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- The Cognitive Telephone Screening Instrument (COGTEL): a reliable and valid tool for the assessment of cognitive functioning in the Brazilian elderlyPublication . Tinôco, Maria Antonieta; Gouveia, Élvio Rúbio; Ihle, Andreas; Marques, Adilson; Gouveia, Bruna R.; Kliegel, MatthiasObjectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/ stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.
- Estilo de vida, função cognitiva e variáveis psicossociais em adultos idosos do Amazonas, BrasilPublication . Tinôco, Maria Antonieta de Campos; Gouveia, Élvio Rúbio; Jurema, Jefferson; Kliegel, Matthias; Ihle, AndreasO declínio na função cognitiva em idades avançadas apresenta-se como um dos maiores desafios atuais para os sistemas de saúde e sociedades envelhecidas. A identificação de fatores preditivos permite detetar e antecipar em fases precoces ou até mesmo abrir novas avenidas com medidas preventivas na função cognitiva. Os objetivos do presente estudo foram: (1) estudar as propriedades psicométricas (fiabilidade/estabilidade e validade concorrente) de um instrumento concebido para avaliar a função cognitiva, o Cognitive Telephone Screening Instrument (COGTEL), e (2) investigar as associações entre a função cognitiva, o estilo de vida e as variáveis psicossociais. As propriedades psicométricas do COGTEL foram estudadas num estudo piloto com 90 adultos idosos (29 homens e 61 mulheres), 68.2±6.7 anos de idade. No estudo das associações da função cognitiva, foram incluídos 701 adultos idosos, 268 homens e 433 mulheres (71.4±6.7 anos de idade). Todos os instrumentos foram aplicados por questionário, com recurso a entrevistas face-to-face. O coeficiente de correlação intraclasse no teste-reteste no score total do COGTEL (e respetivos 6 subtestes), Mini Mental State Examination (MMSE) e nível educacional variou entre aceitável-a-elevado (.708 < R < .946). Verificou-se uma correlação positiva forte, entre o COGTEL com o MMSE (r=.682; p<.001), bem como, com o nível educacional (r=.604; p<.001). Os adultos idosos mais jovens apresentaram scores significativamente mais elevados, na função cognitiva, atividade física, assim como um status socioeconómico superior, comparativamente aos mais idosos (ps< .040). Verificou-se uma correlação parcial negativa, entre a função cognitiva e o score de depressão (-.36, > r >-.39, p<.001) e positiva com o estilo de vida, atividade física, nutrição, qualidade de vida, satisfação social e estatuto socioeconómico (.11> r > = .55, p<.05s). A idade não afetou a força destas correlações, contudo, quando se controlou pelo estatuto socioeconómico as correlações enfraqueceram. Os resultados do presente estudo suportam a utilização do COGTEL como um instrumento breve, fiável e válido para analisar diferenças interindividuais no funcionamento cognitivo. Programas de intervenção focados na melhoria da função cognitiva em adultos idosos devem ter em atenção a força das correlações estudadas, mas, sobretudo, ter em consideração o nível socioeconómico dos participantes e não apenas a idade cronológica.
- Sarcopenia and Physical Activity Predict Falls in Older Adults from Amazonas, BrazilPublication . Ihle, Andreas; Kliegel, Matthias; Jurema, Jefferson; Tinôco, Antonieta; Campos, Pedro; Marques, Adilson; Gouveia, Bruna; Gouveia, Élvio Rúbio; Miranda, Kessketlen Alvest. Introduction: Sarcopenia is a progressive and widespread skeletal muscle disorder involving loss of muscle mass and function, and is associated with several outcomes, including falls, functional decline, frailty, and mortality. Therefore, this study aimed: (1) to estimate the prevalence of sarcopenia, falls, and the risk of falls considering age, sex, and the level of physical activity (PA), and (2) to identify which of these predictors better explained the likelihood that participants present risk of fall. A total of 701 participants (433 women) with a mean age of 70.4±6.9. Sarcopenia was determined according to the most recent guidelines from the European Working Group (EWGSOP2). The prevalence of falls and the level of physical activity were assessed by questionnaires. The risk of falls was assessed using the Fullerton Advance Balance (FAB) scale. This study provides evidence that women (OR: 2.5, p<0.001), the oldest people (OR: 1.1 p<0.001), and people who had identified sarcopenia (OR: 2.9 p<0.001), and lower level of physical activity (OR: 2.9 p<0.001), were more likely to present the risk of falls. Implications for vulnerable aging are discussed.
