Visuospatial Function in Early Alzheimer's Disease-The Use of the Visual Object and Space Perception (VOSP) Battery

Alzheimer's disease (AD) is the most frequent cause of dementia. the clinical symptoms of AD begin with impairment of memory and executive function followed by the gradual involvement of other functions, such as language, semantic knowledge, abstract thinking, attention, and visuospatial abilities. Visuospatial function involves the identification of a stimulus and its location and can be impaired at the beginning of AD. the Visual Object and Space Perception (VOSP) battery evaluates visuospatial function, while minimizing the interference of other cognitive functions.Objectives: To evaluate visuospatial function in early AD patients using the VOSP and determine cutoff scores to differentiate between cognitively healthy individuals and AD patients.Methods: Thirty-one patients with mild AD and forty-four healthy elderly were evaluated using a neuropsychological battery and the VOSP.Results: in the VOSP, the AD patients performed more poorly in all subtests examining object perception and in two subtests examining space perception (Number Location and Cube Analysis). the VOSP showed good accuracy and good correlation with tests measuring visuospatial function.Conclusion: Visuospatial function is impaired in the early stages of AD. the VOSP battery is a sensitive battery test for visuospatial deficits with minimal interference by other cognitive functions.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Associacao Fundo de Incentivo a Pesquisa (AFIP-Research Incentive Fund Association)Universidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilWeb of Scienc

QUALITY OF LIFE AND COGNITION IN PATIENTS WITH PARKINSON\u27S DISEASE DURING THE COVID-19 PANDEMIC

Introduction: Restrictive isolation contributes to the containment of the virus, but it also has negative consequences for mental health. This study aimed to assess the quality of life, during the pandemic, in patients with Parkinson\u27s disease (PD), compare it with measures before the pandemic, and identify factors that may be associated with non-compliance with cognitive intervention activities. Methods: The PDQ-39 questionnaire was reapplied in a sample of PD patients previously followed up in rehabilitation program. In addition, a questionnaire to assess the follow-up of cognitive training activities was elaborated. Results: Twenty-two individuals with mean age of 62.72(7.49) years and a mean duration of the disease of 8.7(3.30) years participated in this study. There was a statistically significant difference in the total score of the PDQ-39(p=0.048), as well as in the mobility (p=0.038), stigma (p=0.035), social support(p=0.045), and cognition(p=0.026) dimensions. When analyzing the questionnaire, it was observed that most of the sample was able to follow the guidelines received during the cognitive training group (77.3%), mainly reading activities (41%), games (35%), and applications (35%). However, 77.3% reported worsening cognition, with attention (50%) and memory (34%) being highlighted, as well as sadness, discouragement, and indisposition (72%), anxiety (77.27%), and difficulty falling asleep (68%). A total of 86.36% perceived the need for professional support in mental health. Conclusion: This study showed the impact of the pandemic on individuals with PD, leading to a worse perception of quality of life and subjective complaints related to sleep disturbance, cognitive impairment, and neuropsychiatric symptoms (depression and anxiety)

IMPACT OF COGNITION ON THE OCCURRENCE OF FALLS IN PATIENTS WITH PARKINSON\u27S DISEASE

Introduction: Falls are common in Parkinson\u27s disease (PD), happening to up to 68% of these individuals. Patients with PD present motor and gait impairment that increase the fall risks by three times. This study aimed to compare cognitive impairment and the occurrence of falls in PD patients. Methods: Retrospective and cross-sectional study through data collection in electronic medical records searching for the occurrence of falls (dichotomous and coded responses: 1=yes and 2=no) in the period of up to three months of cognitive assessment. For data analysis, descriptive statistics, and inferential analyses (Mann-Whitney U Test) were performed to compare the cognitive tests’ scores between the two groups (who answered Yes/fallers and non-fallers). A significance level of p<0.05 was adopted. Results: There was no difference between the subgroups (fallers=23; non-fallers=60) regarding age (p=0.28), schooling (0.51) and years of disease progression (0.99). No difference was observed between the subgroups for most cognitive variables, except Trail Making Test (B and delta). There was a tendency to differ in Addenbrooke\u27s cognitive examination III (ACE-III) (total and attention and memory domains), with lower performance for the fallers subgroup. Worse functionality and more frequent cognitive issues were observed in those with reported falls. Conclusion: It was observed that cognitive measures, especially attentional and memory measures, interfere with episodes of falls in patients with PD. It is necessary to increase the sample and balance between the subgroups for further evidence of these results

Subjective memory complaints in the elderly: a sign of cognitive impairment?

OBJECTIVES: Cognitive impairment in the elderly is frequently overlooked by general practitioners. The use of subjective memory complaints as a sign of cognitive impairment by the general practice is controversial. METHODS: Elderly individuals (N = 248) were asked whether they had memory complaints and underwent a cognitive impairment screening. Subjects classified as exhibiting “probable cognitive impairment” underwent a complete cognitive evaluation, and the final diagnoses were established by expert consensus. RESULTS: A total of 147 patients presented with subjective memory complaints, and 43 were further classified as demented or “cognitively impaired not demented”. Subjective memory complaints presented a sensitivity of 100% and a negative predictive value of 100%. CONCLUSION: Subjective memory complaints are an indicator for cognitive impairment screening

The influence of educational status on motor performance and learning: a literature review

Many studies have shown the impact of the educational status on cognitive and motor control. However, few studies in the area of Physical Therapy and Motor Behavior consider the educational status of the subjects. This study aimed to describe evidences about the influence of the educational status on motor behavior (and its repercussions on physiotherapeutic assessment) and on motor learning (and its repercussions on physiotherapeutic treatment). We included in this review national and international studies from 1998 to 2013 from SciELO, MEDLINE and LILACS databases. We used the keywords: educational status, schooling level, motor control, motor behavior, motor performance, and motor learning. Sixty studies were located and 28 were selected, because they followed the inclusion criteria: (1) to investigate the effect of education on motor performance; (2) be available in Portuguese or English; and (3) be available in Brazil. The review showed that the educational status of patients must be considered by the physiotherapists in experimental and clinical practice, because many studies have shown its influence on assessment and treatment of young and older adults.Muchos estudios han demostrado el impacto de la educación en las habilidades cognitivas y motoras. Sin embargo, muy pocos estudios en el campo de la Terapia Física y Comportamiento Motor consideran la escolarización en la muestra. Este estudio tuvo como objetivo describir la evidencia sobre la influencia de la educación en el comportamiento motor (y sus efectos sobre la evaluación de terapia física) y aprendizaje motor (y sus repercusiones en la fisioterapia). Un sondeo 1998-2013 buscó revistas nacionales e internacionales en las bases de datos SciELO, MEDLINE y LILACS, utilizando las palabras clave: educación, nivel de educación, control de motores, el comportamiento del motor, el rendimiento del motor y de aprendizaje motor. Se localizaron 60 estudios. De éstos, 28 fueron seleccionados porque cumplen con los criterios de inclusión: (1) investigar el efecto de la educación sobre el rendimiento del motor; (2) estar en Portugués o Inglés; y (3) estará disponible en Brasil. La revisión mostró que la educación de los pacientes debe ser considerada por los fisioterapeutas en situaciones experimentales y clínicos, ya que varios estudios han demostrado su influencia en la evaluación y el tratamiento de jóvenes y ancianosMuitos estudos têm mostrado o impacto da escolaridade na cognição e motricidade. Porém, ainda poucos estudos na área de Fisioterapia e Comportamento Motor consideram a escolaridade da amostra. Este trabalho visou descrever evidências sobre a influência da escolaridade no comportamento motor (e suas repercussões na avaliação fisioterapêutica) e na aprendizagem motora (e suas repercussões no tratamento fisioterapêutico). Um levantamento de 1998 a 2013 buscou periódicos nacionais e internacionais nas bases de dados SciELO, MEDLINE e LILACS, com os descritores: escolaridade, nível educacional, controle motor, comportamento motor, desempenho motor e aprendizagem motora. Foram localizados 60 estudos. Desses, 28 foram selecionados por atenderem aos critérios de inclusão: (1) investigar o efeito da escolaridade sobre o desempenho motor; (2) estar em português ou inglês; e (3) estar disponível no Brasil. A revisão mostrou que a escolaridade dos pacientes deve ser considerada pelos fisioterapeutas em situações experimentais e clínicas, pois diversos estudos mostraram sua influência na avaliação e no tratamento de jovens e idosos

Mild cognitive impairment and progression to dementia of Alzheimer's disease

The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimer's disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individual's caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to analyze possibilities for future interventions. Dementias are clinical conditions that impose a burden on the health system with its high costs, whereas the identification of individuals with cognitive impairment without dementia can aid patients and their families to plan the future and mitigate costs. This narrative revision can provide general practitioners with more information on the subject.Univ Fed Sao Paulo, UNIFESP, Escola Paulista Med, Psychiat Dept, Sao Paulo, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Dept Internal Med,Geriatr, Botucatu, SP, BrazilFMB Unesp, Botucatu, SP, BrazilUniv Sao Paulo, Sao Paulo, BrazilHosp Santa Marcelina, Neurol Residency Program, Sao Paulo, BrazilUniv Sao Paulo, Grp Neurol Cognitiva & Comportamento, Sao Paulo, SP, Brazil|Univ Sao Paulo, Ctr Referencia Disturbios Cognit Ceredic, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, UNIFESP, Escola Paulista Med, Psychiat Dept, Sao Paulo, SP, BrazilWeb of Scienc

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