Dementia e Neuropsychologia最新文献

{"title":"From stress to cognitive impairment: an integrative model of oxidative and hemorheological mechanisms.","authors":"Marcel Valério de Arruda, Marcelo Bussotti Reyes, Ruth Ferreira Galduróz","doi":"10.1590/1980-5764-DN-2025-0466","DOIUrl":"10.1590/1980-5764-DN-2025-0466","url":null,"abstract":"<p><p>Psychological stress is associated with oxidative stress, which can have profound implications for cognitive functions. The Free Radical Theory of Aging highlights the potential role of accumulated oxidative damage in cellular aging and the development of age-related diseases. This imbalance is linked to alterations in erythrocyte rheology, potentially contributing to reduced blood flow and impaired cardiovascular function. Due to its high metabolic activity and sensitivity to oxidative conditions, the brain is particularly vulnerable to these effects. An integrative pathway is proposed that describes a cascade of interactions from psychological stress to reduced cognitive function. In this model, psychological stress is hypothesized to contribute to hemorheological changes that decrease the availability of oxygen and nutrients to neural tissues, subsequently impacting cognitive performance. Finally, this manuscript is a narrative review that presents a conceptual framework summarized in an integrative figure, highlighting the interplay between oxidative, vascular, and hemorheological mechanisms.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20250466"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifesto by the editors of Brazilian scientific journals in the field of human aging in support of open access to research and publications.","authors":"Patrick Alexander Wachholz, Adriano Pasqualotti, Alfredo Cataldo, Anelise Crippa, Beltrina Côrte, Carla Helena Augustin Schwanke, Einstein Francisco de Camargos, Graciela de Brum Palmeiras, Johannes Doll, Kenio Costa de Lima, Lilian Cristine Hubner, Maria Elisa Gonzalez Manso, Régis Gemerasca Mestriner, Renato Gorga Bandeira de Melo, Ricardo Nitrini, Roberto Alves Lourenço, Sonia Maria Dozzi Brucki, Vanessa Sgnaolin, Renata Eloah de Lucena Ferretti-Rebustini","doi":"10.1590/1980-5764-DN-2026-E001","DOIUrl":"https://doi.org/10.1590/1980-5764-DN-2026-E001","url":null,"abstract":"","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e2026E001"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clock drawing test strategies among older adults with and without cognitive impairment.","authors":"Bárbara Spenciere, Liana Chaves Mendes Dos Santos, Helenice Charchat-Fichman","doi":"10.1590/1980-5764-DN-2025-0458","DOIUrl":"10.1590/1980-5764-DN-2025-0458","url":null,"abstract":"<p><p>In addition to being used as a screening test, the Clock Drawing Test (CDT) has been used to evaluate executive functioning in older adults. Using a new validated scoring method that classifies CDT construction - planning and organizing strategies -, published in a previous article, the strategies used to perform the test in older adults with cognitive impairment were investigated.</p><p><strong>Objective: </strong>Describe and classify the planning strategies used by older adults with cognitive impairment to perform the CDT, using the CDT Strategies scoring method.</p><p><strong>Methods: </strong>The study included 86 older adults, divided into three groups: 45 with mild cognitive impairment, 13 with major cognitive impairment, and 28 controls.</p><p><strong>Results: </strong>The analysis of the results emphasized CDT strategies and the neuropsychological profile of older adults. The subcategories associated with better executive functioning decrease in occurrence as cognitive impairment becomes more pronounced, and the subcategories associated with worse executive functioning increase in frequency.</p><p><strong>Conclusion: </strong>The qualitative analysis proposed by CDT Strategies has clinical utility as a measure of executive functioning.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20250458"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric neurosurgery and the Theory of Mind network: ethics in the suffering, refractory patient.","authors":"Julio César López-Valdés, Alfonso Arellano-Mata, Erik Rodrigo Velásquez-Coria, Daniel Alejandro Vega-Moreno, Laura Mestre-Orozco","doi":"10.1590/1980-5764-DN-2025-0465","DOIUrl":"10.1590/1980-5764-DN-2025-0465","url":null,"abstract":"<p><p>Psychosurgery has evolved from imprecise lesional procedures to targeted stereotactic and neuromodulation interventions, with significant improvements in precision, safety, and ethical governance. Parallel advances in social neuroscience have mapped out the Theory of Mind (ToM) networks that support the attribution of mental states, empathy, and moral judgment. This article examines the historical progression of psychosurgery, links it to the neural correlates of ToM, and proposes a bioethical framework to mitigate risks to a patient's agency and personal identity.