Resumo: O envelhecimento provoca declínios físico e/ou cognitivo. Ainda, algumas conseqüências da institucionalização do idoso parecem influenciar negativamente suas esferas física e cognitiva, geralmente já prejudicadas. Porém, o exercício aeróbio pode beneficiar ambas as esferas. Assim, esta pesquisa divide-se em Estudo #1 (transversal) e Estudo #2 (longitudinal) OBJETIVO: realizar o perfil de nível de atividade física, independência funcional básica, funções executivas, memória e estado cognitivo geral de idosos moradores de instituições de longa permanência para idosos de Rio Claro-SP (Estudo #1), e analisar possíveis efeitos de um programa de Dança de Salão nestas variáveis (Estudo #2). MATERIAIS E MÉTODOS: para o Estudo #1, a amostra foi aleatória e abrangeu 89,8% da população institucionalizada. Para o Estudo #2, a amostra foi de 14 idosos no Grupo Controle e de 13 idosos no Grupo Treinamento; o treinamento foi de três sessões de Dança de Salão por semana, durante seis meses. Em ambos os estudos foi aplicada a mesma bateria de testes e questionários. Os dados foram analisados com p<0,05. No Estudo #1, foi calculada média, desvio-padrão e quartis, além do coeficiente de correlação de Pearson para nível de atividade física e independência funcional básica com as outras variáveis. No Estudo #2, utilizou-se o teste de Shapiro-Wilk para analisar a normalidade da distribuição dos dados, teste t de Student para análise de similaridade inicial entre ambos os grupos. Assim, utilizou-se ANOVA two-way, three-way e four-way, dependendo do teste, além do coeficiente de correlação de ix Pearson. RESULTADOS: Em ambos os estudos, o desempenho dos idosos foi muito abaixo do esperado. No Estudo #1, obteve-se: idade=75,3 anos; Mini- Exame do Estado Mental=11,5 pontos; Escala Geriátrica de Depressão=12,8 pontos; Questionário Baecke Modificado... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Aging causes physical and/or cognitive decline. Moreover, some consequences of older adult's institutionalization seem to exert a negative influence on their physical and cognitive spheres, which are generally are impaired. Anyhow, aerobic exercise can benefit both spheres. So, this research is divided into Study #1 (transversal) and Study #2 (longitudinal). OBJECTIVE: accomplish the profile of physical activity level, basic functional independence, executive functions, memory and general cognitive state of older adults living in the long-care homes at Rio Claro-SP (Study #1), and to analyze the possible effects of a Ballroom Dancing program in those variables (Study #2). MATERIAL AND METHODS: the sample selected in the framework of the Study#1 was randomized and achieved 89,8% of institutionalized population. With regard to Study #2, the sample included 14 older adults in the control group and 13 older adults in the training group. The training consisted by three sessions of Ballroom Dancing a week, during six months. The same battery of tests and questionnaires was applied to both studies. The data were analyzed with p<0,05. Along the Study #1, the mean and the standard-desviation e quarters were calculated, as well as the Pearson correlation coefficient concerning the physical activity level and the basic functional independence with other variables. Along the Study #2, ANOVA two-way, three-way e fourway was used, according with the test, in addition to the Pearson correlation coefficient. RESULTS: in both studies, older adult's engagement was lower than expected. Study #1 shows that: age=75.3 years old; Mini Exam of Mental State=11.5 points; Geriatric Depression Scale=12.8 points; Modified Baecke 100 Questionnaire for Older Adults=1.0 point, and Katz Scale of Basic Functional Independence=4.5 points, in addition... (Complete abstract click electronic access below) / Orientador: Sebastião Gobbi / Coorientador: Ruth Ferreira Santos / Banca: Hanna Karen Moreira Antunes / Banca: Cátia Mary Volp / Mestre

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Background: Given that individuals with subjective cognitive decline (SCD) report a change that is not yet measurable with standard neuropsychological assessment measures, they are thought to be the earliest along the cognitive continuum between healthy aging and Alzheimer’s disease (AD). The current study used a neuroimaging approach to examine differences in brain function and structure between individuals with SCD and healthy controls (HC). Method: 3T resting state functional MRI and high resolution anatomical images were retrieved from 23 individuals with SCD (mean age = 72.9 years, SD = 5.4, 12 females) and 23 HC (mean age = 74.3 years, SD = 5.0, 12 females) from the screening time point from the AD Neuroimaging Initiative database. All data were processed using the FMRIB Software Library. Seed-based analyses of the default mode network (DMN) were used to compare differences in brain function between SCD and HC groups (Z > 2.3; cluster significance: p < 0.05, corrected). Voxel-based morphometry (VBM) was used to examine differences in grey matter volume between the SCD and HC groups. Results: The SCD and HC groups were not significantly different in age or education level. Results revealed significantly greater activity in the DMN including the bilateral precuneus cortex, bilateral thalamus, and right hippocampal regions in individuals with SCD relative to controls. Conversely, those with SCD showed decreased activation in the bilateral frontal pole, caudate, angular gyrus, lingual gyrus, right superior frontal gyrus, right occipital pole, right superior temporal gyrus, left superior temporal gyrus in the posterior division, left precuneus cortex, left precentral gyrus, left occipital fusiform gyrus, left temporal pole, and left cerebellum compared to HC. Finally, VBM results did not show significant differences in grey matter volume between the groups. Conclusion: Findings revealed changes in brain function but not structure between individuals with SCD and HC. Overall, this study represents a crucial step in characterizing individuals with SCD, a group recognized to be at increased risk for AD. It is imperative to identify biomarkers prior to significant decline on clinical assessment, so that disease-delaying interventions may be delivered at the earliest possible time point. / Graduate / 2020-08-15

