MONICA SANCHES YASSUDA
Projetos de Pesquisa
Unidades Organizacionais
EACH, EACH - Docente
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
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- Addenbrooke's cognitive examination-revised: normative and accuracy data for seniors with heterogeneous educational level in Brazil(2017) CESAR, Karolina G.; YASSUDA, Monica S.; PORTO, Fabio H. G.; BRUCKI, Sonia M. D.; NITRINI, RicardoBackground:Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Addenbrooke's Cognitive Examination - Revised (ACE-R) has been used to detect cognitive impairment; however, there are few studies including samples with low education. The aim of the study was to provide ACE-R norms for seniors within a lower education, including illiterates. An additional aim was to examine the accuracy of the ACE-R to detect dementia and cognitive impairment no dementia (CIND). Methods:Data originated from an epidemiological study conducted in the municipality of Tremembe, Brazil. The Brazilian version of ACE-R was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia, and 135 were classified as having CIND. Results:ACE-R norms were provided with the sample stratified into age and education bands. ACE-R total scores varied significantly according to age, education, and sex. To distinguish CN from dementia, a cut-off of 64 points was established (sensitivity 91%, specificity 76%) and to differentiate CN from CIND the best cut-off was 69 points (sensitivity 73%, specificity 65%). Cut-off scores varied according to the educational level. Conclusions:This study offers normative and accuracy parameters for seniors with lower education and it should expand the use of the ACE-R for this population segment.
- Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembe, Brazil(2016) CESAR, Karolina G.; BRUCKI, Sonia M. D.; TAKADA, Leonel T.; NASCIMENTO, Luiz F. C.; GOMES, Camila M. S.; ALMEIDA, Milena C. S.; OLIVEIRA, Maira O.; PORTO, Fabio H. G.; SENAHA, Mirna L. H.; BAHIA, Valeria S.; SILVA, Thais B. L.; IANOF, Jessica N.; SPINDOLA, Livia; SCHMIDT, Magali T.; JORGE, Mario S.; VALE, Patricia H. F.; CECCHINI, Mario A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONCALVES, Marcia R.; MARTINS, Ana C. S.; DARE, Patricia; SMID, Jerusa; PORTO, Claudia S.; CARTHERY-GOULART, Maria T.; YASSUDA, Monica S.; MANSUR, Leticia L.; NITRINI, RicardoBackground:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.Methods:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembe, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.Results:We assessed 630 individuals [mean age, 71.3 y (7.99); mean years of education, 4.9 (+/- 4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.Conclusions:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.
- Prevalence of depressive symptoms among elderly in the city of Tremembé, Brazil: Preliminary findings of an epidemiological study(2013) CÉSAR, Karolina G.; TAKADA, Leonel T.; BRUCKI, Sonia M.D.; NITRINI, Ricardo; NASCIMENTO, Luiz Fernando C.; OLIVEIRA, Maira O.; GOMES, Camila M.S.; ALMEIDA, Milena C.S.; PORTO, Fábio H.; SENAHA, Mirna L.H.; BAHIA, Valéria S.; YASSUDA, Mônica S.; SILVA, Thaís B.L.; IANOF, Jéssica N.; SPÍNDOLA, Lívia; SCHMIDT, Magali T.; JORGE, Mário S.; VALE, Patrícia H.F.; CECCHINI, Mário A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONÇALVES, Márcia Rúbia; MARTINS, Ana Caroline S.; ROCHA, Elisângela; DARÉ, PatríciaABSTRACT Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%. Objective To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. Methods: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of depressive symptoms. Results: A total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005). Conclusion: The prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completed.
- MoCA Test: normative and diagnostic accuracy data for seniors with heterogeneous educational levels in Brazil(2019) CESAR, Karolina G.; YASSUDA, Monica S.; PORTO, Fabio H. G.; BRUCKI, Sonia M. D.; NITRINI, RicardoThe Montreal Cognitive Assessment (MoCA) has been described as a good tool to detect cognitive impairment. The ideal MoCA cutoff score is still under debate. The aim was to provide MoCA norms and accuracy data for seniors with a lower education level, including illiterates. Methods: Data originated from an epidemiological study conducted in the municipality of Tremembe, Brazil. The Brazilian MoCA test was applied as part of the cognitive assessment in all participants. Of the 630 participants,385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia and 135 were classified as having cognitive impairment no dementia (CIND). Results: The total scores varied significantly according to age and education among the three diagnostic groups: CN, CIND and dementia (p < 0.001). To distinguish participants with CN from dementia, the best MoCA cutoff was 15 points (sensitivity 90%, specificity 77%) and to differentiate those with CN from CIND, the MoCA cutoff was 19 points (sensitivity 84%, specificity 49%). Those scores varied according to education level. Conclusions: The MoCA test did not have a high accuracy for detecting CIND in the population with a low educational level. Nevertheless, this tool may be used to detect dementia, especially in individuals with more than five years of education, if a lower cutoff score is adopted.
