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[PMID]:28448301
[Au] Autor:Lim ML; Ang SGM; Teo KY; Wee YHC; Yee SP; Lim SH; Ang SY
[Ad] Endereço:Nursing Division, Singapore General Hospital, Singapore (Mss Lim, Teo, Wee, Yee, Lim, and Ang); and School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia (Mr Ang).
[Ti] Título:Patients' Experience After a Fall and Their Perceptions of Fall Prevention: A Qualitative Study.
[So] Source:J Nurs Care Qual;33(1):46-52, 2018 Jan/Mar.
[Is] ISSN:1550-5065
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:An exploratory descriptive study was conducted to explore the perspectives of patients who had fallen in the hospital; 100 patients were interviewed. An inductive content analysis approach was adopted. Six themes emerged: Apathetic toward falls, self-blame behavior, reluctance to impose on busy nurses, negative feelings toward nurses, overestimating own ability, and poor retention of information. Patients often downplayed the risks of falls and were reluctant to call for help.
[Mh] Termos MeSH primário: Acidentes por Quedas/prevenção & controle
Apatia
[Mh] Termos MeSH secundário: Envelhecimento/psicologia
Feminino
Hospitais
Seres Humanos
Pesquisa Qualitativa
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1097/NCQ.0000000000000261


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[PMID]:28826872
[Au] Autor:Kolanowski A; Boltz M; Galik E; Gitlin LN; Kales HC; Resnick B; Van Haitsma KS; Knehans A; Sutterlin JE; Sefcik JS; Liu W; Petrovsky DV; Massimo L; Gilmore-Bykovskyi A; MacAndrew M; Brewster G; Nalls V; Jao YL; Duffort N; Scerpella D
[Ad] Endereço:College of Nursing, Penn State, University Park, PA. Electronic address: amk20@psu.edu.
[Ti] Título:Determinants of behavioral and psychological symptoms of dementia: A scoping review of the evidence.
[So] Source:Nurs Outlook;65(5):515-529, 2017 Sep - Oct.
[Is] ISSN:1528-3968
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are prevalent in people with neurodegenerative diseases. PURPOSE: In this scoping review the Kales, Gitlin and Lykestos framework is used to answer the question: What high quality evidence exists for the patient, caregiver and environmental determinants of five specific BPSD: aggression, agitation, apathy, depression and psychosis? METHOD: An a priori review protocol was developed; 692 of 6013 articles retrieved in the search were deemed eligible for review. Gough's Weight of Evidence Framework and the Cochrane Collaboration's tool for assessing risk of bias were used. The findings from 56 high quality/low bias articles are summarized. DISCUSSION: Each symptom had its own set of determinants, but many were common across several symptoms: neurodegeneration, type of dementia, severity of cognitive impairments, and declining functional abilities, and to a lesser extent, caregiver burden and communication. CONCLUSION: Research and policy implications are relevant to the National Plan to Address Alzheimer's Disease.
[Mh] Termos MeSH primário: Agressão
Doença de Alzheimer/fisiopatologia
Apatia
Demência/fisiopatologia
Depressão/fisiopatologia
Agitação Psicomotora/fisiopatologia
Transtornos Psicóticos/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/complicações
Demência/complicações
Depressão/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Agitação Psicomotora/etiologia
Transtornos Psicóticos/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE


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[PMID]:28791690
[Au] Autor:Nijsten JMH; Leontjevas R; Pat-El R; Smalbrugge M; Koopmans RTCM; Gerritsen DL
[Ad] Endereço:Archipel Landrijt, Knowledge Center for Specialized Care, Eindhoven, the Netherlands.
[Ti] Título:Apathy: Risk Factor for Mortality in Nursing Home Patients.
[So] Source:J Am Geriatr Soc;65(10):2182-2189, 2017 Oct.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To determine the prognostic value of apathy for mortality in patients of somatic (SC) and dementia special care (DSC) nursing home (NH) units. DESIGN: Longitudinal design, secondary analyses of a 2-year, cluster-randomized trial with six measurements, approximately 4 months in between. SETTING: SC and DSC-units of Dutch NHs. PARTICIPANTS: NH-patients of seventeen SC-units (n = 342) and sixteen DCS-units (n = 371). MEASUREMENTS: Data were available for 713 NH-patients, 266 of whom died during the study. Apathy was assessed using the 10-item Apathy Evaluation Scale (AES-10) and applied as categorical variable using known cut-off scores as well as dimensional variable. Additionally, depressive symptoms were assessed using the Cornell Scale for Depression in Dementia. RESULTS: Mixed effects cox models using the coxme package in R revealed a higher risk of mortality between two measurements, if apathy was present (hazard ratio (HR) = 1.77; 95% confidence interval (CI] = 1.35-2.31, P < .001). Results remained significant (HR = 1.64; 95% CI = 1.23-2.19, P < .001) when controlled for depressive symptoms. DSC-units and SC-units did not differ (P > .05) in the effect of apathy on mortality. Male gender (HR = 1.67; 95% CI = 1.23-2.27, P < .001), and higher age in years (HR = 1.06; 95% CI = 1.04-1.08, P < .001) were also predictors of mortality. Regarding apathy as a dimensional construct, one standard deviation increase of AES-10 scores was associated with a 62% increase of mortality risk (HR = 1.62, 95% CI = 1.40-1.88, P < .001). CONCLUSIONS: Apathy was associated with mortality over a 4-month period in NH patients, even when controlling for depression. These data suggest that screening and treatment strategies for apathy should be developed for this patient population.
[Mh] Termos MeSH primário: Apatia
Demência/mortalidade
Instituição de Longa Permanência para Idosos
Pacientes Internados/psicologia
Casas de Saúde
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Análise por Conglomerados
Demência/psicologia
Depressão/mortalidade
Depressão/psicologia
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Fatores de Risco
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.15007


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[PMID]:28628541
[Au] Autor:Jang SH; Kwon HG
[Ad] Endereço:From the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
[Ti] Título:Apathy Due to Injury of the Prefrontocaudate Tract Following Mild Traumatic Brain Injury.
[So] Source:Am J Phys Med Rehabil;96(7):e130-e133, 2017 Jul.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this study, we report on a patient who developed apathy resulting from injury to the prefrontocaudate tract following mild traumatic brain injury (TBI), which was observed on diffusion tensor tractography (DTT). A 46-year-old female patient was involved in a bus accident. Her history included intracerebral hemorrhage (ICH) in the left putamen 4 years ago before the head trauma, and her family reported that she had fully recovered. She developed apathy after the TBI, worsening over time. Decreased neural connectivity of the left caudate nucleus (CN) to the left upper medial prefrontal cortex (PFC) resulting from the ICH was observed on the pre-TBI-DTT, whereas on the post-TBI-DTT (28 months after TBI), the neural connectivity of the left CN to the left upper medial PFC was increased, whereas that to the left lower medial PFC and orbitofrontal cortex was decreased. In the right hemisphere, decreased neural connectivity of the CN to the medial PFC and orbitofrontal cortex was observed on the post-TBI-DTT compared with the pre-TBI-DTT. Injury of the prefrontocaudate tract was observed in a patient with old ICH who developed apathy following mild TBI, using DTT.
[Mh] Termos MeSH primário: Apatia
Concussão Encefálica/fisiopatologia
Núcleo Caudado/lesões
Córtex Pré-Frontal/lesões
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Concussão Encefálica/diagnóstico por imagem
Núcleo Caudado/diagnóstico por imagem
Imagem de Tensor de Difusão/métodos
Feminino
Seres Humanos
Meia-Idade
Córtex Pré-Frontal/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000630


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[PMID]:28493898
[Au] Autor:Lohner V; Brookes RL; Hollocks MJ; Morris RG; Markus HS
[Ad] Endereço:Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
[Ti] Título:Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease.
[So] Source:PLoS One;12(5):e0176943, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD), and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed. METHODS: 196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation. Path analysis and binary logistic regression were used to assess the relation between apathy, depression and cognitive impairment. RESULTS: 31 participants with SVD (15.8%) met criteria for apathy only, 23 (11.8%) for both apathy and depression, and 2 (1.0%) for depression only. In the SVD group the presence of apathy was related to global cognition, and specifically to impaired executive functioning/processing speed, but not memory/orientation. The presence of depression was not related to global cognition, impaired executive functioning/processing speed or memory/orientation. CONCLUSIONS: Apathy is a common feature of SVD and is associated with impaired executive functioning/processing speed suggesting the two may share biological mechanisms. Screening for apathy should be considered in SVD, and further work is required to develop and evaluate effective apathy treatment or management in SVD.
[Mh] Termos MeSH primário: Apatia
Doenças de Pequenos Vasos Cerebrais/complicações
Disfunção Cognitiva/etiologia
Depressão/complicações
Função Executiva
[Mh] Termos MeSH secundário: Idoso
Doenças de Pequenos Vasos Cerebrais/fisiopatologia
Cognição
Disfunção Cognitiva/fisiopatologia
Depressão/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176943


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[PMID]:28486594
[Au] Autor:Lansdall CJ; Coyle-Gilchrist ITS; Jones PS; Vázquez Rodríguez P; Wilcox A; Wehmann E; Dick KM; Robbins TW; Rowe JB
[Ad] Endereço:Department of Clinical Neurosciences, University of Cambridge, UK.
[Ti] Título:Apathy and impulsivity in frontotemporal lobar degeneration syndromes.
[So] Source:Brain;140(6):1792-1807, 2017 Jun 01.
[Is] ISSN:1460-2156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Apathy and impulsivity are common and disabling consequences of frontotemporal lobar degeneration. They cause substantial carer distress, but their aetiology remains elusive. There are critical limitations to previous studies in this area including (i) the assessment of either apathy or impulsivity alone, despite their frequent co-existence; (ii) the assessment of behavioural changes within single diagnostic groups; and (iii) the use of limited sets of tasks or questions that relate to just one aspect of these multifactorial constructs. We proposed an alternative, dimensional approach that spans behavioural and language variants of frontotemporal dementia, progressive supranuclear palsy and corticobasal syndrome. This accommodates the commonalities of apathy and impulsivity across disorders and reveals their cognitive and anatomical bases. The ability to measure the components of apathy and impulsivity and their associated neural correlates across diagnostic groups would provide better novel targets for pharmacological manipulations, and facilitate new treatment strategies and strengthen translational models. We therefore sought to determine the neurocognitive components of apathy and impulsivity in frontotemporal lobar degeneration syndromes. The frequency and characteristics of apathy and impulsivity were determined by neuropsychological and behavioural assessments in 149 patients and 50 controls from the PIck's disease and Progressive supranuclear palsy Prevalence and INcidence study (PiPPIN). We derived dimensions of apathy and impulsivity using principal component analysis and employed these in volumetric analyses of grey and white matter in a subset of 70 patients (progressive supranuclear palsy, n = 22; corticobasal syndrome, n = 13; behavioural variant, n = 14; primary progressive aphasias, n = 21) and 27 control subjects. Apathy and impulsivity were present across diagnostic groups, despite being criteria for behavioural variant frontotemporal dementia alone. Measures of apathy and impulsivity frequently loaded onto the same components reflecting their overlapping relationship. However, measures from objective tasks, patient-rated questionnaires and carer-rated questionnaires loaded onto separate components and revealed distinct neurobiology. Corticospinal tracts correlated with patients' self-ratings. In contrast, carer ratings correlated with atrophy in established networks for goal-directed behaviour, social cognition, motor control and vegetative functions, including frontostriatal circuits, orbital and temporal polar cortex, and the brainstem. Components reflecting response inhibition deficits correlated with focal frontal cortical atrophy. The dimensional approach to complex behavioural changes arising from frontotemporal lobar degeneration provides new insights into apathy and impulsivity, and the need for a joint therapeutic strategy against them. The separation of objective tests from subjective questionnaires, and patient from carer ratings, has important implications for clinical trial design.awx101media15448041163001.
[Mh] Termos MeSH primário: Apatia/fisiologia
Degeneração Lobar Frontotemporal/diagnóstico por imagem
Degeneração Lobar Frontotemporal/fisiopatologia
Substância Cinzenta/diagnóstico por imagem
Comportamento Impulsivo/fisiologia
Substância Branca/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Afasia Primária Progressiva/diagnóstico por imagem
Afasia Primária Progressiva/fisiopatologia
Feminino
Demência Frontotemporal/diagnóstico por imagem
Demência Frontotemporal/fisiopatologia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Doença de Pick/diagnóstico por imagem
Doença de Pick/fisiopatologia
Análise de Componente Principal
Paralisia Supranuclear Progressiva/diagnóstico por imagem
Paralisia Supranuclear Progressiva/fisiopatologia
Síndrome
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.1093/brain/awx101


