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DOI: 10.1055/s-0042-1759760
High performance older adults in a population-based sample with low education: Pietà study
Idosos de alta performance cognitiva em uma amostra de base populacional com baixa escolaridade: estudo Pietà
Abstract
Background Healthy brain aging can be defined as aging without neurological or psychiatric disorders, sustaining functional independence. In addition to the absence of disease and preserved functionality, there are individuals who stand out for their superior performance to that considered normal for their age in cognitive tests. These individuals are called “high-performance older adults” (HPOA).
Objectives To investigate the presence of HPOA in an oldest-old population with low education, and if present, to investigate associations with sociodemographic, clinical, and lifestyle variables.
Methods We evaluated 132 cognitively healthy individuals from the Pietà Study, a population-based investigation with 639 participants. We used the delayed recall from the Rey Auditory-Verbal Learning Test to verify the existence of HPOA and to classify participants based on their performance. Sociodemographic, clinical, and lifestyle variables associated with HPOA were investigated.
Results We identified 18 individuals fulfilling HPOA criteria (age: 77.4 ± 2.6 years old; 14 women; education: 4.6 ± 3.4 years). The other participants, 114 total (age: 79.8 ± 4.5 years old; 69 women; education: 3.0 ± 2.7 years) were classified as “standard performance older adults” (SPOA). In multivariate analysis, younger age (odds ratio [OR] = 0.672; 95% confidence interval [CI]: 0.462–0.979; p = 0.037) and lower scores on the Geriatric Depression Scale (OR = 0.831; 95%CI: 0.688–0.989; p = 0.038) were associated with HPOA.
Conclusions The present study identifies for the first time HPOA with low educational level, thereby reinforcing the existence of biological substrates related to this condition. Furthermore, the data suggest an association between younger age and less depressive symptoms with HPOA.
Resumo
Antecedentes Envelhecimento cerebral saudável pode ser definido como envelhecimento sem transtornos neurológicos ou psiquiátricos e com independência funcional. Além da ausência de doença e funcionalidade preservada, existem indivíduos que se destacam pelo desempenho superior ao normal em testes cognitivos. Estes indivíduos são chamados de “high performance older adults” (HPOA, na sigla em inglês).
Objetivos Investigar a presença de HPOA em uma população de idosos com baixa escolaridade e, se presente, investigar associações com variáveis sociodemográficas, clínicas e de estilo de vida.
Métodos Avaliamos 132 indivíduos cognitivamente saudáveis do Estudo Pietà (n = 639). Foi utilizado o Teste de Aprendizagem Auditivo-Verbal de Rey para verificar a existência de HPOA e classificar os participantes em dois grupos com base em seu desempenho. Variáveis sociodemográficas, clínicas e de estilo de vida associadas a HPOA foram investigadas.
Resultados Identificamos 18 indivíduos que preencheram critérios para HPOA (idade: 77,4 ± 2,6 anos; 14 mulheres; escolaridade: 4,6 ± 3,4 anos). Os demais, 114 no total (idade: 79,8 ± 4,5 anos; 69 mulheres; escolaridade: 3,0 ± 2,7 anos), foram classificados como “standard performance older adults” (SPOA, na sigla em inglês). Na análise multivariada, menor idade (odds ratio [OR] = 0,672; intervalo de confiança [IC] 95%: 0,462–0,979; p = 0,037) e menor pontuação na Escala de Depressão Geriátrica (OR = 0,831; IC95%: 0,688–0,989; p = 0,038) foram associados ao grupo HPOA.
Conclusões O presente estudo identifica pela primeira vez HPOA entre indivíduos de baixa escolaridade, reforçando a existência de substratos biológicos relacionados a esta condição. Além disso, os dados sugerem uma associação entre idade mais jovem e menos sintomas depressivos com HPOA.
Palavras-chave
Envelhecimento - Memória - Envelhecimento Saudável - Depressão - Idoso - EscolaridadeAuthors' Contributions
KCC, PC: data analysis and writing; EPFR, HCG, THM, VAC, ELS, MTB: review and editing; All authors: data collection, approval of the final version.
Support
The Pietà study was supported by grants from CNPQ and FAPEMIG, Brazil. Paulo Caramelli is supported by CNPq, Brazil (productivity in research grant).
