Caring for a demented family member has been associated with burden. Studies concerning health self-perception of family caregivers are still scarce. Objective: To investigate caregivers perceived health and to look into relationships with patients and caregivers' sociodemographic and clinical data. Method: Dyads of dementia outpatients and family caregivers (n=137) were assessed with Mini Mental State Examination, Functional Activities Questionnaire, Neuropsychiatric Inventory and Clinical Dementia Rating. Caregivers answered Sociodemographic Questionnaire, Beck Depression and Anxiety Inventories, Zarit Burden Interview and Maslach Burnout Inventory. Results: Caregivers poor perceived health was associated with emotional exhaustion, burden, depression and anxiety. Logistic regression analyses revealed caregivers' age, anxiety and physical problem as the main predictors of health self-perception. Conclusion: Aged family caregivers with anxiety who also report physical problem characterize a group at risk for poor self-perceived health. Evaluation of health self-perception may be useful for designing interventions to improve anxiety and physical health. Key words: dementia family caregiver, dementia, health self-perception, age, anxiety.Autopercepção de saúde em cuidadores familiares de pacientes com demência: fatores sociodemográficos e clínicos RESUMO Cuidar de familiar com demência tem sido associado a sobrecarga. Estudos sobre autopercepção de saúde em cuidadores ainda são escassos. Objetivo: Investigar autopercepção de saúde em cuidadores e relação entre dados sociodemográficos e clínicos de cuidadores e pacientes. Método: Díades de pacientes demenciados e cuidadores familiares (n=137) foram avaliados pelo Mini Exame do Estado Mental,

No abstract

-Background: Vascular white matter lesions (WML) represent one of the main neuroimage findings in individuals older than 65 years and its clinical significance is still partially understood. Objective: To describe and analyze the clinical profile of a high severity sample with WML focusing on the frontal executive control. Method: Outpatients (n=20) with high severity WML evaluated with magnetic resonance imaging were selected using the Fazekas scale. Results: Most patients (n=17; 85%) presented an altered Trail Making Test ratio (section B/section A); on verbal fluency, 15 individuals (75%) performed below the cutoff score. Apathy (5.9±4.65) and depression (3.05±3.67) were frequent as assessed by the Neuropsychiatric Inventory. The impairment in functional activities strongly correlated with apathy (r=0.814, p<0.001) and verbal fluency (r=0.744, p<0.001). Conclusion: Executive dysfunction, apathy, and ratio depression were the main characteristics found. Extension of WML may have distinct impact on the clinical picture, but further studies with methodological adjustments are necessary to provide more definitive conclusions.KEy WOrds: neuropsychology, cognition, behavior, function, vascular dementia, white matter lesions.Características clínicas na doença isquêmica da substância branca subcortical resumo -Fundamento: Lesões vasculares em substância branca (LsB) são um dos principais achados de neuroimagem em indivíduos acima de 65 anos e sua importância em termos clínicos é ainda parcialmente conhecida. Objetivo: descrever e analisar o perfil clínico de amostra com LsB grave enfocando as alterações do controle executivo frontal. Método: Pacientes ambulatoriais (n=20) avaliados pela ressonância nuclear magnética e com maior proporção de LsB foram selecionados através da escala de Fazekas. Resultados: A maioria dos pacientes (n=17; 85%) apresentou alteração na proporção teste das trilhas (seção B/A); na fluência verbal, 15 indivíduos (75%) apresentaram desempenho abaixo do ponto de corte. Apatia (5,9±4,65) e depressão (3,05±3,67) foram freqüentes na avaliação pelo Inventário Neuropsiquiátrico. O prejuízo nas atividades funcionais correlacionou-se fortemente à apatia (r=0, 814, p<0,001) e à fluência verbal (r=0, 744, p<0,001). Conclusão: disfunção executiva, apatia e depressão foram as principais características encontradas. A extensão e localização das LsB parecem exercer um impacto distinto nas manifestações clínicas, porém estudos futuros com ajustes metodológicos são necessários para conclusões mais definitivas.PALAVrAs-chAVE: neuropsicologia, cognição, comportamento, função, demência vascular, lesões de substância branca.

No abstract

Objective: Cerebrovascular disease (CVD) is associated with cognitive deficits. This crosssectional study examines differences among healthy elderly controls and patients with vascular mild cognitive impairment (VaMCI) and vascular dementia (VaD) in performances on CAMCOG subscales. Method: Elderly individuals (n=61) were divided into 3 groups, according to cognitive and neuroimaging status: 16 controls, 20 VaMCI and 25 VaD. VaMCI and VaD individuals scored over 4 points on the Hachinski Ischemic Scale. Results: Significant differences in total CAMCOG scores were observed across the three groups (p<0.001). VaD subjects performed worse than those with VaMCI in most CAMCOG subscales (p<0.001). All subscales showed differences between controls and VaD (p<0.001). Performance on abstract thinking showed difference between VaMCI and controls (p<0.001). Vascular mild cognitive impairment (VaMCI) can be defined as a cognitive impairment of vascular etiology that does not fulfill criteria for dementia 1 . It has been proposed that vascular-related cognitive impairment exists throughout a continuum comprising VaMCI, vascular cognitive impairment no-dementia (Va-CIND) and vascular dementia (VaD) 2 . In a sample of cerebrovascular disease (CVD) patients with cognitive difficulties, Wentzel et al. 3 reported a 50% rate of conversion to dementia over a five-year period. The early detection of VaM-CI may allow therapeutic intervention designed to halt or delay the progression of vascular lesions so as to prevent the conversion to dementia 4,5 . Presently, the diagnosis of mild cognitive impairment (MCI) requires improvement in the sensitivity of conventional screening tests for dementia, since the rate of false-negative results is usually high for those individuals 6,7 . Studies attempting to increase such sensitivity have shown that a combination of different screening tests provides higher diagnostic accuracy compared to each test individually 8,9 . Diniz et al. 7 analyzed Mini-Mental State Examination (MMSE) subtests in a sample of MCI subjects and managed to identify distinct profiles of cognitive deficits among the MCI subtypes. A higher rate of patients with MCI could be identified when the item scores were analyzed, which was not possible when only MMSE final scores were considered. ROC curve analyses were performed to determinate cutoff scores in the Cambridge Cognitive Examination (CAMCOG) for MCI patients, but discrimination between MCI subjects and controls with this method showed low accuracy 10 . ConclusionIt was suggested that some cognitive domains might be specifically impaired in MCI subjects and these aspects could serve as differential markers to distinguish this condition from normal aging. Rodríguez et al. found that individuals diagnosed as MCI performed significantly worse than controls in CAMCOG subtests assessing various areas, with higher significance levels corresponding to the variables memory, abstract thinking and executive function 11 . In a previous study, Erkinjuntii et al. observed im...