OBJECTIVE:To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatric symptoms in patients with mild Alzheimer's disease.METHOD:The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention.INTERVENTION:Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings.MEASUREMENTS:The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments.RESULTS:Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life.CONCLUSION:This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield adjunct and clinically relevant benefits in dementia treatment.

Being frail may be associated with cognitive decline, thus, gerontological assessments and interventions should consider that these forms of vulnerability may occur simultaneously.

Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

ResumoIndicadores de atitudes etárias representados por categorização e identifi cação etária e suas relações com variáveis sociodemográfi cas e de saúde física e emocional foram investigados entre idosos residentes na comunidade. A amostra foi composta por 302 idosos participantes do Estudo FIBRA -Fragilidade em Idosos Brasileiros (Pólo Universidade Estadual de Campinas [Unicamp]; M = 72,3 anos; DP = 5,76; 64,6% mulheres), com escolaridade média de 3,32 anos (DP = 2,61) e renda de um a três salários mínimos (53,7%). A existência e atribuição de idade para início da velhice foram tomadas como indicadoras de categorização etária e o autorrelato de sentir-se idoso indicou identifi cação etária. Embora a maior parte dos idosos tenha atribuído uma idade para esse início (M = 62,3 anos; DP = 14,66), a maioria (60,3%) não se identifi cou como pertencente a essa categoria etária. Escolaridade, fragilidade e satisfação com a vida revelaram ser importantes preditores dessas atitudes em relação à velhice. Palavras-chave: Atitudes, idosos, envelhecimento. AbstractThis study investigated age categorization and identifi cation among elderly living in the community and their relationship with sociodemographic variables and physical and emotional health. The sample consisted of 302 elderly participants in the FIBRA study -Fragilidade em Idosos Brasileiros (Polo Universidade Estadual de Campinas [Unicamp]; M = 72.3 years old, SD = 5.76; 64.6% women), with average education of 3.32 years (SD = 2.61) and income from one to three minimum wages (53.7%). The belief of existence and age attributed to the onset of old age were taken as indicators of age categorization and the self-report of feeling like an elderly person was taken as age identifi cation. Although most elderly have assigned an age for the onset of old age (M = 62.3 anos; SD =14.66), most (60.3%) are not identifi ed as belonging to this age category. Education, frailty and life satisfaction were found to be important predictors of these attitudes towards old age.

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ResumoO estudo objetivou investigar a associação entre Atividades avançadas de vida diária (AAVD) e o desempenho cognitivo entre idosos participantes do estudo FIBRA em Ermelino Matarazzo, São Paulo. Foram investigados 302 idosos sem declínio cognitivo, classificados em muito ativos e pouco ativos nas AAVDs, e avaliados pelo Mini exame do estado mental (MEEM), bateria breve de rastreio cognitivo (BBRC), fluência verbal (FV), teste do desenho do relógio (TDR) e escala de depressão geriátrica (EDG). As AAVDs associaram-se ao desempenho no MEEM e no TDR, nas análises univariadas, mas esta associação perdeu significância no modelo multivariado. O desempenho, no MEEM, esteve associado à idade, escolaridade, sexo e número de sintomas depressivos. O escore, no TDR, associou-se à escolaridade. Conclui-se que a relação entre as AAVDs e o desempenho cognitivo parece ser modulada por variáveis sociodemográficas e por sintomas depressivos. Palavras-chave: idoso; cognição; lazer. Advanced Activities of Daily Living (AADL) and cognitive performance among older adults AbstractThis study aimed to investigate the association between advanced activities of daily living (AADL) and cognitive performance in a community of dwelling older adults participants of the FIBRA study in Ermelino Matarazzo, São Paulo. 302 older adults without cognitive decline, classified as very active or little active in AADLs, were assessed by the Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), Verbal Fluency (VF), Clock Drawing Test (CDT), and Geriatric Depression Scale (GDS). The AADLs were associated with performance in the MMSE and CDT in univariate analyses, but the association lost statistical significance in the multivariate model. The MMSE score was associated with age, education, sex and depression symptoms. The CDT score was associated with education. The association between AADLs and cognitive performance seems to be modulated by socio-demographic variables and the number of depression symptoms. Actividades Avanzadas de la Vida Diaria (AAVD) y desempeño cognitivo entre ancianosResumen Este estudio investigó la asociación entre las Actividades Avanzadas de la Vida Diaria (AAVD) y el desempeño cognitivo entre las personas ancianas, participantes del Estudio FIBRA, en Ermelino Matarazzo, San Pablo. Fueron investigadas 302 ancianos, sin deterioro cognitivo, clasificados en muy activos y poco activos en las AAVD, y evaluadas por el Mini-Examen del Estado Mental (MEEM), la Batería Breve de Rastreo Cognitivo (BBRC), Fluidez Verbal (FV), Test del Dibujo del Reloj (TDR), y la Escala de Depresión Geriátrica (EDG). Las AAVD se asociaron con el rendimiento en el MEEM y en el TDR en los análisis univariados, pero perdieron importancia en el modelo multivariado. El desempeño en el MEEM estuvo asociado a la edad, escolaridad, sexo y número de síntomas depresivos. El resultado en el TDR se asoció a la escolaridad. La relación entre el rendimiento cognitivo y las AAVD parece estar regido por las variables sociodemográficas y por sí...

Relations between memory complaints, depressive symptoms and cognitive performance among community dwelling elderly AbstractBackground: Memory complaints are quite common among the elderly; yet, the clinical relevance of these complaints to diagnose cognitive decline is debatable, since several different factors could be associated with them. Objective: The present paper examined the correlations between memory complaints, depressive symptoms and cognitive performance in a group of 301 elderly individuals who lived in the district of Ermelino Matarazzo, São Paulo, and who participated in the population-based survey entitled Profiles of Frailty in Elderly Brazilians by the FIBRA Network. Methods: Cognitive performance was assessed with the memorization test involving 10 common pictures, the Mini Mental State Examination (MMSE), the Verbal Fluency (VF) test, and the Clock Drawing Test, which comprise the Brief Cognitive Screening Battery (BCSB). Memory complaints were assessed with the Memory Complaint Questionnaire (MAC-Q), and depressive symptoms with the Geriatric Depression Scale (GDS). Results: Female participants had higher rates of memory complaints when compared to male participants (p = 0.013). Subjects with less years of schooling had more severe memory complaints and poorer cognitive performance than those with more years of schooling (p < 0.003). The presence of depressive symptoms was associated with poorer memory assessment scores (r = 0.39, p < 0.001). Discussion: Memory complaints were correlated with sex, schooling and depressive symptoms among elderly individuals residing in the community. No correlation was found between complaints and cognitive performance.Silva LSV, et al. / Rev Psiq Clín. 2014;41(3):67-71 Keywords: Older adults, elderly, memory, depressive symptoms, memory complaints. ResumoContexto: A queixa de memória é comum entre pessoas idosas, entretanto sua relevância clínica para o diagnóstico de alterações cognitivas é questionável, visto que diversos fatores podem se associar às queixas. Objetivo: O presente estudo avaliou a relação entre queixas de memória, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Métodos: O desempenho cognitivo foi avaliado por meio dos testes de memorização de 10 figuras comuns, Miniexame do Estado Mental (MEEM), Fluência Verbal (FV) e Teste do Desenho do Relógio, que compõem a Bateria Breve de Rastreio Cognitivo (BBRC). As queixas de memória foram avaliadas pelo Questionário de Queixas de Memória (MAC-Q) e os sintomas depressivos, pela Escala de Depressão Geriátrica (EDG). Resultados: Participantes do sexo feminino apresentaram maior índice de queixas de memória, comparado aos homens (p = 0,013). Idosos menos escolarizados apresentaram queixas de memória mais intensas e pior desempenho cognitivo, comparados aos de maior escolaridade (p < 0,003). A presença de sintomas depressivos associou-se a pior ava...

IntroductionDiagnosing neurocognitive disorders is challenging in low-educated individuals.ObjectiveTo report normative data for the Brief Cognitive Screening Battery (BCSB) and to assess the association of age and education with performance on the BCSB in 240 community-dwelling elderly from Ermelino Matarazzo, São Paulo city.MethodsThe inclusion criteria were scoring above the education-adjusted cut-off points on the Mini-Mental State Examination (MMSE) and below six points on the Geriatric Depression Scale (GDS).ResultsAge was associated with performance on the Naming, Incidental Memory, Verbal Fluency, Clock Drawing Test, Delayed Recall and Recognition subtests. Education was associated with performance on Naming, Recognition, Verbal Fluency and the Clock Drawing Test.ConclusionThe normative values reported are relevant for diagnosing neurocognitive disorders in low-educated elderly.