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Indicadores nutricionais em pacientes com doen?a de alzheimer: rela??es com fatores cl?nicos / Nutritional Indicators in Patients with Alzheimer's disease: Clinical factors relationship

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Previous issue date: 2017-02-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The increase of the population's average age, there was a prevalence increment on the chronic nerological disorders, degenerative such as the Alzheimer's Disease (AD). The deepening on the knowledge of the processes of lifestyle, regarding the nutritional state and its relations with the cognition are important for the guidance and conducting of the elderly people. This study aimed to analyze the nutritional status of elderly patients with AD and its relationship with the clinical aspects, neurocognitive, behavioral and lifestyle. 43 elderlies from the Clinical Neurology Ambulatory of the Celso Pierro Hospital and Maternity (PUCCampinas) were evaluated with the diagnosis of light, moderate and severe AD, according to the Clinical Dementia Rating (CDR) and 51 controls matched by age, gender, schooling and socioeconomic level, whith no history of cognitive decline. The procedures used were: clinical evaluation, mental State mini-exam, simple drawing memory, verbal fluency, clock drawing, functional ability, neuropsychiatric inventory (NPI), CDR, socioeconomic evaluation, physical and social activity (International Questionnaire of Physical Activity - IQPA short version), Mini Nutritional Assessment (MNA), Body mass Index (BMI), Waist circumference (WC), Arm Circumference (AC), Calf Circumference (CC), Triciptal Cutaneous Fold (TCF), Subscapular cutaneous fold (SCF), Muscular Arm circumference (MAC), Corrected Arm Muscle Area (CAMA), Thumb Adductor Muscle (TAM), Palmar Holding Force (PHF) and Bioelectric Impedance. Comparison were made between Alzheimer's Disease Group (ADG) and Control Group (CG) with sociodemographic aspects, lifestyle, cognitive, MNA, Nutritional indicators and nutritional indicators by gender Comparisons were made between CG and AD stages according to the CDR with nutritional variables, It were also performed correlations between PHF with anthropometric variables on the ADG and CG and between cognitive and anthropometric variables on the ADG. With suitable statistical tests the situation and level of significance of 5% in all cases. It was noticed that the ADG develops less social activity and has a smaller relationship network, less physically active, and has poor performance in Daily life activities, mostly in instrumental activities. GDA showed malnutrition with a decrease in total food intake and higher daily intake of some foods on the MNA. Among genders, woman showed diferences in most anthropometric measurements with lower values in the ADG. In the comparison between CG and fazes of ADG there were differences in some measures with lower values in the severe ADG, and higher in the CG. In the comparison between CG and ADG, CG versus light and moderate ADG versus severe ADG there was a difference for some anthropometric measurements. There were no differences between Light and Moderate stages. The Lean Mass (LM) composition measurements were lower in the ADG. No difference was seen on the WC and reactance comparison. There were correlations between PHF and anthropometric variables in the ADG but not between nutritional variables with socioeconomic aspects, behavioral, NPI, social and physical activities. The findings suggests a significant association between social and leisure activities during the eld and a lower dementia risk. In the MNA the lowest score indicates greater deterioration of mental state. As per the feeding, it was noticed that, possibly, ADG feeds with lower amount and higher quality, suggesting a better selection of food by the caregiver. The authors reports a significant difference between BMI in AD phases, with reduction in BMI at the severe stage compared to light and moderate. In the study, there was a greater presence of elderly individuals at malnutrition risk in the AD group when compared to the CG, suggesting that the malnutrition is a factor of risk to the dementia progression. The nutritionals variables were progressively more committed with the advancement of cognitive deficits, since there was a LM reduction trend with the AD progression, more evident in the transition from moderate to severe. / Com o aumento da idade m?dia da popula??o houve incremento de preval?ncia de afec??es neurol?gicas cr?nicas, degenerativas, como a Doen?a de Alzheimer (DA). O aprofundamento do conhecimento dos processos do estilo de vida no que se refere ao estado nutricional e de suas rela??es com a cogni??o s?o de import?ncia para orienta??o e conduta desses idosos. O objetivo desse trabalho foi analisar o estado nutricional de idosos com DA e sua rela??o com aspectos cl?nicos, neurocognitivos, comportamentais e de estilo de vida. Foram avaliados 43 idosos procedentes do ambulat?rio de Neurologia Cl?nica do Hospital e Maternidade Celso Pierro (PUC-Campinas) com diagn?stico de DA leve, moderado e grave, segundo o Clinical Dementia Rating (CDR) e 51 controles pareados por idade, g?nero, escolaridade e n?vel socioecon?mico, sem hist?ria de decl?nio cognitivo. Os procedimentos foram avalia??o cl?nica, Mini-Exame do estado mental, mem?ria do desenho simples, Flu?ncia Verbal, desenho do rel?gio, capacidade funcional, Invent?rio Neuropsiqui?trico (INP), CDR, avalia??o socioecon?mica, atividade f?sica (Question?rio Internacional de Atividade F?sica ? IPAQ vers?o curta) e sociais, Mini Avalia??o Nutricional (MAN), ?ndice de Massa Corp?rea (IMC), Circunfer?ncia da Cintura (CC), Circunfer?ncia do Bra?o (CB), Circunfer?ncia da Panturrilha (CP), Dobra Cut?nea Tricipital (DCT), Dobra Cut?nea Subescapular (DCSE), Circunfer?ncia Muscular do Bra?o (CMB), ?rea Muscular do Bra?o corrigida (AMBc), M?sculo Adutor do Polegar (MAP), For?a de Preens?o Palmar (FPP) e Imped?ncia Bioel?trica. Foi realizada a compara??o entre Grupo Doen?a de Alzheimer (GDA) e Grupo Controle (GC) com aspectos sociodemogr?ficos, estilo de vida, cognitivos, comportamentais, MAN, indicadores nutricionais e indicadores nutricionais por g?nero. Foram feitas compara??es entre GC e est?gios da DA de acordo com CDR com as vari?veis nutricionais, tamb?m foram realizadas correla??es entre FPP com vari?veis antropom?tricas no GDA e GC e entre vari?veis cognitivas e antropom?tricas no GDA. Com testes estat?sticos adequados a situa??o e n?vel de signific?ncia de 5% em todos os casos. Foi observado que o GDA desenvolve menos atividade social e tem rede de relacionamento menor, ? fisicamente menos ativo e tem desempenho inferior nas Atividades de Vida Di?ria, principalmente nas atividades instrumentais. O GDA apresentou desnutri??o com diminui??o da ingest?o alimentar total e maior ingest?o di?ria de alguns alimentos, na MAN. Entre os g?neros, as mulheres apresentaram diferen?a em mais medidas antropom?tricas, com valores menores no GDA. Na compara??o entre GC e fases do GDA, houve diferen?a em algumas medidas com valores menores no GDA grave e maior no GC. Na compara??o entre GC e GDA, GC versus GDA leve e moderado e GDA leve e moderado versus GDA grave houve diferen?a para algumas medidas antropom?tricas. N?o houve diferen?a entre os est?gios leve e moderado. As medidas de composi??o de Massa Magra (MM) foram menores no GDA. CC e Reat?ncia n?o apresentaram diferen?a em nenhuma compara??o. Houve correla??es entre FPP e vari?veis antropom?tricas nos GDA e n?o houve entre vari?veis nutricionais com aspectos socioecon?micos, comportamentais, INP, atividades sociais e f?sicas. Os achados da literatura sugerem uma associa??o significativa entre atividades sociais e de lazer durante a velhice e o menor risco de dem?ncia. Na MAN a menor pontua??o indica maior deteriora??o do estado mental. Quanto a alimenta??o, foi observado que possivelmente o GDA se alimenta com menor quantidade e maior qualidade, sugerindo uma melhor sele??o dos alimentos pelo cuidador. Os autores relatam diferen?a significativa entre IMC nas fases da DA, com redu??o no IMC no est?gio grave comparado ao leve e moderado. No estudo houve maior presen?a de idosos em risco de desnutri??o no grupo com DA quando comparados ao GC, sugerindo que a desnutri??o ? um fator de risco para a progress?o da dem?ncia. As vari?veis nutricionais foram progressivamente mais comprometidas com o avan?ar dos d?ficits cognitivos, pois houve uma tend?ncia a redu??o de MM com a progress?o da DA, sendo mais evidente na transi??o da fase moderada para o grave.

Identiferoai:union.ndltd.org:IBICT/oai:tede.bibliotecadigital.puc-campinas.edu.br:tede/933
Date02 February 2017
CreatorsSantos, Tamires Barbosa Nascimento dos
ContributorsFonseca, Lineu Corr?a, Tedrus, Gloria Maria de Almeida Souza, Bernardi, Julia Delbue Bernardi, Assump??o, Daniela de
PublisherPontif?cia Universidade Cat?lica de Campinas, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, PUC-Campinas, Brasil, CCV ? Centro de Ci?ncias da Vida
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_CAMPINAS, instname:Pontifícia Universidade Católica de Campinas, instacron:PUC_CAMP
Rightsinfo:eu-repo/semantics/openAccess
Relation6411916762624721206, 500, 500, 600, -8538742193007695607, 3590462550136975366

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