No description available.

Objective: Grit is a noncognitive trait related to perseverance and consistent pursuit of long-term goals. Research on grit and aging provides evidence that grit increases with age and may be protective of cognitive and everyday functioning. However, no studies to date have examined relations between concurrently measured grit, cognitive abilities, and everyday functioning. This study tested two hypotheses: 1) that grit would predict cognitive performance and that this relation would be moderated by clinical diagnosis of cognitive status (i.e., healthy vs. mild cognitive impairment; MCI), and 2) that grit would predict everyday functioning and that this effect would be mediated by compensatory strategy use. Methods: Sixty-one older adults were recruited from the Penn Memory Center’s National Alzheimer’s Coordinating Center (NACC) cohort, including forty healthy controls with normal cognition and twenty-one individuals with mild cognitive impairment (MCI). Participants completed tests of verbal episodic memory, executive functioning, grit, compensatory strategy use, and everyday functioning. Results: Grit was not associated with cognitive functioning in either domain. Instead, memory performance was predicted only by clinical status (healthy vs. MCI), and executive functioning was predicted by clinical status, depressive symptoms, and years of education. Grit was negatively associated with everyday functional difficulties; however, there was no indirect effect of compensatory strategy use. Additionally, grit was moderately correlated with depression symptoms (r = -0.41). Conclusions: Grit is predictive of preserved everyday functioning, but not cognitive functioning, in a sample of healthy older adults and individuals with MCI. Mechanisms explaining the role of grit on everyday function remain elusive, though secondary analyses support that grit also influences affective well-being and may have a weaker role in the context of cognitive impairment. / Psychology

Yes / Background People with dementia or mild cognitive impairment (MCI) and their family carers face challenges in managing medicines. How medicines self-management could be supported for this population is unclear. This review identifies interventions to improve medicines self-management for people with dementia, MCI and their family carers, and which core components of medicines self-management they address. Methods A database search was conducted for studies with all research designs and ongoing citation searches from inception to December 2021. Selection criteria included community dwelling people with dementia and MCI and their family carers, and interventions with a minimum of one medicine self-management component. Exclusion criteria were wrong population, not focusing on medicines management, incorrect medicines self-management components, not in English and wrong study design. Results are presented and analysed through narrative synthesis. The review is registered [PROSPERO (CRD42020213302)]. Quality assessment was carried out independently applying the QATSDD quality assessment tool. Results Thirteen interventions were identified. Interventions primarily addressed adherence. A limited number focused on a wider range of medicine self-management components. Complex psychosocial interventions with frequent visits considered the person’s knowledge and understanding, supply management, monitoring effects and side-effects and communicating with healthcare professionals; and addressed more resilience capabilities. However, these interventions were delivered to family carers alone. None of the interventions described patient and public involvement. Conclusion Interventions, and measures to assess self-management, need to be developed which address all components of medicines self-management, to better meet the needs for people with dementia and MCI and their family carers.

The purpose of this study was to examine the influence of mild cognitive impairment (MCI) on marital relationships. MCI refers to age-related decline in memory and other cognitive processes that do not necessarily interfere with daily activities or the maintenance of social relationships with others (Petersen et al., 1999). Using social exchange theory as the theoretical framework to guide this qualitative study, aspects of the marital relationship explored from the nonimpaired spouses’ perspective were couple interaction, intimacy, and the division of household labor. In-depth interviews were conducted with five husbands and five wives (M age = 76.6 yrs., S.D. = 6.64). Open-ended interview questions that focus on issues specific to the marital relationship included: (a) range of activities participated in as a couple, (b) ways of showing care or affection toward one another, and (e) management of everyday life. In addition to participating in the semi-structured interviews, the spouses completed three standardized scales (e.g., Revised Memory & Behavior Problems Checklist, Zarit Burden Interview, Center for Epidemiological Studies-Depression Scale). Their responses to these measures provided information about the memory and behavioral changes of the elder as it related to the outcomes for and responses of the spouse. Spouses noted both change and stability within their marriages. They expressed “mixed emotions” concerning the influence of MCI on both them as individuals and on their relationship. Husbands’ responses focused on the negative relationship outcomes (e.g., frustration, stress) associated with caring for a spouse with memory loss; however, wives reported higher levels of burden and depression on the standardized measures than did the husbands. Gender differences were found regarding how husbands and wives view their roles in context to the caregiving situation, as well as how they adapt and cope. Longitudinal research is needed to examine the changes in the dynamics of these late-life marital relationships over time. / Master of Science

Indiana University-Purdue University Indianapolis (IUPUI) / Alzheimer’s disease (AD) is the most common age-related neurodegenerative disease. Many researchers believe that an effective AD treatment will prevent the development of disease rather than treat the disease after a diagnosis. Therefore, the development of tools to detect AD-related pathology in early stages is an important goal. In this report, MRI-based markers of neurodegeneration are explored as biomarkers of AD. In the first chapter, the sensitivity of cross-sectional MRI biomarkers to neurodegenerative changes is evaluated in AD patients and in patients with a diagnosis of mild cognitive impairment (MCI), a prodromal stage of AD. The results in Chapter 1 suggest that cross-sectional MRI biomarkers effectively measure neurodegeneration in AD and MCI patients and are sensitive to atrophic changes in patients who convert from MCI to AD up to 1 year before clinical conversion. Chapter 2 investigates longitudinal MRI-based measures of neurodegeneration as biomarkers of AD. In Chapter 2a, measures of brain atrophy rate in a cohort of AD and MCI patients are evaluated; whereas in Chapter 2b, these measures are assessed in a pre-MCI stage, namely older adults with cognitive complaints (CC) but no significant deficits. The results from Chapter 2 suggest that dynamic MRI-based measures of neurodegeneration are sensitive biomarkers for measuring progressive atrophy associated with the development of AD. In the final chapter, a novel biomarker for AD, visual contrast sensitivity, was evaluated. The results demonstrated contrast sensitivity impairments in AD and MCI patients, as well as slightly in CC participants. Impaired contrast sensitivity was also shown to be significantly associated with known markers of AD, including cognitive impairments and temporal lobe atrophy on MRI-based measures. The results of Chapter 3 support contrast sensitivity as a potential novel biomarker for AD and suggest that future studies are warranted. Overall, the results of this report support MRI-based measures of neurodegeneration as effective biomarkers for AD, even in early clinical and preclinical disease stages. Future therapeutic trials may consider utilizing these measures to evaluate potential treatment efficacy and mechanism of action, as well as for sample enrichment with patients most likely to rapidly progress towards AD.

The population of China is ageing. Accompanying this aging population, dementia and frailty have a growing importance. However there is little consensus on the association between dementia and frailty, in terms of how the criteria that are part of this two syndromes overlap, as both disorders are age-related and increase the risk for falls, further leading to loss of independence. To meet the above needs, the thesis describes research into different frailty diagnostic criteria, as well as its association with dementia symptoms. We examined cognitive measures that can be used for assessment of Mild Cognitive Impairment (MCI) and dementia screening (the Hopkins Verbal Learning Test, HVLT) and compared its discriminant ability with the commonly used cognitive screening tool, the Mini-Mental State Examination (MMSE) in distinguishing Cognitive Impairment (including MCI and dementia) from No Cognitive Impairment (NCI, normal controls) in two community-dwelling elderly