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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.
- The role of leisure activities in mediating the relationship between physical health and well-being: differential patterns in old and very old agePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; van der Linden, Bernadette W.A.; Sauter, Julia; Gabriel, Rainer; Oris, Michel; Fagot, Delphine; Kliegel, MatthiasBackground: Recently, Paggi et al. [Gerontology 2016; 6 2: 450–458] for the very first time showed in a cross-sectional sample of 259 adults aged 18–81 years that the relation of physical health to psychological well-being was mediated via frequency of leisure activity participation. Objective: To extend this framework, we followed theories on successful aging and vulnerability to propose to add a differential perspective predicting that certain individuals may be more vulnerable than others and therefore may show differences in the mediation pattern. Specifically, we examined whether mediation patterns were differential in certain populations, such as in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. Methods: We analyzed data from 3,080 individuals on physical health (number of chronic diseases, subjective health status, and subjective evaluation of change in health over the last 10 years), frequency of participation in 18 leisure activities, and physical and psychological well-being using moderated mediation models with a path model approach that allowed the simultaneous estimation of all model paths, including their significance. Results: We found that the relation of physical health to physical and psychological well-being was mediated via frequency of activity participation. For physical (but not for psychological) well-being, this mediation was more pronounced in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. These moderated mediations were attributable to differential relations of physical health to frequency of activity participation and to differential relations of frequency of activity participation to physical wellbeing between the investigated moderator levels. Conclusion: Present data suggest that participation in leisure activities may play a key role in mediating the relationship between physical health and well-being, particularly in very old age. Findings are discussed with respect to theories of successful aging and differences between physical and psychological well-being.
- The effect of the ProBalance Programme on health-related quality of life of community-dwelling older adults: A randomised controlled trialPublication . Gouveia, Bruna R.; Gouveia, Élvio R.; Ihle, Andreas; Jardim, Helena G.; Martins, Maria M.; Freitas, Duarte L.; Kliegel, MatthiasBackground: Health-related quality of life (HRQoL) is an important health outcome in older adults. This study aimed toassess the efficacyoftheProBalance rehabilitation programmeon HRQoLofcommunity-dwelling older adults with balance impairments and to investigate whether effects differ between age groups and/or HRQoL components. Methods: A single-blind, randomised controlled trial included community-dwelling older adults, aged 65–85, with balance impairments. Participants (n = 52) were randomly allocated to an intervention group (IG) or a control group (CG). A rehabilitation programme included gait, balance, functional training, strengthening, flexibility, and 3D training. A group-based intervention was administered over a period of 12 weeks (90-min sessions, 2days per week). A wait-list control group was instructed to maintain their usual activities during the same period. Participants’ HRQoL was assessed using the SF-36 questionnaire. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). Results: A trend for higher HRQoL in the IG compared to the CG and a significant interaction of group with time were found, with significantly higher increases in HRQoL from the pre-test to the post-test (and to follow-up) in the IG, compared to the CG. Results: were independent of age group (young-old vs. old-old) and HRQoL component (physical vs. mental). Conclusions: Present results suggest that the ProBalance programme had a beneficial effect on HRQoL of community-dwelling older adults, which held across young and old adults and not only comprised physical but also mental HRQoL.
- O ensino dos jogos desportivos coletivos de invasão segundo uma abordagem tática ao jogo: um estudo quasiexperimental em alunos do ensino básicoPublication . Gouveia, Élvio Rúbio; Ihle, Andreas; Gouveia, Bruna; Kliegel, Matthias; Malho, Hélvio; Freitas, Bruno; Oliveira, Ricardo; Gaspar, Maria; Freitas, Duarte; Prudente, João; Lopes, Helder
- The Cognitive Telephone Screening Instrument (COGTEL): A Brief, Reliable, and Valid Tool for Capturing Interindividual Differences in Cognitive Functioning in Epidemiological and Aging StudiesPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Kliegel, MatthiasAims: The present study set out to evaluate the psychometric properties of the Cognitive Telephone Screening Instrument (COGTEL) in 2 different samples of older adults. Methods: We assessed COGTEL in 116 older adults, with retest after 7 days to evaluate the test-retest reliability. Moreover, we assessed COGTEL in 868 older adults to evaluate convergent validity to the Mini-Mental State Examination (MMSE). Results: Test-retest reliability of the COGTEL total score was good at 0.85 (p < 0.001). Latent variable analyses revealed that COGTEL and MMSE correlated by 0.93 (p < 0.001), indicating convergent validity of the COGTEL. Conclusion: The present analyses suggest COGTEL as a brief, reliable, and valid instrument for capturing interindividual differences in cognitive functioning in epidemiological and aging studies, with the advantage of covering more cognitive domains than traditional screening tools such as the MMSE, as well as differentiating between individual performance levels, in healthy older adults.
- The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailtyPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Freitas, Duarte; Jurema, Jefferson; Odim, Angeany P.; Kliegel, MatthiasBackground: It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. Methods: We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: Greatergripstrength,longereducation,highercognitivelevelofjob,andgreaterengagingincognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. Conclusions: Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.
