LIM/66 - Laboratório de Investigação Médica em Envelhecimento
URI Permanente desta comunidade
O Laboratório de Investigação Médica em Envelhecimento é ligado ao Departamento de Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Linhas de pesquisa: bases epidemiológicas do envelhecimento; capacidade intrínseca; fragilidade; sarcopenia; condições agudas e críticas no envelhecimento; bases educacionais no envelhecimento; promoção do envelhecimento saudável.
Site oficial: http://lim-66-laboratorio-de-investigacao-medica-em-envelhecimento/
Linhas de pesquisa: bases epidemiológicas do envelhecimento; capacidade intrínseca; fragilidade; sarcopenia; condições agudas e críticas no envelhecimento; bases educacionais no envelhecimento; promoção do envelhecimento saudável.
Site oficial: http://lim-66-laboratorio-de-investigacao-medica-em-envelhecimento/
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- LIM/66 - Laboratório de Investigação Médica em Envelhecimento
- LIM/66 - Laboratório de Investigação Médica em Envelhecimento
- LIM/66 - Laboratório de Investigação Médica em Envelhecimento
Submissões Recentes
Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms
(2023) SILVA, V. C.; DIAS, A. S.; GREVE, J. M. D.; DAVIS, C. L.; SOARES, A. L. D. S.; BRECH, G. C.; AYAMA, S.; JACOB-FILHO, W.; BUSSE, A. L.; BIASE, M. E. M. de; CANONICA, A. C.; ALONSO, A. C.
The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.
Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study
(2023) SILVA, E. C. G. E.; SCHMITT, A. C. B.; GODOY, C. G. de; OLIVEIRA, D. B. de; TANAKA, C.; TOUFEN, C. Jr.; CARVALHO, C. R. R. de; CARVALHO, C. R. F.; FU, C.; HILL, K. D.; POMPEU, J. E.
(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients’ medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients’ reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.
Aging predictive factors for oxygenation response and mortality in COVID-19 and acute respiratory distress syndrome (ARDS) patients exposed to prone position: A multicenter cohort study
(2023) CABRAL, Marieta; CUNHA, Amaral; LUNARDI, Adriana C.; SCHARDONG, Jociane; RIGHI, Natiele C.; SANT'ANNA, Guadalupe N.; ISENSEE, Larissa P.; XAVIER, Rafaela F.; POMPEU, Jose E.; WEIGERT, Ranata M.; MATTE, Darlan L.; CARDOSO, Rozana A.; ABRAS, Ana C. V.; SILVA, Antonio M. V.; DORNELES, Camila C.; WERLE, Roberta W.; STARKE, Ana C.; PLENTZ, Rodrigo D. M.; FERREIRA, Juliana C.; CARVALHO, Celso R. F.
The impact of the COVID-19 pandemic on delivering post-acute care in a low- to middle-income country
(2023) ALIBERTI, Marlon Juliano Romero; LEVITES, Marcelo Rozenfeld; BERARDO, Frederico Alberto Nogueira
Aerobic Exercise Modulates Visceral Adipose Tissue of Estrogen Deprived Rats in an Experimental Model of Dyslipidemia
(2024) MAGALHAES, Walkyria Villegas; CHUCATA, Kemily Loren Barros; DSOUKI, Nuha Ahmad; NUCCI, Ricardo Aparecido Baptista; VELOSO, Aparecida Gabriela Bexiga; FONSECA, Fernando Luiz Affonso; MAIFRINO, Laura Beatriz Mesiano
Introduction Menopausal women have an increase deposition of body fat and changes in the lipid profile, being especially susceptible to cardiovascular diseases, and type 2 diabetes. However, physical activity can mitigate this situation. Thus, the aim of the present study is to evaluate the effects of moderate aerobic exercise on visceral adipose tissue (VAT) of female LDL-receptor knockout ovariectomized mice.Methods We used 48 animals, divided into six groups ( n = 8/per group): sedentary control (SC), sedentary ovariectomized control (SCO), trained ovariectomized control (TCO), sedentary non-ovariectomized LDL-receptor knockout (KS), sedentary ovariectomized LDL-receptor knockout (KOS), and trained LDL-receptor knockout ovariectomized (KOT). We analyzed the VAT through morphometric and stereological parameters in hematoxylin and eosin stained sections. Additionally, we evaluated biochemical parameters as glucose, triglycerides, and total cholesterol. Finally, immunohistochemical techniques for matrix remodeling, inflammation, apoptosis, and oxidative stress were evaluated. Results We observed that menopause is related to increased visceral adiposity, inflammation, oxidative stress, macrophages activity, serum levels of glucose, triglycerides, and total cholesterol. However, exercise was effective in reducing these parameters, as well as being associated with increased vascularization of VAT and interstitial volume density. Conclusions Moderate exercise is a key factor in mitigating the effects of dyslipidemia in estrogen deprivation. However, further studies are needed to corroborate with our findings.
Association between APOE-ε4 allele and cognitive function is mediated by Alzheimer's disease pathology: a population-based autopsy study in an admixed sample
(2023) PARADELA, Regina Silva; JUSTO, Alberto Fernando Oliveira; PAES, Vitor Ribeiro; LEITE, Renata E. P.; PASQUALUCCI, Carlos A.; GRINBERG, Lea T.; NASLAVSKY, Michel Satya; ZATZ, Mayana; NITRINI, Ricardo; JACOB-FILHO, Wilson; SUEMOTO, Claudia Kimie
Background: Apolipoprotein E epsilon 4 allele (APOE-epsilon 4) is the main genetic risk factor for late-onset Alzheimer's disease (AD) and may impact cognitive function also via other neuropathological lesions. However, there is limited evidence available from diverse populations, as APOE associations with dementia seem to differ by race. Therefore, we aimed to evaluate the pathways linking APOE-epsilon 4 to cognitive abilities through AD and non-AD neuropathology in an autopsy study with an admixed sample.Methods: Neuropathological lesions were evaluated following international criteria using immunohistochemistry. Participants were classified into APOE-epsilon 4 carriers (at least one epsilon 4 allele) and non-carriers. Cognitive abilities were evaluated by the Clinical Dementia Rating Scale sum of boxes. Mediation analyses were conducted to assess the indirect association of APOE-epsilon 4 with cognition through AD-pathology, lacunar infarcts, hyaline arteriosclerosis, cerebral amyloid angiopathy (CAA), Lewy body disease (LBD), and TAR DNA-binding protein 43 (TDP-43).Results: We included 648 participants (mean age 75 +/- 12 years old, mean education 4.4 +/- 3.7 years, 52% women, 69% White, and 28% APOE-epsilon 4 carriers). The association between APOE-epsilon 4 and cognitive abilities was mediated by neurofibrillary tangles (beta = 0.88, 95% CI = 0.45; 1.38, p < 0.001) and neuritic plaques (beta = 1.36, 95% CI = 0.86; 1.96, p < 0.001). Lacunar infarcts, hyaline arteriosclerosis, CAA, LBD, and TDP-43 were not mediators in the pathway from APOE-epsilon 4 to cognition.Conclusion: The association between APOE-epsilon 4 and cognitive abilities was partially mediated by AD-pathology. On the other hand, cerebrovascular lesions and other neurodegenerative diseases did not mediate the association between APOE-epsilon 4 and cognition.
Aren't you forgetting something? Cognitive screening beyond delirium in the emergency department
(2023) MORAES, Gabriel Stanziola de; CURIATI, Pedro K.; AVELINO-SILVA, Thiago Junqueira; MORINAGA, Christian V.; APOLINARIO, Daniel; SUEMOTO, Claudia Kimie; ALIBERTI, Marlon Juliano Romero
Untangle the relationship of muscle mass and bone mineral content on handgrip strength: Results of ELSA-Brasil
(2023) TAVARES, Nayranne Hivina Carvalho; RODRIGUES, Brena Custodio; ARRUDA, Soraia P. M.; SZLEJF, Claudia; SUEMOTO, Claudia Kimie; GRIEP, Rosane Harter; DINIZ, Maria de F. H. S.; GIATTI, Luana; BARRETO, Sandhi M.; FORTUNATO, Larissa
The study aims to investigate the independent association of muscle mass (MM) and bone mineral content (BMC) in the performance of the handgrip strength (HGS) test and whether there is effect modification by sex and age. In 12,491 participants from the ELSA-Brasil we estimated the associations between MM, BMC and HGS using linear regression models. All the analyses were performed for total population, also stratified for sex and age. For total population an interaction term was included between each explanatory variable of interest with sex and age to verify the presence of effect modification. We observed that the higher quintiles of MM and BMC were associated to an increasing in the mean of HGS compared to the first quintile, with greater magnitudes in men compared to women, also adults compared to elderly. When we estimated the independent effect of each exposure of interest, MM showed stronger effect in HGS in women, men and adults then BMC. In conclusion, we observed that higher amounts of MM and BMC are associated with higher HGS, regardless of sociodemographic characteristics, health conditions and lifestyle, with this effect being greater in men and adults.
