LIVEA CARLA FIDALGO GARCEZ SANT'ANA

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LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
    Diagnostic Performance of an Eye-Tracking Assisted Visual Inference Language Test in the Assessment of Cognitive Decline due to Alzheimer's Disease
    (2023) BELAN, Ariella Fornachari Ribeiro; PAIS, Marcos Vasconcelos; CAMARGO, Marina von Zuben de Arruda; ANA, Livea Carla Fidalgo Garcez Sant'; RADANOVIC, Marcia; FORLENZA, Orestes Vicente
    Background: The assessment of language changes associated with visual search impairment can be an important diagnostic tool in the Alzheimer's disease (AD) continuum. Objective: Investigate the performance of an eye-tracking assisted visual inference language task in differentiating subjects with mild cognitive impairment (MCI) or AD dementia from cognitively unimpaired older adults (controls). Methods: We assessed a group of 95 older adults (49 MCI, 18 mild dementia due to AD, and 28 controls). The subjects performed the same task under multiple experimental conditions which generate correlated responses that need to be taken into account. Thus, we performed a non-parametric repeated measures ANOVA model for verbal answers, and a linear mixed model (LMM) or its generalized version for the analysis of eye tracking variables. Results: Significant differences were found in verbal answers across all diagnostic groups independently of type of inference, i.e., logic or pragmatic. Also, eye-tracking parameters were able to discriminate AD from MCI and controls. AD patients did more visits to challenge stimulus (Control-AD, -0.622, SE = 0.190, p = 0.004; MCI-AD, -0.514, SE = 0.173, p = 0.011), more visits to the correct response stimulus (Control-AD, -1.363, SE = 0.383, p = 0.002; MCI-AD, -0.946, SE = 0.349, p = 0.022), more fixations on distractors (Control-AD, -4.580, SE = 1.172, p = 0.001; MCI-AD, -2.940, SE = 1.070, p = 0.020), and a longer time to first fixation on the correct response stimulus (Control-AD, -0.622, SE = 0.190, p = 0.004; MCI-AD, -0.514, SE = 0.173, p = 0.011). Conclusion: The analysis of oculomotor behavior along with language assessment protocols may increase the sensitivity for detection of subtle deficits in the MCI-AD continuum, representing an important diagnostic tool.
  • article 0 Citação(ões) na Scopus
    Balance and Gait Associations With Cognitive Impairment and Dementia in Individuals With Down Syndrome
    (2023) CONCEICAO, Aline S. G. G.; SANT'ANA, Livea F. G.; MATTAR, Guilherme P.; SILVA, Maria de Fatima R.; RAMOS, Andressa R.; OLIVEIRA, Alexandra M.; CARVALHO, Claudia L.; GONCALVES, Octavio R.; VAROTTO, Bruna L. R.; MARTINEZ, Luana D.; LEDUC, Vinicius; FONSECA, Luciana M.; FORLENZA, Orestes V.
    Background: Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS.Methods: We evaluated 66 individuals with DS (>= 20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities.Results: The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia (P<0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score (P<0.05).Conclusion: A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility.