No presente trabalho foram avaliados os efeitos da estimulação em ambiente enriquecido (AE) para a memória e para os marcadores neuropatológicos da Doença de Alzheimer (DA) em camundongos transgênicos (TG) que superexpressam a proteína precursora de amilóide humana. Nos animais TG ou C57Bl/6, estimulados dos 3 aos 7 meses de idade, o AE promoveu manutenção da memória relacionada a estímulo aversivo por até 2 meses. Em animais mais velhos (8 a 12 meses de idade), a manutenção da memória foi verificada, independente do estímulo. Em ambas as idades, a memória espacial não foi alterada com o AE. Não houve alteração do número de placas senis nos animais mais jovens. Porém, em TG de 12 meses estimulados, houve redução de 85% na densidade de placas no hipocampo quando comparados ao grupo TG controle. Nessa idade, porém, não foi possível identificar a formação de enovelamentos neurofibrilares. Em conclusão, a estimulação crônica em ambiente enriquecido contribuiu para a formação de reservas cognitivas, protetoras no caso de doenças neurodegenerativas como a DA. / In the present work the effects of chronic stimulation in enriched envitonment (EE) for memory and neuropathological hallmarks of the Alzheimer\'s disease (AD) were evaluated in transgenic mice (TG) that overexpress the human amyloid precursor protein. In TG or C57Bl/6 animals, stimulated from 3 to 7 months of age, submition in EE kept fear conditioning memory for as long as two months. In older mice (8 to 12 months of age) memory keeping was verified, independent of the stimulus. In both ages, spatial memory was not altered with EE. There was no difference in senile plaques density in younger animals. However, in stimulated 12-months-old animals, there was a reduction of 85% in the density of senile plaques in hippocampus, when compared to TG control animals. In this age, however, it was not possible to identify neurofibrilary tangles. In conclusion, chronic stimulation in enriched environment contributed to formation of cognitive reserves, protective in the presence of neurodegenerative diseases, as AD.

A doença de Alzheimer (AD) é uma desordem neurodegenerativa caracterizada pelo declínio progressivo da função cognitiva. Esta é a maior causa de demência, sendo que a grande maioria dos casos da AD é do tipo esporádica (SAD), a qual tem como principal fator de risco o envelhecimento. A injeção intracerebroventricular de estreptozotocina (icv-STZ) tem sido utilizada como modelo experimental da SAD em roedores e representa uma promissora ferramenta para análises etiopatogênicas e avaliação de novas propostas terapêuticas para a AD. O modelo icv-STZ mostra muitos aspectos das anormalidades da SAD, produzindo decréscimo no metabolismo cerebral de glicose e energia, prejuízo cognitivo, estresse oxidativo, astrogliose, perda neuronal e angiopatia amiloide. A geleia real (GR), substância produzida pelas abelhas operárias da espécie Apis mellifera, vem sendo popularmente utilizada há mais de 30 anos em áreas relacionadas à alimentação saudável e medicina natural. Pesquisas apontam que a GR possui uma série de atividades farmacológicas, incluindo ação neuroprotetora, antioxidante, anti-inflamatória e melhora da função cognitiva. O objetivo deste estudo foi investigar os efeitos do tratamento oral prolongado com geleia real em ratos Wistar submetidos ao modelo icv-STZ sobre o aprendizado e memória, e na neuroproteção, esta avaliada pela neurogênese, neurodegeneração e estresse oxidativo. A injeção icv-STZ utilizada neste trabalho induziu efeitos deletérios no hipocampo de ratos, sendo estes representados por déficit cognitivo avaliado no labirinto aquático de Morris, e desenvolveu acentuada neurodegeneração, além da redução da neurogênese e aumento do estresse oxidativo. Por outro lado, a administração oral prolongada da GR foi capaz de induzir efeitos benéficos em animais lesionados pela injeção icv-STZ, ampliando o tempo de retenção da memória espacial operacional dos animais, reduzindo a neurodegeneração, aumentando a proliferação de novos neurônios e reduzindo o nível de estresse oxidativo na região do giro denteado do hipocampo. Assim, a Geleia Real mostrou efeitos benéficos em funções cognitivas e uma ação neuroprotetora no modelo experimental de AD esporádica / Alzheimer\'s disease (AD) is a neurodegenerative disorder characterized by progressive decline in cognitive function. This is the major cause of dementia and the sporadic AD (SAD) represents the majority of cases which aging is the main risk factor. Intracerebroventricular injection of Streptozotocin (icv-STZ) has been used as an experimental model of SAD in rodents and represents a promising tool for etiopathogenic analysis and evaluation of new therapeutic proposals for AD. The icv-STZ model shows many aspects of SAD abnormalities, resulting in decreased brain glucose and energy metabolism, cognitive impairment, oxidative stress, astrogliosis, neuronal loss, and amyloid angiopathy. Royal jelly (RJ), a substance produced by worker honeybees of the Apis mellifera species, has been popularly used for more than 30 years in areas related to healthy eating and natural medicine. Researches indicate that RJ has a series of pharmacological activities, including neuroprotective, antioxidant, anti-inflammatory action and improvement of cognitive function. The objective of this study was to investigate the effects of long-term oral treatment with royal jelly in Wistar rats submitted to the icv-STZ on working memory version of the Morris\' water maze task and neuroprotection, evaluated by neurogenesis, neurodegeneration and oxidative stress. In this work, the icv-STZ injection induced deleterious effects in the hippocampus, which were represented by cognitive impairments, and developed marked neurodegeneration, besides the reduction of neurogenesis and increased oxidative stress. On the other hand, RJ long-term oral administration was able to induce beneficial effects in animals lesioned by icv-STZ injection, increasing the retention time on working spatial memory, reducing neurodegeneration and oxidative stress level and increasing the proliferation of new neurons in the hippocampus. Thus, Royal Jelly showed beneficial effects on cognitive functions and a neuroprotective action in the STZ experimental model of sporadic AD

No presente estudo, propôs-se estudar a deglutição em idosos saudáveis e em idosos com Demência devido à Doença de Alzheimer (DDA), em estágios leve e moderado. Objetivou-se especificamente: verificar a frequência de disfagia nessa população; verificar se há associação entre a presença de disfagia e os aspectos cognitivos, de estado nutricional e de independência funcional; adaptar um protocolo de avaliação clínica da deglutição para esta população; analisar a confiabilidade inter examinadores; avaliar a validade de critério do protocolo; e verificar as medidas de sensibilidade e de especificidade do instrumento de avaliação. Participaram do estudo 52 idosos saudáveis; 50 com diagnóstico de DDA leve (DAL), 50 idosos com DDA moderada (DAM). Foram realizadas avaliações da deglutição, cognitivas utilizando os instrumentos: Mini Exame do Estado Mental (MEEM), Teste do Desenho do Relógio (TDR), a prova da Memória de Leitura de Palavras (MLP), a Evocação Tardia da Leitura de Palavras (ETLP), Teste de Nomeação de Boston - versão reduzida (TNB), a American Speech-Language-Hearing Association Functional Assessment of Communication Skills (ASHA FACS); avaliação do estado nutricional utilizando a escala a Mini Avaliação Nutricional (MAN); e avaliação da independência funcional, utilizando a Medida de Independência Funcional (MIF). Para a etapa de validação, participaram 27 idosos do Grupo Controle (GC) e 25 do grupo Demência de Alzheimer Leve (DAL) e 25 do grupo Demência de Alzheimer Moderada (DAM). Realizou-se a adaptação do protocolo de avaliação clínica da deglutição, proposto por Pacheco (2017), para a população com demência e utilização neste estudo. Foram realizadas também uma avaliação clínica da deglutição por outra fonoaudióloga e também realizou-se a videofluoroscopia da deglutição, ambas para as análises de confiabilidade inter examinadores e acurácia dos instrumento, respectivamente. Os resultados do estudo demonstram que houve predomínio na amostra do gênero feminino em todos os grupos. A média mais elevada de idade 77,0 (±7,7) foi do grupo DAL, e de escolaridade no GC (4,7±3,7). A presença da disfagia foi mais frequente nos idosos do grupo DAM (44%). Houve associação entre a presença de disfagia e a idade no GC (p=0,003). No grupo DAL houve associação com