- A associação entre o estilo de vida e a atitude de alunos do ensino básico e secundário em relação à disciplina de educação físicaPublication . Gouveia, Élvio Rúbio; Ihle, Andreas; Rodrigues, Ana; Correia, Ana Luisa; Alves, Ricardo; Simões, Joana; Gouveia, Bruna; Kliegel, Matthias; Freitas, Duarte; Lopes, HelderEste estudo teve por objetivo o seguinte: investigar a associação entre o estilo de vida e a atitude positiva (EñgEFD) ou negativa (EgEFD) dos alunos sobre a Educação Física (EF). Um estudo de natureza transversal foi conduzido em 243 estudantes (15.6 ±2.5 anos). A informação demográfica, a opinião sobre a EF, e a auto perceção foram avaliados através de questionários. A aptidão física foi determinada a partir da FITNESSGRAM e da EUROFIT. A percentagem de gordura foi estimada a partir das equações de Slaughter et al., (1988). Análises descritivas e o t-test de medidas independentes foram conduzidas nas análises. Nesta amostra, 74.5% dos estudantes afirmam gostar de EDF. Os EgEFD apresentam scores significativamente mais elevados comparativamente aos EñgEFD na força, velocidade/agilidade, força resistência do tronco e resistência aeróbia (p<.007). Os EgEFD têm uma melhor percepção das suas capacidades físicas, assim como referem ter uma boa saúde e adotarem estilos de vida mais saudáveis (p<.001). Os EgEFD apresentam um perfil funcional e psicológico mais saudável, auto percecionam um melhor estado de saúde e preferem envolver-se em atividades físicas em detrimento das atividades sedentárias no seu dia-a-dia.
- High-density lipoprotein cholesterol level relates to working memory, immediate and delayed cued recall in brazilian older adults: the role of cognitive reservePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Freitas, Duarte L.; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasAims: The present study set out to investigate the relation of the high-density lipoprotein cholesterol (HDL-C) level to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. Methods: We assessed tests of working memory, immediate and delayed cued recall in 701 older adults from Amazonas, Brazil. The HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: A critically low HDL-C level (<40 mg/dL) was significantly related to lower performance in working memory, immediate and delayed cued recall. Moderation analyses suggested that the relations of the HDL-C level to working memory and delayed cued recall were negligible in individuals with longer education, a higher cognitive level of the job, and greater engagement in cognitive leisure activity. Conclusion: Cognitive reserve accumulated during the life course may reduce the detrimental influences of a critically low HDL-C level on cognitive functioning in old age.
- Correlates of health-related quality of life in young-old and old–old community-dwelling older adultsPublication . Gouveia, Élvio R. Quintal; Gouveia, Bruna R.; Ihle, Andreas; Kliegel, Matthias; Maia, José A.; Bermúdez i Badia, Sergi; Freitas, Duarte L.Purpose This study aimed (1) to examine the role of potential correlates of HRQoL in a large representative sample of older adults, and (2) to investigate whether the relationships between HRQoL and potential factors differ as a function of HRQoL component (physical vs. mental) and/or age cohort (young-old vs. old–old). Methods This cross-sectional study included 802 older adults aged 60–79 years old. HRQoL was assessed using the SF-36 questionnaire. Functional fitness was assessed using the Senior Fitness Test. Physical activity was measured via the Baecke questionnaire. Demographic information, mental and health features were obtained through questionnaires. Results A multiple regression analysis showed that BMI (β = −0.15, p = 0.001), body strength (β = 0.21, p < 0.001), aerobic endurance (β = 0.29, p < 0.001), physical activity (β = 0.11, p = 0.007), depressive symptoms (β = −0.19, p < 0.001), falls (β = −0.19, p < 0.001), and living alone (β = −0.16, p < 0.001) were all significantly related to HRQoL-SF-36 total score. The positive relation with aerobic endurance was significantly higher for the physical component of HRQoL, while the negative relation with living alone was significantly higher for the mental component. The positive relation of HRQoL with physical activity was significantly higher in old–old compared to young-old adults. Conclusion This data suggest that body composition, functional fitness, psycho-social factors, and falls are important correlates of HRQoL in old age. There are HRQoL-component and age-cohort differences regarding these correlates, underlying the need for specific strategies at the community level to promote HRQoL in older adults.
- Cognitive reserve attenuates 6-year decline in executive functioning after strokePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Cheval, Boris; Sieber, Stefan; Cullati, Stéphane; Kliegel, MatthiasAims: We investigated whether the longitudinal relationship between history of stroke and subsequent decline in executive functioning over 6 years differed by cognitive reserve. Methods: We analyzed longitudinal data from 897 older adults (mean age, 74.33 years) tested on the Trail Making Test (TMT) in two waves 6 years apart. Participants reported information on key frequently used proxies of lifelong cognitive reserve accumulation (i.e., education, occupation, and leisure activity engagement), and history of stroke. Results: There was a significant interaction of stroke with leisure activity engagement on latent change in executive functioning. Specifically, only for individuals with low (but not those with high) leisure activity engagement, history of stroke significantly predicted a steeper subsequent decline in executive functioning across 6 years (i.e., increases in TMT completion time). Conclusion: The detrimental aftereffects of stroke on subsequent decline in executive functioning may be attenuated in individuals who have accumulated greater cognitive reserve through leisure activity engagement across their life.