A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education. A physiotherapist alone carried out the intervention in group 2. Group 3 was considered as control. Assessors were blinded to guarantee the absence of bias. Cognitive functions were analysed with the Mini-Mental State Examination and the Brief Cognitive Screening Battery. Balance was assessed with the Berg Balance Scale and the Timed Get-Up-and-Go Test. Multiple analysis of variance (MANOVA) was used to test possible main effects of the interventions.Results: The results showed benefits on the balance of subjects in both groups 1 (F=3.9, P < 0.05) and 2 (F= 3.1, P < 0.05), compared with group 3. MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 (F= 1.1, P > 0.05) and groups 2 and 3 (F= 1.6, P > 0.05). However, univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery (F=26.5, P < 0.05; F= 4.4, P < 0.05).Conclusion: Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person's balance. Although global cognition did not improve through treatment, when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains. Exercises applied in different contexts may have positive outcomes for people with dementia.

Physical Exercise in MCI Elderly Promotes Reduction of Pro-Inflammatory Cytokines and Improvements on Cognition and BDNF Peripheral Levels

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

The decline in frontal cognitive functions contributes to alterations of gait and increases the risk of falls in patients with dementia, a category which included Alzheimer's disease (AD). The objective of the present study was to compare the gait parameters and the risk of falls among patients at different stages of AD, and to relate these variables with cognitive functions. This is a cross-sectional study with 23 patients with mild and moderate AD. The Clinical Dementia Rating was used to classify the dementia severity. The kinematic parameters of gait (cadence, stride length, and stride speed) were analyzed under two conditions: (a) single task (free gait) and (b) dual task (walking and counting down). The risk of falls was evaluated using the Timed Up-and-Go test. The frontal cognitive functions were evaluated using the Frontal Assessment Battery (FAB), the Clock Drawing Test (CDT) and the Symbol Search Subtest. The patients who were at the moderate stage suffered reduced performance in their stride length and stride speed in the single task and had made more counting errors in the dual task and still had a higher fall risk. Both the mild and the moderate patients exhibited significant decreases in stride length, stride speed and cadence in the dual task. Was detected a significant correlation between CDT, FAB, and stride speed in the dual task condition. We also found a significant correlation between subtest Similarities, FAB and cadence in the dual task condition. The dual task produced changes in the kinematic parameters of gait for the mild and moderate AD patients and the gait alterations are related to frontal cognitive functions, particularly executive functions.

Information and mechanical models of intelligence: What can we learn from cognitive science?

The impact of new advanced technology on issues that concern meaningful information and its relation to studies of intelligence constitutes the main topic of the present paper. The advantages, disadvantages and implications of the synthetic methodology developed by cognitive scientists, according to which mechanical models of the mind, such as computer simulations or self-organizing robots, may provide good explanatory tools to investigate cognition, are discussed. A difficulty with this methodology is pointed out, namely the use of meaningless information to explain intelligent behavior that incorporates meaningful information. In this context, it is inquired what are the contributions of cognitive science to contemporary studies of intelligent behavior and how technology may play a role in the analysis of the relationships established by organisms in their natural and social environments. © John Benjamins Publishing Company.

Arquitetura moderna paulista, imaginário social urbano, uso e apropriação do espaço

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Patient with a Starr-Edwards Prosthesis in the Aortic Position for 40 Years

Herein is reported the case of a patient who presented initially with aortic insufficiency and a fistula between the sinus of Valsalva and right atrium when aged 31 years. Closure of the fistula and replacement of the aortic valve with a Starr-Edwards A-9 caged-ball prosthesis was performed in 1972, since when the valve has survived for 40 years without dysfunction. This is one of the longest follow ups of the Starr-Edwards prosthesis reported, and highlights the possibility of acceptable valve performance over long periods of time.