Publication History
Received: 07 March 2022
Accepted: 05 June 2022
Article published online:
22 March 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Rogalski EJ, Gefen T, Shi J. et al. Youthful memory capacity in old brains: anatomic and genetic clues from the Northwestern SuperAging Project. J Cogn Neurosci 2013; 25 (01) 29-36 DOI: 10.1162/jocn_a_00300.
- 2 Sun FW, Stepanovic MR, Andreano J, Barrett LF, Touroutoglou A, Dickerson BC. Youthful Brains in Older Adults: Preserved Neuroanatomy in the Default Mode and Salience Networks Contributes to Youthful Memory in Superaging. J Neurosci 2016; 36 (37) 9659-9668 DOI: 10.1523/JNEUROSCI.1492-16.2016.
- 3 Borelli WV, Carmona KC, Studart-Neto A, Nitrini R, Caramelli P, da Costa JC. Operationalized definition of older adults with high cognitive performance. Dement Neuropsychol 2018; 12 (03) 221-227 DOI: 10.1590/1980-57642018dn12-030001.
- 4 Borelli WV, Schilling LP, Radaelli G. et al. Neurobiological findings associated with high cognitive performance in older adults: a systematic review. Int Psychogeriatr 2018; 30 (12) 1813-1825 DOI: 10.1017/S1041610218000431.
- 5 Harrison TM, Weintraub S, Mesulam MM, Rogalski E. Superior memory and higher cortical volumes in unusually successful cognitive aging. J Int Neuropsychol Soc 2012; 18 (06) 1081-1085 DOI: 10.1017/S1355617712000847.
- 6 Gefen T, Peterson M, Papastefan ST. et al. Morphometric and histologic substrates of cingulate integrity in elders with exceptional memory capacity. J Neurosci 2015; 35 (04) 1781-1791 DOI: 10.1523/JNEUROSCI.2998-14.2015.
- 7 Cook Maher A, Kielb S, Loyer E. et al. Psychological well-being in elderly adults with extraordinary episodic memory. PLoS One 2017; 12 (10) e0186413 DOI: 10.1371/journal.pone.0186413.
- 8 Calandri IL, Crivelli L, Martin ME, Egido N, Guimet NM, Allegri RF. Environmental factors between normal and superagers in an Argentine cohort. Dement Neuropsychol 2020; 14 (04) 345-349 DOI: 10.1590/1980-57642020dn14-040003.
- 9 Caramelli P, Barbosa MT, Sakurai E. et al; Pietà Study Group. The Pietà study: epidemiological investigation on successful brain aging in Caeté (MG), Brazil. Methods and baseline cohort characteristics. Arq Neuropsiquiatr 2011; 69 (04) 579-584 DOI: 10.1590/S0004-282X2011000500002.
- 10 Associação Brasileira de Empresas de Pesquisa (ABEP). Critério de Classificação Econômica Brasil - 2003 http://www.abep.org
- 11 Fleck MP, Chachamovich E, Trentini C. Development and validation of the Portuguese version of the WHOQOL-OLD module. Rev Saude Publica 2006; 40 (05) 785-791 DOI: 10.1590/s0034-89102006000600007.
- 12 Ramos LR, Toniolo J, Cendoroglo MS. et al. Two-year follow-up study of elderly residents in S. Paulo, Brazil: methodology and preliminary results. Rev Saude Publica 1998; 32 (05) 397-407 DOI: 10.1590/s0034-89101998000500001.
- 13 Masur J, Monteiro MG. Validation of the “CAGE” alcoholism screening test in a Brazilian psychiatric inpatient hospital setting. Braz J Med Biol Res 1983; 16 (03) 215-218
- 14 Fahn S, Elton R. Members of the UPDRS Development Committee. In: Fahn S, Marsden CD, Calne DB, Goldstein M. eds. Recent Developments in Parkinson's Disease, Vol 2. Florham Park, NJ.: Macmillan Health Care Information; 1987. :15 3–163, 293–304
- 15 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (03) 189-198
- 16 Nitrini R, Lefèvre BH, Mathias SC. et al. Testes neuropsicológicos de aplicação simples para o diagnóstico de demência. Arq Neuropsiquiatr 1994; 52 (04) 457-465
- 17 Pfeffer RI, Kurosaki TT, Harrah Jr CH, Chance JM, Filos S. Measurement of functional activities in older adults in the community. J Gerontol 1982; 37 (03) 323-329
- 18 Reisberg B. Functional assessment staging (FAST). Psychopharmacol Bull 1988; 24 (04) 653-659
- 19 Almeida OP, Almeida SA. Confiabilidade da versão brasileira da escala de depressão em geriatria (GDS) versão reduzida. Arq Neuropsiquiatr 1999; 57 (2B): 421-426 DOI: 10.1590/S0004-282X1999000300013.
