Estudo de base populacional dos fatores associados ao desempenho no Mini Exame do Estado Mental entre idosos: Projeto Bambuí

Abstract

The aim of this study was to examine factors associated with cognitive functioning in community-dwelling older adults with low schooling. 1,588 subjects residing in Bambuí, Minas Gerais State, Brazil, and aged > 60 IntroduçãoO Mini Exame do Estado Mental (MEEM) 1 é a escala mais utilizada para rastreamento do comprometimento cognitivo. Clinicamente, tem sido usado para detecção e acompanhamento da evolução de alterações cognitivas, bem como para o monitoramento da eficácia e efetividade de tratamentos para as mesmas. Como instrumento de pesquisa, tem sido empregado em grandes estudos populacionais 2,3,4,5 ou acoplado a baterias de testes neuropsicológicos 6,7 . Compõem o MEEM questões que se correlacionam em cinco dimensões, quais sejam: concentração, linguagem/práxis, orientação, memória e atenção, com um escore máximo de 30 pontos 8 . Na prática clí-nica, o ponto de corte 23/24 é mais comumente empregado, apresentando alta sensibilidade e especificidade para a detecção de comprometimento cognitivo e demência. Entretanto, como a performance no MEEM é influenciada pela escolaridade, outros pontos de corte têm sido recomendados no Brasil para populações com baixa escolaridade 9,10,11,12,13 , mas não existe consenso quanto ao melhor ponto de coorte para esta população.Estudos conduzidos em outros países têm descrito associações consistentes entre o baixo escore do MEEM e a idade avançada 14,15,16

Avaliação cognitiva de pessoas idosas cadastradas na estratégia saúde da família: município do Sul de Minas

“…Morbidity from chronic non-communicable diseases is common for the age range studied, but the prevalence observed in this study was lower than that found in studies conducted throughout the country (4,11) .…”

“…Studies show that age and education are factors that are directly related to the decline in cognition (1,3,11) , with illiteracy being associated with the risk of disability and death (12) . This fact is corroborated by the findings of this study, since the average age was high and there was a significant proportion of subjects with no or low education (75.7%).…”

“…The educational level plays an important role in the performance of neuropsychological tasks and in brain organization, besides being a protective factor against neurological diseases. It is an accurate indicator, as it is related to the possibility of access to health services, employment, paid work, and adhesion to health and educational programs, while illiteracy causes increased susceptibility to loss of independence (11,23) . Education significantly influences the results of the MMSE; the higher the education level, the higher the scores (13) .…”

Control of diabetes and fibrinogen levels as well as improvement in health care might delay low cognitive performance in societies aging progressively

“…Schooling has consistently been described in the literature as strongly associated with cognitive performance 3,4,5,20 , and these findings were confirmed in the present study. The inverse relationship between educational level and cognitive performance may have resulted from the greater exposure among individuals of lower educational level to environmental factors with adverse effects on the central nervous system, such as poor nutrition, low neuropsychomotor stimulation, and greater exposure to precarious living conditions, particularly during the early years of life, reflected in adulthood as LCP 21 .…”

“…Such losses consequently have direct implications for these individuals' lives and may interfere in their day-to-day activities, in maintaining their social relationships and in their professional performance, thereby contributing towards reducing their wellbeing and quality of life 3 . Different authors have identified associations between low cognitive performance (LCP) and sociodemographic 4,5 , behavioral 6,7 and health-related factors 8,9 . The influence of age and schooling level on LCP have been consistently observed, as have certain habits such as smoking and alcohol abuse and diseases such as hypertension and diabetes.…”