Alzheimer’s disease (AD) progression and hypotheses of the cognitive reserve theory were investigated by testing for a relation between educational attainment and rate of decline in patients with Mild Cognitive Impairment, possible AD, probable AD, and other progressive neurodegenerative dementias. Patient data (n = 726) were acquired from a clinical database at the Minneapolis VAMC GRECC Memory Loss Clinic. Analyses using mixed effect regression models found education was significantly related to an accelerated rate of decline in global cognition (MMSE: -0.022, SE = 0.007, p = .003) and a steeper linear rate of decline in functional ability (Cognitive Performance Test: -0.034, SE = 0.011, p = .005). Cox proportional hazard models found little evidence to support an association between educational attainment and relative mortality risk. These results are consistent with previous findings and predictions of the cognitive reserve theory.

Recent neuropsychological research has stressed the sensitivity of the Prefrontal Cortex, mostly the Dorsolateral region, in relation to aging (Darowski et al., 2008). Prefrontal Cortex functions, such as Inhibitory Control (IC), are thought to wane steadily after the ages of 60-65 (Craik & Bialystok, 2006). Little is known about what changes occur between the stages of prefrontal optimal performance (i.e., ages 20-25), and the later periods of functional decline. The present study aimed to investigate performance differences between younger (ages 30-40; n=9), middle-aged (ages 50-60; n=10), and older adults (ages 70 and up; n=13), on five tasks of Executive Functions (EFs); specifically, assessing the abilities of problem representation, shifting, updating working memory, inhibition, and integrating valence and rewards into pursuing a goal. It was hypothesized that (a) quantitative age trends differentiating the three groups on the tasks would be found, (b) IC would be particularly targeted by the hypothesized age trends, and (c) the devolution of IC across the adult lifespan would be linear. MANOVA tests with all tasks of EFs representing the Dependent Variables and age serving as the Independent Variable revealed no significant main effect. Follow-up separate ANOVA tests however, suggested a statistically significant difference between the means of Groups 2 and 3 for the Updating Working Memory task, F(2,29)=5.374, p=.010, Scheffe (p=.012) and Bonferroni (p=.010). The contributions of interactions among EFs to the present results, recruitment challenges, and potential age effects are discussed. / Graduate / 0622 / emiliecq@uvic.ca

Abstract Sheltered housing for the elderly is an intermediate type of housing, between living in ones own home and living in an institution. The aim of this study was to describe the changes in physical, cognitive and psychological abilities among the elderly living in sheltered housing during a two-year follow-up period. In this study psychological abilities were represented by depressive symptoms. The changes in the abilities of the elderly people living in sheltered housing were compared with the corresponding changes among the elderly living in their own homes. Furthermore, the associated factors and the predictors of the decline in physical and cognitive abilities, as well as the depressive symptoms were examined. The control group consisted of elderly people who were matched with those living in sheltered housing in regard to age, sex, coping with activities of daily living and depressive symptoms. The data of this study were collected among elderly people living in 20 units of sheltered housing in Finland in 1994 and 1996. 725 residents were interviewed and 340 re-interviewed after two years. Cognitive capacity was assessed with the help of the Mini-Mental Examination test (MMSE). Depressive symptoms were assessed using the shortened version of the Zung Self-rating Depression Scale (ZSDS). The results showed that the elderly living in sheltered housing were widows or widowers and lived alone more often than the home-dwelling elderly. They perceived their health as poorer, had less contacts with other people and had fewer hobbies than the elderly living at home. Nevertheless, they felt less lonely and were more satisfied with their lives than those living at home. During the two-year follow-up period the decline in the functional capacity of the elderly living in sheltered housing did not essentially differ from the corresponding change among the home-dwelling elderly. The decline in physical and psychological abilities among the elderly living in sheltered housing was similar to the decline among those living at home. Even if the decline in cognitive abilities among the elderly living in sheltered housing was more rapid than the change among the home-dwelling elderly, the difference between the groups was slight. Living in sheltered housing appeared to have neither a negative nor a positive effect on the functional capacity of the elderly. The predictors of the physical decline among the elderly living in sheltered housing were a high age, poor physical abilities at baseline, a high number of depressive symptoms, the use of medication and a low number of hobbies. The predictors of the physical decline among the home-dwelling elderly were the female sex, a high age, poor physical abilities at baseline, a high number of depressive symptoms, health perceived as poor and low social participation. The predictors of the decline in cognitive abilities among the elderly living in sheltered housing included a high age, poor cognitive abilities at baseline, poor education, dissatisfaction with life and health perceived as good. Among the home-dwelling elderly the predictors of the decline in cognitive abilities were poor cognitive abilities at baseline and a low number of hobbies. Among the elderly living in sheltered housing the predictors of depressive symptoms included a high number of depressive symptoms at baseline, poor cognitive abilities, health perceived as poor, a high number of feelings of loneliness, a low number of visits paid to other people and high education. Among the home-dwelling elderly the predictors of depressive symptoms were a high number of depressive symptoms at baseline and a high age.

