Navegando por Assunto "Linguagem e memória"
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Dissertação Acesso aberto (Open Access) Efeitos da estimulação multissensorial e cognitiva sobre o declínio cognitivo senil agravado pelo ambiente empobrecido das instituições de longa permanência(Universidade Federal do Pará, 2012-08-27) OLIVEIRA, Thaís Cristina Galdino de; DINIZ, Cristovam Wanderley Picanço; http://lattes.cnpq.br/2014918752636286; DINIZ, Domingos Luiz Wanderley Picanço; http://lattes.cnpq.br/9601463988942971The aim of the present report is to investigate possible impacts of cognitive and multisensory stimulation on the performances of institutionalized and community people in the mini-mental state examination (MMSE) and in language tests. Subjects were divided in two groups paired by years of school and age: 1) institutionalized (n = 25, 76.0 ± 6.9 years old) which inhabit in long-stay institutions and 2) non-institutionalized (n = 17, 74.2 ± 4.0 years old) which inhabit in the community with their families. MMSE was applied to select cognitively healthy volunteers which were subsequently submitted to the stimulation and neuropsychological and language assessments. MMSE and specific language tests, including Boston naming, semantic (VSF) and phonological (PSF) verbal fluencies, Montreal Communication Evaluation Battery (MAC) and the Boston cookie theft picture description task were done. The multisensory and cognitive intervention was applied in groups of 10 volunteers submitted to a series of stimulation sessions twice a week, over six months in a total of 48 sessions. Sessions were based on language and memory exercises, visual, olfactory and auditory stimulus, as well as ludic activities including music, sing and dance. Both groups were assessed at the beginning (before interventions), in the middle (after 24 sessions) and at the end (after 48 sessions) of intervention. As compared to the non-institutionalized (community) group, the institutionalized one showed lower performances in all tasks in all time windows. Each patient was compared with himself using a contrast index (C) that was designed to be able to express performances of all tests in a single (0 -1) scale of cognitive performances. The contrast index was estimated as follow: (C = (D – A) / (D + A), where D corresponds to the scores before stimulation and A after stimulation). All patients improve their performances after intervention and the impact was significantly higher in the institutionalized group. We suggest that the impoverished environment where institutionalized people live is contributing to the lower cognitive scores observed at the first assessment and by the higher impact of the stimulation program in this group. As compared to the classic MMSE neuropsychological test, language tests seem to be much significantly more sensitive to detect early changes in the cognitive status. Taken together the results may have implications for public health policies dedicated to the aged population.Dissertação Acesso aberto (Open Access) Estudo exploratório comparativo do declínio cognitivo senil após estimulação multissensorial e cognitiva em idosos institucionalizados e não institucionalizados(Universidade Federal do Pará, 2014-01-21) MACEDO, Liliane Dias e Dias de; DINIZ, Cristovam Wanderley Picanço; http://lattes.cnpq.br/2014918752636286The objective of this study was to investigate, using selected neuropsychological tests, the duration of the beneficial effects of multisensory and cognitive stimulation program in two groups of elderly living in community or in long term care institutions. The participants were institutionalized (n = 20, 75.1 ± 6.8 years old) and non-institutionalized (n =15, 74.1 ± 3.9 years old; mean ± standard deviation), with 65 years or more with no history of traumatic brain injury, cerebrovascular accident or major depression, minimal visual acuity 20/30 as measured by the Snellen test and regular participation in the program of somato-motor and cognitive stimulation. Revaluations were conducted after completion of multisensory and cognitive intervention, in five consecutive time windows (2, 4, 6, 8 and 12 months). Both elderly groups were submitted to the following tests: Boston naming; semantic and phonological verbal fluencies, Mini Mental State Examination, Narrative Tests based on the picture “The Theft of Biscuits” and selected tests of the Montreal Battery of Evaluation of Communication, and of the Cambridge Neuropsychological Test Battery (CANTAB). CANTAB tests included Motor Screening Test; Rapid Visual Information Processing; Reaction Time; Paired Associated Learning - PAL; Spatial Working Memory - SWM, and delayed matching to sample. As compared with non-institutionalized a higher rate of cognitive decline was observed in the institutionalized elderly. These results are in line with previous report that associated the poor environmental stimuli of long-term care institutions with faster aging cognitive decline. Furthermore, the ROC analysis indicated a higher specificity, selectivity and efficiency for PAL and SWM tests of the CANTAB battery. as well as memory space for work efficiency allowing the distinction between I and NI groups at all-time windows. The results demonstrated gradual cognitive decline after ended the stimulation program in both groups, with earlier and more severe losses in institutionalized elderly than in those living in the community with their families. The duration of the beneficial effects were closely related to the nature of the workshops and therefore the scores of language tests declined more slowly. The results are of interest to the planner of public policies to recommend regular programs of somato-motor and cognitive stimulation for elderly to reduce the progression of aging cognitive decline.