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e2025465"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Quick Dementia Rating System (QDRS): diagnostic properties and cutoff values.","authors":"Joana Emilia Senger, Renata Kochhann, Daniel Arnold, Marco Antonio de Bastiani, Ariele Detogni, Neide Maria Bruscato, Emilio Hideyuki Moriguchi, João Senger, Anelise Vivian Fuhr, André Luiz Rodrigues Palmeira, Eduardo Rigon Zimmer, Luiz Antonio Nasi, Sheila Cristina Ouriques Martins, Wyllians Vendramini Borelli","doi":"10.1590/1980-5764-DN-2026-0520","DOIUrl":"10.1590/1980-5764-DN-2026-0520","url":null,"abstract":"<p><p>Dementia underdiagnosis persists because lengthy staging tools hinder routine clinical use. The Quick Dementia Rating System (QDRS) offers a brief, informant-based alternative.</p><p><strong>Objective: </strong>This study validates the Brazilian Portuguese QDRS and establishes optimal cutoff values for diagnostic accuracy.</p><p><strong>Methods: </strong>Individuals from primary care and a secondary memory clinic in Southern Brazil were included. Informants completed the QDRS prior to clinical evaluation. All participants underwent comprehensive neurological and neuropsychological assessment, including the Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCa). Psychometric properties (internal consistency and concurrent validity), diagnostic accuracy, and staging agreement between different diagnostic groups and CDR categories were investigated.</p><p><strong>Results: </strong>A total of 180 participants were included in this study (59 cognitively unimpaired, 63 with mild cognitive impairment [MCI], and 58 with dementia). The QDRS demonstrated excellent internal consistency (Cronbach's α=0.94) and strong concurrent validity with the CDR-Sum of Boxes (p=0.82, p<0.001), MMSE and MoCa scores. Agreement between corresponding QDRS and CDR domains ranged from moderate to good (Intraclass Correlation Coefficient - ICC=0.73-0.89). Diagnostic accuracy for dementia was excellent relative to both clinical diagnosis (cutoff 3.25; Area Under the Curve - AUC=0.98) and CDR staging (cutoff 4.25; AUC=0.97), with sensitivities and specificities exceeding 92%. Staging agreement with the CDR was substantial (weighted Kappa=0.64).</p><p><strong>Conclusion: </strong>The Brazilian Portuguese QDRS is a reliable and efficient instrument for dementia screening and staging. Large-scale testing in clinical practice and population-based research are warranted.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20260520"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the safety of investigational anti-Alzheimer's drugs: a comprehensive meta-analysis in the past to current decade.","authors":"Neelufar Shama Shaik, Harika Balya, Srinivasan Ramamurthy, Balaji Pandiyan, Joel Mart Elias, Suvarnalakshmi Gunturu","doi":"10.1590/1980-5764-DN-2025-0472","DOIUrl":"10.1590/1980-5764-DN-2025-0472","url":null,"abstract":"<p><p>Alzheimer's disease is a progressive illness that results in the degeneration of neurons with considerable burden. The pharmacological treatments for Alzheimer's disease include cholinesterase inhibitors, monoclonal antibodies, NMDA receptor antagonists despite having different adverse drug reactions (ADR) alongside the health benefits. Limited data exists for the complete safety evaluation across different classes of anti-Alzheimer's drugs.</p><p><strong>Objective: </strong>The meta-analysis evaluated the severity, frequency and variability of ADR as a result of Alzheimer's drugs to determine relative safety across various classes.</p><p><strong>Methods: </strong>This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with studies derived from the United States National Library of Medicine (PubMed), Embase, Scopus and ClinicalTrials.gov that focus on randomized controlled trials (RCTs) and observational studies which detailed ADRs of anti-Alzheimer's drugs. Jeffrey's Amazing Statistics Program (JASP) software was used to conduct heterogeneity assessment (I2), risk ratio (RR) and publication bias analysis in addition to meta-regression.