Assessment of judgment ability in a Brazilian sample of patients with mild cognitive impairment and dementia

Judgment is the ability to make sound decisions after consideration of relevant information, possible solutions, likely outcomes, and contextual factors. Loss of judgment is common in patients with mild cognitive impairment (MCI) and dementia. The Test of Practical Judgment (TOP-J) evaluates practical judgment in adults and the elderly, with 15- and 9-item versions that require individuals to listen to scenarios about everyday problems and report their solutions. Objective: Adaptation of TOP-J for a Brazilian sample, preparation of a reduced version and verification of the accuracy of both. Methods: Eighty-five older adults, including 26 with MCI, 20 with Alzheimer’s disease (AD), 15 with frontotemporal dementia behavioral variant (FTDbv) and 24 controls, underwent neuropsychological assessment including the Brazilian adaptation of the TOP-J (TOP-J-Br). Results: On both TOP-J-Br versions, controls outperformed MCI, AD and FTDbv patients (

Brain metabolism and cerebrospinal fluid biomarkers profile of non-amnestic mild cognitive impairment in comparison to amnestic mild cognitive impairment and normal older subjects

Abstract\ud \ud Introduction\ud Mild cognitive impairment (MCI) is classically considered a transitional stage between normal aging and dementia. Non-amnestic MCI (naMCI) patients, however, typically demonstrate cognitive deficits other than memory decline. Furthermore, as a group, naMCI have a lower rate of an eventual dementia diagnosis as compared to amnestic subtypes of MCI (aMCI). Unfortunately, studies investigating biomarker profiles of naMCI are scarce. The study objective was to investigate the regional brain glucose metabolism (rBGM) with [18F]FDG-PET and cerebrospinal fluid (CSF) biomarkers in subjects with naMCI as compared to a control group (CG) and aMCI subjects.\ud \ud \ud Methods\ud Ninety-five patients were included in three different groups: naMCI (N = 32), aMCI (N = 33) and CG (N = 30). Patients underwent brain MRI and [18F]FDG-PET. A subsample (naMCI = 26, aMCI = 28) also had an assessment of amyloid-β, tau, and phosphorylated tau levels in the CSF.\ud \ud \ud Results\ud Both MCI groups had lower rBGM in relation to the CG in the precuneus. Subjects with naMCI showed decreased right prefrontal metabolism as well as higher levels of CSF amyloid-β relative to aMCI subjects.\ud \ud \ud Conclusion\ud While amnestic MCI subjects showed a biomarker profile classically related to MCI due to Alzheimer’s disease, naMCI patients illustrated a decrease in both prefrontal hypometabolism and higher CSF amyloid-β levels relative to the aMCI group. These biomarker findings indicate that naMCI is probably a heterogeneous group with similar precuneus hypometabolism compared to aMCI, but additional frontal hypometabolism and less amyloid-β deposition in the brain. Clinical follow-up and reappraisal of biomarkers of the naMCI group is needed to determine the outcome and probable etiological diagnosis.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) numbers 2011/18245-4 and 2009/17398-1 in BrazilCoordination for the Improvement of Higher Education Personnel (CAPES)/Brazi

Brain metabolism and cerebrospinal fluid biomarkers profile of non-amnestic mild cognitive impairment in comparison to amnestic mild cognitive impairment and normal older subjects

Abstract\ud \ud Introduction\ud Mild cognitive impairment (MCI) is classically considered a transitional stage between normal aging and dementia. Non-amnestic MCI (naMCI) patients, however, typically demonstrate cognitive deficits other than memory decline. Furthermore, as a group, naMCI have a lower rate of an eventual dementia diagnosis as compared to amnestic subtypes of MCI (aMCI). Unfortunately, studies investigating biomarker profiles of naMCI are scarce. The study objective was to investigate the regional brain glucose metabolism (rBGM) with [18F]FDG-PET and cerebrospinal fluid (CSF) biomarkers in subjects with naMCI as compared to a control group (CG) and aMCI subjects.\ud \ud \ud Methods\ud Ninety-five patients were included in three different groups: naMCI (N = 32), aMCI (N = 33) and CG (N = 30). Patients underwent brain MRI and [18F]FDG-PET. A subsample (naMCI = 26, aMCI = 28) also had an assessment of amyloid-β, tau, and phosphorylated tau levels in the CSF.\ud \ud \ud Results\ud Both MCI groups had lower rBGM in relation to the CG in the precuneus. Subjects with naMCI showed decreased right prefrontal metabolism as well as higher levels of CSF amyloid-β relative to aMCI subjects.\ud \ud \ud Conclusion\ud While amnestic MCI subjects showed a biomarker profile classically related to MCI due to Alzheimer’s disease, naMCI patients illustrated a decrease in both prefrontal hypometabolism and higher CSF amyloid-β levels relative to the aMCI group. These biomarker findings indicate that naMCI is probably a heterogeneous group with similar precuneus hypometabolism compared to aMCI, but additional frontal hypometabolism and less amyloid-β deposition in the brain. Clinical follow-up and reappraisal of biomarkers of the naMCI group is needed to determine the outcome and probable etiological diagnosis.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) numbers 2011/18245-4 and 2009/17398-1 in BrazilCoordination for the Improvement of Higher Education Personnel (CAPES)/Brazi