- 20 Lecrubier Y, Sheehan D, Weiller E. et al. The Mini International Neuropsychiatric Interview (M.I.N.I.), a short diagnostic interview: reliability and validity according to the CIDI. Eur Psychiatry 1997; 12: 232-241
- 21 Porto CS, Fichman HC, Caramelli P, Bahia VS, Nitrini R. Brazilian version of the Mattis dementia rating scale: diagnosis of mild dementia in Alzheimer's disease. Arq Neuropsiquiatr 2003; 61 (2B): 339-345 DOI: 10.1590/s0004-282X2003000300004.
- 22 Chaves ML, Camozzato AL, Godinho C. et al. Validity of the clinical dementia rating scale for the detection and staging of dementia in Brazilian patients. Alzheimer Dis Assoc Disord 2007; 21 (03) 210-217 DOI: 10.1097/WAD.0b013e31811ff2b4.
- 23 Bertolucci PH, Okamoto IH, Brucki SM, Siviero MO, Toniolo Neto J, Ramos LR. Applicability of the CERAD neuropsychological battery to Brazilian elderly. Arq Neuropsiquiatr 2001; 59 (3-A): 532-536 DOI: 10.1590/s0004-282X2001000400009.
- 24 Beato RG, Nitrini R, Formigoni AP, Caramelli P. Brazilian version of the Frontal Assessment Battery (FAB): Preliminary data on administration to healthy elderly. Dement Neuropsychol 2007; 1 (01) 59-65 DOI: 10.1590/S1980-57642008DN10100010.
- 25 Malloy-Diniz LF, Lasmar VA, Gazinelli LdeS, Fuentes D, Salgado JV. The Rey Auditory-Verbal Learning Test: applicability for the Brazilian elderly population. Rev Bras Psiquiatr 2007; 29 (04) 324-329 DOI: 10.1590/s1516-44462011005000007.
- 26 Magalhães SS, Hamdan AC. The Rey Auditory Verbal Learning Test: Normative data for the Brazilian population and analysis of the influence of demographic variables. Psychol Neurosci 2010; 3 (01) 85-91 DOI: 10.3922/j.psns.2010.1.011.
- 27 SPSS Inc., Chicago IL, USA
- 28 Livingston G, Sommerlad A, Orgeta V. et al. Dementia prevention, intervention, and care. Lancet 2017; 390 (10113): 2673-2734 DOI: 10.1016/s0140-6736(17)31363-6.
- 29 Yaffe K, Fiocco AJ, Lindquist K. et al; Health ABC Study. Predictors of maintaining cognitive function in older adults: the Health ABC study. Neurology 2009; 72 (23) 2029-2035 DOI: 10.1212/WNL.0b013e3181a92c36.
- 30 Goveas JS, Rapp SR, Hogan PE. et al. Predictors of Optimal Cognitive Aging in 80+ Women: The Women's Health Initiative Memory Study. J Gerontol A Biol Sci Med Sci 2016; 71 (Suppl. 01) S62-S71 DOI: 10.1093/gerona/glv055.
- 31 Chang YH, Liu ME, Huang CC. et al. Cognitive performance in older elderly men with late-life depression and cardiovascular comorbidities: symptomatological correlation. Ann Gen Psychiatry 2013; 12 (01) 36 DOI: 10.1186/1744-859X-12-36.
- 32 Dias FLDC, Teixeira AL, Guimarães HC. et al. Cognitive performance of community-dwelling oldest-old individuals with major depression: the Pietà study. Int Psychogeriatr 2017; 29 (09) 1507-1513 DOI: 10.1017/S1041610217000850.