ALEXANDRE LEOPOLD BUSSE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/66, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Effects of resistance training and aerobic exercise in elderly people concerning physical fitness and ability: a prospective clinical trial(2013) ROMA, Maria Fernanda Bottino; BUSSE, Alexandre Leopold; BETONI, Rosana Aparecida; MELO, Antonio Cesar de; KONG, Juwando; SANTAREM, Jose Maria; JACOB FILHO, WilsonOBJECTIVE: To compare the effects of physical fitness and function on older adults in two programs of supervised exercise activity: resistance training and aerobic exercise. METHODS: This study is a randomized, prospective clinical trial composed of sedentary elderly people who did not have contraindications to exercise. Participants were divided into two groups: group one performed 6 exercises of resistance training twice a week, and group two participated in walking activity for 30 minutes twice a week. Functional assessment (time 0,6 and 12 months) was measured by the Short Physical Performance Battery (time to sit or stand, gait speed, and balance), flexibility test, and the six-minute walking test. We randomly selected 96 patients: 46 in the Resistance Training Group and 50 in the Aerobic Exercise Group. In the Resistance Training Group, 46 attended the first assessment and 20 attended until the third section. In the Aerobic Exercise Group, 50 attended the first assessment and 12 attended until the third assessment. RESULTS: Mean age was 68.8 years in the Resistance Training Group and 69.1 years in the Aerobic Exercise Group. The Resistance Training Group showed improvement in the sit/stand (p=0.022), balance with feet in a row (p=0.039) and queued (p=0.001). The second showed a statistical difference in speed and balance with the feet lined up and the feet together (p=0.008; p=0.02; and p=0.043, respectively). Concerning flexibility, the Resistance Training Group had improvement (p=0.001), whereas in the Aerobic Exercise Group, no significant difference was seen (p=0.359). Both groups had improvement in the six-minute walking test, but no significant improvement was seen in the Aerobic Exercise Group (p=0.033). CONCLUSION: Both groups showed improvement in physical fitness. No statistical difference was seen when groups was compared in the short physical performance battery, flexibility, and six-minute walking test.
- Estimating Premorbid Cognitive Abilities in Low-Educated Populations(2013) APOLINARIO, Daniel; BRUCKI, Sonia Maria Dozzi; FERRETTI, Renata Eloah de Lucena; FARFEL, Jose Marcelo; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; JACOB-FILHO, WilsonObjective: To develop an informant-based instrument that would provide a valid estimate of premorbid cognitive abilities in low-educated populations. Methods: A questionnaire was drafted by focusing on the premorbid period with a 10-year time frame. The initial pool of items was submitted to classical test theory and a factorial analysis. The resulting instrument, named the Premorbid Cognitive Abilities Scale (PCAS), is composed of questions addressing educational attainment, major lifetime occupation, reading abilities, reading habits, writing abilities, calculation abilities, use of widely available technology, and the ability to search for specific information. The validation sample was composed of 132 older Brazilian adults from the following three demographically matched groups: normal cognitive aging (n = 72), mild cognitive impairment (n = 33), and mild dementia (n = 27). The scores of a reading test and a neuropsychological battery were adopted as construct criteria. Post-mortem inter-informant reliability was tested in a sub-study with two relatives from each deceased individual. Results: All items presented good discriminative power, with corrected item-total correlation varying from 0.35 to 0.74. The summed score of the instrument presented high correlation coefficients with global cognitive function (r = 0.73) and reading skills (r = 0.82). Cronbach's alpha was 0.90, showing optimal internal consistency without redundancy. The scores did not decrease across the progressive levels of cognitive impairment, suggesting that the goal of evaluating the premorbid state was achieved. The intraclass correlation coefficient was 0.96, indicating excellent inter-informant reliability. Conclusion: The instrument developed in this study has shown good properties and can be used as a valid estimate of premorbid cognitive abilities in low-educated populations. The applicability of the PCAS, both as an estimate of premorbid intelligence and cognitive reserve, is discussed.
- Characterizing spontaneously reported cognitive complaints: the development and reliability of a classification instrument(2013) APOLINARIO, Daniel; MIRANDA, Rafaela Branco; SUEMOTO, Claudia Kimie; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; SOARES, Aline Thomaz; LOPES, Leonardo da Costa; KASAI, Juliana Yumi Tizon; SATOMI, Erika; KIKUCHI, Elina Lika; JACOB-FILHO, WilsonBackground: The characteristics and associated risks of spontaneously reported cognitive complaints have not been investigated due to the lack of a classification instrument. Methods: In phase 1, a classification system with descriptive categories and cognitive domains was developed by experts through a modified Delphi technique. In phase 2, 180 elderly patients seeking medical attention for cognitive complaints provided free reports of their cognitive difficulties and each complaint was recorded verbatim. Three observers were asked to classify each complaint into a descriptive category. Perceived cognitive function was further characterized using the Memory Complaint Questionnaire (MAC-Q). Results: The patients reported 493 spontaneous complaints, with a range of 1-6 complaints per patient and a mean of 2.7 (+/- 1.3). The proportion of complaints that could be classified into a category by each of the three observers varied from 91.9% to 95.7%. Inter-observer agreement assessed using the kappa statistic varied from 0.79 to 1 for descriptive categories and 0.83 to 0.97 for domains. Compared with the MAC-Q, spontaneously reported complaints provided complementary information by avoiding the cueing effect provoked by the questionnaire. The total number of complaints and their occurrences in specific domains were associated with important sociodemographic and clinical factors, indicating that their meaning and associated risks need to be further investigated. Conclusion: The instrument developed in this study proved to be a practical tool for classifying the majority of spontaneously reported cognitive complaints with high reliability. Further studies are needed to investigate clinical usefulness of this approach.