Chinese populations and in one institutionalised elderly population in Shanghai, China. Subsequently we investigated whether physical and cognitive symptoms clustered together to form frailty phenotypes. We employed indicators that have been widely used to diagnose frailty, including physical measures (grip strength, Time-Up and Go test, 15 feet gait speed test and Berg balance test), and psychological measures (the HVLT and the MMSE) to predict cognitive impairment (CI) and frailty. Additionally, we described demographics (age, gender, education) and other potential modifiers when detecting cognitive impairment and functional disability. We then built up a model for possible frailty phenotype using various indicators. Lastly, we examined whether demographic (age, gender, education and profession), and lifestyle (smoking/alcohol history, exercise frequency, and dietary habit) could be used to predict future cognitive impairment. It was found that advanced age, lower education (no or primary level), and being vegetarian were significant risk factors for cognitive impairment. Furthermore, whereas high consumption of green vegetables is a protector against cognitive impairment, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China. To meet the above needs, the thesis describes research into different frailty diagnostic criteria, as well as its association with dementia symptoms. We examined cognitive measures that can be used for assessment of Mild Cognitive Impairment (MCI) and dementia screening (the Hopkins Verbal Learning Test, HVLT) and compared its discriminant ability with the commonly used cognitive screening tool, the Mini-Mental State Examination (MMSE) in distinguishing Cognitive Impairment (including MCI and dementia) from No Cognitive Impairment (NCI, normal controls) in two community-dwelling elderly Chinese populations and in one institutionalised elderly population in Shanghai, China. Subsequently we employed these two cognitive measures to investigate whether they were part of the frailty syndrome among elderly from the community-based studies. We investigated whether physical and cognitive symptoms clustered together to form frailty phenotypes. We employed indicators that have been widely used to diagnose frailty, including physical measures (grip strength, Time-Up and Go test, 15 feet gait speed test and Berg balance test), and psychological measures (the HVLT and the MMSE) to predict cognitive impairment (CI). We found four distinct subtypes of elderly characterised by increasing care needs: 1. Persona elderly as defined by age >78, year of education<6 years, grip strength <11.8 KG, and a MMSE total score <25; 2. Persona Physical frailty (fitness), defined by a total score on the Timed-Up and Go (TUG) test >12.7 seconds and 15 feet gait speed >4.4 seconds; 3. Persona Cognitive impairment, defined by a MMSE total score <25, a HVLT Immediate Recall (IR) score <15, and a HVLT Delayed Recall (DR) <5; 4. Persona Physical frailty (balance,) defined by a Berg Balance test score of <53. Additionally, we described demographics (age, gender, education) and other potential modifiers when detecting cognitive impairment and functional disability. We then built up a model for possible frailty phenotype using various indicators, Frailty here was defined as: 1. Low BMI as measured by this algorithm: BMI= Weight (kg)/Height (m)2 2. Weakness (upper and lower body): grip strength in the lowest quintile, adjusted for gender; and TUG get up with assistance or unable to get up 3. Slowness (lower body): TUG score in the lowest quintile, adjusted for gender; and 15 feet gait speed in the lowest quintile, adjusted for gender; 4. Poor balance: Berg Balance test score in the lowest quintile, adjusted for gender; 5. Low physical activity: engaging in exercise less than once per week. An individual with 4 or more present frailty components out of a total of 7 was considered to be frail , whereas equal or less than 3 characteristics were hypothesized to be pre-frail . Those with no present frailty components were considered as robust. Lastly, we examined whether demographic (age, gender, education and profession), and lifestyle (smoking/alcohol history, exercise frequency, and dietary habit) could be used to predict future cognitive impairment (as defined by a HVLT IR score of ≤19). The results of our studies show that compared to the MMSE, the HVLT is superior in differentiating MCI and dementia from NCI, and is also less affected by demographic factors in detecting frailty. Furthermore, in the current study, physical, psychological, demographic and other modifiable risk factors cluster together into different phenotypes of cognitive impairment and functional disability in these cohorts. A phenotype of frailty is built up using BMI, grip strength, TUG, 15 feet gait speed, balance and exercise frequency as indicators. The most common was the elderly phenotype followed by the cognitively impaired. A novel finding of the current study is that only 4.8% (8 out 168) of the whole sample fulfilled all three categories in the current study (cognitive impairment, functional disability and frailty). Finally, advanced age, lower education (no or primary level), and being vegetarian were significant risk factors for cognitive impairment. Furthermore, whereas high consumption of green vegetables is a protector against cognitive impairment, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China.

