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
19 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.
- Relations between memory complaints, depressive symptoms and cognitive performance among community dwelling elderly(2014) SILVA, Lais dos Santos Vinholi E; SILVA, Thais Bento Lima da; FALCAO, Deusivania Vieira da Silva; BATISTONI, Samila Satler Tavares; LOPES, Andrea; CACHIONI, Meire; NERI, Anita Liberalesso; YASSUDA, Monica SanchesBackground: Memory complaints are quite common among the elderly; yet, the clinical relevance of these complaints to diagnose cognitive decline is debatable, since several different factors could be associated with them. Objective: The present paper examined the correlations between memory complaints, depressive symptoms and cognitive performance in a group of 301 elderly individuals who lived in the district of Ermelino Matarazzo, Sao Paulo, and who participated in the population-based survey entitled Profiles of Frailty in Elderly Brazilians by the FIBRA Network. Methods: Cognitive performance was assessed with the memorization test involving 10 common pictures, the Mini Mental State Examination (MMSE), the Verbal Fluency (VF) test, and the Clock Drawing Test, which comprise the Brief Cognitive Screening Battery (BCSB). Memory complaints were assessed with the Memory Complaint Questionnaire (MAC-Q), and depressive symptoms with the Geriatric Depression Scale (GDS). Results: Female participants had higher rates of memory complaints when compared to male participants (p = 0.013). Subjects with less years of schooling had more severe memory complaints and poorer cognitive performance than those with more years of schooling (p < 0.003). The presence of depressive symptoms was associated with poorer memory assessment scores (r = 0.39, p < 0.001). Discussion: Memory complaints were correlated with sex, schooling and depressive symptoms among elderly individuals residing in the community. No correlation was found between complaints and cognitive performance.
- Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization(2023) CRIVELLI, Lucia; CALANDRI, Ismael Luis; SUEMOTO, Claudia Kimie; SALINAS, Rosa Maria; VELILLA, Lina Marcela; YASSUDA, Monica Sanches; CARAMELLI, Paulo; LOPERA, Francisco; NITRINI, Ricardo; SEVLEVER, Gustavo Emilio; SOSA, Ana Luisa; ACOSTA, Daisy; BAIETTI, Ana Maria Charamelo; CUSICANQUI, Maria Isabel; CUSTODIO, Nilton; SIMONE, Sergio Dansilio De; DERIO, Carolina Delgado; DUQUE-PENAILILLO, Lissette; DURAN, Juan Carlos; JIMENEZ-VELAZQUEZ, Ivonne Z.; LEON-SALAS, Jorge Mario; BERGAMO, Yanina; CLARENS, Maria Florencia; DAMIAN, Andres; DEMEY, Ignacio; HELOU, Maria Belen; MARQUEZ, Carlos; MARTIN, Maria Eugenia; MARTIN, Maria da Graca Morais; QUERZE, Diego; SURACE, Ezequiel Ignacio; ACOSTA-EGEA, Sabrina; AGUIRRE-SALVADOR, Esteban; SOUZA, Leonardo Cruz de; CANCADO, Gustavo Henrique da Cunha Peixoto; BRUCKI, Sonia Maria Dozzi; FRIEDLAENDER, Clarisse Vasconcelos; GOMES, Karina Braga; GUTIERREZ, Myriam; RIOS, Carlos Laforcada; GALINDO, Joyce Graciela Martinez; MONTESINOS, Rosa; NUNEZ-HERRERA, Alberto; OSPINA-HENAO, Sebastian; RODRIGUEZ, Guillermina; MASSON, Victoria Ruiz; SANCHEZ, Monica; SCHENK, Christian E.; SOTO, Ligia; BARBOSA, Maira Tonidandel; TOSATTI, Jessica Abdo Goncalves; VICUNA, Yosselin; ESPELAND, Mark; HAKANSSON, Krister; KIVIPELTO, Miia; BAKER, Laura; SNYDER, Heather; CARRILLO, Maria; ALLEGRI, Ricardo FranciscoINTRODUCTION: Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS) is the first non-pharmacological multicenter randomized clinical trial (RCT) to prevent cognitive impairment in Latin America (LA). Our aim is to present the study design and discuss the strategies used for multicultural harmonization. METHODS: This 1-year RCT (working on a 1-year extension) investigates the feasibility of a multi-domain lifestyle intervention in LA and the efficacy of the intervention, primarily on cognitive function. An external harmonization process was carried out to follow the FINGER model, and an internal harmonization was performed to ensure this study was feasible and comparable across the 12 participating LA countries. RESULTS: Currently, 1549 participants have been screened, and 815 randomized. Participants are ethnically diverse (56% are Nestizo) and have high cardiovascular risk (39% have metabolic syndrome). DISCUSSION: LatAm-FINGERS overcame a significant challenge to combine the region's diversity into a multi-domain risk reduction intervention feasible across LA while preserving the original FINGER design.
- 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.
- Adherence to the Mediterranean and MIND diets is associated with better cognition in healthy seniors but not in MCI or AD(2018) CALIL, Silvia R. B.; BRUCKI, Sonia M. D.; NITRINI, Ricardo; YASSUDA, Monica S.Background: Dietary habits have become the focus of intensive research in cognitive aging and neuro-degenerative diseases, showing potential to promote and maximize cognitive function. Aim: The aim was to investigate the association between the degree of adherence to the Mediterranean and MIND diets and cognitive performance in elderly with different cognitive profiles. Methods: Cross-sectional study with participants from neurology outpatient clinic. Participants: A total of 96 individuals were classified by a multidisciplinary team into normal controls (NC), individuals with mild cognitive impairment, and Alzheimer's disease. Measurements: The Brief Cognitive Screening Battery, Mini-Mental State Examination, and a 98-item food frequency questionnaire were applied. Anthropometric data were also collected. Adherence scores to the Mediterranean and MIND diets were subsequently calculated. Results: Clinical groups did not differ regarding body mass index or level of adherence to the diets. Greater adherence to the Mediterranean and MIND diets was associated with higher scores on the MMSE and BCSB Learning in the NC group only. Conclusions: Moderate adherence to the Mediterranean and MIND dietary patterns may be associated with better cognition among healthy seniors living in middle to low income countries.
- Vocabulary Is an Appropriate Measure of Premorbid Intelligence in a Sample with Heterogeneous Educational Level in Brazil(2014) OLIVEIRA, Maira Okada de; NITRINI, Ricardo; YASSUDA, Mnica Sanches; BRUCKI, Sonia Maria DozziCrystallized intelligence refers to one's knowledge base and can be measured by vocabulary tests. Fluid intelligence is related to nonverbal aspects of intelligence, depends very little on previously acquired knowledge, and can be measured by tests such as Block Design (BD) and Raven Colored Matrices (RCM). Premorbid intelligence quotient (IQ) refers to one's intellectual ability level previous to the onset of disorders like mild cognitive impairment (MCI) and Alzheimer's disease (AD) and it is important to estimate disease severity. The objective was to compare performance in tests that measure crystallized and fluid intelligence in healthy subjects and patients with amnestic MCI (aMCI) and AD. One hundred forty-four participants (aMCI (n = 38), AD (n = 45), and healthy controls (n = 61)) were submitted to neuropsychological tests (WAIS-III vocabulary, BD, and RCM). There were significant among groups, except for vocabulary, indicating a relative stability of crystallized intelligence in the continuum from normal to pathological cognitive decline. Vocabulary seems to be stable during the progression of the disease and useful as a measure of premorbid intelligence, that is, to estimate previous function in relation to the level of education and, as a collateral measure of cognition in people with low education.
- Predicting Dementia Due to Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia Using Algorithms with the Addenbrooke's Cognitive Examination-Revised Subscores Combined with Sociodemographic Factors(2023) AMARAL-CARVALHO, Viviane; LIMA-SILVA, Thais Bento; MARIANO, Luciano Inacio; SOUZA, Leonardo Cruz de; GUIMARAES, Henrique Cerqueira; BAHIA, Valeria Santoro; NITRINI, Ricardo; BARBOSA, Maira Tonidandel; YASSUDA, Monica Sanches; CARAMELLI, PauloBackground: Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are important causes of dementia with challenging differential diagnoses in many cases. Addenbrooke's Cognitive Examination-Revised (ACE-R) is a cognitive battery that may be useful to differentiate the two disorders.Objective: The objectibe of this study is to investigate the value of the ACE-R combined with sociodemographic factors in the differential diagnosis between AD and bvFTD.Methods The ACE-R was administered to 102 patients with mild dementia due to probable AD, 37 with mild bvFTD, and 135 controls. Performances of patients and controls were analyzed by logistic regression and by ROC curves to refine the diagnostic accuracy of the ACE-R in AD and bvFTD.Results: The ACE-R subscores Attention and Orientation, Fluency, and Memory, in combination with schooling differentiated AD from controls with an area under the ROC curve (AUC) of 0.936 (86% sensitivity and 87% specificity). The ACE-R subscores Attention and Orientation, Fluency, and Language, in combination with sex (male), age, and schooling, discriminated bvFTD from controls with an AUC of 0.908 (81% sensitivity and 95% specificity). In the differentiation between AD and bvFTD, the ACE-R subscores Attention and Orientation, Fluency, and Language, together with age, displayed an AUC of 0.865 (78% sensitivity and 85% specificity).Conclusion: The combination of ACE-R scores with sociodemographic data allowed good differentiation between AD and bvFTD in the study sample.
