Atividade física e sintomas depressivos em cuidadores de idosos com demência de Alzheimer

The Alzheimer's dementia (AD) is a chronic, neurodegenerative and progressive disorder, characterized by cognitive decline, affecting brain functions like memory, reasoning and communication, occurrence of behavioral disturbances and difficulty in performing activities of daily living (ADLs). These conditions lead to patient’s dependence, which can cause depressive symptoms in caregivers, due to physical and mental burden caused by of the difficulties of the act of caring. Whereupon, it became necessary to find strategies to improve the caregivers’ quality of life. An interesting hypothesis is that physical activity can be considered a non-pharmacological alternative in reducing depressive symptoms, being an important factor for maintaining the physical and mental well-being of the general population, especially on positive changes in mood and social interaction. This study aimed to analyze the effects of a physical activity protocol on depressive symptoms and burden of caregivers of patients with AD. This experimental study, of longitudinal character, comprised a sample of 19 caregivers, of both genders, divided into two groups: a) intervention group – IG (10 caregivers who participated in a physical activity protocol) and b) control group – CG (9 caregivers who didn’t participate in the physical activity protocol). This protocol, which worked the components of functional ability and social interaction of participants, was held three times a week, being 48 sessions of 60 minutes each, for 16 weeks. Data collect was performed at pre and post-intervention for both groups. The assessment instruments used were: a) Zarit Burden Interview, b) Hospital Anxiety and Depression Scale (HAD) and c) battery of motor tests of the American Alliance for Health Physical Education Recreation and Dance (AAHPERD). Nonparametric statistics was used, with intra-group comparison by Wilcoxon test... (Complete abstract click electronic access below)

Equilíbrio, funções executivas e quedas de idosos com demência de Alzheimer: um estudo longitudinal

Falls among older people is a major clinical problem due to its high incidence, with consequent implications for the health and care costs. Elderly patients with dementia of Alzheimer type (AD) are more susceptible to falls due to the impairment of executive functions and gait, with the risk of falls 3 times higher than non-demented elderly. This study used a longitudinal design and aimed to analyze the effects of a regular and systematized physical activity program on the frequency of falls in patients with AD. Additionally, we aimed to correlate the frequency of falls with the executive functions and equilibrium, after and before the physical activity program. The study included 21 patients with clinical diagnosis of AD, divided into two groups: control group (CG), composed of 11 subjects not engaged in any systematized physical activity and training group (TG): 10 seniors who participated in the Cinesioterapia Functional and Cognitive in Elderly with Alzheimer's disease program (PRO-CDA). The physical activity program lasted four months, with weekly frequency of three times, with each session lasting 60 minutes. Were administered the Mini-Mental State Examination (MMSE) to assess cognitive functioning and global score of the Clinical Dementia Rating (CDR) to classify the severity of dementia. For the evaluation of executive functions were used the Clock Drawing Test (TDR) and Frontal Assessment Battery (FAB). In addition, we used the Functional Balance Scale, Berg test (EEFB) and Timed Up-and-Go (TUG) to assess the equilibrium and risk of falls. Falls were recorded by means of a questionnaire, which included the number of falls in the last four months. Analyzing the results, it was observed that TG obtained significant improvements in equilibrium and in executive functions, highlighting the beneficial effects of physical activity in these variables... (Complete abstract click electronic access below)

Efeitos do treinamento com pesos nas atividades de vida diária básicas e instrumentais de pacientes com doença de Alzheimer

The Alzheimer's disease (AD) is a neurodegenerative and progressive disease, mostly seen in elderly people, characterized by memory loss. This commitment leads causes deficits in functional capacity, compromising the individual in execution of activities of daily living, like dressing and bathing. This study, with a longitudinal character, aimed analyze the effects of a protocol of weights training (WT) in global cognitive status and realization of activities of daily living (ADL´s) basic and instrumental in AD patients, comparing the effects of four months of WT in the performance of ADL´s in global cognitive status. And also aimed to verify the possible relations between ADL's and global cognitive status of patients before and after the experimental period. The study included 24 patients with clinical diagnosis of AD, divided into two groups: a) training group (TG) consisted of 13 patients who underwent a protocol of WT b) Social Gathering Group (SCG) consists of 11 patients participating in a protocol of social gathering not systematized with activities of reading, writing and walking. Both protocols lasted four months, being developed in three non-consecutive weekly sessions, lasting 60 minutes each. To quantify global cognitive status and the basic and instrumental ADLs were used, respectively, the Mini-Mental State Examination and the Self Perception of Performance in Activities of Daily Living, along with the battery of tests of Activities of Daily Life of Andreotti and Okuma (1999). To analyze the results where complied the nature of the data, using analysis of variance for repeated measures ANOVA two-way and Pearson correlation for continuous data and tests of U Mann Whitney, Wilcoxon and Spearman correlation for non-continuous data, assuming level significance of 5% for all analysis. After analysis it´s possible... (Complete abstract click electronic access below)

Efeito de intervenções não farmacológicas nos níveis de estresse em cuidadores de pacientes com doença de Alzheimer: uma revisão sistemática

Beside aging process comes the incidence of dementia and, among them Alzheimer's disease (AD) accounts for approximately 60% of cases. This disease is characterized as a neuropathology with unknown etiology that causes cognitive deficits and behavioral disorders. Caring for patients with AD can cause an overload, both physical and psychological, which can cause high levels of stress on the primary caregiver. It is necessary that the caregiver also receives attention and develop activities that promote health benefits, while providing moments of distraction from the task of caring. Nonpharmacological interventions may be favorable for improving health with consequent decreased on the levels of stress. The objective of this study was to conduct a systematic review of scientific papers that aimed to verify the effect of nonpharmacological interventions on stress levels in caregivers of patients with AD. To contamplate this goal was accomplished a systematic search in the following databases: Biological Abstracts, PsycINFO, PubMed/Medline, Web of Science, LILACS and SciELO. The following keywords and Boolean operators was used: “caregivers” OR “family” and “nonpharmacological interventions” OR “support groups” OR “therapies” AND “Alzheimer's disease” OR “Alzheimer's dementia” OR “Alzheimer” OR “elderly” AND “stress”. There were found 3studies that met inclusion criteria adopted for the present work, and none showed significant results for the variable stress. It is not possible to affirm, according to the studies, that nonpharmacologial interventions programs for caregivers of patients with AD are effective to influence and to control the stress. However, studies show benefits for other variables such as self-efficacy and confidence in relation to care... (Complete abstract click electronic access below)

Efeito do treinamento com pesos nos distúrbios do sono e na qualidade de vida de pacientes com demência de Alzheimer

The Alzheimer's dementia (AD) is the most prevalent form of dementia in the elderly. Among the harmful changes arising from the DA, there may be sleep disturbance and impaired quality of life. Physical activity is an important non-pharmacological feature that would provide positive effects for the treatment of disease. However, there are still few studies that clarify the effects of resistance training in this population. Thus, the present study has as objective analyzes the effects of the resistance training in sleep disturbance and quality of life of patients with AD. Participated in this study 22 patients with clinical diagnosis of AD divided into two groups: Training Group (TG) and Social Interaction Group (SIG). The subjects of TG underwent a resistance training protocol, appropriate to the individual conditions, during three days no consecutive in the week, with duration of 60 minutes each session, for 16 weeks. The SIG won't participate in any systematized physical activity, but they realized other activities, such as reading, poetry, hiking and painting, among others. This protocol also was realized three times in week for 16 weeks, with duration of 60 minutes each session. Both groups were assessed at the beginning of the program and after 16 weeks. For the assessment of sleep disturbance was used the Mini Sleep Questionnaire and to assess of quality of life was used the Scale for Assessment of Quality of Life in Alzheimer's disease (QL), versions: patient, caregiver, family and the final score. Due to the scalar nature of the data and small sample, all variables were analyzed by nonparametric statistics. The U-Mann Whitney test, Wilcoxon test and Spearman correlation test was used, except for the Modified Baecke... (Complete abstract click electronic access below)

Exercício físico e funções cognitivas em pacientes com doença de Alzheimer: associação com BDNF e APOE

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Variabilidade da frequência cardíaca, funções cognitivas e nível de atividade física em pacientes com doença de Alzheimer

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Los predictores psiconeuroinmunológicos de la sobrecarga de cuidado en ancianos cuidadores de pacientes con enfermedad de Alzheimer

Introduction: The responsibility of giving care to patients with Alzheimer’s disease (AD) may result in health changes in the older caregiver. It is important to explore the factors which influence the presence of care burden and to create strategies to face this condition. In this context, the aims of present study were to investigate the relationships between psychoneuroimmunological parameters and determine the predictors to burden in older caregivers of patients with AD. Material and methods: A total of 30 AD older caregivers participating in the «Cognitive and Functional Kinesiotherapy Program in Elderly with Alzheimer’s disease«(PRO-CDA)», de Rio Claro, SP-Brazil, were submitted to an assessment protocol to evaluate the psychoneuroimmunological parameters. A descriptive statistical analysis, Pearson correlation and multiple linear regressions were performed.

Efeitos do treinamento aeróbio no fator de crescimento endotelial vascular (VEGF), funções cognitivas e funcionalidade motora na Doença de Alzheimer

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

Atividade física para promoção da saúde de idosos com doença de Alzheimer e seus cuidadores

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

Nível de atividade física, sono e qualidade de vida em pacientes com doença de Alzheimer

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

Nível de atividade física, estado nutricional e níveis de BACE 1 e BACE 2 em idosos neurologicamente saudáveis e com doença de Alzheimer

Pós-graduação em Ciências da Motricidade - IBRC

Reduced serum levels of adiponectin in elderly patients with major depression

Recent studies have implicated adiponectin and other adipocytokines in brain function, particularly in processes related to memory and cognition. Blood levels of adiponectin are reduced in patients with primary cognitive disorders, such as Alzheimer's disease and mild cognitive impairment, and in adult patients with major depression. The aim of the present study is to determine serum levels of adiponectin in a sample of elderly patients with major depressive disorder (MOD) as compared to healthy older adults, and to examine the correlations between adiponectin levels and parameters indicative of mood and cognitive state. We recruited fifty-one unmedicated outpatients with late-life depression (LLD) and 47 age-matched controls in this study. The diagnosis of MDD was made according to the DSM-IV criteria, and the severity of depressive episode was determined with the 21-item Hamilton Depression Scale (HORS). Cognitive state was ascertained with the Cambridge Cognitive Test (CAMCOG) and the Mini-Mental State Examination (MMSE). Serum concentrations of adiponectin were determined using a sandwich ELISA method. Serum levels of adiponectin were significantly reduced in individuals with LLD (F = p < 0.001). Adiponectin level remained significantly reduced in after controlling for BMI index, scores on the CAMCOG, MMSE and HDRS and educational level (p < 0.001). Adiponectin levels showed a negative correlation with HORS scores (r = -0.59, p < 0.001) and BMI index (r = -0.42, p < 0.001); and showed a positive correlation with CAMCOG (r = 0.34, p < 0.01) and MMSE scores (r = 0.20, p = 0.05). The availability of circulating adiponectin is reduced in older adults with major depression, with likely implications on cognitive and mood state. Additional studies are required to determine whether this abnormality pertains to the pathophysiology of geriatric depression per se, or is a consequence of the morbid state. (C) 2012 Elsevier Ltd. All rights reserved.

Does Lithium Prevent Alzheimer's Disease?

Lithium salts have a well-established role in the treatment of major affective disorders. More recently, experimental and clinical studies have provided evidence that lithium may also exert neuroprotective effects. In animal and cell culture models, lithium has been shown to increase neuronal viability through a combination of mechanisms that includes the inhibition of apoptosis, regulation of autophagy, increased mitochondrial function, and synthesis of neurotrophic factors. In humans, lithium treatment has been associated with humoral and structural evidence of neuroprotection, such as increased expression of anti-apoptotic genes, inhibition of cellular oxidative stress, synthesis of brain-derived neurotrophic factor (BDNF), cortical thickening, increased grey matter density, and hippocampal enlargement. Recent studies addressing the inhibition of glycogen synthase kinase-3 beta (GSK3B) by lithium have further suggested the modification of biological cascades that pertain to the pathophysiology of Alzheimer's disease (AD). A recent placebo-controlled clinical trial in patients with amnestic mild cognitive impairment (MCI) showed that long-term lithium treatment may actually slow the progression of cognitive and functional deficits, and also attenuate Tau hyperphosphorylation in the MCI-AD continuum. Therefore, lithium treatment may yield disease-modifying effects in AD, both by the specific modification of its pathophysiology via inhibition of overactive GSK3B, and by the unspecific provision of neurotrophic and neuroprotective support. Although the clinical evidence available so far is promising, further experimentation and replication of the evidence in large scale clinical trials is still required to assess the benefit of lithium in the treatment or prevention of cognitive decline in the elderly.

Reduced platelet amyloid precursor protein ratio (APP ratio) predicts conversion from mild cognitive impairment to Alzheimer's disease

Studies have shown that platelet APP ratio (representing the percentage of 120-130 kDa to 110 kDa isoforms of the amyloid precursor protein) is reduced in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). In the present study, we sought to determine if baseline APP ratio predicts the conversion from MCI to AD dementia after 4 years of longitudinal assessment. Fifty-five older adults with varying degrees of cognitive impairment (34 with MCI and 21 with AD) were assessed at baseline and after 4 years. MCI patients were re-classified according to the conversion status upon follow-up: 25 individuals retained the diagnostic status of MCI and were considered as stable cases (MCI-MCI); conversely, in nine cases the diagnosis of dementia due to AD was ascertained. The APP ratio (APPr) was determined by the Western blot method in samples of platelets collected at baseline. We found a significant reduction of APPr in MCI patients who converted to dementia upon follow-up. These individuals had baseline APPr values similar to those of demented AD patients. The overall accuracy of APPr to identify subjects with MCI who will progress to AD was 0.74 +/- A 0.10, p = 0.05. The cut-off of 1.12 yielded a sensitivity of 75 % and a specificity of 75 %. Platelet APPr may be a surrogate marker of the disease process in AD, with potential implications for the assessment of abnormalities in the APP metabolism in patients with and at risk for dementia. However, diagnostic accuracy was relatively low. Therefore, studies in larger samples are needed to determine whether APPr may warrant its use as a biomarker to support the early diagnosis of AD.