- Deficits in short-term memory binding are detectable in individuals with brain amyloid deposition in the absence of overt neurodegeneration in the Alzheimer's disease continuum(2021) CECCHINI, Mario Amore; YASSUDA, Monica Sanches; SQUARZONI, Paula; COUTINHO, Artur Martins; FARIA, Daniele de Paula; DURAN, Fabio Luiz de Souza; COSTA, Naomi Antunes da; PORTO, Fabio Henrique de Gobbi; NITRINI, Ricardo; FORLENZA, Orestes Vicente; BRUCKI, Sonia Maria Dozzi; BUCHPIGUEL, Carlos Alberto; PARRA, Mario A.; BUSATTO, Geraldo F.The short-term memory binding (STMB) test involves the ability to hold in memory the integration between surface features, such as shapes and colours. The STMB test has been used to detect Alzheimer's disease (AD) at different stages, from preclinical to dementia, showing promising results. The objective of the present study was to verify whether the STMB test could differentiate patients with distinct biomarker profiles in the AD continuum. The sample comprised 18 cognitively unimpaired (CU) participants, 30 mild cognitive impairment (MCI) and 23 AD patients. All participants underwent positron emission tomography (PET) with Pittsburgh compound B labelled with carbon-11 ([C-11]PIB) assessing amyloid beta (A beta) aggregation (A) and 18fluorine-fluorodeoxyglucose ([F-18]FDG)-PET assessing neurodegeneration (N) (A -N-[n = 35]); A+N-[n = 11]; A+ N+ [n = 19]). Participants who were negative and positive for amyloid deposition were compared in the absence (A-N vs. A+N-) of neurodegeneration. When compared with the RAVLT and SKT memory tests, the STMB was the only cognitive task that differentiated these groups, predicting the group outcome in logistic regression analyses. The STMB test showed to be sensitive to the signs of AD pathology and may represent a cognitive marker within the AD continuum.
- Prevalence of cognitive impairment in tremembe, Brazil(2015) CESAR, K. G.; BRUCKI, S. M. D.; TAKADA, L. T.; OLIVEIRA, M. O.; PORTO, F. H. G.; SENAHA, M. L. H.; BAHIA, V. S.; SILVA, T. B. L.; CECCHINI, M. A.; CASSIMIRO, L.; SMID, J.; PORTO, C. S.; CARTHERY-GOULART, M. T.; YASSUDA, M. S.; MANSUR, L. L.; NITRINI, R.
- Relationship Between PET-Assessed Amyloid Burden and Visual and Verbal Episodic Memory Performance in Elderly Subjects(2020) SQUARZONI, Paula; FARIA, Daniele de Paula; YASSUDA, Monica Sanches; PORTO, Fabio Henrique de Gobbi; COUTINHO, Artur Martins; COSTA, Naomi Antunes da; NITRINI, Ricardo; FORLENZA, Orestes Vicente; DURAN, Fabio Luiz de Souza; BRUCKI, Sonia Maria Dozzi; BUCHPIGUEL, Carlos Alberto; BUSATTO, Geraldo F.Background: Studies of elderly subjects using biomarkers that are proxies for Alzheimer's disease (AD) pathology have the potential to document meaningful relationships between cognitive performance and biomarker changes along the AD continuum. Objective: To document cognitive performance differences across distinct AD stages using a categorization based on the presence of PET-assessed amyloid-beta (A beta) burden and neurodegeneration. Methods: Patients with mild dementia compatible with AD (n = 38) or amnestic mild cognitive impairment (aMCI; n = 43) and a cognitively unimpaired group (n = 27) underwent PET with Pittsburgh compound-B (PiB) assessing A beta aggregation (A+) and [F-18]FDG-PET assessing neurodegeneration ((N)+). Cognitive performance was assessed with verbal and visual episodic memory tests and the Mini-Mental State Examination. Results: The A+(N)+ subgroup (n = 32) showed decreased (p < 0.001) cognitive test scores compared to both A+(N)-(n = 18) and A-(N)- (n = 49) subjects, who presented highly similar mean cognitive scores. Despite its modest size (n = 9), the A-(N)+ subgroup showed lower (p < 0.043) verbal memory scores relative to A-(N)- subjects, and trend lower (p = 0.096) scores relative to A+(N)- subjects. Continuous A beta measures (standard uptake value ratios of PiB uptake) were correlated most significantly with visual memory scores both in the overall sample and when analyses were restricted to dementia or (N)+ subjects, but not in non-dementia or (N)- groups. Conclusion: These results demonstrate that significant A beta-cognition relationships are highly salient at disease stages involving neurodegeneration. The fact that findings relating A beta burden to memory performance were detected only at (N)+ stages, together with the similarity of test scores between A+(N)- and A-(N)- subjects, reinforce the view that A beta-cognition relationships during early AD stages may remain undetectable unless substantially large samples are evaluated.