NATALIA GOMES GONCALVES
Projetos de Pesquisa
Unidades Organizacionais
LIM/22 - Laboratório de Patolologia Cardiovascular, Hospital das Clínicas, Faculdade de Medicina
3 resultados
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- Dissipating the fog: Cognitive trajectories and risk factors 1 year after COVID-19 hospitalization(2023) GONCALVES, Natalia Gomes; ALIBERTI, Marlon Juliano Romero; BERTOLA, Laiss; AVELINO-SILVA, Thiago; DIAS, Murilo Bacchini; APOLINARIO, Daniel; BUSATTO, Geraldo; FORLENZA, Orestes; NITRINI, Ricardo; BRUCKI, Sonia Maria Dozzi; BRUNONI, Andre Russowsky; VIDAL, Kallene Summer Moreira; JACOB-FILHO, Wilson; SUEMOTO, Claudia KimieIntroduction: Cognitive impairment is common after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, associations between post-hospital discharge risk factors and cognitive trajectories have not been explored. Methods: A total of 1105 adults (mean age SD 64.9 9.9 years, 44% women, 63% White) with severe coronavirus disease 2019 (COVID-19) were evaluated for cognitive function 1 year after hospital discharge. Scores from cognitive tests were harmonized, and clusters of cognitive impairment were defined using sequential analysis. Results: Three groups of cognitive trajectories we re observed during the follow-up: no cognitive impairment, initial short-term cognitive impairment, and long-term cognitive impairment. Predictors of cognitive decline after COVID-19 were older age (beta = -0.013, 95% CI = -0.023;-0.003), female sex (beta = -0.230, 95% CI = -0.413;-0.047), previous dementia diagnosis or substantial memory complaints (beta = -0.606, 95% CI = -0.877;-0.335), frailty before hospitalization (beta = -0.191, 95% CI = -0.264;-0.119), higher platelet count (beta = -0.101, 95% CI = -0.185;-0.018), and delirium (beta = -0.483, 95% CI = -0.724;-0.244). Post-discharge predictors included hospital readmissions and frailty. Discussion: Cognitive impairment was common and the patterns of cognitive trajectories depended on sociodemographic, in-hospital, and post-hospitalization predictors. Highlights Cognitive impairment after coronavirus disease 2019 (COVID-19) hospital discharge was associated with higher age, less education, delirium during hospitalization, a higher number of hospitalizations post discharge, and frailty before and after hospitalization. Frequent cognitive evaluations for 12-month post-COVID-19 hospitalization showed three possible cognitive trajectories: no cognitive impairment, initial short-term impairment, and long-term impairment. This study highlights the importance of frequent cognitive testing to determine patterns of COVID-19 cognitive impairment, given the high frequency of incident cognitive impairment 1 year after hospitalization.
- Association Between Consumption of Ultraprocessed Foods and Cognitive Decline(2023) GONCALVES, Natalia Gomes; FERREIRA, Naomi Vidal; KHANDPUR, Neha; STEELE, Euridice Martinez; LEVY, Renata Bertazzi; LOTUFO, Paulo Andrade; BENSENOR, Isabela M.; CARAMELLI, Paulo; MATOS, Sheila Maria Alvim de; MARCHIONI, Dirce M.; SUEMOTO, Claudia KimieImportance Although consumption of ultraprocessed food has been linked to higher risk of cardiovascular disease, metabolic syndrome, and obesity, little is known about the association of consumption of ultraprocessed foods with cognitive decline.Objective To investigate the association between ultraprocessed food consumption and cognitive decline in the Brazilian Longitudinal Study of Adult Health.Design, Setting, and Participants This was a multicenter, prospective cohort study with 3 waves, approximately 4 years apart, from 2008 to 2017. Data were analyzed from December 2021 to May 2022. Participants were public servants aged 35 to 74 years old recruited in 6 Brazilian cities. Participants who, at baseline, had incomplete food frequency questionnaire, cognitive, or covariate data were excluded. Participants who reported extreme calorie intake (6000 kcal/day) and those taking medication that could negatively interfere with cognitive performance were also excluded.Exposures Daily ultraprocessed food consumption as a percentage of total energy divided into quartiles.Main Outcomes and MeasuresChanges in cognitive performance over time evaluated by the immediate and delayed word recall, word recognition, phonemic and semantic verbal fluency tests, and Trail-Making Test B version.Results A total of 15 105 individuals were recruited and 4330 were excluded, leaving 10 775 participants whose data were analyzed. The mean (SD) age at the baseline was 51.6 (8.9) years, 5880 participants (54.6%) were women, 5723 (53.1%) were White, and 6106 (56.6%) had at least a college degree. During a median (range) follow-up of 8 (6-10) years, individuals with ultraprocessed food consumption above the first quartile showed a 28% faster rate of global cognitive decline (beta = -0.004; 95% CI, -0.006 to -0.001; P = .003) and a 25% faster rate of executive function decline (beta = -0.003, 95% CI, -0.005 to 0.000; P = .01) compared with those in the first quartile.Conclusions and Relevance A higher percentage of daily energy consumption of ultraprocessed foods was associated with cognitive decline among adults from an ethnically diverse sample. These findings support current public health recommendations on limiting ultraprocessed food consumption because of their potential harm to cognitive function.
- Education and cognitive function among older adults in Brazil and Mexico(2023) GONCALVES, Natalia Gomes; AVILA, Jaqueline Contrera; BERTOLA, Laiss; OBREGON, Alejandra Michaels; FERRI, Cleusa Pinheiro; WONG, Rebeca; SUEMOTO, Claudia KimieEducation is protective against cognitive impairment. We used nationally representative data from Mexico and Brazil to assess the association between education and cognitive function. The sample included adults & GE; 50 years from the Brazilian Longitudinal Study of Aging (ELSI) and the Mexican Health and Aging Study (MHAS). Participants were classified as cognitively impaired or not impaired. We used logistic regression models to estimate the association between education and cognitive function. Education level was higher in MHAS than in ELSI. Participants with at least 1 year of education were less likely to have cognitive impairment than those with no formal education in both cohorts. Men in ELSI had higher odds for cognitive impairment compared to men in MHAS. In both cohorts, higher educational level was associated with lower odds of cognitive impairment compared to no formal education. Sex was an effect modifier in MHAS but not in ELSI.HIGHLIGHTSCognitive test batteries were harmonized using a regression-based approach.Even very low levels of education were associated with reduced odds of cognitive impairment compared to no formal education.Brazilians were more likely to have cognitive impairment than Mexicans given the same education level.The differences in the association of education with cognition between Brazil and Mexico were only observed among men.