</p><p><strong>Results: </strong>31 studies were utilized. The studies with cholinesterase inhibitors exhibited more gastrointestinal ADRs and monoclonal antibodies exhibited amyloid-related imaging abnormalities (ARIA-H and E). The BACE1 inhibitors showed liver toxicity that led to increased patient drug discontinuation. A random-effects model was used for the analysis due to heterogeneity (I²>50%). The meta-regression analysis indicated drug class as a predictor for the type of ADR.</p><p><strong>Conclusion: </strong>The research demonstrates considerable variations in the safety of Alzheimer's drugs that need tailored treatment supported by post-approval monitoring systems. The literature needs extended investigations of safety evaluation as well as practical treatment investigations in actual clinical settings. Unlike conventional reviews focusing solely on currently approved therapies, this study provides a cross-generational analysis of adverse drug reactions across both historical and investigational anti-Alzheimer's agents, offering insights into mechanism-related safety patterns that may inform the development and clinical use of emerging therapies.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20250472"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key pillars of active aging in the context of the Decade of Healthy Ageing (2021-2030): an integrative literature review.","authors":"Michel Siqueira da Silva, Ana Laís Gomes da Silva, Fátima Heloyse Alexandria Firmino da Silva, Maria Caroline Nascimento Pereira da Luz, Vilani Medeiros de Araújo Nunes, Gilson de Vasconcelos Torres","doi":"10.1590/1980-5764-DN-2025-0439","DOIUrl":"10.1590/1980-5764-DN-2025-0439","url":null,"abstract":"<p><p>The number of older adults worldwide has increased significantly, and by 2030 one in six people will be aged 60 years or older. Population aging is a central issue in global health agendas. The Decade of Healthy Ageing (2021-2030) aims to improve the quality of life of older adults.</p><p><strong>Objective: </strong>To identify key pillars associated with active aging within this framework.</p><p><strong>Methods: </strong>Integrative literature review conducted in six stages using the Population-Concept-Context (PCC) strategy. Searches were performed in the United States National Library of Medicine (PubMed), Web of Science, Scopus, and Scientific Electronic Library Online (SciELO), including studies published between 2020 and 2025.</p><p><strong>Results: </strong>Five dimensions were identified: healthy lifestyle behaviors, social engagement and cognitive stimulation, spirituality, socioeconomic determinants, and digital health technologies, linked to autonomy and quality of life.</p><p><strong>Conclusion: </strong>Active aging is a multidimensional process requiring intersectoral and person-centered strategies aligned with public policies. However, the available evidence remains uneven across domains, with a predominance of studies focused on individual behavioral factors.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20250439"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of diabetes, hypertension and obesity with cognitive impairment in adults.","authors":"Sara Beatriz Raimann, Nathalia Avila Dimer, Bárbara Niegia Garcia de Goulart","doi":"10.1590/1980-5764-DN-2025-0471","DOIUrl":"10.1590/1980-5764-DN-2025-0471","url":null,"abstract":"<p><p>Cognitive impairment (CI) is prevalent in aging and affects the functionality and autonomy of individuals. Previous studies have demonstrated its association with metabolic diseases such as diabetes <i>mellitus</i> (DM), systemic arterial hypertension (SAH), hypercholesterolemia, and obesity. Still, the synergic association of these comorbidities in the Brazilian population has not yet been explored. Elucidating the magnitude of the relationship between metabolic diseases and CI informs the planning of more effective health care and attention strategies.</p><p><strong>Objective: </strong>To investigate the association between DM, SAH, hypercholesterolemia and obesity and CI in adults aged 50 years or older.</p><p><strong>Methods: </strong>Cross-sectional population-based study using data from the second wave of the Brazilian longitudinal study of aging - ELSI-Brazil (2019). A total of 6,449 participants with complete data on the variables of interest and who responded directly to the survey were included in the analysis. CI was defined using standardized test z-scores. Exposures were identified through self-reported medical diagnoses and waist circumference measurements.