Neurobiological Correlates of Apathy in Alzheimer's Disease and Mild Cognitive Impairment: A Critical Review

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Depression and Cognitive Decline: Factors Related to Demographics and Psycho Pharmacotherapy on Elderly in Nursing Homes

Objectives: To identify the prevalence of neuropsychiatric disorders, especially DP and CD, on a sample of nursing home residents, relating this prevalence with some aspects of the demographics and psycho pharmacotherapy. Methods: 48 elders from two different nursing homes were selected. The collection of demographic and pharmacological data was made utilizing medical records. The medication was classified according to the Anatomical Therapeutic Chemical Code (ATC) criteria. The Geriatric Depression Scale (GDS 30) and the Mini Mental State Examination (MMSE) tests were utilized to determine the prevalence of DP and CD. Results: It was observed in the sample a high incidence of DP and CD among the researched elders. More schooling individuals tend to present less CD. Individuals with less CD indicatives present less symptomatology for DP. Of all the researched elders, 54,2% are submitted to psycho pharmacotherapy. Of all the consumed medicine, 16,5% belonged to the class of neuropsychiatric medicine. The medicated elders present, in average, a larger symptomatology for DP (12 points/average/GDS) than the non-medicated elders (9,9 points/average/GDS). The inverse occurs in relation to the CD indicatives. The use of psychotropics, especially in association, can have negative effects related to depression and cognition. Discussion: The pharmacotherapy, characterized for the polymedication and chronicity, especially of neuropsychiatric medicines, deserves special attention among elders, because the data suggest a significant relation between the utilization of medicines, singly or in association, and the increase of CD and DP. In addition, the data suggest that DP is a risk factor for CD and DM.

Physical Exercise Improves Peripheral BDNF Levels and Cognitive Functions in Mild Cognitive Impairment Elderly with Different BDNF Val66Met Genotypes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Teletandem and performativity

Teletandem is a virtual autonomous VoIP2 technology-based context (webcam images, voice and text). Within this context, two students help each other learn their native (or other) language through intercultural and linguistic collaboration. Performative Theory can shed light on the constitution of these students' national identities, as they engage in linguistic performances of marking and discussing differences between their countries during teletandem. Based on critical approaches to discourse and intercultural communication, my analysis shows that this online intercultural contact opens innovative possibilities for foreign language teachers to promote intercultural contact with the different. However, without teacher mediation, teletandem interactions may fall into shallow performances of sedimented and pre-given representations of self and other. Subsequently, this article concludes with a discussion of relevant pedagogical points for foreign language teachers.

Unfaithful narratives: methodological and affective notes about experiences of masculinity in a dating website for married people

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ethanol intake-induced apoptosis in glial cells and axonal disorders in the cerebellar white matter of UChA rats (voluntary ethanol consumers)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Elegância e atitude: diferenças sociais e de gênero no mundo da moda

As distinções mais óbvias que podem ser observadas no mercado de moda são aquelas que dizem respeito às diferenças de gênero, independente da classe ou do grupo social a que se faça referência. Dentro desse universo podem ser encontradas duas noções, elegância e atitude, que condensam, a um só tempo, marcas de gênero, sociais e individuais. No caso da noção de elegância, o discurso, tanto quanto a roupa ou o próprio indivíduo, traduz sempre um ato de remissão a uma determinada concepção de ordem social, entendida como natural. As diferenças de gênero são relevantes, nesse contexto, porque demarcam posições sociais entendidas como naturais. Já a noção de atitude não cobra, necessariamente, uma ordem social e natural, mas uma ordem pessoal. O discurso e a roupa traduzem um caráter individualista, supondo ser o indivíduo quem imprime um sentido a sua inserção social, ainda que eventual ou momentânea. Nesse contexto, na maior parte das vezes, o individualismo ganha expressão através de uma linguagem estruturada como se não tivesse gênero.

A percepção de enfermeiros sobre o cuidar de pacientes com problemas físicos que interferem na autoimagem: uma abordagem fenomenológica

O presente estudo tem como objetivo compreender a percepção e o significado do cuidar de pacientes com problemas de auto-imagem, resultantes de alteração física, por enfermeiros de um hospital universitário. A trajetória metodológica foi a fenomenologia, os sujeitos da pesquisa foram oito enfermeiros. Para a análise dos depoimentos, realizou-se a transcrição e as leituras, buscando a essência das unidades, expressão dos significados, tematizando e interpretando as falas, buscando convergências, divergências e idiossincrasias e a síntese do fenômeno. Os temas desvelados foram: (não)aceitação da enfermidade; trabalho em equipe; limitações conseqüentes da doença; sentimentos e comportamento do enfermeiro e equipe; vínculo entre equipe, paciente e família; a família; auto-imagem do paciente; idade dos pacientes; o preconceito; (re) conhecimento da doença; nível e cuidados mais intensos; a religião e capacitação. Pela amplitude do fenômeno outros ângulos podem ser desvelados e outras perspectivas habitadas.

Estratégias de coping desenvolvidas por cuidadores de idosos portadores de doença crônica

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)