Dementia e Neuropsychologia最新文献

With population aging, the growing concern about cognitive decline and dementias highlights the need for early and accessible cognitive assessment. In this context, a telephone-adapted version of the Mini-Mental State Examination, the Brazilian Telephone Version of the Mini-Mental State Examination (Braztel-MMSE), was developed.

Objective: The aim of the study was to compare cognitive performance assessed by the Braztel-MMSE, administered by telephone, with the traditional Mini-Mental State Examination (MMSE), administered in person, in highly educated older adults without diagnosed dementia or depression, and who are socially engaged.

Methods: This is a descriptive cross-sectional study. The initial sample consisted of 578 older adults who completed the Braztel-MMSE during the screening phase of a clinical trial. Of these, a subsample of 190 older adults completed the traditional MMSE after 18 months. Data were analyzed descriptively and inferentially to compare scores obtained from both instruments.

Results: The results showed a significant correlation between scores on the Braztel-MMSE and the traditional MMSE (Spearman's rho=0.354, p<0.001). Bland-Altman analysis revealed satisfactory agreement between the two cognitive assessment methods, with a mean difference of 0.002 between scores.

Conclusion: This study demonstrates that the telephone-administered Braztel-MMSE shows good agreement with the traditional face-to-face MMSE. These findings suggest that the Braztel-MMSE can be a useful and valid tool for cognitive screening in contexts where in-person evaluation is not feasible, including long-term clinical trials.

Hospitalizations related to Alzheimer's disease (AD) impose a growing burden on health systems, but recent, nationally representative estimates for Brazil are limited.

Objective: To describe the epidemiological profile of hospital admissions due to AD in Brazil from 2018 to 2024.

Methods: Ecological time-series study using the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), accessed via the Department of Informatics of the SUS (DATASUS). We included all regions and states from January 2018 to December 2024. Admissions were identified by the International Classification of Diseases, 10^th Revision (ICD-10) codes G30.0-G30.9 and F00.0-F00.9. Variables comprised sex, age group, race/color, admission type (urgent/elective), in-hospital mortality, length of stay, and hospital costs. Temporal trends were evaluated with linear regression.

Results: From 2018 to 2024, 11,212 AD-related hospitalizations were recorded; 79.4% were urgent. The Southeast had the highest absolute number (47.8%), followed by the South (25.1%), Northeast (17.2%), Midwest (6.5%), and North (3.4%). Females accounted for 65% of admissions and 64.7% of in-hospital deaths. Older adults, especially those ≥80 years, represented most hospitalizations (59.3%) and deaths (69.7%). Total hospital expenditures exceeded R$ 14 million, with the Southeast concentrating >60% of national costs. No significant linear trend was detected in annual rates.

Conclusion: Urgent admissions comprised the majority of AD hospitalizations nationwide, with the Southeast presenting the highest numbers. The predominance of older female patients and high in-hospital mortality underscore the need for targeted clinical and public health strategies. Rising expenditures reinforce investment in health infrastructure and long-term dementia-care policies in Brazil.

A highly educated and intellectually active 84-year-old male presented with word-finding pauses and impaired sentence repetition, with preserved single-word comprehension, reading, and writing, a clinical profile consistent with the logopenic variant of primary progressive aphasia (lvPPA). Interestingly, the initial symptom was difficulty with auditory verbal comprehension in Portuguese, his second language, while comprehension in English remained initially preserved. Structural and functional imaging revealed no atrophy in the temporoparietal region or cortical hypometabolism. Plasma biomarkers, including Aβ42/40 and plasma-measured tau phosphorylated at threonine 217 (p-tau217), were within normal limits, arguing against biological Alzheimer's disease (AD). This case illustrates a rare constellation of findings - bilingual asymmetry, negative AD biomarkers, and unremarkable neuroimaging - suggestive of a non-Alzheimer's pathology. Alternative etiologies such as primary age-related tauopathy (PART) and argyrophilic grain disease (AGD) are discussed, emphasizing the utility of fluid biomarkers in distinguishing phenocopies within the lvPPA spectrum.

There is a gap in the literature regarding popular knowledge about dementia. Although dementia affects older individuals more frequently, it does not belong to senescence. Lack of awareness contributes to the normalization of cognitive decline, delaying the search for healthcare services, diagnosis, and treatments.

Objective: Assess the population's knowledge about dementia and its relationship with socioeconomic characteristics.

Methods: Cross-sectional study with a semi-structured questionnaire administered in person to a convenience sample of residents of Ribeirão Preto, São Paulo, Brazil. Descriptive and inferential statistical analyses were conducted. Significance level: p<0.05.

Results: Three hundred residents were interviewed. Among them, 189 (63%) were unaware of the meaning of dementia. In a multivariable regression, higher income increased the odds of knowing what dementia is compared to the lowest income group (adjusted Odds Ratio [aOR]=4.29, 95% confidence interval [95%CI] 1.40-14.11, p=0.013). Working in healthcare (aOR=3.30, 95%CI 1.24-9.66, p=0.021) or having relatives in this sector (aOR=2.16, 95%CI 1.16-4.07, p=0.016) increased the probability of awareness. Limited awareness of risk factors was observed, along with the normalization of dementia signs and symptoms, which were commonly perceived as part of normal aging.

Conclusion: Significant lack of knowledge on the subject was observed, particularly among socioeconomic vulnerable individuals. Dementia was not widely recognized as a pathological and preventable condition. Given an aging society, this study provides a critical foundation for future public health initiatives and research aimed at improving dementia literacy and promoting early intervention.

[This corrects the article DOI: 10.1590/1980-5764-DN-2024-0222.].

[This corrects the article DOI: 10.1590/1980-5764-DN-2024-0261.].

The "Caregiver Guilt Questionnaire" CGQ was originally developed in Spain and contains 22 self-report items covering the following factors: guilt about doing wrong by the care recipient, guilt about failing to meet the challenges of caregiving, guilt about self-care, guilt over feeling negative emotions while caregiving, and guilt about neglecting other relatives.

Objective: To analyze the psychometric properties of the Brazilian version of the CGQ.

Methods: The sample was established for convenience, consisting of 153 family caregivers of people with Alzheimer's disease. The following measures were applied: a sociodemographic questionnaire, the CGQ, the Depression, Anxiety and Stress Scale (DASS-21), and the Life Satisfaction Scale. An exploratory factor analysis was performed for analyzing construct validity to obtain evidence of validity with internal structure and external correlation measures.

Results: The exploratory factor analysis identified five factors with 22 items, which explained 71% of the total variance. Criterion validity was supported by positive associations between CGQ-BR scores and levels of depression, anxiety, and stress, and a negative association with life satisfaction. Good to excellent reliability indexes were found for the total score and subscales.

Conclusion: The psychometric properties of the CGQ-BR, when applied to a sample of family caregivers of people with Alzheimer's disease in the Brazilian population, proved to be a valid tool for measuring feelings of guilt. The findings suggest that this tool can be used in clinical and research settings with caregivers.

Inclusive research is a relatively new concept that has received attention in recent years as a scientific priority to respond to health disparities and maximize the practical implications of research. This approach involves a partnership between academics and the individuals who are experiencing the problem to be investigated. Despite the high incidence of dementia and asymptomatic Alzheimer's disease in aging individuals with Down syndrome, inclusive research with this population or those with intellectual disability (ID) at risk of dementia is an area that is little approached and not well documented. Here, we describe the evolution of inclusive research on ID and dementia, some of the challenges and benefits of its implementation, and key aspects to consider when planning such studies. There is an urgent need for national and international guidelines to support inclusive research involving this population. Such frameworks should ensure accessibility, ethical rigor, the meaningful participation of co-researchers, ultimately advancing equity and scientific quality in this underrepresented field.

There is a growing interest in the study of vascular mild cognitive impairment (vMCI) and vascular dementia (VD) due to the increasing incidence of cardiovascular risk factors such as diabetes and overweight. The study of non-pharmacological interventions in individuals with vMCI and VD is crucial due to the cognitive and motor consequences of these conditions on the daily lives of individuals. Whereas most interventions are designed from a single disciplinary perspective, the intervention employed in this study integrated both psychomotor and cognitive approaches to concurrently stimulate participants' embodied experience and cognitive processes.

Objective: To assess the effects of an intervention combining cognitive stimulation and motor work on memory, attention, praxis, visuospatial abilities, and motor skills.

Methods: A two-case study (one with vMCI and one with VD) with psychomotor and cognitive assessments pre- and post-intervention. The intervention combined psychomotor skills and cognitive stimulation and was applied over four months (32 sessions).

Results: The participant with vMCI showed improvements in attention processes, executive functions, and psychomotor skills. The participant with VD showed improvements in memory and psychomotor skills. In both participants, stability was observed in the majority of the cognitive variables measured, along with improvements in processing visuospatial stimuli and neuropsychiatric symptoms (anxiety and apathy).

Conclusion: Motor work can catalyze mental ability, promoting cognitive stimulation from the body to thought, which may be useful in improving and/or achieving stability in cognitive performance in individuals with vMCI and VD.

Emotion recognition is a key component of social cognition. Symptoms of depression and anxiety may modulate this ability.

Objective: To investigate the effect of subclinical depressive and anxiety symptoms on performance in a facial emotion recognition test.

Methods: A total of 203 participants (109 females and 94 males; mean age 48.8±19 years; mean schooling 9.3±5.1 years) without current or past history of psychiatric or neurological disorders were enrolled. None had abnormal scores on the anxiety or depression subscales of the Hospital Anxiety and Depression (HAD) Scale. All participants (N=203) underwent the Mini-Mental State Exam (MMSE) and the Facial Emotion Recognition Test (FERT), which assesses recognition of: anger, disgust, fear, happiness, sadness, surprise, and neutral expressions. Multivariate analyses included HAD-Anxiety, HAD-Depression, MMSE, age, and schooling as covariates.

Results: Age, schooling, and MMSE were significantly correlated with FERT scores. A significant negative correlation was found between FERT-Total and HAD-Depression (r=-0.22; p<0.002), and between FERT-Fear and HAD-Depression (r=-0.31; p<0.0001). No other significant correlations were observed between FERT scores and psychiatric measures. Anxiety and depression scores were not retained in the final multivariate models, except for a negative correlation between HAD-Anxiety and FERT-Fear.

Conclusion: Subclinical anxious and depressive symptoms have a modest effect on FERT.