Background: The available studies have not fully analyzed the several factors involved in the genesis of hypertension (HT), especially the association among blood pressure, urinary sodium excretion and renal dysfunction.

OBJECTIVE:To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden.DESIGN:This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms.SETTING:The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly.SUBJECTS:Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences).INTERVENTIONS:Aerobic exercises (flexibility, strength, and agility) and functional balance exercises were conducted over six months for 60 minutes three times per week.MAIN MEASURES:Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA) was applied to observe interactions (pre- vs. post-intervention; participants vs. controls).RESULTS:Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F∶11.12; p = 0.01; Cornell Depression scale: F∶11.97; p = 0.01). The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01).CONCLUSIONS:Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study.

Background Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician Rating Scale (NPI-C) is a comprehensive and versatile instrument to assess neuropsychiatric symptoms (NPS) in dementia. In the NPI-C, the clinician incorporates information from caregiver and patient interviews, and any other relevant available data to accurately measure NPS. The present study is a followup to the original, cross-national NPI-C validation evaluating the reliability and concurrent validity of NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort. Methods Two blind raters evaluated 312 participants (156 patient-knowledgeable informant dyads) with the NPI-C totaling 624 observations in 5 Brazilian centers. Inter-rater reliability was determined through calculation of intraclass correlation coefficients for the NPI-C domains and traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS); the Cohen Mansfield Agitation Index (CMAI); the Cornell Scale for Depression in Dementia (CSDD); and the Apathy Inventory (AI). Results Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/Delusions and BPRS; NPI-C/Apathy-Indifference with the AI; NPI-C/Depression-Dysphoria with the CSDD; NPI-C/Agitation with the CMAI; and NPI-C/Aggression with the CMAI. There was moderate correlation between the NPI-C/Aberrant Vocalizations and CMAI and the NPI-C/Hallucinations with the BPRS. Conclusion The NPI-C is a comprehensive tool which provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains.

The V allele may be a risk factor for AD, mainly in the presence of the apoE 4 allele, while the presence of GSTT1 may indicate protection against the disease.

ResumoIntrodução: O envelhecimento populacional tem aumentado a prevalência das doenças crônicas não transmissíveis, síndromes geriátricas e alterações no estado nutricional, comprometendo a qualidade de vida e funcionalidade dos idosos. Objetivo: Levantar na literatura científica, estudos relacionados à sarcopenia e sua influência no estado nutricional da população idosa. Material e Métodos: A pesquisa foi realizada a partir das bases de dados PubMed, MEDLINE, LILACS e IBECS. A análise dos estudos envolveu leitura de títulos, resumos e textos completos. Foram incluídos estudos realizados com humanos com idade igual ou superior a 60 anos e publicados entre 2008 e 2012. Foram excluídos artigos de revisão, publicações apresentadas em conferência e simpósios e publicações que relacionavam o estado nutricional e/ou sarcopenia com quedas e com doenças (como câncer, doença pulmonar obstrutiva crônica e/ou doença renal). Resultados: Foi encontrada maior prevalência de sarcopenia em homens. Os idosos institucionalizados apresentaram maior desnutrição do que os que vivem na comunidade. A sarcopenia foi inversamente associada com índice de massa corporal. A sarcopenia foi associada a níveis baixos de vitamina D e à inatividade física. Conclusão: Estado nutricional adequado mensurado pela mini avaliação nutricional e/ou índice de massa corporal, envolvimento em atividades físicas de lazer diárias por uma hora ou mais, suplementação de vitamina D e de proteínas, parecem prevenir ou tratar os idosos com sarcopenia.Descritores: Idoso; Sarcopenia; Estado Nutricional. Abstract Introduction: Demographic aging has increased the prevalence of chronic non-communicable diseases, geriatric syndromes, and changes in nutritional status, affecting the quality of life and functionality of the elderly people. Objective: To search in the scientific literature studies related to sarcopenia and its influence on the nutritional status of the elderly population. Materials and Methods: We searched the electronic databases of PubMed, MEDLINE, LILACS, and IBECS. We further limited our inclusion to articles focused on humans aged 60, and over that were published between 2008 and 2012. Studies were evaluated to determine fit into the inclusion criteria by review of titles, abstracts, and full texts. Studies were excluded if they were repeated publications, review articles, publications presented in conferences and symposia, and publications related to nutritional status and/or sarcopenia with falls and diseases (cancer, chronic obstructive pulmonary disease, and/or renal disease). Results: We found a higher prevalence of sarcopenia in men. Our study showed that institutionalized elderly people presented with higher malnutrition than those living in the community. Sarcopenia was inversely associated to body mass index. It was also associated to vitamin D levels and physical inactivity. Conclusion: Adequate nutritional status measured by the Mini Nutritional Assessment short-form and/ or body mass index, involvement in physical activities of daily le...

Caregivers may have incomplete perception of patient NPS mainly in mild dementia. NPS ratings might be confounded by cultural beliefs, sometimes leading caregiver to interpret symptoms as part of "normal" aging.

Narrative review.

Cognitive screening instruments are influenced by education and/or culture. In Brazil, as illiteracy and low education rates are high, it is necessary to identify the screening tools with the highest diagnostic accuracy for Alzheimer's disease (AD). Objective: To identify the cognitive screening instruments applied in the Brazilian population with greater accuracy, to detect AD in individuals with a low educational level or who are illiterate. Methods: Systematic search in SciELO, PubMed and LILACS databases of studies that used cognitive screening tests to detect AD in older Brazilian adults with low or no education. Results: We found 328 articles and nine met the inclusion criteria. The identified instruments showed adequate or high diagnostic accuracy. Conclusion: For valid cognitive screening it is important to consider sociocultural and educational factors in the interpretation of results. The construction of specific instruments for the low educated or illiterate elderly should better reflect the difficulties of the Brazilian elderly in different regions of the country.