Tidigare forskning har funnit samband mellan gång och kognitiv funktion, men sambandet mellan lindrig kognitiv svikt (MCI) och gång är inte helt klarlagt. Syftet med den föreliggande examensuppsatsen var således att undersöka hur gångvariabler och gångvariabilitet är påverkat hos personer med MCI i relation till kognitivt friska individer. Studien genomfördes i det pågående projektet the Healthy Ageing Initiative vid Umeå Universitet. Totalt 1937 personer inkluderades i studien. Samtliga var 70 år gamla och bosatta i Umeå kommun. Totalt 112 personer bedömdes ha MCI utifrån instrumentet Mini-Mental State Examination (MMSE). Gånganalys genomfördes med den elektroniska gångmattan GAITRite® system och deltagarna utförde fyra gångförsök: egenvald hastighet, snabb hastighet, kognitiv dual task och motorisk dual task. Resultatet visade att det finns skillnader mellan grupper vad gäller både spatiala och temporala aspekter, främst i de tre första försöken. Exempelvis uppvisade gruppen MCI lägre gånghastighet, kortare steg och kliv samt längre double support och kortare swing. Gruppen MCI uppvisade högre variabilitet under kognitiv dual task. Ett flertal gång- och variabilitets-variabler under kognitiv dual task kunde, enligt logistisk regression, predicera sannolikheten att ha MCI. Resultaten indikerar att gången hos de med MCI kan ge ökad fallrisk. / Previous research has found a connection between gait and cognitive function. However, the relationship between mild cognitive impairment (MCI) and gait has not been fully explored. Thus, the aim of this study was to examine how spatiotemporal gait parameters, and gait variability, are affected in people with MCI compared to cognitively healthy individuals (CHI). The study was carried out in cooperation with the Healthy Ageing Initiative research project, Umeå University, Sweden. A total of 1937 participants were included in the study. All participants were 70-years old and residents of the municipality Umeå. A total of 112 participants were classified as having MCI, as measured with the Mini-Mental State Examination (MMSE). Gait analysis was performed with the GAITRite® system, and participants performed four trials: preferred pace, fast pace, cognitive dual task and motor dual task. Results showed group differences in both spatial and temporal aspects of gait, especially during the first three trials. For example, participants with MCI walked more slowly, had shorter steps and strides, as well as a longer duration of the double support phase and lower duration of the swing phase. Participants with MCI revealed higher gait variability during cognitive dual task. Several of these variability variables, as well as spatiotemporal variables, could predict probability of having MCI, as seen through logistic regression. Results indicate that the gait observed in MCI could be related to a higher risk of falling.

Introdução: Memória prospectiva é a capacidade de formular intenções e realizá-las em um momento no futuro. Apesar da relevância da memória prospectiva para o funcionamento diário e do potencial das tarefas de memória prospectiva em detectar os primeiros sinais de declínio cognitivo, essas tarefas raramente são utilizadas na avaliação clínica de idosos. Objetos: Os objetivos do presente estudo foram: (1) Caracterizar o desempenho da memória prospectiva em pacientes com Comprometimento Cognitivo Leve (CCL) e compará-lo a controles saudáveis; (2) Investigar a relação entre medidas de memória prospectiva, testes neuropsicológicos e variáveis demográficas; (3) Avaliar a acurácia diagnóstica de medidas subjetivas e objetivas de memória prospectiva para a detecção de CCL. Métodos: O estudo inclui 30 pacientes com Comprometimento Cognitivo Leve amnéstico (CCLa), 20 com Comprometimento Cognitivo Leve não-amnéstico (CCLna) e 30 controles saudáveis. Todos os participantes foram submetidos a avaliação neuropsicológica e responderam ao Questionário de Memória Prospectiva e Retrospectiva (QMPR). Os participantes também foram convidados a realizar uma tarefa de memória prospectiva na vida diária. Resutados: Os grupos CCLa e CCLna apresentaram desempenho significativamente pior comparado ao grupo controle em medidas objetivas de memória prospectiva baseadas em tempo e evento. O grupo CCLa apresentou pior