Dementia e Neuropsychologia最新文献

Long-term anxiety disrupts emotional, hormonal, and cognitive systems, including elevated cortisol and impaired memory performance.

Objective: This quasi-experimental study evaluated the effects of Dhikrullah breathing therapy on anxiety symptoms, serum cortisol, brain-derived neurotrophic factor (BDNF), and memory performance.

Methods: Anxiety levels were assessed using the Depression Anxiety Stress Scales (DASS-42), cortisol and BDNF concentrations were measured using an enzyme-linked immunosorbent assay (ELISA), and verbal memory was evaluated using a standardized word recall task.

Results: Statistical analyses using the Wilcoxon signed-rank test and the paired t-test revealed significant reductions in anxiety (p=0.001) and cortisol levels (p=0.001), as well as a significant improvement in memory performance (p=0.001). In contrast, serum BDNF levels showed a small numerical decrease that was not statistically significant (p=0.284). Correlational analysis showed a moderate positive correlation between changes in BDNF and memory performance (r=0.54; p=0.01), as well as a moderate negative correlation between changes in BDNF and cortisol (r=-0.51; p=0.04). In addition, changes in anxiety were moderately negatively correlated with changes in memory performance (r=-0.50; p=0.005), whereas the correlation between changes in anxiety and cortisol was weak and not statistically significant (r=0.39; p=0.17).

Conclusion: Dhikrullah breathing therapy promotes positive changes in the emotional, hormonal, and cognitive responses of people who experience anxiety. Additional controlled studies are needed to determine the potential use of this treatment in both clinical and community mental health settings.

As pharmacological treatments for Alzheimer disease (AD) offer only modest symptomatic improvement, non-pharmacological interventions - including therapeutic arts - are increasingly being explored for their potential to enhance cognitive, emotional, and psychosocial well-being in individuals with AD. This mini-narrative review aimed to summarize the various neurobiological mechanisms through which therapeutic arts impact progression of AD. It also compares the findings, clinical benefits, and changing attitudes of patients and caregivers toward therapeutic arts, such as music therapy, visual arts, dance/movement therapy, and creative expression, before and after 2000. With robust studies and advanced technologies, there is growing evidence that integrating structured arts-based programs into dementia care may provide cost-effective solutions to improve patient outcomes and slow functional decline in patients with AD.

Dementia is a major public health concern, and culturally adapted cognitive tools are essential for accurate screening among older adults.

Objective: To evaluate the discriminant validity of the Shiraz Verbal Learning Test (SVLT) in differentiating verbal memory performance among elderly women with and without dementia in Shiraz, Iran.

Methods: A cross-sectional study was conducted with 60 women aged 65 years or older, recruited between 2024 and 2025 by convenience sampling in Shiraz. The sample included 30 cognitively healthy participants and 30 with mild to moderate dementia diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria and confirmed by a neurologist. Assessments included a demographic questionnaire, the Mini-Mental State Examination (MMSE), the 28-item General Health Questionnaire (GHQ-28), and the SVLT. Data were analyzed using multivariate analysis of variance (MANOVA) and univariate analysis of variance (ANOVA).

Results: The dementia group scored significantly lower than the healthy group across all SVLT memory measures - learning, immediate recall, delayed free recall, delayed cued recall, and recognition (p<0.01) - demonstrating strong discriminant capacity.

Conclusion: The SVLT demonstrated satisfactory psychometric validity and promising clinical usefulness in differentiating dementia-related verbal memory deficits among elderly Iranian women, indicating its potential as a culturally adapted tool for early cognitive screening in clinical and research contexts.

Metformin is a widely prescribed drug for managing diabetes mellitus. Recent studies have investigated its potential effects on cognitive function in adults aged 60 years and older, a population that is steadily increasing and often exhibits cognitive impairments associated with aging and other chronic conditions.

Objective: This study aimed to evaluate the impact of metformin use on cognitive functions in older adults through a meta-analysis.

Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines, utilizing the Embase, LILACS, PubMed, Scopus, and Web of Science databases. The review protocol was registered in PROSPERO (CRD42024624045).

Results: Thirteen articles met the eligibility criteria for inclusion in this systematic review, of which five provided sufficient data for the meta-analysis. The findings indicate that metformin has a small but positive effect on overall cognitive function in older adults. Additionally, the meta-analysis demonstrated low heterogeneity (49.6%) and a low risk of bias (p>0.05).

Conclusion: The results suggest that metformin may have a protective effect on the overall cognitive function of older adults, in addition to its well-established metabolic benefits.

COVID-19 infection has been frequently associated with cognitive deficits that persist for months after the acute phase, but the impact of vaccination on preventing these deficits remains uncertain. Evidence suggests that immunization reduces the incidence and severity of post-COVID symptoms, yet few studies have evaluated its influence on cognition using objective measures. To address this gap, a mini-review was conducted using a systematic search strategy, following PRISMA recommendations where applicable, with a protocol registered in PROSPERO (CRD42025636772). Searches were carried out in the PubMed/MEDLINE and Scopus databases, and eligible studies were those that assessed cognition using objective measures and compared vaccinated and unvaccinated individuals at the time of infection. A total of 1,796 records were identified, of which only five met the inclusion criteria. The included studies varied considerably in cognitive assessment tools, study designs, and sample sizes. Four of the five studies found no association between prior vaccination and cognitive deficits, whereas the only study that identified a subtle difference among individuals who had received at least two doses of the vaccine had a substantially larger sample than all the others combined. Methodological inconsistencies in cognitive assessment, variability in the definitions of vaccination status, and the lack of stratification by specific cognitive domains limit the interpretation of the current findings. Although vaccination may play a role in protecting against cognitive deficits following COVID-19 infection, the evidence remains limited and inconclusive. Further studies with standardized definitions of vaccination status and comprehensive objective assessments are needed to clarify this relationship.

Episodic memory is one of the cognitive domains most vulnerable to age-related changes and the early stages of neurodegenerative syndromes. In Brazilian clinical practice, however, the interpretation of memory performance frequently remains restricted to the quantitative analysis of delayed recall, without adequate consideration of the underlying neurocognitive mechanisms. This study aimed to critically examine the neurobiological foundations of the distinction between hippocampal consolidation deficits and executive retrieval impairments mediated by prefrontal circuits, discussing their diagnostic and gerontological implications. This integrative narrative review is grounded in recent national and international literature (2019-2024) and integrates evidence from neuroimaging, theoretical models of memory, and clinical data relevant to aging. Differentiating hippocampal consolidation deficits from executive retrieval impairments, integrated with the assessment of functional capacity, is proposed as a clinically actionable, mechanism-based framework for improving diagnostic accuracy in aging within heterogeneous sociocultural contexts such as Brazil.

The prevalence of neurocognitive disorder increases with age; nearly one in two nonagenarians may be affected, representing a clinical challenge during hospitalization because of their admission condition, comorbidities, decision-making needs, and management.

Objective: This study aimed to describe the clinical characteristics of individuals aged 90 years old or older with a history of major neurocognitive disorder admitted due to an acute medical condition.

Methods: A descriptive cross-sectional study was conducted using institutional data from the Geriatrics Department of a high-complexity hospital in Bogotá, Colombia. Information on the history and type of neurocognitive disorder was obtained through self-report or proxy report, and disease severity was assessed using information recorded during the comprehensive geriatric assessment. A descriptive analysis was performed to examine clinical characteristics, baseline functional status, and in-hospital outcomes.

