PAULA VILLELA NUNES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Current pharmacological approaches and perspectives in the treatment of geriatric mood disorders(2011) DINIZ, Breno S.; NUNES, Paula V.; MACHADO-VIEIRA, Rodrigo; FORLENZA, Orestes V.Purpose of review This work aims to review the most recent developments in the treatment of mood disorders (major depression and bipolar disorder) in the elderly. Recent findings In the last years, few new pharmacological interventions for mood disorders have been developed. Recent studies seek to provide alternative treatment strategies to achieve higher remission rates, including the association of antidepressants, mood stabilizers and psychotherapy and the treatment of specific clusters of symptoms, such as the adjunctive treatment of cognitive impairment with cholinesterase inhibitors. Also, recent studies have been assessing the potential of pharmacogenetic information in the prediction of treatment outcomes. Summary These factors altogether are expected to help the development of personalized treatment strategies that may improve outcomes with fewer adverse effects.
- Effects of a multidisciplinar cognitive rehabilitation program for patients with mild Alzheimer's disease(2011) VIOLA, Luciane F.; NUNES, Paula V.; YASSUDA, Monica S.; APRAHAMIAN, Ivan; SANTOS, Franklin S.; SANTOS, Glenda D.; BRUM, Paula S.; BORGES, Sheila M.; OLIVEIRA, Alexandra M.; CHAVES, Gisele F. S.; CIASCA, Eliane C.; FERREIRA, Rita C. R.; PAULA, Vanessa J. R. de; TAKEDA, Oswaldo H.; MIRANDEZ, Roberta M.; WATARI, Ricky; FALCAO, Deusivania V. S.; CACHIONI, Meire; FORLENZA, Orestes V.OBJECTIVE: To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatric symptoms in patients with mild Alzheimer's disease. METHOD: The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention. INTERVENTION: Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings. MEASUREMENTS: The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments. RESULTS: Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life. CONCLUSION: This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield adjunct and clinically relevant benefits in dementia treatment.
- Optimizing the CAMCOG test in the screening for mild cognitive impairment and incipient dementia: saving time with relevant domains(2011) APRAHAMIAN, Ivan; DINIZ, Breno Satler; IZBICKI, Rafael; RADANOVIC, Marcia; NUNES, Paula Villela; FORLENZA, Orestes VicenteObjective: To identify the CAMCOG sub-items that best contribute for the identification of patients with mild cognitive impairment (MCI) and incipient Alzheimer's disease (AD) in clinical practice. Methods: Cross-sectional assessment of 272 older adults (98 MCI, 82 AD, and 92 controls) with a standardized neuropsychological battery and the CAMCOG schedule. Backward logistic regression analysis with diagnosis (MCI and controls) as dependent variable and the sub-items of the CAMCOG as independent variable was carried out to determine the CAMCOG sub-items that predicted the diagnosis of MCI. Results: Lower scores on Language, Memory, Praxis, and Calculation CAMCOG sub-items were significantly associated with the diagnosis of MCI. A composite score obtained by the sum of these scores significantly discriminated MCI patients from comparison groups. This reduced version of the CAMCOG showed similar diagnostic accuracy than the original schedule for the identification of patients with MCI as compared to controls (AUC = 0.80 +/- 0.03 for the reduced CAMCOG; AUC = 0.79 +/- 0.03 for the original CAMCOG). Conclusion: This reduced version of the CAMCOG had similar diagnostic properties as the original CAMCOG and was faster and easier to administer, rendering it more suitable for the screening of subtle cognitive deficits in general clinical practice.