desempenho em tarefa de memória prospectiva realizada na vida diária comparado ao grupo CCLna. Foram encontras correlações significativas entre as medidas objetivas de memória prospectiva e testes neuropsicológicos de memória retrospectiva, atenção e funções executivas e idade. O grupo CCLa apresentou mais queixas de memória prospectiva e retrospectiva comparado aos idosos saudáveis. As medidas objetivas de memória prospectiva apresentaram boa acurácia para discriminar os grupos de pacientes dos controles, tanto no subtipo amnéstico quanto não amnéstico. As medidas subjetivas de memória prospectiva apresentaram boa acurácia para diferenciar os grupos, prém não se correlacionaram com as medidas objetivas de memória prospectiva. Conclusão: Os resultados apresentados sugerem que indivíduos com CCL apresentam comprometimento de memória prospectiva quando comparados com adultos saudáveis. Estes resultados têm implicações importantes para a prática clínica e para o desenvolvimento de programas mais adequados de reabilitação cognitiva. / Introduction: Prospective memory is the ability to formulate intentions and realize them at a future time. Despite the relevance of prospective memory to everyday functioning and the potential for prospective memory task in to detect the earliest signs of cognitive decline, these tasks rarely are utilized as part of the clinical evaluations of older adults. Objectives: The objectives of the present study were to: (1) Characterize the prospective memory performance of patients with Mild Cognitive Impairment (MCI) and compare their performance with normal controls; (2) Investigate the relationship between prospective memory measures, neuropsychological tests and demographic variables; (3) Evaluate the diagnostic accuracy of subjective and objective prospective memory measures for detecting MCI. Methods: The study included 30 patients with amnestic MCI (aMCI), 20 with nonamnestic MCI (naMCI) and 30 healthy controls. All participants underwent neuropsychological assessment completed the Prospective and Retrospective Memory Questionnaire. Participants were also asked to perform a prospective memory task in their everyday lives. Results: Individuals with aMCI and naMCI performed significantly worse than controls on time-based and event-based objective prospective memory measures. Participants with aMCI demonstrated poorer performance in prospective memory measure carried out in everyday life than naMCI. Significant correlations were found between objective prospective memory measures, neuropsychological tests of retrospective memory, attention and executive functioning and age. Participants with aMCI reported more prospective and retrospective memory complaints than the healthy adults. The objective prospective memory measure was able to discriminate with good accuracy the groups of patients from controls in both amnestic and nonaminestic subtypes. The subjective prospective memory measure showed good accuracy to differentiate the groups, but not correlated with objective measures of prospective memory. Conclusion: The results suggest that individuals with MCI display prospective memory impairment when compared to healthy adults. These results have important implications for clinical practice and to develop of more appropriate programs of cognitive rehabilitation.

(Contexto) Segundo a Organização Mundial da Saúde, as demências são um problema de custo social elevado, cujo manejo é um desafio para as próximas décadas. Demências comuns incluem a Doença de Alzheimer (DA), bastante conhecida. Outra síndrome menos conhecida, o Comprometimento Cognitivo Leve (CCL), é relevante por ser o estágio inicial clinicamente definido da DA. Embora o CCL não seja tão conhecido do público, pessoas com um tipo especial dessa síndrome, o CCL amnéstico, evoluem para a DA a uma taxa bastante maior que a da população em geral. O diagnóstico das demências e síndromes relacionadas é feito com base na análise de aspectos linguísticos e cognitivos do paciente. Testes clássicos incluem testes de fluência, nomeação, e repetição. Entretanto, pesquisas recentes têm reconhecido cada vez mais a importância da análise da produção discursiva, especialmente de narrativas, como uma alternativa mais adequada, principalmente para a detecção do CCL. (Lacuna) Enquanto uma análise qualitativa do discurso pode revelar o tipo da doença apresentada pelo paciente, uma análise quantitativa é capaz de revelar a intensidade do dano cerebral existente. A grande dificuldade de análises quantitativas de discurso é sua exigência de esforços: o processo de análise rigorosa e detalhada da produção oral é bastante laborioso, o que dificulta sua adoção em larga escala. Nesse cenário, análises computadorizadas despontam como uma solução de interesse. Ferramentas de análise automática de discurso com vistas ao diagnóstico de demências de linguagem já existem para o inglês, mas nenhum trabalho nesse sentido foi feito para o português até o presente momento. (Objetivo) Este projeto visa criar um ambiente unificado, intitulado Coh-Metrix-Dementia, que se valerá de recursos e ferramentas de Processamento de Línguas Naturais (PLN) e de Aprendizado de Máquina para possibilitar a análise e o reconhecimento automatizados de demências, com foco inicial na DA e no CCL. (Hipótese) Tendo como base o ambiente Coh-Metrix adaptado para o português do Brasil, denominado Coh-Metrix-Port, e incluindo a adaptação para o português e inserção de vinte e cinco novas métricas para calcular a complexidade sintática, a densidade de ideias, e a coerência textual, via semântica latente, é possível classificar narrativas de sujeitos normais, com DA, e com CCL, em uma abordagem de aprendizado de máquina, com precisão comparável a dos testes clássicos. (Conclusão) Nos resultados experimentais, foi possível separar os pacientes entre controles, CCL, e DA com medida F de 81,7%, e separar controles e CCL com medida F de 90%. Os resultados indicam que o uso das métricas da ferramenta Coh-Metrix-Dementia é bastante promissor como recurso na detecção precoce de declínio nas habilidades de linguagem. / (Backgroung) According to the World Health Organization, dementia is a costly social issue, whose management will be a challenge on the coming decades. One common form of dementia is Alzheimers Disease (AD). Another less known syndrome, Mild Cognitive Impairment (MCI), is relevant for being the initial clinically defined stage of AD. Even though MCI is less known by the public, patients with a particular variant of this syndrome, Amestic MCI, evolve to AD in a considerably larger proportion than that of the general population. The diagnosis of dementia and related syndromes is based on the analysis of linguistic and cognitive aspects. Classical exams include fluency, naming, and repetition tests. However, recent research has been recognizing the importance of discourse analysis, specially narrative-based, as a more suitable alternative, specially for MCI detection. (Gap) While qualitative discourse analyses can determine the nature of the patients disease, quantitative analyses can reveal the extent of the existing brain damage. The greatest challenge in quantitative discourse analyses is that a rigorous and thorough evaluation of oral production is very labor-intensive, which hinders its large-scale adoption. In this scenario, computerized analyses become of increasing interest. Automated discourse analysis tools aiming at the diagnosis of language-impairing dementias already exist for the English language, but no such work has been made for Brasilian Portuguese so far. (Goal) This project aims to create a unified environment, entitled Coh-Metrix-Dementia, that will make use of Natural Language Processing and Machine Learning resources and tools to enable automated dementia analysis and classification, initially focusing on AD and MCI. (Hypothesis) Basing our work on Coh-Metrix-Port, the Brazilian Portuguese adaption of Coh-Metrix, and including the adaptation and inclusion of twenty-five new metrics for measuring syntactical complexity, idea density, and text cohesion through latent semantics, it is possible to classify narratives of healthy, AD, and MCI patients, in a machine learning approach, with a precision comparable to classical tests. (Conclusion) In our experiments, it was possible to separate patients in controls, DA, and CCL with 81.7% F-measure, and separate controls and CCL with 90% F-measure. These results indicate that Coh-Metrix-Dementia is a very promising resource in the early detection of language impairment.

Introdução: A demência é um dos principais problemas de saúde devido ao rápido crescimento populacional de idosos, com prevalência estimada de 8,5% em estudos latino-americanos. Comprometimento cognitivo leve e Comprometimento Cognitivo sem Demência (CCSD) são designações utilizadas para a condição clínica entre o envelhecimento normal e demência com prevalência ainda insuficientemente determinada em estudos populacionais, particularmente no Brasil. Objetivos: Estabelecer a prevalência de CCSD e de demência em idosos que vivem na comunidade no município de Tremembé, estado de São Paulo, e avaliar a influência de variáveis sociodemográficas. Verificar se a prevalência de demência foi mais elevada entre sexagenários do que em países desenvolvidos. Secundariamente, verificar a adequação dos instrumentos: Questionário de Mudança Cognitiva (QMC), Addenbrooke\'s Cognitive Examination-Revised (ACE-R) e Montreal Cognitive Assessment (MoCA) para estudos populacionais. Métodos: O estudo populacional foi realizado em fase única com os idosos com 60 anos ou mais residentes no município de Tremembé. Foram selecionados, de forma aleatória, 20% dos domicílios dos idosos de cada setor censitário do município. Além da avaliação clínica e neurológica, questionários foram aplicados aos informantes para avaliar atividade funcional (Informant Questionnaire on Cognitive Decline in the Elderly [IQCODE] e o Questionário de Atividades Funcionais de Pfeffer), e testes neuropsicológicos foram aplicados aos participantes (Bateria Breve do Rastreio Cognitivo, Mini Exame do Estado Mental, teste de fluência verbal e teste do desenho do relógio) juntamente com escalas de avaliação psiquiátrica. Os diagnósticos de CCSD e de demência foram estabelecidos em reunião de consenso entre dois especialistas em neurologia cognitiva, com base no conjunto dos dados obtidos. / Introduction: Dementia is one of the major health issues due to the rapidly growing elderly population, with an estimated prevalence of 8.5% in Latin American studies. Mild cognitive impairment and Cognitive impairment no dementia (CIND) are designations for a clinical condition that lies between normal aging and dementia, and its prevalence is insufficiently determined in population studies, particularly in Brazil. Objectives: To determine the prevalences of CIND and dementia in the communitydwelling elderly living in the municipality of Tremembé, São Paulo state and to evaluate the influence of socio-demographic variables. To verify whether the prevalence of dementia was higher among sexagenarians than in developed countries. Secondarily, to investigate the suitability of the use of Questionnaire of Cognitive Change (QCC), Addenbrooke\'s Cognitive Examination-Revised (ACE-R) and Montreal Cognitive Assessment (MoCA) in epidemiological studies. Methods: The population study was conducted in a single phase with the elderly aged 60 years or more living in municipality of Tremembé. Twenty percent of the households with elderly were randomly selected from each city\'s census tract. In addition to clinical and neurological evaluations, questionnaires were applied to informants to assess functional activities (Informant Questionnaire on Cognitive Decline in the Elderly [IQCODE] and Pfeffer Functional Activities Questionnaire); and neuropsychological tests were administered to participants (Brief Cognitive Screening Battery, Mini-Mental State Examination, verbal fluency test and clock drawing test) along with psychiatric rating scales. The diagnoses of dementia and CIND were established in consensus meetings by two neurologists specialized in cognitive neurology, based on the available set of data. Results: Six hundred and thirty subjects (63% women) were examined with mean age of 71.28 (±7.99) and mean years of schooling of 4.90 (±4.54). The prevalence of dementia was 17.5%, higher than in developed countries in all age groups, but the prevalence was even higher among individuals aged between 60 and 69 years. The prevalence of CIND was 19.5%. These prevalences were influenced by age (p< 0.001) and by educational level (p < 0.001). There was no significant gender difference among diagnostic groups (p= 0.166). In multiple comparisons analysis, age was significantly different among the three groups, being higher in the dementia group, lower in the cognitively normal group and intermediate in the CIND group; and education was higher in the normal group compared to the mean years of schooling in the other two groups. Diagnosis of dementia was significantly associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy, while diagnosis of CIND was only associated with stroke. Conclusions: The prevalence of dementia in this study was higher than those reported by other studies, particularly among sexagenarians elderly. The prevalences of dementia and CIND were influenced by age and by educational attainment. The QCC was a suitable instrument for the diagnosis of dementia but the ACE-R and MoCA did not show good accuracies in this population with heterogeneous educational background