Prospective memory performance of patients with Mild Cognitive Impairment

Introdução: Memória prospectiva é a capacidade de formular intenções e realizá-las em um momento no futuro. Apesar da relevância da memória prospectiva para o funcionamento diário e do potencial das tarefas de memória prospectiva em detectar os primeiros sinais de declínio cognitivo, essas tarefas raramente são utilizadas na avaliação clínica de idosos. Objetos: Os objetivos do presente estudo foram: (1) Caracterizar o desempenho da memória prospectiva em pacientes com Comprometimento Cognitivo Leve (CCL) e compará-lo a controles saudáveis; (2) Investigar a relação entre medidas de memória prospectiva, testes neuropsicológicos e variáveis demográficas; (3) Avaliar a acurácia diagnóstica de medidas subjetivas e objetivas de memória prospectiva para a detecção de CCL. Métodos: O estudo inclui 30 pacientes com Comprometimento Cognitivo Leve amnéstico (CCLa), 20 com Comprometimento Cognitivo Leve não-amnéstico (CCLna) e 30 controles saudáveis. Todos os participantes foram submetidos a avaliação neuropsicológica e responderam ao Questionário de Memória Prospectiva e Retrospectiva (QMPR). Os participantes também foram convidados a realizar uma tarefa de memória prospectiva na vida diária. Resutados: Os grupos CCLa e CCLna apresentaram desempenho significativamente pior comparado ao grupo controle em medidas objetivas de memória prospectiva baseadas em tempo e evento. O grupo CCLa apresentou pior desempenho em tarefa de memória prospectiva realizada na vida diária comparado ao grupo CCLna. Foram encontras correlações significativas entre as medidas objetivas de memória prospectiva e testes neuropsicológicos de memória retrospectiva, atenção e funções executivas e idade. O grupo CCLa apresentou mais queixas de memória prospectiva e retrospectiva comparado aos idosos saudáveis. As medidas objetivas de memória prospectiva apresentaram boa acurácia para discriminar os grupos de pacientes dos controles, tanto no subtipo amnéstico quanto não amnéstico. As medidas subjetivas de memória prospectiva apresentaram boa acurácia para diferenciar os grupos, prém não se correlacionaram com as medidas objetivas de memória prospectiva. Conclusão: Os resultados apresentados sugerem que indivíduos com CCL apresentam comprometimento de memória prospectiva quando comparados com adultos saudáveis. Estes resultados têm implicações importantes para a prática clínica e para o desenvolvimento de programas mais adequados de reabilitação cognitiva.Introduction: Prospective memory is the ability to formulate intentions and realize them at a future time. Despite the relevance of prospective memory to everyday functioning and the potential for prospective memory task in to detect the earliest signs of cognitive decline, these tasks rarely are utilized as part of the clinical evaluations of older adults. Objectives: The objectives of the present study were to: (1) Characterize the prospective memory performance of patients with Mild Cognitive Impairment (MCI) and compare their performance with normal controls; (2) Investigate the relationship between prospective memory measures, neuropsychological tests and demographic variables; (3) Evaluate the diagnostic accuracy of subjective and objective prospective memory measures for detecting MCI. Methods: The study included 30 patients with amnestic MCI (aMCI), 20 with nonamnestic MCI (naMCI) and 30 healthy controls. All participants underwent neuropsychological assessment completed the Prospective and Retrospective Memory Questionnaire. Participants were also asked to perform a prospective memory task in their everyday lives. Results: Individuals with aMCI and naMCI performed significantly worse than controls on time-based and event-based objective prospective memory measures. Participants with aMCI demonstrated poorer performance in prospective memory measure carried out in everyday life than naMCI. Significant correlations were found between objective prospective memory measures, neuropsychological tests of retrospective memory, attention and executive functioning and age. Participants with aMCI reported more prospective and retrospective memory complaints than the healthy adults. The objective prospective memory measure was able to discriminate with good accuracy the groups of patients from controls in both amnestic and nonaminestic subtypes. The subjective prospective memory measure showed good accuracy to differentiate the groups, but not correlated with objective measures of prospective memory. Conclusion: The results suggest that individuals with MCI display prospective memory impairment when compared to healthy adults. These results have important implications for clinical practice and to develop of more appropriate programs of cognitive rehabilitation

Alpha band EEG coherence in healthy nonagenarians

ABSTRACT Electroencephalographic (EEG) coherence is a parameter that enables evaluation of cerebral connectivity. It may be related to the functional state of the brain. In the elderly, it may reflect the neuronal loss caused by aging. Objective To describe characteristics of coherence in nonagenarians. Methods We evaluated interhemispheric coherence for the alpha band in 42 cognitively normal individuals aged 90 to 101 years. Coherence values in the occipital electrode (O1O2), in the resting state with closed eyes, were calculated by means of spectral analysis using digital EEG EMSA 32 channels, 12 bits and a frequency of 200 Hz. Results The mean coherence value for the alpha band at O1O2 was 0.65 (SD 0.13). No significant differences were found between men and women. Conclusions The findings from this study did not show any decrease in interhemispheric coherence for the alpha band in cognitively normal nonagenarians. This may be useful as a standard value for this age group

Phenolic composition, antiproliferative and antiulcerogenic activities of a polyphenol‐rich purified extract from açai ( Euterpe oleracea ) fruits

The bioactivity and phytochemical composition of a partially purified extract of açai (PPEA), concentrated in phenolic compounds (PC) and without the presence of macronutrients, were investigated. The major PC quantified by UHPLC-DAD-LTQ-Orbitrap MS-MS/MS in the PPEA are anthocyanins. In vitro, PPEA showed a cytostatic effect on the K-562 lymphoid leukaemia at a concentration of 40 μg PC mL−1, with a GI50 equal to 1.08 μg PC mL−1. In vivo, the extract did not promote acute toxicity in mice in any of the doses tested. The extract displayed gastroprotective activity in rats treated orally with 16, 48 and 160 mg PC kg−1, with a significant decrease in the ulcerative lesion index, compared with the negative control. The lack of toxicity and the bioactivity of the PPEA show that this extract is beneficial to health and useful as a commercial food additive containing natural violet colourant, with pharmaceutical and functional potentials

Characterization Of A Refinement Of The Pylorus Ligation" Model Of Rat Gastric Ulceration Resulting In "no Pain" And A More Specific Pharmacological Response."

The pharmacological assessment of the factors for gastric protection of a test substance should involve experimental models that can determine the involvement of cytoprotective factors, as well as their influence on the secretion of hydrochloric acid. The original protocol of pylorus ligation in rats proposed by Shay et al. in 1945, still in use today, provides a latency time of 240 min without considering the effect of postoperative pain in the mechanisms of peptic ulcer. This paper proposes a modification of this experimental protocol by eliminating the pain throughout the postoperative period, as a refinement of the test with consequent improvement of the pharmacological response. Adult male Wistar/Uni rats underwent surgical ligation of the pylorus and were kept anesthetized throughout the experimental period (4h) in contrast to the other experimental groups that followed the original protocol proposed by Shay et al., 1945. We were able to determine effective doses for a positive control, as well as of a variety of secretagogues in the new experimental protocol proposed. The suppression of post-surgical pain, through the use of anesthesia throughout the experimental period, brought several benefits for the study of gastric acid secretion, rendering a more homogeneous pharmacologic response in non-inbred animals, thus being an effective experimental procedure.67121-

Molecular Dereplication and In Vitro and In Silico Pharmacological Evaluation of Coriandrum sativum against Neuroblastoma Cells

The aim of this study was to investigate the cytotoxic activity of the Coriandrum sativum (C. sativum) ethanolic extract (CSEE) in neuroblastoma cells, chemically characterize the compounds present in the CSEE, and predict the molecular interactions and properties of ADME. Thus, after obtaining the CSEE and performing its chemical characterization through dereplication methods using UPLC/DAD-ESI/HRMS/MS, PM6 methods and the SwissADME drug design platform were used in order to predict molecular interactions and ADME properties. The CSEE was tested for 24 h in neuroblastoma cells to the establishment of the IC50 dose. Then, the cell death was evaluated, using annexin-PI, as well as the activity of the effector caspase 3, and the protein and mRNA levels of Bax and Bcl-2 were analyzed by ELISA and RT-PCR, respectively. By UHPLC/DAD/HRMS-MS/MS analysis, the CSEE showed a high content of isocoumarins-dihydrocoriandrin, coriandrin, and coriandrones A and B, as well as nitrogenated compounds (adenine, adenosine, and tryptophan). Flavonoids (apigenin, hyperoside, and rutin), phospholipids (PAF C-16 and LysoPC (16:0)), and acylglicerol were also identified in lower amount as important compounds with antioxidant activity. The in silico approach results showed that the compounds 1 to 6, which are found mostly in the C. sativum extract, obey the “Five Rules” of Lipinski, suggesting a good pharmacokinetic activity of these compounds when administered orally. The IC50 dose of CSEE (20 µg/mL) inhibited cell proliferation and promoted cell death by the accumulation of cleaved caspase-3 and the externalization of phosphatidylserine. Furthermore, CSEE decreased Bcl-2 and increased Bax, both protein and mRNA levels, suggesting an apoptotic mechanism. CSEE presents cytotoxic effects, promoting cell death. In addition to the promising results predicted through the in silico approach for all compounds, the compound 6 showed the best results in relation to stability due to its GAP value

Prevalência de sintomas depressivos em idosos na cidade de Tremembé, Brasil: resultados preliminares de um estudo epidemiológico

Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%. Objective: To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. Methods: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city’s census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of \ud depressive symptoms. Results: A total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005). Conclusion: The prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completedDepressão é uma doença mental heterogênea classificada como um conjunto de transtornos, que se manifestam numa certa duração, frequência e intensidade. A prevalência de depressão em idosos varia de 0,5 a 16%. Objetivo: estabelecer a prevalência de sintomas depressivos significantes em estudo epidemiológico em população acima de 60 anos. Métodos: Estudo epidemiológico do tipo transversal, no qual estão sendo realizadas visitas domiciliares na cidade de Tremembé, Brasil. A amostra foi aleatória, através do sorteio de 20% da população acima de 60 anos de cada setor censitário do município. Este estudo é de única fase, sendo realizada anamnese, exames físico e neurológico, avaliação cognitiva e aplicação de escalas de Cornell e questionário Patient Health Questionnaire para verificar sintomas psiquiátricos. Foi adotado como critério da presença de sintomas depressivos, pontuação maior ou igual a 8 na escala de Cornell. Resultados: Foram avaliadas 455 pessoas e destas 169 (37,1%) apresentaram sintomas depressivos significativos clinicamente (SDSC). A maior prevalência foi entre as mulheres (p<0,001) e com escolaridade mais baixa (p=0,033). Quando realizado o teste de qui-quadrado de tendência, houve relação significativa, à medida que diminui o nível socioeconômico, aumenta a chance da presença de sintomas depressivos (p=0,005). Conclusão: A prevalência de sintomas depressivos foi elevada nesta amostra do estudo populacional e com associação com gênero feminino, baixo nível educacional e socioeconômico, mas há necessidade de finalizar toda amostragem.FAPESP 2012/04815-6

Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembe, Brazil

Made available in DSpace on 2019-09-12T16:53:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2016Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.Methods:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembe, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.Results:We assessed 630 individuals [mean age, 71.3 y (7.99); mean years of education, 4.9 (+/- 4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.Conclusions:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.[Cesar, Karolina G.; Brucki, Sonia M. D.; Takada, Leonel T.; Oliveira, Maira O.; Porto, Fabio H. G.; Senaha, Mirna L. H.; Bahia, Valeria S.; Silva, Thais B. L.; Ianof, Jessica N.; Spindola, Livia; Schmidt, Magali T.; Jorge, Mario S.; Vale, Patricia H. F.; Cecchini, Mario A.; Cassimiro, Luciana; Soares, Roger T.; Goncalves, Marcia R.; Martins, Ana C. S.; Dare, Patricia; Smid, Jerusa; Porto, Claudia S.; Carthery-Goulart, Maria T.; Yassuda, Monica S.; Mansur, Leticia L.; Nitrini, Ricardo] Univ Sao Paulo, Dept Neurol, Cognit & Behav Neurol Unit, Sao Paulo, Brazil[Cesar, Karolina G.; Nascimento, Luiz F. C.; Gomes, Camila M. S.; Almeida, Milena C. S.] Universidade de Taubaté (Unitau