Risk factors for dementia in Brazil: Differences by region and race
(2023) SUEMOTO, Claudia K.; MUKADAM, Naaheed; BRUCKI, Sonia M. D.; CARAMELLI, Paulo; NITRINI, Ricardo; LAKS, Jerson; LIVINGSTON, Gill; FERRI, Cleusa P.
Introduction Twelve risk factors (RFs) account for 40% of dementia cases worldwide. However, most data for population attributable fractions (PAFs) are from high-income countries (HIC). We estimated how much these RFs account for dementia cases in Brazil, stratifying estimates by race and socioeconomic level. Methods We calculated the prevalence and communalities of 12 RFs using 9412 Brazilian Longitudinal Study of Aging participants, then stratified according to self-reported race and country macro-regions. Results The overall weighted PAF was 48.2%. Less education had the largest PAF (7.7%), followed by hypertension (7.6%), and hearing loss (6.8%). PAF was 49.0% and 54.0% in the richest and poorest regions, respectively. PAFs were similar among White and Black individuals (47.8% and 47.2%, respectively) but the importance of the main RF varied by race. Discussion Brazil's potential for dementia prevention is higher than in HIC. Education, hypertension, and hearing loss should be priority targets.
Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study
(2024) BICALHO, Maria Aparecida Camargos; ALIBERTI, Marlon Juliano Romero; DELFINO-PEREIRA, Polianna; CHAGAS, Victor Schulthais; ROSA, Patryk Marques da Silva; PIRES, Magda Carvalho; RAMOS, Lucas Emanuel Ferreira; BEZERRA, Adriana Falangola Benjamin; FERES, Ana Beatriz de Castro; GOMES, Angelica Gomides dos Reis; BHERING, Angelinda Rezende; PESSOA, Bruno Porto; SILVA, Carla Thais Candida Alves da; CIMINI, Christiane Correa Rodrigues; SUEMOTO, Claudia Kimie; DIAS, Cristiana Andrade Coelho; CARAZAI, Daniela dos Reis; PONCE, Daniela; RIOS, Danyelle Romana Alves; MANENTI, Euler; ANSCHAU, Fernando; BATISTA, Joanna d'Arc Lyra; ALVARENGA, Joice Coutinho de; VIGUINI, Julia Avancini; ZANELLATO, Julia Mariot; RUGOLO, Juliana Machado; RUSCHEL, Karen Brasil; NASCIMENTO, Leticia do; MENEZES, Luanna Silva Monteiro; OLIVEIRA, Lucas Moyses Carvalho de; CASTRO, Luis Cesar de; NASI, Luiz Antonio; CARNEIRO, Marcelo; FERREIRA, Maria Angelica Pires; GODOY, Mariana Frizzo de; GUIMARAES-JUNIOR, Milton Henriques; OLIVEIRA, Neimy Ramos de; ZIEGELMANN, Patricia Klarmann; PORTO, Paula Fonseca; MENDES, Paulo Mascarenhas; PARAISO, Pedro Gibson; REIS, Priscilla Pereira dos; FRANCISCO, Saionara Cristina; ARAUJO, Silvia Ferreira; AVELINO-SILVA, Thiago Junqueira; MARCOLINO, Milena Soriano
Background Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia.Methods This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged >= 60 years admitted to 38 hospitals from 19 cities in Brazil. Data were obtained from electronic hospital records. A propensity score analysis was used to match patients with and without dementia (up to 3:1) according to age, sex, comorbidities, year, and hospital of admission. Our primary outcome was in-hospital mortality. We also assessed admission to the intensive care unit (ICU), invasive mechanical ventilation (IMV), kidney replacement therapy (KRT), sepsis, nosocomial infection, and thromboembolic events.Results Among 1,556 patients included in the study, 405 (4.5%) had a diagnosis of dementia and 1,151 were matched controls. When compared to matched controls, patients with dementia had a lower frequency of dyspnoea, cough, myalgia, headache, ageusia, and anosmia; and higher frequency of fever and delirium. They also had a lower frequency of ICU admission (32.7% vs. 47.1%, p < 0.001) and shorter ICU length of stay (7 vs. 9 days, p < 0.026), and a lower frequency of sepsis (17% vs. 24%, p = 0.005), KRT (6.4% vs. 13%, p < 0.001), and IVM (4.6% vs. 9.8%, p = 0.002). There were no differences in hospital mortality between groups.Conclusion Clinical manifestations of COVID-19 differ between older inpatients with and without dementia. We observed that dementia alone could not explain the higher short-term mortality following severe COVID-19. Therefore, clinicians should consider other risk factors such as acute morbidity severity and baseline frailty when evaluating the prognosis of older adults with dementia hospitalised with COVID-19.