</p><p><strong>Results: </strong>The combination of DM, hypertension, and obesity was associated with a 4% increase in the prevalence of CI. With the addition of hypercholesterolemia, this increase reached 10%. The isolated or combined presence of only two of these conditions was not associated with significant differences.</p><p><strong>Conclusion: </strong>Among people aged 50 and over, CI is more prevalent in those with multiple metabolic alterations. In a scenario of aging and high burden of chronic diseases, the findings reinforce the urgency of integrated prevention and control strategies to contain CI.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20250471"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension and depression coexistence and its association with frailty in older adults: a cross-sectional study.","authors":"María Lucia Mansilla-Rivero, Pedro Jorge Lino-Pomasoncco, Lyanne Valery López-Cosme, Alvaro Micael Ñaña-Cordova, José Francisco Parodi, Fernando Miguel Runzer-Colmenares","doi":"10.1590/1980-5764-DN-2026-0482","DOIUrl":"10.1590/1980-5764-DN-2026-0482","url":null,"abstract":"<p><p>Frailty syndrome is a common condition in older adults, characterized by a decline in physiological reserves and increased vulnerability to stressors. It is particularly prevalent among individuals with comorbidities such as hypertension and depression.</p><p><strong>Objective: </strong>To assess the association between the coexistence of hypertension and depressive symptoms and frailty syndrome in older adults.</p><p><strong>Methods: </strong>This observational, cross-sectional study included 1,492 adults aged ≥60 years from the CEMENA Frailty Study. Depressive symptoms was assessed using the 5-item Yesavage Geriatric Depression Scale. Frailty was measured using the Fried phenotype. Poisson regression models were used to estimate prevalence ratios and their 95% confidence intervals (CI), adjusting for potential confounders such as age, gender, education, and multimorbidity.</p><p><strong>Results: </strong>Of the 1,492 participants, 24.9% (n=372) were classified as frail, and 26.2% (n=391) had both hypertension and depressive symptoms. Their coexistence was significantly associated with frailty (adjusted prevalence ratio=1.90, 95%CI 1.34-2.68, p<0.001). Other factors, including advanced age, multimorbidity, polypharmacy, anxiety symptoms, and neurocognitive impairment, were also associated with frailty.</p><p><strong>Conclusion: </strong>The coexistence of hypertension and depressive symptoms was significantly associated with frailty in older adults. This finding highlights the need for an integrated approach to managing both cardiovascular and mental health conditions in geriatric care. Early identification and treatment of these conditions may help mitigate frailty and improve overall health and quality of life in aging populations.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20260482"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of cognitive training on Lamb-Shaffer syndrome: a case report.","authors":"Gabriel Henrique Velozo Gonçalves, Fernanda Buzzinari Ribeiro de Sá, Nadia Shigaeff","doi":"10.1590/1980-5764-DN-2026-0524","DOIUrl":"10.1590/1980-5764-DN-2026-0524","url":null,"abstract":"<p><p>Lamb-Shaffer Syndrome (LAMSHF) is a rare neurodevelopmental condition caused by haploinsufficiency of the SOX5 gene, characterized by intellectual disability, language impairments, and executive dysfunctions. Few studies have explored therapeutic interventions for this population. This case report describes the cognitive profile and intervention outcomes of a 20-year-old woman diagnosed with LAMSHF. The patient presented with difficulties in attention, memory, language comprehension, and executive functions. A neuropsychological assessment confirmed mild intellectual disability and specific deficits in working memory, attention, and verbal memory. A cognitive training program was conducted targeting working memory and attention. Post-intervention reassessment revealed improvements in working memory, alternating and divided attention, and verbal long-term memory. These findings suggest that non-pharmacological cognitive training may provide improvements in cognitive functioning for individuals with LAMSHF. Given the scarcity of evidence-based treatments for rare neurodevelopmental syndromes, cognitive training may represent a promising therapeutic alternative.</p>","PeriodicalId":39167,"journal":{"name":"Dementia e Neuropsychologia","volume":"20 ","pages":"e20260524"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}