- The Relation of Having Experienced a Fall in the Past to Lower Cognitive Functioning in Old Age Is Mediated via Less Physical Activity Engagement as Cognitive Reserve ContributorPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; Nascimento, Marcelo de Maio; Haas, Maximilian; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasSimple Summary: Experiencing a fall in old age represents a critical life event affecting physical and cognitive health and the ability to engage in physical activities and exercise. This is crucial since physical activity engagement contributes to the accumulation of the so-called cognitive reserve relevant for maintaining cognitive health at old age. The goal of our study was to investigate whether the relationship between having experienced a fall and lower cognitive functioning can be explained by hampered physical activity engagement. Confirming this idea, our findings demonstrated that experiencing a fall at an older age hinders sufficient physical activity engagement and thereby impedes cognitive reserve accumulation, resulting in lower cognitive functioning outcomes. Consequently, our study suggests that at old age, the prevention of falls and related accidents is not only crucial to avoid injuries and preserve physical health, but it is also essential for maintaining one’s ability to engage in physical activities and exercises and, consequently, for preserving cognitive health in later life. Abstract: Physical activity and exercise contribute to the accumulation of cognitive reserve, which is instrumental for preserving cognitive health in old age. In a large sample of 701 older adults (mean age = 70.36 years), we investigated whether the relationship between having experienced a fall in the past and lower performance in cognitive functioning was mediated via less physical activity engagement as a cognitive reserve contributor. General cognition was assessed using the mini-mental state examination (MMSE), long-term memory using a word-pair delayed recall test and working memory using a backward digit-span test. In face-to-face interviews, individuals reported information on falls during the past 12 months and their habitual physical activity engagement. Our analyses demonstrated that the relationship between having experienced a fall in the past and lower performance in the cognitive functioning measures was partly mediated (by 16.3% for general cognition, 30.6% for ong-term memory, and 33.1% for working memory, respectively) via less physical activity engagement. In conclusion, we suggest as a core bio-psychological mechanism that experiencing a fall at an older age is a critical life event that hinders sufficient physical activity engagement and thereby impedes cognitive reserve build-up, resulting in lower cognitive functioning outcomes.
- Cognitive function and its associations in older adults from Amazonas, BrazilPublication . Freitas, Duarte Luís; Gouveia, Bruna Raquel; Ribeiro, Euler Esteves; Muniz, Bárbara Régia; Odim, Angeany Pinto; Machado, Floramara Teles; Jurema, Jefferson; Kliegel, Matthias; Ihle, Andreas; Gouveia, Élvio Rúbio; Tinôco, Maria Antonieta de CamposThe objectives of this study were: (1) to investigate the age-related differences in cognitive function (CF), nutritional status (MNA), physical activity (AF), quality of life (QoL), depression, social satisfaction (SS) and socioeconomic status (SES), and (2) to explore the relationships between CF and the previous variables. This cross sectional study included 268 men and 433 women (aged 71.4 ± 7.0 years). CF was determined with the Cognitive Telephone Screening Instrument (COGTEL) and the Mini-Mental State Examination (MMSE). Correlates were as follows: Mini Nutritional Assessment (MNA), PA (Baecke questionnaire modified for older adults), Quality of life (QoL SF12), Geriatrics Depression Scale (GDS), Satisfaction and Social Support Scale, and Socioeconomic status (SES). All instruments were applied in a face to face interview. An independent t-test identified significantly higher scores in young-old adults (≤ 69 years) for CF (p < 0.001), PA (p = 0.046) and SES (p = 0.007), compared to old-old adults (≥ 70 years). The results of multiple linear regression analysis indicated that the most significant CF correlates were SES (β = 0.45; p < 0.001), age (β = -0.12; p < 0.001), SS (β = 0.12; p = 0.001), GDS (β = -0.11; p = 0.003) and QoL (β = 0.08; p = 0.017). The overall regression model explained 36% of the total variance in the COGTEL. The oldest and the more depressed adults obtained lower scores for FC. The present study suggests that, between the correlates studied, SES was the strongest predictor in the explanation of CF in older adults.
- Cognitive Functioning Mediates the Association of Cognitive Reserve with Health-Related Quality of LifePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; Nascimento, Marcelo de Maio; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasWe investigated whether the relations of the cognitive reserve markers education and cogni tive level of work to the physical and the mental component of health-related quality of life (HRQoL) were mediated via cognitive functioning in a large sample of 701 older adults (mean age = 70.36 years, SD = 6.87). HRQoL was measured with the 12-item Short-Form Health Survey. To measure cog nitive functioning, we used the COGTEL, which is a cognitive test battery assessing prospective memory, verbal short-term memory, verbal long-term memory, working memory, verbal fluency, and inductive reasoning, combined into a composite score. Individuals reported information on their education and their main profession during their working life. Mediation analyses showed that better cognitive functioning mediated the association of higher values in the cognitive reserve markers (longer education and a high cognitive level of work) with higher HRQoL. In conclusion, the present study suggests that the sustainability of cognitive functioning in old age with the help of cognitive reserve is fundamental for the sustainability of quality of life, presumably particularly for the mental HRQoL component.