Objectives: Accumulating evidence shows depression as a risk factor for frailty, but studies are mainly population-based and widely differ in their assessment of either depression or frailty. We investigated the association between depression and frailty among geriatric outpatients using different assessment instruments for both conditions. Method: Among 315 geriatric outpatients (mean age 72.1 years, 68.3% female sex) participating the MiMiCS-FRAIL cohort study, major and subthreshold depression were measured with psychiatric diagnostic interview according to DSM-5 criteria (SCID-5) as well as with instruments to screen and measure severity of depressive symptoms (GDS-15 and PHQ-9). Frailty was assessed according to a screening instrument (FRAIL-BR) and a multidimensional Frailty Index (FI-36 items). Multiple logistic and linear regression were performed to assess the association between depression (independent variable) and frailty (dependent variable) adjusted for confounders. Results: Frailty prevalence in patients with no, subthreshold or major depressive disorder increases from either 14.5%, 46.5% to 65.1% when using the FRAIL-BR questionnaire, and from 10.2%, 20.9%, to 30.2% when using the FI-36 index. These association remain nearly the same when adjusted for covariates. Both the FRAIL-BR and the FI-36 were strongly associated with major depressive disorder, subthreshold depression, and depressive symptoms by PHQ-9 and GDS-15. Conclusion: Late life depression and frailty are associated in a dose-dependent manner, irrespective of the used definitions. Nonetheless, to avoid residual confounding, future research on underlying biological mechanisms should preferably be based on formal psychiatric diagnoses and objectively assessment frailty status.
The Pentagon Drawing Test (PDT) is a common cognitive screening test.Objective: The aim of this study was to evaluate performance properties of a specific PDT scoring scale in older adults with Alzheimer's disease (AD) and healthy controls.Methods: A cross-sectional study of 390 elderly patients, aged 60 years or older with at least two years of education was conducted. All participants completed clinical and neuropsychological evaluations, including the Cambridge Cognitive Examination, the Mini-Mental State Examination (MMSE), and the Clock Drawing Test. All PDT were blindly scored with the scale of Bourke et al.Results: PDT analyses of the binary score on the MMSE (0 or 1 point) did not discriminate AD from controls (p = 0.839). However, when PDT was analyzed using the Bourke et al. scale, the two groups could be distinguished (p <0.001). PDT was not affected by education, showed sensitivity of 85.5% and specificity of 66.9%, discriminated different clinical stages of dementia, and correlated with the other cognitive tests (p <0.001). A 1-point difference on the Bourke et al. scale was associated with an odds ratio of 3.46 for AD.Conclusion: PDT can be used as a cognitive screen for suspected cases of dementia, especially AD, irrespective of educational level.
The CDT did not show a strong correlation with MMSE and CAMCOG, both important instruments in Brazilian population to investigate dementia. For elderly individuals with high education levels, the CDT did not seem to be a good test to detect cognitive impairment.
A atividade física oferece benefícios com relação à saúde física e mental dos praticantes. Contudo, pouco se conhece sobre o que motiva os participantes adultos e idosos a procurar a prática de exercício físico. Objetivou-se investigar a relação entre autoestima e a motivação de praticantes de atividade física acima de 40 anos de idade. Para isso, foram coletadas informações de 43 praticantes de atividades físicas em academias. Além do questionário socioeconômico, foram aplicadas a Escala de Motivações para a prática de Exercício Físico em Academias e Escala de Autoestima de Rosemberg. Optou-se, ainda, dividir a escala de motivação em 4 aspectos: “Indicação Médica”, “Socialização”, “Aparência Física” e “Manutenção da Saúde”. Os dados mostraram que o grupo de adultos (40 a 59 anos) possuem motivação multifatorial para à prática de exercício físico. Grupo de idosos (acima dos 60 anos) apresentou correlação entre autoestima e os aspectos motivacionais Indicação médica (p< 0,0001), Socialização (p= 0,048), Aparência física (p= 0,047) e Manutenção da saúde (p< 0,0001). Pode-se concluir que os adultos procuram a prática de atividade física devido a diversos fatores (aspectos multifatorial), enquanto que os idosos buscam a prática da atividade física pela preocupação com a sensação de sentir-se só, manutenção da saúde, indicação médica e também pela preocupação com a aparência física.
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