Results: Among the 178 people, the majority were women (71.34%), with a mean age of 93±3 years, and had polypharmacy. Upon admission, 55.61% had delirium, and among the 68 patients who underwent nutritional assessment, 75.00% had moderate or severe malnutrition. The most frequent diagnoses were urinary tract infection and pneumonia. Alzheimer disease (62.5%) and multiple etiologies (Alzheimer disease and vascular) (6.2%) were the most frequent reported etiologies. The median length of stay was 7 days, 4.49% experienced in-hospital complications such as healthcare-associated pneumonia or bacteremia, 45.51% continued management through a home care plan, and 34.83% completed the planned hospital care.

Conclusion: Nonagenarians with major neurocognitive disorder have multiple healthcare needs during hospitalization, requiring multidimensional and interdisciplinary assessment and intervention.

[This corrects the article DOI: 10.1590/1980-5764-DN-2021-0057.].

Dementias have heterogeneous functional decline trajectories, but little is known about the factors that shape this differential progression.

Objective: To identify relevant predictors of functional decline in patients with dementia.

Methods: A total of 76 subjects were included in this longitudinal retrospective, observational study. Functional outcome was assessed using the Technology-Activities of Daily Living Questionnaire (T-ADLQ), a 33-item scale encompassing basic, instrumental, and advanced activities of daily living (ADLs), with higher scores indicating greater deterioration. Participants were assessed three times: at baseline, and after a mean follow-up of 6.2 and 11.2 months, respectively. Cognitive and noncognitive variables were evaluated as predictors of functional decline using a linear mixed-effect model.

Results: Females represented 63.2% of the sample. Subjects had a mean age of 79.5 (±7.9) years, 6.2 (±4.3) years of education, and a Global Deterioration Scale (GDS) score of 4.7 (±0.68) (median 5; range, 4-6). The linear mixed-effect model (R²=0.387) identified global cognition (Mini-Mental State Examination - MMSE), neuropsychiatric symptoms (NPI-Q), and gait/balance (Tinetti test and gait speed) as independent predictors of functional decline, with 𝛽 coefficients of -0.305, 0.299, and -0.281, respectively.

Conclusion: This study underscores the importance of noncognitive predictors of functional trajectories in established dementia. In particular, neuropsychiatric symptoms and gait should be considered during the follow-up of people living with dementia to ensure tailored interventions and counseling for patients and their families. These findings support the inclusion of gait variables in further longitudinal studies on dementia prognosis.

The progressive onset of dementia and mild cognitive impairment (MCI) is a major global health concern due to its profound impact on quality of life. The challenge of identifying MCI and dementia lies partly in the high cost and invasiveness of some biomarkers. In this context, the oxygen extraction fraction (OEF) has emerged as a promising imaging biomarker. This review summarizes current evidence on cerebral OEF as a neuroimaging biomarker in MCI and dementia, focusing on pathophysiology, imaging techniques, comparison with established biomarkers, clinical applications, and future directions. A literature search was conducted from July 1-31, 2025, using the United States National Library of Medicine (PubMed), Scopus, and Web of Science. Search terms included "oxygen extraction fraction" OR "cerebral oxygen metabolism" AND ("mild cognitive impairment" OR "MCI" OR dementia OR "Alzheimer's disease" OR "vascular dementia") AND (qBOLD OR TRUST MRI OR mcQQ MRI OR 15O PET). English-language studies from the past ten years reporting OEF in cognitive impairment were included; case reports and non-human studies were excluded. OEF demonstrates distinct alterations across the spectrum of cognitive impairment. In MCI, reduced OEF has been linked to impaired neurovascular coupling and mitochondrial dysfunction. In dementia, patterns diverge - typically reduced in Alzheimer's disease but heterogeneous in vascular conditions, often elevated under chronic hypoperfusion yet reduced when vascular pathology coexists with Alzheimer's disease. Non-invasive techniques such as mcQQ magnetic resonance imaging (MRI) and TRUST MRI estimate OEF, while ¹⁵O PET remains the gold standard. OEF shows promise as a neuroimaging biomarker for early detection, differential classification, and monitoring disease progression in cognitive impairment.