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
5 resultados
Resultados de Busca
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- Use of computerized tests to assess the cognitive impact of interventions in the elderly(2014) OLIVEIRA, Rafaela Sanches de; TREZZA, Beatriz Maria; BUSSE, Alexandre Leopold; JACOB FILHO, WilsonABSTRACT With the aging of the population, the possibility of the occurrence of cognitive decline rises. A number of types of intervention seek to attenuate or reverse this impairment. The use of computerized tests helps quantify the effects of interventions on cognitive function in the elderly. The objective of the present review was to analyze studies that have utilized computerized cognitive tests to determine the effects of interventions in the elderly population, describing the batteries and tests employed, the populations studied and reports by authors on the limitations or benefits of employing these tests in older adults. The review was performed on the PubMed database using the descriptors: cognitive computerized test and elderly. We retrieved 530 studies and, following analysis of their abstracts, selected 32 relevant to the subject. The studies utilized 19 different types of computerized tests and batteries to assess the interventions, which were predominantly drug trials. There were no reports on limitations in the use of the computerized tests, suggesting this type of intervention had good applicability, sensitivity, and little or no practice effects in this population.
- Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms(2020) BIELLA, Marina Maria; SIQUEIRA, Alaise Silva Santos de; BORGES, Marcus Kiiti; RIBEIRO, Elyse Soares; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; APOLINARIO, Daniel; APRAHAMIAN, IvanObjective: Decision-making (DM) is a component of executive functioning. DM is essential to make proper decisions regarding important life and health issues. DM can be impaired in cognitive disorders among older adults, but current literature is scarce. The aim of this study was to evaluate the DM profile in participants with and without cognitive impairment. Design: Cross-sectional analysis of a cohort study on cognitive aging. Participants: 143 older adults. Setting: University-based memory clinic. Methods: Patients comprised three groups after inclusion and exclusion criteria: healthy controls (n=29), mild cognitive impairment (n=81) and dementia (n=33). Participants were evaluated using an extensive neuropsychological protocol. DM profile was evaluated by the Melbourne Decision Making Questionnaire. Multinomial logistic regression was used to evaluate associations between age, sex, educational level, estimated intelligence quotient (IQ), cognitive disorders, depressive or anxiety symptoms, and the DM profiles. Results: The most prevalent DM profile was the vigilant type, having a prevalence of 64.3%. The vigilant profile also predominated in all three groups. The multinomial logistic regression showed that the avoidance profile (i.e. buck-passing) was associated with a greater presence of dementia (p=0.046) and depressive symptoms (p=0.024), but with less anxious symptoms (p=0.047). The procrastination profile was also associated with depressive symptoms (p=0.048). Finally, the hypervigilant profile was associated with a lower pre-morbid IQ (p=0.007). Conclusion: Older adults with cognitive impairment tended to make more unfavorable choices and have a more dysfunctional DM profile compared to healthy elders.
- Using temporal orientation, category fluency, and word recall for detecting cognitive impairment: the 10-point cognitive screener (10-CS)(2016) APOLINARIO, Daniel; LICHTENTHALER, Daniel Gomes; MAGALDI, Regina Miksian; SOARES, Aline Thomaz; BUSSE, Alexandre Leopold; AMARAL, Jose Renato das Gracas; JACOB-FILHO, Wilson; BRUCKI, Sonia Maria DozziObjectives: A screening strategy composed of three-item temporal orientation and three-word recall has been increasingly used for detecting cognitive impairment. However, the intervening task administered between presentation and recall has varied. We evaluated six brief tasks that could be useful as intervening distractors and possibly provide incremental accuracy: serial subtraction, clock drawing, category fluency, letter fluency, timed visual detection, and digits backwards. Methods: Older adults (n = 230) consecutively referred for suspected cognitive impairment underwent a comprehensive assessment for gold-standard diagnosis, of whom 56 (24%) presented cognitive impairment not dementia and 68 (30%) presented dementia. Among those with dementia, 87% presented very mild or mild stages (Clinical Dementia Rating 0.5 or 1). The incremental value of each candidate intervening task in a model already containing orientation and word recall was assessed. Results: Category fluency (animal naming) presented the highest incremental value among the six candidate intervening tasks. Reclassification analyses revealed a net gain of 12% among cognitively impaired and 17% among normal participants. A four-point scaled score of the animal naming task was added to three-item temporal orientation and three-word recall to compose the 10-point Cognitive Screener. The education-adjusted 10-point Cognitive Screener outperformed the longer Mini-Mental State Examination for detecting both cognitive impairment (area under the curve 0.85 vs 0.77; p = 0.027) and dementia (area under the curve 0.90 vs 0.83; p= 0.015). Conclusions: Based on empirical data, we have developed a brief and easy-to-use screening strategy with higher accuracy and some practical advantages compared with commonly used tools.
- Development of a word accentuation test for predicting cognitive performance in Portuguese-speaking populations(2019) GIL, Gislaine; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; RIBEIRO, Elyse Soares; BRUCKI, Sonia Maria Dozzi; YASSUDA, Monica Sanches; JACOB-FILHO, Wilson; APOLINARIO, DanielThe Word Accentuation Test (WAT) has been used to predict premorbid intelligence and cognitive performance in Spanish-speaking populations. It requires participants to read a list of words without the accent marks that indicate the stressed syllable. Objective: As Portuguese pronunciation is also strongly based on accent marks, our aim was to develop a Brazilian version of the WAT. Methods: An initial pool of 60 items was constructed and a final version of 40 items (named WAT-Br) was derived by item response theory. A sample of 206 older adults underwent the WAT-Br and a standardized neuropsychological battery. Independent ratings were performed by two observers in 58 random participants. Results: The items showed moderate to high discrimination (alpha between 0.93 and 25.04) and spanned a wide range of difficulty (beta between -2.07 and 1.40). The WAT-Br was shown to have an excellent internal consistency (Kuder-Richardson Formula 20 = 0.95) and inter-rater reliability (intraclass correlation coefficient = 0.92). It accounted for 61% of the variance in global cognitive performance. Conclusion: Aversion of the WAT for Portuguese-speaking populations was developed and proved to be a valuable tool for estimating cognitive performance.
- 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.