a idade (p=0,000), com o MEEM (p=0,031) e com a MAN (p=0,000); e no grupo DAM, a presença de disfagia se associou com a idade (p=0,000) e com a MAN (p=0,000). A etapa de validação do instrumento de avaliação clínica da deglutição demonstrou que a confiabilidade inter examinador foi considerada boa, sendo K=0,767 e p=0,000. A análise da validade de critério, obteve-se K=0,890, p=0,000, considerado concordância ótima. A sensibilidade do instrumento foi de 100% e a especificidade de 92,5%. O estudo demonstrou que a disfagia é mais frequente nos idosos com DDA em fase moderada, e que esta aumenta com a instalação da doença e progressão da mesma. A presença de disfagia se associou com alterações cognitivas e com a idade; a presença da disfagia causa impacto no estado nutricional dos idosos com DDA. Oinstrumento de avaliação demonstrou ter boa confiabilidade, ótima concordância com o instrumento considerado padrão ouro, e também altas medidas de sensibilidade e especificidade. / In the present work, it we proposed to study swallowing in healthy elderly people and in elderly people with Alzheimer\'s Disease (AD), in mild and moderate stages. The objective was specifically to verify the frequency of dysphagia in this population; to verify if there is an association between the presence of dysphagia and the cognitives aspects, nutritional status and functional independence; to adapt a protocol of clinical evaluation of swallowing for this population; to assess the inter-examiner reliability; evaluate the validity of the protocol criterion; and to verify the measures of sensitivity and specificity of the evaluation instrument. Fifty-two healthy elderly people participated in the study; 50 with diagnosis of mild Alzheimer\'s Disease (mild-AD), 50 elderly with moderate Alzheimer\'s Disease (modAD). Cognitive evaluation of swallowing was performed using the following instruments: Mini-Mental State Examination (MMSE), the clock drawing (CD), Long Term Memory (LTM), Late Evocation of the Word List (LEWL), Boston Naming Test (BNT), American Speech-Language-Hearing Association Functional Assessment of Communication Skills (ASHA-FACS); assessment of nutritional status using a Mini-Nutritional Assessment (MNA) scale; and functional independence assessment, use a Functional Independence Measure (FIM). For a validation stage, 27 elderly people from the Control Group (CG) and 25 from the mild-AD groups and 25 from the mod-AD group participated. An adaptation of the protocol for the clinical evaluation of swallowing, proposed by Pacheco (2017) was carried out for a population with dementia and the utilized in this study. An overview of swallowing by another speech-language-hearing scientist was also performed, and videofluoroscopy of swallowing was also performed, both for inter-examiner reliability analyzes and criterion validity, respectively. The results of the study showed that female gender was predominant in all groups The highest mean age was 77.0 (± 7.7) in the mild-AD group, and scholarly level in CG was (4.7 ± 3.7). The presence of dysphagia was more frequent in the elderly in the mod-AD group (44%). There was an association between the presence of dysphagia and age in the GC (p = 0.003). In the mild-ADD group there was association with age (p = 0.000), with MMSE (p = 0.031) and with MNA (p = 0.000); and in the mod-AD group, the presence of dysphagia was associated with age (p = 0.000) and with MNA (p = 0.000). The validation stage of the instrument for clinical evaluation of swallowing demonstrated that interexaminer reliability was considered good, with K = 0.767 and p = 0.000. The analysis of the criterion validity obtained K = 0.890, p = 0.000, considered an optimal agreement. The sensitivity of the instrument was 100% and the specificity was 92.5%. The study demonstrated that dysphagia is more frequent in the elderly with moderate-phase DD, and that this increases with the onset of the disease and its progression. The presence of dysphagia was associated with cognitive alterations and with age; the presence of dysphagia causes an impact on the nutritional status of the elderly with AD. The evaluation instrument showed good reliability, excellent agreement with the gold standard instrument, as well as high sensitivity and specificity measurements.

Para descrever os achados da espectroscopia de prótons (1H-ERM) na doença de Alzheimer (DA) e no comprometimento cognitivo sem demência (CIND) em uma amostra da comunidade foram avaliados 13 pacientes com DA, 12 com CIND e 15 controles normais. A 1H-ERM foi realizada com voxel de 8 cm3 nas regiões temporal direita, parietal esquerda e occipital medial estudando os metabólitos: N-acetilaspartato (NAA), creatina (Cr), colina (Cho) e mio-inositol (mI). O NAA foi maior nos indivíduos controles do que nos DA e intermediário no CIND; o mI foi maior no grupo DA do que nos controles; a Cho mostrou tendência a estar aumentada na DA e CIND. Correlação entre os testes cognitivos e a 1H-ERM confirmou a hipótese de que alterações metabólicas estão presentes quando do aparecimento das primeiras alterações cognitivas. A espectroscopia pode, em função disso, contribuir para o diagnóstico e seguimento de indivíduos com queixa de memória em indivíduos da comunidade com a possibilidade de diagnósticos mais precoces. / For the description of the proton magnetic resonance spectroscopy (1H-ERM) data in Alzheimer´s disease (AD) and Cognitive Impairment Not Dementia (CIND) in a community set, subjects with AD (n=13), CIND (n=12) and normal control (n=15) were investigated. 1H-ERM was performance with single voxel (8 cm3) placed in temporal, parietal e occipital region and studied metabolites: N-acetylaspartate (NAA), creatine (Cr), choline (Cho) and myo-inositol (mI). NAA concentration was higher in control subjects than AD and intermediated level in CIND patients; mI was higher in patients with AD and CIND; Cho tended to be higher in AD and CIND. Metabolisms changes are present together the first cognitive deficits as showed by correlation between cognitive tests and 1H-ERM. Spectroscopy can be used in the diagnosis and follow-up of individuals with memory complain in the community set with the possibility of early diagnosis

Nos últimos anos, o desenvolvimento de novas plataformas biossensoras trouxe importantes avanços à área médica, incluindo maior rapidez na detecção de biomarcadores, menor custo de análise e portabilidade. Essa tese traz a descrição do desenvolvimento de três tipos de biossensores que visam à auxiliar o diagnóstico de diferentes doenças. No primeiro capítulo, detalha-se a construção de um dispositivo microfluídico baseado em papel para a quantificação simultânea de dois biomarcadores da doença de Alzheimer: Fetuína B e Clusterina. O dispositivo foi capaz de quantificar as proteínas estudadas de maneira precisa e de baixo custo através do uso de técnicas eletroquímicas e colorimétricas, apresentando limites de detecção na ordem de p-nmol/L. O segundo capítulo trata do desenvolvimento de um imunossensor eletroquímico para a quantificação de melatonina. O dispositivo foi capaz de detectar a biomolécula em amostras biológicas rapidamente e com boa especificidade, diferenciando a melatonina de componentes com alta semelhança estrutural. Por fim, o terceiro capítulo descreve um genossensor eletroquímico para diagnóstico e determinação do traço da doença genética mais comum no Brasil, a anemia falciforme. O sensor foi capaz de diferenciar sequências normais de mutadas de maneira simples e rápida, sendo adequado para o diagnóstico e a determinação de seu traço. Esperamos que os dispositivos aqui apresentados levem à diagnósticos mais acessíveis fornecendo assim melhores condições de saúde à população. / The development of new biosensor platforms has brought important advances to the medical field, including faster detection of biomarkers, lower cost of analysis and portability. This thesis provides a description of the development of three biosensors that aim to assist the diagnosis of three different diseases. The first chapter describes the construction of a paper-based microfluidic device for the simultaneous quantification of two Alzheimer\'s disease biomarkers: Fetuin B and Clusterin. The device was able to quantify the studied proteins in a precise and low cost manner through the use of electrochemical and colorimetric techniques, presenting limits of detection in the order of p-nmol/L. The second chapter details the the development of an electrochemical immunosensor for the quantification of melatonin. The device was able to detect the biomolecule in biological samples quickly and with good specificity, differentiating melatonin from components with high structural similarity. Finally, the third chapter describes an electrochemical genosensor for diagnosis and determination of the trait of the most common genetic disease in Brazil, sickle cell anemia. The sensor was able to differentiate normal and mutated sequences in a simple and fast manner, being suitable for the diseases diagnosis and the determination of its trait. Therefore, we expect the devices presented here to lead to more accessible diagnoses, providing better health conditions for the population.

A acetilcolinesterase (AChE) é uma enzima essencial que encerra a transmissão colinérgica através de uma rápida hidrólise do neurotransmissor, acetilcolina (ACh). Uma ampla série de evidências mostraram que os inibidores da AChE podem interferir com a progressão da doença de Alzheimer (DA). O desenvolvimento bem sucedido de compostos inibidores da AChE foi baseado na teoria de que o declínio nas funções cognitivas e mentais associadas a DA está relacionado com a perda da neurotransmissão cortical colinérgica, sendo assim, esses compostos podem ser usados para tratar as deficiências colinérgicas. Uma coleção de moléculas orgânicas foi escaneada para ser avaliada a capacidade dessas moléculas em inibir a atividade enzimática da AChE com o objetivo de se encontrar compostos líderes para posteriores otimizações, conduzindo a fármacos com aumento da eficácia e/ou menores efeitos adversos. As estratégias aplicadas incluem o screening ou triagem virtual baseado na estrutura e também no ligante, modelagem farmacofórica, docking molecular e buscas por similaridade (forma e eletrostática). Os estudos foram também concentrados na descoberta de novas classes de inibidores da AChE, tendo como molécula de referência o fármaco donepezil, o qual inaugurou uma nova classe de inibidores da AChE com a ação mais longa e mais seletiva com efeitos adversos manejáveis. Do total de compostos triados, 50 foram selecionados com adequadas propriedades físico-químicas e ADME/Tox. Em geral, esses compostos possuem substancial interação com o sítio periférico aniônico (PAS) da AChE e a maioria deles faz interações adicionais com o sítio catalítico (CAS) e com outros resíduos de aminoácidos importantes ao longo da enzima. Destes 50 compostos, oito foram comercialmente adquiridos e os ensaios enzimáticos revelaram que estes compostos exibem uma alta afinidade pela AChE. Os resultados apontam, ainda, que o composto entitulado ZINC30019441 exibiu a mais potente atividade inibitória para a AChE, com 1,8 micromolar de concentração, e os demais ficaram ainda situados em baixo micromolar, de 2 a 3 micromolar de concentração. Estes resultados, além das modificações químicas ora propostas in silico para estes inibidores protótipos, apontam para o desenvolvimento de uma nova e promissora série de potentes anticolinesterásicos, contendo propriedades de fármacos, as quais são ainda apropriadas para atuarem no Sistema Nervoso Central e interagirem com o peptídeo beta-amiloide, com vistas ao tratamento quimioterápico da doença de Alzheimer. A perspectiva imediata inclui os ensaios de anti-agregação do peptídeo com os oito inibidores já testados com a Acetilcolinesterase. / Acetylcholinesterase (AChE) is an essential enzyme that terminates cholinergic transmission by rapid hydrolysis of the neurotransmitter acetylcholine (ACh). A wide range of evidence shows that AChE inhibitors may interfere with the progression of Alzheimer\'s disease (AD). The successful development of AChE inhibitor compounds was based on the theory that the decline in cognitive and mental functions associated with AD is related to the loss of cortical cholinergic neurotransmission, thus, these compounds can be used for treating cholinergic deficiencies. A collection of organic molecules has been scanned to evaluate the ability of these molecules to inhibit the enzymatic activity of AChE in order to find lead compounds for further optimization, leading to drugs with increased efficacy and/or fewer adverse effects. The strategies applied include structure-based virtual screening and also in ligand-based virtual screening, pharmacophoric modeling, molecular docking and similarity searches (shape and electrostatic). Studies have also focused on the discovery of new classes of AChE inhibitors, having as a reference molecule the drug donepezil, which has opened a new class of AChE inhibitors with longer and more selective action with manageable side effects. 50 of the compounds screened, were selected with appropriate physical and chemical properties and ADME/Tox. In general, these compounds possess substantial interaction with the peripheral anionic site (PAS) of AChE and most of them make further interact with the catalytic site (CAS) and other key amino acid residues throughout the enzyme. Out of these 50 compounds, eight were commercially purchased and the enzyme assays have shown that these compounds exhibit a high affinity for AChE. The results show also that the compound titled ZINC30019441 exhibited the most potent inhibitory activity for AChE, with 1.8 micromolar concentration, and the rest were still located in low micromolar, 2-3 micromolar concentration. These results as well as chemical modifications herein proposed for these prototypes, indicate the development of a new and promising series of potent anticholinesterase containing drug properties, which are still suitable to act on the central nervous system and interact with the ?-amyloid peptide, for chemotherapy treatment of Alzheimer\'s disease. The immediate prospect includes the peptide anti-aggregation assays with the eight inhibitors already tested against acetylcholinesterase

The primary purpose of this study was to investigate the effects of aerobic and resistance training on BDNF and IGF-I expression in a 3xTg-AD mouse model of Alzheimer’s disease. Twenty-four 3xTg-AD mice were randomly assigned to either an aerobic (AT, n=8), resistance (RT, n=8), or control (CNT, n=8) group. Intervention groups underwent 9 weeks of exercise training. Motor behavior and grip strength were measured pre- and post- intervention. Our results showed a significant increase in hippocampal BDNF expression in AT mice after a 9-week intervention. Further, AT mice were found to have higher concentrations of IGF-I, and improved motor behavior when compared to RT and CNT. No significant differences were observed in IGF-I concentration between RT and other groups. RT improved grip strength after nine weeks of training. These findings support the use of AT and RT as a tool to improve comorbidities found in Alzheimer’s disease. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

Two skills necessary for the execution of proficient calculation, retrieving arithmetic facts from memory and accessing number magnitude information, were studied in a group of patients diagnosed with Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy controls to try to elucidate the locus of impairment in AD-related calculation deficits. This was achieved through the use of an arithmetic production task and a number-matching task as measures of explicit and implicit retrieval of arithmetic facts, and a numerical Stroop task that assesses automatic access to number magnitude representation. AD patients, but not MCI patients, showed high response latencies and a high number of errors when performing multiplications in the production task, and reduced automatic retrieval of arithmetic task in the number-matching task. All participants showed the classic problem-size effect often reported in the mathematical cognition literature. Performance on the numerical Stroop task suggests that access to number magnitude information is relatively resistant to cognitive impairment. ... Results for the AD group are consistent with a pattern of preserved and impaired cognitive processes that might mediate the reported calculation deficits in AD. / by Marâia Beatriz Jurado Noboa. / Thesis (Ph.D.)--Florida Atlantic University, 2013. / Includes bibliography. / Mode of access: World Wide Web. / System requirements: Adobe Reader.

Data was provided by researchers of the Einstein Aging Study (EAS) of the Albert Einstein College of Medicine, Yeshiva University whom statistically analyzed data from the Bronx Aging Study cohort, concluding that participation in cognitive leisure activities and one physical activity, dancing, were associated with a reduced risk of dementia [1]. We explore data from a second (the EAS) cohort, utilizing Cox Proportional-Hazards and extended Cox regression [13]. Cognitive leisure activities in general, and particularly doing crossword puzzles, reading books, watching television, and emailing are associated with a reduced risk of dementia. Doing aerobics, learning computer programming, babysitting, dancing, jogging singing, and weight training are associated with an increased risk of dementia. Participation in cognitive leisure activities in general, and reading books in particular, remains highly significant even after adjustment for well-known risk factors [14] such as: age, cognitive status, depression, medical illnesses, gender, ethnicity, education and economic status. / by Carrie Stevens. / Thesis (M.S.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

This qualitative case study investigated the impact of sand tray on individuals diagnosed with Alzheimer’s and other forms of dementia. Four participants successfully completed the creation of sand trays while the researcher observed, interviewed, and documented the individual sand trays. The intervention established that sand tray allows the dementia patient to kinesthetically connect to their inner cognitions through the intentional symbolic expression offered by this unique therapeutic medium. Using a series of eight sand trays of varying thematic concepts, the participants were offered a modality to facilitate a synthesization of their continued individuation, presenting a possible neural pathway to connect and express thoughts, feelings, emotions, concerns, challenges, and fears. The findings of this study include the fact that all trays were classified as “empty” and that the majority of the participants placed objects almost exclusively on the right side of the tray, which is commonly associated with the concreteor conscious side. The use of sand tray allowed each individual the opportunity to create autobiographies in the sand and literally navigate through time – past, present, and future, confronting fears, expressing hope and possibilities. The results of the research study offer insight into the psychotherapeutic effects of using sand tray with dementia patients, as well as a better understanding of the cognitive and expressive abilities and limitations of an individual with impaired memory. The results also offer insight into the difficulties with short-term memory in this population and possibly indicate a potential means for monitoring cognitive decline. Keywords: Neurocognitive disorder, Alzheimer’s, dementia, sand tray, play therapy / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2013.