Cette thèse avait pour objectif de tester la théorie de la rétrogenèse appliquée au langage des personnes atteintes de la maladie d’Alzheimer, afin de tirer des conclusions permettant d’adapter notre comportement aux patients et de mettre en place des méthodes de maintient dans le langage plus appropriées.Pour ce faire, trois tâches ont été mises en place : une tâche de fluence verbale (phonémique (lettre initiale P) puis sémantique (animaux)), une tâche de dénomination d’images, ainsi qu’une tâche de répétition de phrases. Trois groupes de participants ont été créés : un groupe de 80 personnes atteintes de la maladie d’Alzheimer, un groupe de 60 enfants, âgés de 3 à 11 ans, puis un groupe contrôle de personnes âgées saines. Le groupe des patients était divisé en 4 sous-groupes en fonction de leur score au MMSE. Il en était de même pour les enfants, répartis en trois sous-groupes.Les analyses effectuées par le biais de modèles mixtes, ont permis de montrer que le déclin du langage dans la maladie d’Alzheimer semble bien suivre un ordre symétrique à celui de son acquisition. L’effet d’AoA permet souvent d’expliquer ce phénomène. Toutefois, des différences entre les enfants et les personnes Alzheimer sont également observables : si le langage semble suivre une involution symétrique à celle de l’enfant, il n’en est pas moins que les processus sous-jacents impliqués ne sont pas les mêmes que chez l’enfant. / The aim of this thesis was to test retrogenesis hypothesis applied to the language of people with Alzheimer's disease, in order to draw conclusions allowing us to adapt our behavior to patients and to implement appropriate methods of maintaining language.To do this, three tasks were established: a verbal fluency task (phonemic (initial letter P) and then semantic (animals)), an picture naming task, and a sentence repetition task. Three groups of participants were created: a group of 80 people with Alzheimer's disease, a group of 60 children, aged 3 to 11, and a healthy elderly control group. The patient group was divided into 4 subgroups based on their MMSE score. It was the same for children, divided into three subgroups.Analyzes conducted runing mixed models have shown that the decline of language in Alzheimer's disease seems to follow a symmetrical order to that of its acquisition. The effect of AoA can often explain this phenomenon. However, differences between children and Alzheimer's patients are also observable: if the language seems to follow an involution symmetrical to that of the child, it is nonetheless that the underlying processes involved are not the same as in the child.

Orientadora: Profª. Drª. Ruth Ferreira dos Santos-Galduróz / Dissertação (mestrado) - Universidade Federal do ABC, Programa de Pós-Graduação em Neurociência e Cognição, 2017. / Na Doença de Alzheimer (DA) observa-se declínio importante da funcionalidade que impacta na qualidade e sobrevida dos idosos. A Teoria da Retrogênese propõe que o declínio de certas capacidades na DA mostrava-se reverso aos estágios do desenvolvimento de Piaget. Sendo assim, as habilidades perdidas nas fases iniciais da DA seriam as mais complexas, ou seja, as últimas a serem adquiridas no desenvolvimento neuropsicomotor (funções executivas e praxia). Porém, a teoria não descreve uma possível correlação entre funções cognitivas complexas com equilíbrio e risco de quedas. O objetivo deste estudo foi avaliar as perdas psicomotoras, cognitivas e o risco de quedas em idosas hígidas e com diagnóstico provável da DA de acordo com a Teoria da Retrogênese. Trata-se de um estudo transversal realizado com 45 idosas (27 hígidas e 18 com DA em fase leve), residentes na Grande São Paulo, no período de 2016 a 2017. Inicialmente, responderam uma anamnese com dados sociodemográficos, clínicos, número de quedas e a escala de depressão Geriátrica Yesavage (GDS-30). Obtidas as primeiras informações foram aplicadas avaliações cognitivas: Avaliação Cognitiva Montreal (MoCA) e Cambridge Cognitive Examination Revisado (CAMCOG-R); avaliações motoras: Escala de Equilíbrio de Berg (EEB) e Timed Up and Go Test (TUGT) e avaliação funcional: Direct Assessment of Functional Status (DAFS-BR). Para análise de dados foi utilizado o teste de U Mann-Whitney que avaliou a diferença das pontuações das escalas nos dois grupos; correlação de Spearman entre os escores das escalas e número de quedas e por fim, análise de regressão múltipla. Foi adotado um nível de significância de p<0,05. Houve uma relação entre o número de quedas e os escores de CAMCOG-R totais em ambos os grupos (p = 0,03), ou seja, quanto menor o índice de CAMCOG-R, maior o número de quedas. Os itens praxia (p <0,00) e funções executivas (p <0,00) de CAMCOG-R foram altamente correlacionados com TUGT e com EEB. Isso sugere uma provável relação entre essas funções cognitivas e o risco de cair. Na análise de regressão linear, observou-se uma relação de dependência entre EEB e CAMCOG-R Total. Para cada ponto aumentado em CAMCOG-R Total, o escore total de EEB aumentou 0,27 (p <0,01). O mesmo foi observado entre DAFS-BR Total e CAMCOG-R Total. O aumento de um ponto no CAMCOG-R Total implicou um aumento de 0,69 (p <0.01) no DAFS-BR Total. É possível sugerir uma relação de dependência entre funcionalidade e cognição; equilíbrio e cognição e correlação entre o risco de queda e o desempenho cognitivo em ambos os grupos. / In Alzheimer's disease (AD), there is a significant decline in functionality, directly impacting the quality and survival of the elderly. The Theory of Retrogenesis proposes that the decline of certain capacities in AD was reversed at the stages of Piaget's development. Thus, the skills lost in the early stages of AD would be the most complex, that is, the last ones to be acquired in neuropsychomotor development - executive functions and praxia. However, the theory does not describe a possible correlation between complex cognitive functions with changes in balance and risk of falls. The objective was to evaluate the psychomotor, cognitive and risk of falls in healthy elderly women with probable diagnosis of AD according to the Theory of Retrogenesis. This is a cross-sectional study of 45 elderly women (27 healthy and 18 with AD in the light phase), living in Greater São Paulo, from 2016 to 2017 who answered an anamnesis with sociodemographic, clinical data and number of falls and Geriatric Yesavage Depression Scale (GDS-30). Was applied cognitive evaluations: Montreal Cognitive Assessment (MoCA) and Cambridge Cognitive Examination Revised (CAMCOG-R); motor ratings: Berg Balance Scale (EEB) and Timed Up and Go Test (TUGT) and functional assessment: Direct Assessment of Functional Status (DAFS-BR). For data analysis, the Mann-Whitney U test was used to evaluate the difference of the scales scores in the two groups; Spearman correlation between scales scores and number of falls and finally, multiple regression analysis with boostrap regression and bias correction. A significance level p <0.05. There was a relation between the number of falls and the total CAMCOG-R scores in both groups (p = 0.03), that is, the lower the CAMCOG-R, the greater the number of falls. The praxia item (p <0.00) as well as the executive functions of the CAMCOG-R item (p <0.00) were highly correlated with TUGT. The same occurred with EEB - praxia (p <0.00) and executive functions (p <0.00). This suggests a probable relationship between these cognitive functions and the risk of falling. In the linear regression analysis, a relationship of dependence between EEB and Total CAMCOG-R is observed. For each point increase in CAMCOG-R Total, the total EEB score increased by 0.276 (p <0.01). There was no difference between groups. The same was observed between DAFS-BR Total and CAMCOG-R Total. The one-point increase in CAMCOG-R Total implied an increase of 0.692 (p <0.01) in DAFS-BR Total. It is possible to suggest a relation of dependence between functionality and cognition; balance and cognition and correlation between the risk of falling and cognitive performance.

Dementia of Alzheimer‟s Type is a degenerative neurocognitive disease accounting for majority of Dementia‟s. It affects millions of people worldwide and thousands of people in South Africa. Apart from the economic burden this illness places on the country, it has detrimental effects for those who provide care for individuals with this illness, who are mostly spouses. The spousal caregivers bears great financial, social and emotional burden which worsens as the disease progresses. The aim of this study is to phenomenologically explore and describe the lived experiences of spousal caregivers in caring for the spouses with Dementia of Alzheimer‟s Type. This South African study was therefore qualitative in nature and was conducted in the province of KwaZulu- Natal, in the city of Pietermaritzburg. Eight participants were interviewed using a semi-structured questionnaire. Data was analysed using interpretative phenomenological analysis (IPA). The main findings of this study are the negative emotional affects that the caregiving role creates. Caregiver stress and strain is experienced as well as the experiences of various losses including lack of intimacy and ruined expectations for the future as the disease progresses. The caregiving role also created negative implications for the social lives of caregivers and coping mechanisms were seen to be very important. / Psychology / M.A. (Psychology)