Background Sarcopenia and age-related cognitive decline (ARCD) are important age-related conditions which significantly impact upon the quality of life of older adults. ARCD is a well-established research area, whereas sarcopenia is a relatively new field. Research into the inter-relationships between them and possible common underlying mechanistic processes is lacking. Methods Several research techniques were used: a large systematic review; the development of an image analysis technique to measure neck muscle size on volumetric MR brain scans; the subsequent use of the technique in elderly cohort studies; statistical modelling to investigate the role of glucocorticoids in sarcopenia; and an invasive clinical study to develop a novel technique to measure the activity of 11beta-hydroxysteroid dehydrogenase (11βHSD1) in the human brain in vivo. Results I consistently found a relationship between: some measures of brain structure and muscle size; markers of brain structure and muscle function, mostly grip strength and gait speed; and cognition and muscle function. However, I found no relationship between current cognition and muscle size in any of the above studies. Cortisol was identified as a possible explanatory factor in the relationship between both cognition and brain volume with gait speed. I found an association between markers of immunosenescence and sarcopenia (neck muscle CSA and grip strength) and an association between expression of the cortisol amplifying enzyme 11βHSD1 and quadriceps strength. I developed a technique to measure 11βHSD1 activity across the human brain, which found that the amount of cortisol produced within the brain was not detectable and highlighted the asymmetries within the cerebrovascular venous system. Conclusions Further longitudinal studies looking at the association between sarcopenia and ARCD are now required to investigate these important relationships further and hopefully this will lead to improved therapeutic options.

No / Background. Early detection of cognitive decline in the elderly is important because this may precede progression to Alzheimer's disease. The aim of this study was to see whether sensitive neuropsychological tests could identify pre-clinical cognitive deficits and to characterize the cognitive profile of a subgroup with poor memory. Methods. A neuropsychological test battery was administered to a community-dwelling sample of 155 elderly volunteers who were screened with CAMCOG at enrolment (mean age 74·7 years). The battery included tests of episodic memory, semantic and working memory, language and processing speed. Results. Episodic memory test z scores below 1 S.D. from the cohort mean identified 25 subjects with `non-robust¿ memory performance. This group was compared to the remaining `robust memory¿ group with a General Linear Model controlling for age, IQ, education and gender. Test performance was significantly different in all tests for episodic and semantic memory, but not in tests for working memory, processing speed and language. CANTAB paired associates learning and spatial recognition tests identified the highest percentages of those in the `non-robust memory¿ group. Processing speed partialled out the age effect on memory performance for the whole cohort, but the `non-robust memory¿ group's performance was not associated with age or processing speed. Conclusions. Sensitive neuropsychological tests can detect performance below the norm in elderly people whose performance on MMSE and CAMCOG tests is well within the normal range. Age-related decline in memory performance in a cohort of the elderly may be largely due to inclusion within the cohort of individuals with undetected pre-clinical Alzheimer's disease or isolated memory impairment.

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The earliest stage of Alzheimer’s disease (AD) pathology begins in one of the main components of the olfactory pathway, the entorhinal cortex, making deficits in smell a potential prospective biomarker for the early detection of AD. This study contributes to the field with a reproduction and extension of work by Wilson, Arnold, Schneider, Boyle, Buchman, and Bennett (2009). A sample of 1089 individuals (M=78.4 years), more than double the data available in 2009, completed annual assessments of olfactory functioning, and cognitive functioning for up to 18 years with brain donation at death. Mixed effects models conditioned on demographics estimated between and within-person effects in olfactory functioning and episodic memory (EM). After successful reproduction of Wilson et al. (2009), addition of AD pathology (ADP) demonstrated that both ADP and olfaction were significantly related to EM at baseline. Higher ADP at autopsy was significantly related to faster declines in olfaction, as well as more rapid declines in EM. Higher olfactory scores were associated with higher EM scores and a model for EM with olfaction as time-varying covariate indicated that at a given occasion, individuals with higher olfactory scores also have higher EM scores. These results align with the hypotheses that difficulty in identifying odors predicts development of cognitive impairment; increased levels of AD pathology are related to both decreased EM at baseline and faster declines, as well as faster rates of decline in olfaction; and olfaction and cognition are travelling together over time. / Graduate / 2018-06-01 / 0766 / 0633 / jknight@uvic.ca