Doença de Alzheimer: declínio funcional e estágio da demência

Use of multisensory stimulation in institutionalized older adults with moderate or severe dementia

The Multisensory Stimulation Program can help manage behavioral and psychological symptoms of dementia.

Loss of functional capacity in elderly individuals with Alzheimer disease

ABSTRACT. Background: The functional capacity of elderly individuals with Alzheimer disease (AD) progressively declines. Objective: To verify the influence of sociodemographic, clinical, staging, mobility, and postural and cognitive balance data on the impairment of the functional capacity of elderly individuals with AD. Methods: This observational, analytical, cross-sectional study was performed at the Physiotherapy Department of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. The study consisted of forty elderly individuals aged ≥60 years old with mild or moderate AD, who could ambulate independently. The instruments used included a questionnaire to assess sociodemographic and anthropometric data; the Mini-Mental Health State Examination (MMSE); the Clinical Dementia Rating (CDR); a clock drawing test (CDT); a verbal fluency test (VFT); the Timed Up and Go Test (TUG); and the Clinical Test of Sensory Organization and Balance (CTSIB). Simple descriptive analyses, Mann-Whitney test, Spearman's correlation test, linear regression modeling, and prediction equation (p<0.05, 95% confidence interval [95%CI]) were performed. Results: Fifteen linear regression models were generated, with the final model chosen for analysis. The variables assumed in that model were CDR, MMSE score, and condition 3 of the CTSIB, which explained 60.1% of the outcome. Conclusions: Impairment of functional capacity in elderly individuals with AD was influenced by disease progression, which was due to cognitive deficits and deficits in postural balance, which are related to the inaccuracy of the somatosensory system in performing sensory integration.

Challenges and technologies of care developed by caregivers of patients with Alzheimer's disease

Abstract Objective: to identify the challenges and technologies of care developed by caregivers of patients with Alzheimer's disease. Method: an exploratory study with a qualitative approach was carried out with nine caregivers of elderly people with Alzheimer's disease from the mutual help group of a university hospital in the south of Brazil. Data collection took place between May and August 2017 through a semi-structured interview. Content analysis was used to analyze the data. Results: two categories emerged from the analysis of the data: the challenges faced by caregivers of elderly people with Alzheimer's Disease and the care technologies developed by caregivers of elderly people with Alzheimer's disease. Conclusion: the study showed that the care strategies elaborated by the caregiver can enhance understanding, reflection and discussion among health professionals, caregivers and family members about quality care for the elderly and minimize the difficulties of care in order to provide greater quality of care for the elderly.

Scientometric profile of physiotherapists Brazilian scientists

Abstract Introduction: Knowledge of Brazilian scientists profile is important to understand the factors that influence the behavior of those interested in developing science. Objective: To outline the profile of Brazilian physiotherapist researchers, permanent, or collaborator professors of PhD programs in physiotherapy. Methods: Study of documentary analysis with scientometric techniques on physiotherapist data in Brazilian doctors associated professors in PhD programs. To identify the professors, the Sucupira and Lattes Platforms were used, and the research areas were categorized according to COFFITO. Data on the research area, the number of orientations, publications and impact factor average (JCR) were analyzed by 1-way ANOVA test (p < 0.05), and a collaboration network was built using Gephi 0.9.1 software. Results: Nine institutions of higher education in Brazil have a PhD in physiotherapy. A total of 119 professors are associated with UFMG (20.2%), UFSCAR (17.6%), UFRN (13.4%), and UNINOVE (10.9%). The median number of doctors graduated by the professors was 1.0 (0.0 - 6.0) and in publications in the period was 4.6 (2.4 - 8.4). The main study designs were observational 71 (59.7%), and the main research area was neurofunctional 25 (21.0%). The collaboration between UFSCAR and UFMG professors is strengthened. Conclusion: There are few specific doctoral programs for physiotherapists in Brazil. The majority of them are concentrated in the southeast region, and the professor staff have very heterogeneous characteristics related to the duration of the programs, the nature of the institution, or the affiliation of the professor.

[Effectiveness of non-pharmacological interventions in the quality of life of caregivers of Alzheimer]

OBJECTIVE

Explore the effectiveness of non-pharmacological interventions to improve the quality of life of family caregivers of Alzheimer's patients.

METHODS

We conducted a systematic review, in pairs, in the following databases: PubMed, Scopus, CINAHL, PsycINFO, WOS, Cochrane Library, IME, Cuiden Plus and Dialnet. Inclusion criteria were: 1. Studies published between 2010-2015. 2. Language: English, Portuguese and Spanish. 3. Randomized controlled clinical trials. 4. Score greater than or equal to 3 on the Jadad scale.

RESULTS

13 studies were included. Four performed a psychosocial intervention with family caregivers, three psychotherapeutic, two psychoeducational, two multicomponent, one educational and another with mutual support groups. The tools to assess quality of life: three studies used the Health Status Questionnaire (HSQ), three EuroQol-5D (two only used the EVA), two health questionnaire SF-36, two WHOQOL-BREF, two Quality of Life SF-12 and one Perceived Quality of Life Scale (PQoL). Regarding the effectiveness of non-pharmacological interventions, five studies obtained favorable results in the quality of life after psychotherapeutic interventions and community-type multicomponent training.

CONCLUSION

The diversity of non-pharmacological interventions used and contents, differences in the number of sessions and hours, and variability of valuation tools used to measure quality of life of family caregivers, leads us to reflect on the appropriateness to standardize criteria, for the sake to improve clinical practice.

Mudanças no cotidiano de cuidadores de idosos em processo demencial

À medida que o número de idosos aumenta devido ao envelhecimento populacional, a prevalência de doenças crônico-degenerativas cresce significativamente. Dentre estas, a demência se destaca como fator de risco para a incapacidade e a perda funcional, podendo promover uma relação de aumento de assistência nas atividades/ocupações cotidianas do idoso e modificações no contexto diário de quem cuida. Este artigo teve como objetivo apreender a percepção do cuidador de idosos em processo demencial frente ao seu cotidiano, identificando o status de suas ocupações/atividades em decorrência das relações de cuidado assumidas. Trata-se de estudo transversal, correlacional comparativo, com abordagem quantitativa. Para tanto, foi selecionada uma amostra de 22 cuidadores de idosos com diagnóstico de processo demencial, sendo seis cuidadores formais e 16 cuidadores informais. Para a coleta de dados, foram utilizados uma lista de ocupações e um questionário de caracterização do cuidador. Os dados mostraram que os cuidadores informais dedicam maior tempo às atividades de cuidado, com abandono de várias atividades cotidianas produtivas, de lazer e de cuidados pessoais após assumirem a atividade de cuidado. Nos cuidadores formais esses impactos são bem menores, uma vez que a atividade de cuidado compõe sua vida laborativa. Em ambos os grupos, constatou-se um baixo número de cuidadores que se capacitam para a atividade e estes referiram sentir dificuldades em lidar e orientar famílias no manejo para o cuidado do idoso. Conforme os dados obtidos nesta pesquisa e com base na literatura existente, o cuidadores informais são os principais responsáveis pelo cuidado e caracterizam-se por ter suas atividades cotidianas alteradas ou substituídas pela responsabilidade do cuidado.