirty healthy older adults told 24 neutral facts to eight neutral faces, eight positive faces, and eight negative faces. On a subsequent recognition task, participants had to decide whether they had previously told a given fact to a given face or not. Data revealed no emotional effect on destination memory in AD patients. However, in healthy older adults, better destination memory was observed for negative faces than for positive faces, and the latter memory was better than for neutral faces. The absence of emotional effect on destination memory in AD is interpreted in terms of substantial decline in this memory in the disease