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[PMID]:28472425
[Au] Autor:Barber TR; Lawton M; Rolinski M; Evetts S; Baig F; Ruffmann C; Gornall A; Klein JC; Lo C; Dennis G; Bandmann O; Quinnell T; Zaiwalla Z; Ben-Shlomo Y; Hu MTM
[Ad] Endereço:Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK.
[Ti] Título:Prodromal Parkinsonism and Neurodegenerative Risk Stratification in REM Sleep Behavior Disorder.
[So] Source:Sleep;40(8), 2017 Aug 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Objectives: Rapid eye movement (REM) sleep behavior disorder (RBD) is the most specific marker of prodromal alpha-synucleinopathies. We sought to delineate the baseline clinical characteristics of RBD and evaluate risk stratification models. Methods: Clinical assessments were performed in 171 RBD, 296 control, and 119 untreated Parkinson's (PD) participants. Putative risk measures were assessed as predictors of prodromal neurodegeneration, and Movement Disorders Society (MDS) criteria for prodromal PD were applied. Participants were screened for common leucine-rich repeat kinase 2 (LRRK2)/glucocerebrosidase gene (GBA) gene mutations. Results: Compared to controls, participants with RBD had higher rates of solvent exposure, head injury, smoking, obesity, and antidepressant use. GBA mutations were more common in RBD, but no LRRK2 mutations were found. RBD participants performed significantly worse than controls on Unified Parkinson's Disease Rating Scale (UPDRS)-III, timed "get-up-and-go", Flamingo test, Sniffin Sticks, and cognitive tests and had worse measures of constipation, quality of life (QOL), and orthostatic hypotension. For all these measures except UPDRS-III, RBD and PD participants were equally impaired. Depression, anxiety, and apathy were worse in RBD compared to PD participants. Stratification of people with RBD according to antidepressant use, obesity, and age altered the odds ratio (OR) of hyposmia compared to controls from 3.4 to 45.5. 74% (95% confidence interval [CI] 66%, 80%) of RBD participants met the MDS criteria for probable prodromal Parkinson's compared to 0.3% (95% CI 0.009%, 2%) of controls. Conclusions: RBD are impaired across a range of clinical measures consistent with prodromal PD and suggestive of a more severe nonmotor subtype. Clinical risk stratification has the potential to select higher risk patients for neuroprotective interventions.
[Mh] Termos MeSH primário: Doença de Parkinson/complicações
Sintomas Prodrômicos
Transtorno do Comportamento do Sono REM/complicações
[Mh] Termos MeSH secundário: Idoso
Antidepressivos/farmacologia
Ansiedade
Apatia
Estudos de Casos e Controles
Depressão
Feminino
Seres Humanos
Masculino
Meia-Idade
Mutação/genética
Obesidade
Doença de Parkinson/genética
Doença de Parkinson/fisiopatologia
Doença de Parkinson/psicologia
Fenótipo
Qualidade de Vida
Transtorno do Comportamento do Sono REM/genética
Transtorno do Comportamento do Sono REM/fisiopatologia
Transtorno do Comportamento do Sono REM/psicologia
Medição de Risco
Fumar
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx071


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[PMID]:28426010
[Au] Autor:Knowlton N
[Ad] Endereço:Smithsonian's National Museum of Natural History and co-host of the Earth Optimism Summit in Washington DC.
[Ti] Título:Doom and gloom won't save the world.
[So] Source:Nature;544(7650):271, 2017 04 18.
[Is] ISSN:1476-4687
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Conservação dos Recursos Naturais/métodos
Ecologia/educação
Política Ambiental
Esperança
Otimismo
Pessimismo
Pesquisadores/psicologia
[Mh] Termos MeSH secundário: Pessoal Administrativo/psicologia
Animais
Apatia
Organismos Aquáticos
Biodiversidade
Recifes de Corais
Depressão/prevenção & controle
Ecologia/recursos humanos
Espécies em Perigo de Extinção/legislação & jurisprudência
Extinção Biológica
Pesqueiros/normas
Estudantes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170421
[St] Status:MEDLINE
[do] DOI:10.1038/544271a