- A subtest analysis of the Montreal cognitive assessment (MoCA): which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease?(2016) CECATO, Juliana Francisco; MARTINELLI, Jose Eduardo; IZBICKI, Rafael; YASSUDA, Monica Sanches; APRAHAMIAN, IvanBackground: It is necessary to continue to explore the psychometric characteristics of key cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) to diagnose cognitive decline as early as possible and to attend to the growing need of clinical trials involving mild cognitive impairment (MCI) participants. The main aim of this study was to assess which MoCA subtests could best discriminate between healthy controls (HC), participants with MCI, and Alzheimer's disease (AD). Methods: Cross-sectional analysis of 136 elderly with more than four years of education. All participants were submitted to detailed clinical, laboratory, and neuroimaging evaluation. The MoCA, Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination (CAMCOG), Geriatric Depression Scale (GDS), and Functional Activities Questionnaire (FAQ) were applied to all participants. The MoCA test was not used in the diagnostic procedure. Results: Median MoCA total scores were 27, 23 and 18 for HC, MCI, and AD, respectively (p < 0.001). Word repetition, inverse digits, serial 7, phrases, verbal fluency, abstraction, and word recall discriminated between MCI and HC participants (p < 0.001). The clock drawing, the rhino naming, delayed recall of five words and orientation discriminated between patients with MCI and AD (p < 0.001). A reduced version of the MoCA with only these items did not improve accuracy between MCI and HC (p = 0.076) or MCI and AD (p = 0.119). Conclusions: Not all MoCA subtests might be fundamental to clinical diagnosis of MCI. The reduced versions of MoCA did not add diagnostic accuracy.
- The Mini-Addenbrooke’s Cognitive Examination (M-ACE) as a brief cognitive screening instrument in Mild Cognitive Impairment and mild Alzheimer’s disease(2018) MIRANDA, Diane da Costa; BRUCKI, Sonia Maria Dozzi; YASSUDA, Mônica SanchesABSTRACT The Mini-Addenbrooke’s Cognitive Examination (M-ACE) is a brief cognitive screening test that evaluates four main cognitive domains (orientation, memory, language and visuospatial function) with a maximum score of 30 points and administration time of five minutes. Objective: To assess the performance of healthy elderly, MCI patients and mild AD patients using the Brazilian version of the M-ACE. Methods: The test was applied to a group of 36 Mild Cognitive Impairment (MCI), 23 mild Alzheimer’s Disease (AD) and 25 cognitive healthy elderly. All participants were aged ≥60 years. Results: The M-ACE displayed high internal consistency (Cronbach alpha >0.8; 95% CI 0.7-0.8) and proved effective for differentiating the AD group from MCI and control groups, providing superior accuracy than the MMSE (the cut-off point of 20 points had the highest sensitivity and specificity – 95.6% and 90.16% respectively, with a high area under the curve – AUC=0.8; 95% CI 0.7-0.9). Performance on the M-ACE was strongly correlated with that of the MMSE and Functional Activities Questionnaire (FAQ). The M-ACE was not accurate in discriminating MCI from control subjects. Conclusion: The M-ACE is a brief screening test which provided high accuracy for diagnosing AD in this sample. The suggested cut-off point in this study was 20 points for AD.
- The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States(2023) SIMON, Sharon Sanz; BRUCKI, Sonia Maria Dozzi; FONSECA, Luciana Mascarenhas; BECKER, Jacqueline; CAPPI, Carolina; MARQUES, Andrea Horvath; HEYN, Patricia C.; GONCALVES, Priscila Dib; MARTINS, Silvia S.; BUSATTO, Geraldo; SUEMOTO, Claudia Kimie; NITRINI, Ricardo; CARAMELLI, Paulo; YASSUDA, Monica Sanches; MIOTTO, Eliane Correa; GRINBERG, Lea Tenenholz; RENTERIA, Miguel Arce; ALEGRIA, Margarita; STERN, Yaakov; RIVERA-MINDT, Monica; BERTOLA, LaissIntroduction: The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities. It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population.Methods: We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles.Results: This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials.Conclusions: The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities.