CLAUDIA KIMIE SUEMOTO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/22 - Laboratório de Patolologia Cardiovascular, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/22 - Laboratório de Patolologia Cardiovascular, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina - Líder
58 resultados
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- Serum uric acid is associated with better executive function in men but not in women: Baseline assessment of the ELSA-Brasil study(2017) BAENA, Cristina Pellegrino; SUEMOTO, Claudia Kimie; BARRETO, Sandhi Maria; LOTUFO, Paulo Andrade; BENSENOR, IsabelaBackground: Serum uric acid (SUA) may protect against free radical stress damage and was previously linked to cognitive impairment in older adults, but evidence in middle-aged adults is scarce. Purpose: We sought to analyze whether SUA is associated with cognitive performance in apparently healthy middle-aged participants in the ELSA-Brasil cohort study. Methods: We excluded participants older than age 65, those taking allopurinol, benzbromarone, or medications that could impair cognitive performance, those with previous stroke, and those with incomplete data on cognitive tests or SUA. The Consortium to Establish a Registry for Alzheimer's Disease Word List Memory Test (CERAD-WLMT), the Semantic Fluency Test (SFT), and the Trail Making Test version B (TMT) were used as dependent variables. Sex -specific linear regression models were used to assess the association between SUA and cognitive tests, adjusted by age, education, hypertension, dyslipidemia, diabetes, smoking, alcohol consumption, body mass index, coronary heart disease, renal function, depression, aspirin use, thyroid function, and menopausal status (in women). We used the Bonferroni procedure to control for the false discovery rate associated with multiple comparisons. Results: We analyzed cross-sectional data from 6751 women and 5464 men. Mean age and standard deviation (SD) of the sample was 49.6 (SD 7.4) years for men and 49.9 (SD 7.3) years for women. The majority of men (52%) and women (51%) were white. Mean SUA value was 4.75 (SD 1.16) mg/dL in women and 6.44 (SD 139) mg/dL in men. Multivariate linear models showed no association in women and a significant inverse association between SUA levels and (beta =-3.106, 95% CI = -4.594; -1.618, p = 0.0004) in men. Conclusion: In a middle-aged subset population, SUA is associated with better performance on an executive function test in men, but not in women in the ELSA-Brasil cohort study.
article 3 Citação(ões) na Scopus Empowering older adults and their communities to cope with depression in resource-limited settings(2022) ALIBERTI, Marlon Juliano Romero; SUEMOTO, Claudia Kimie- Thyroid Function and Sarcopenia: Results from the ELSA-Brasil Study(2020) SZLEJF, Claudia; SUEMOTO, Claudia K.; JANOVSKY, Carolina C. P. S.; BARRETO, Sandhi M.; DINIZ, Maria de Fatima H. S.; LOTUFO, Paulo A.; BENSENOR, Isabela M.OBJECTIVES We aimed to investigate the association of subclinical thyroid disease and thyroid hormone levels with sarcopenia and its defining components in community-dwelling middle-aged and older adults without overt thyroid dysfunction. DESIGN Cross-sectional study. SETTING Active and retired employees from public institutions located in six Brazilian cities. PARTICIPANTS A total of 6974 participants from the ELSA-Brasil study's second wave, aged 50 years and older, without overt thyroid dysfunction and with complete data for exposure, outcome, and covariates. METHODS Serum levels of thyrotropin (TSH), free thyroxine, and free triiodothyronine (FT3) were measured and divided in quintiles for the analyses. Participants were classified with euthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism. Muscle mass was assessed by bioelectrical impedance analysis and muscle strength by handgrip strength. Sarcopenia was defined according to the Foundation for the National Institutes of Health criteria. Possible confounders included sociodemographic characteristics, clinical conditions, and lifestyle. Analyses were performed separately for middle-aged and older adults (>= 65 y). RESULTS The frequencies of sarcopenia, low muscle mass, low muscle strength, subclinical hypothyroidism, and subclinical hyperthyroidism were 1.5%, 20.8%, 3.8%, 9.1%, and .9%, respectively. Subclinical thyroid dysfunction was not associated with sarcopenia and its defining components. Among older adults, TSH had a U-shaped association with sarcopenia and low muscle strength. The odds ratios (ORs) (95% confidence intervals [CIs]) for the associations of the first, second, fourth, and fifth quintile with sarcopenia, respectively, were 5.18 (1.47-18.28), 6.28 (1.82-21.73), 4.12 (1.15-14.76), and 4.81 (1.35-17.10), and with low muscle strength was (OR (95% CI) for the first, second, and fifth quintiles, respectively: 1.43 (1.16-5.07), 2.07 (1.24-4.70), and 2.18 (1.03-4.60). Additionally, FT3 had a negative association with muscle mass in both age strata. CONCLUSION Subtle thyroid hormone alterations are associated with sarcopenia or its defining components in middle-aged and older adults without overt thyroid dysfunction. J Am Geriatr Soc 68:1545-1553, 2020.
conferenceObject Validating intrinsic capacity to measure healthy aging in a low to middle-income country: findings from the ELSI-Brazil(2020) ALIBERTI, M.; SUEMOTO, C.- Direct Measurements of Abdominal Visceral Fat and Cognitive Impairment in Late Life: Findings From an Autopsy Study(2019) NISHIZAWA, Aline; CUELHO, Anderson; FARIAS-ITAO, Daniela S. de; CAMPOS, Fernanda M.; LEITE, Renata E. P.; FERRETTI-REBUSTINI, Renata E. L.; GRINBERG, Lea T.; NITRINI, Ricardo; JACOB-FILHO, Wilson; PASQUALUCCI, Carlos A.; SUEMOTO, Claudia K.Background: The relationship between cognitive impairment and abdominal visceral is controversial. Moreover, all studies so far used imaging studies to evaluate visceral fat and this association has not been described yet using autopsy material, which allows the direct quantification of abdominal fat. We aimed to investigate the association between direct measurements of abdominal visceral fat and cognitive impairment in an autopsy study. Methods: In this cross-sectional study, we collected information on sociodemographics, cardiovascular risk factors, and cognitive status from subjects aged 50 or older at time of death in a general autopsy service in Brazil. Abdominal visceral fat was obtained in natura by the dissection of perirenal, mesenteric, omental, and mesocolon fat. The associations of total abdominal visceral fat with cognitive impairment [clinical dementia rating (CDR) score >= 0.5] and CDR-sum of boxes (CDR-SB) were evaluated using logistic regression and negative binomial regression models, respectively. All analyses were adjusted for height, age, sex, education, hypertension, diabetes mellitus, stroke, smoking, alcohol use, and physical inactivity. In addition, we compared the discrimination of visceral fat, body mass index (BMI), and waist circumference (WC) measurements in predicting cognitive impairment. Results: We evaluated 234 participants (mean age = 71.2 +/- 12.9 years old, 59% male). Abdominal visceral fat was inversely associated with cognitive impairment (OR = 0.46, CI = 0.30; 0.70, p < 0.0001) and with CDR-SB scores (beta = 0.85, 95% CI = 1.28; 0.43, p < 0.0001). When we compared the area under the ROC curve (AUC), visceral fat (AUC = 0.754), BMI (AUC = 0.729), and WC (AUC = 0.720) showed similar discrimination in predicting cognitive impairment (p = 0.38). Conclusion: In an autopsy study, larger amount of directly measured abdominal visceral fat was associated with lower odds of cognitive impairment in older adults.