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[PMID]:28413709
[Au] Autor:Jacus JP
[Ad] Endereço:Consultations MémoireCentre Hospitalier du val d'AriègeFoix CedexFrance.
[Ti] Título:Awareness, apathy, and depression in Alzheimer's disease and mild cognitive impairment.
[So] Source:Brain Behav;7(4):e00661, 2017 Apr.
[Is] ISSN:2162-3279
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Results from studies on awareness disorders in Alzheimer's disease (AD) are controversial because the methodologies, the "objects" of awareness, and the patients' pathologic stage all vary. Our study aimed to compare scores and correlates of awareness according to the stage of the disease and the assessment method. METHODS: We compared 20 mild AD patients to 20 mild cognitive impairment (MCI) patients, using the (PCRS; patient vs. caregiver report) and the (rating scale). All patients underwent cognitive, psycho-affective and behavioral assessments (global cognition, executive functions, episodic memory, anxiety-depression, and apathy measures). RESULTS: Groups were matched for age, education, and gender. They were comparable on the depression, anxiety, apathy and awareness scales ( s > .05), and differed for all cognitive variables ( < .05). Using the median split approach, greater apathy and lower depression were associated with poorer awareness on the (respectively: odds ratio [OR] = 4.8, = .03; OR = 4.84, = .04), and the PCRS (only apathy: OR = 9.3, = .003). Greater apathy plus lower depression were associated with poorer awareness in both scales (PCRS: OR = 40.5, = .005; Self-consciousness scale: OR = 28, = .012). CONCLUSION: These results evidence comparable awareness between AD and MCI patients. The correlates were more affective and behavioral than cognitive, independently from assessment method.
[Mh] Termos MeSH primário: Doença de Alzheimer/psicologia
Apatia
Conscientização
Disfunção Cognitiva/psicologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cuidadores
Depressão
Escolaridade
Feminino
Seres Humanos
Masculino
Entrevista Psiquiátrica Padronizada
Meia-Idade
Testes Neuropsicológicos
Escalas de Graduação Psiquiátrica
Autorrelato
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE
[do] DOI:10.1002/brb3.661


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[PMID]:28406265
[Au] Autor:Ayers E; Shapiro M; Holtzer R; Barzilai N; Milman S; Verghese J
[Ad] Endereço:Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
[Ti] Título:Symptoms of Apathy Independently Predict Incident Frailty and Disability in Community-Dwelling Older Adults.
[So] Source:J Clin Psychiatry;78(5):e529-e536, 2017 May.
[Is] ISSN:1555-2101
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Although depressive symptoms are widely recognized as a predictor of functional decline among older adults, little is known about the predictive utility of apathy in this population. We prospectively examined apathy symptoms as predictors of incident slow gait, frailty, and disability among non-demented, community-dwelling older adults. METHODS: We examined 2 independent prospective cohort studies-the LonGenity study (N = 625, 53% women, mean age = 75.2 years) and the Central Control of Mobility in Aging (CCMA) study (N = 312, 57% women, mean age = 76.4 years). Individuals were recruited from 2008 to 2014. Apathy was assessed using 3 items from the Geriatric Depression Scale. Slow gait was defined as 1 standard deviation or more below age- and sex-adjusted mean values, frailty was defined using the Cardiovascular Health Study criteria, and disability was assessed with a well-validated disability scale. RESULTS: The prevalence of apathy was 20% in the LonGenity cohort and 26% in the CCMA cohort. The presence of apathy at baseline, independent of depressive symptoms (besides apathy), increased the risk of developing incident slow gait (hazard ratio [HR] = 2.10; 95% CI, 1.36-3.24; P = .001), frailty (HR = 2.86; 95% CI, 1.96-4.16; P < .001), and disability (HR = 3.43; 95% CI, 1.73-6.79; P < .001) in the pooled sample. These associations remained significant when accounting for demographics, medical illnesses, and cognitive function. CONCLUSIONS: Apathy is associated with increased risk of developing slow gait, frailty, and disability, independent of other established risk factors, in non-demented older adults. Apathy should be screened for as a potentially preventable cause of functional decline in clinical psychiatric settings.
[Mh] Termos MeSH primário: Apatia
Avaliação da Deficiência
Idoso Fragilizado/psicologia
Vida Independente/psicologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Coortes
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE



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