- Comparison of 3 Frailty Instruments in a Geriatric Acute Care Setting in a Low-Middle Income Country(2018) LIN, Sumika Mori; ALIBERTI, Marlon Juliano Romero; FORTES-FILHO, Sileno de Queiroz; MELO, Juliana de Araujo; APRAHAMIAN, Ivan; SUEMOTO, Claudia Kimie; JACOB FILHO, WilsonObjective: Comparison of frailty instruments in low-middle income countries, where the prevalence of frailty may be higher, is scarce. In addition, less complex diagnostic tools for frailty are important in these settings, especially in acutely ill patients, because of limited time and economic resources. We aimed to compare the performance of 3 frailty instruments for predicting adverse outcomes after 1 year of followup in older adults with an acute event or a chronic decompensated disease. Design: Prospective cohort study. Setting: Geriatric day hospital (GDH) specializing in acute care. Participants: A total of 534 patients (mean age 79.6 +/- 8.4 years, 63% female, 64% white) admitted to the GDH. Measurements: Frailty was assessed using the Cardiovascular Health Study (CHS) criteria, the Study of Osteoporotic Fracture (SOF) criteria, and the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) questionnaire. Monthly phone contacts were performed over the course of the first year to detect the following outcomes: incident disability, hospitalization, fall, and death. Multivariable Cox proportional hazard regression models were performed to evaluate the association of the outcomes with frailty as defined by the 3 instruments. In addition, we compared the accuracy of these instruments for predicting the outcomes. Results: Prevalence of frailty ranged from 37% (using FRAIL) to 51% (using CHS). After 1 year of follow-up, disability occurred in 33% of the sample, hospitalization in 40%, fall in 44%, and death in 16%. Frailty, as defined by the 3 instruments was associated with all outcomes, whereas prefrailty was associated with disability, using the SOF and FRAIL instruments, and with hospitalization using the CHS and SOF instruments. The accuracy of frailty to predict different outcomes was poor to moderate with area under the curve varying from 0.57 (for fall, with frailty defined by SOF and FRAIL) to 0.69 (for disability, with frailty defined by CHS). Conclusions: In acutely ill patients from a low-middle income country GDH acute care unit, the CHS, SOF, and FRAIL instruments showed similar performance in predicting adverse outcomes. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
- Implementing the Objective Structured Clinical Examination (OSCE) in a Geriatrics Fellowship Program - a three-year experience(2012) AVELINO-SILVA, T. J.; GIL, L. A.; LIN, S. M.; FARIAS, L. L.; KIKUCHI, E. L.; SUEMOTO, C. K.; JACOB-FILHO, W.Background: The Objective Structured Clinical Examination (OSCE) appears to be an effective alternative for assessing not only medical knowledge, but also clinical skills, including effective communication and physical examination skills. Our purpose was to implement an OSCE model in a Geriatrics fellowship program and to compare the instrument with traditional essay examination. Methods: Seventy first- and second-year geriatric fellows were initially submitted to a traditional essay examination and scored from 0 to 10 by a faculty member. Subsequently, the same fellows underwent an OSCE with eight ten-minute stations, covering a wide range of essential aspects of geriatric knowledge. Each OSCE station had an examiner responsible for its evaluation according to a predefined checklist. Checklist items were classified for analysis purposes as clinical knowledge items (CKI) and communication skills items (CSI); student responses were scored 0-10. Results: While essay exams took from 30 to 45 minutes to complete, 180 to 200 minutes were required to evaluate students using the proposed OSCE method. Students scored an average of 6.2 ± 1.2 on the traditional essay examination versus 6.6±1.0 on the OSCE(p<0.001). Sub-analyses of OSCE scores indicated that average performance on CKI was lower than the average on CSI (6.4±1.1 vs.8.4±1.1; p<0.001). Students’ performance on the essay exam was similar to their performance on CKI (p=0.13). Second-year fellows performed better than first-year fellows on both the essay exam (p<0.001) and CKI (p=0.05), but not on CSI (p=0.25). Conclusion: The OSCE was successfully implemented as an educational strategy during our Geriatrics fellowship program. Combining different testing modalities may provide the best assessment of competence for various domains of knowledge, skills, and behavior comparison of first and second-year fellows’ performance on traditional essay examination and OSCE.
article Autopsy studies are key to identifying dementia cause(2023) SUEMOTO, Claudia K.; LEITE, Renata E. P.- Targeted Geriatric Assessment for Fast-Paced Healthcare Settings: Development, Validity, and Reliability(2018) ALIBERTI, Marlon J. R.; APOLINARIO, Daniel; SUEMOTO, Claudia K.; MELO, Juliana A.; FORTES-FILHO, Sileno Q.; SARAIVA, Marcos D.; TRINDADE, Carolina B.; COVINSKY, Kenneth E.; JACOB-FILHO, WilsonObjectivesTo develop and examine the validity and reliability of a targeted geriatric assessment (TaGA) for busy healthcare settings. DesignThe TaGA was developed through the consensus of experts (Delphi technique), and we investigated its construct validity and reliability in a cross-sectional study. SettingGeriatric day hospital specializing in acute care in Brazil. ParticipantsOlder adults (N = 534) aged 79.5 8.4, 63% female, consecutively admitted to the geriatric day hospital. MeasurementsThe Frailty Index (FI), Physical Frailty Phenotype, and Identification of Seniors at Risk (ISAR) were used to explore the TaGA's validity. External scales were used to investigate the validity of each matched TaGA domain. The interrater reliability and time to complete the instrument were tested in a 53-person subsample. ResultsIn 3 rounds of opinion, experts achieved consensus that the TaGA should include 10 domains (social support, recent hospital admissions, falls, number of medications, basic activities of daily living, cognitive performance, self-rated health, depressive symptoms, nutritional status, gait speed). They arrived at sufficient agreement on specific tools to assess each domain. A single numerical score from 0 to 1 expressed the cumulative deficits across the 10 domains. The TaGA score was highly correlated with the FI (Spearman coefficient = 0.79, 95% confidence interval (CI)=0.76-0.82) and discriminated between frail and nonfrail individuals better than the ISAR (area under the receiver operating characteristic curve 0.84 vs 0.72; P < .001). The TaGA score also had excellent interrater reliability (intraclass correlation coefficient = 0.92, 95% CI=0.87-0.95). Mean TaGA administration time was 9.5 +/- 2.2 minutes. ConclusionThe study presents evidence supporting the TaGA's validity and reliability. This instrument may be a practical and efficient approach to screening geriatric syndromes in fast-paced healthcare settings. Future research should investigate its predictive value and effect on care.
- Different Sources of Sugar Consumption and Cognitive Performance in Older Adults: Data From the National Health and Nutrition Examination Survey 2011-2014(2023) GONCALVES, Natalia Gomes; SUEMOTO, Claudia Kimie; FERREIRA, Naomi VidalObjectives Excess sugar consumption, particularly in sugar-sweetened beverages (SSBs), has been linked to poor cognitive performance. We aimed to assess the association of consumption of total sugar, as well as the consumption of SSBs, solid desserts, and 100% fruit juice with cognitive performance among older adults. Methods Consumption of total sugar, SSBs, solid desserts, and 100% fruit juice were obtained from the 24-hr recall interview. Cognitive performance was evaluated using the Consortium to Establish a Registry for Alzheimer's Disease word list, the Animal Fluency Test, and the Digit Symbol Substitution Test. Binary logistic regression models were used to evaluate the association between consumption of sugar (total and from different sources) and cognitive performance. Results A total of 1,938 participants aged 60 years or older from the National Health and Nutrition Examination Survey 2011-2014 were included. Compared to the lowest tertile, the highest tertile of total sugar consumption was independently associated with higher odds of low memory performance (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.00; 3.50, p = .049). Consumption of SSBs was associated with higher risk of low memory (OR = 1.58, 95% CI = 1.11; 2.25, p = .014), whereas consumption of solid desserts was associated with lower risk of low verbal fluency performance (OR = 0.62, 95% CI = 0.41; 0.95, p = .032). Discussion Higher consumption of total sugars and SSBs was associated with lower memory performance, while consumption of solid desserts was associated with higher verbal fluency performance.