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A relação entre a reserva cognitiva e processos cognitivos no envelhecimento
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Abstract(s)
Enquadramento teórico: O processo de envelhecimento está relacionado com a diminuição de competências de vária ordem, das quais fazem parte as cognitivas, sendo as funções executivas e a memória as primeiras a sofrerem esse declínio. A Reserva Cognitiva (RC) é um constructo hipotético usado que descreve a capacidade do cérebro adulto em lidar com os efeitos de processos neurodegenerativos típicos do envelhecimento e é concebida como uma construção dinâmica. O modelo RC postula que diferenças pessoais ao nível do pensamento cognitivo e da capacidade de reestruturação da atividade neural possibilitam alguns indivíduos a lidar melhor do que outras com o processo de senescência. Este estudo tem com objetivo estudar a relação entre RC e as funções cognitivas no envelhecimento, verificar qual dos indicadores de reserva cognitiva (escolaridade, ocupação laboral ou atividades de lazer) é o melhor preditor.
Metodologia: A amostra de conveniência deste estudo transversal correlacional inclui 40 participantes, com idades compreendidas entre os 65 e os 87 anos. Após entrevista clínica breve, aplicou-se o QRC, o MoCA, o INECO frontal screening, o teste de Stroop, o TMT, o teste de fluência verbal (semântica e fonética), os subtestes Memória I e II da Weschler Memory Scale (WMS) e a Escala de Depressão Geriátrica.
Resultados: Foi possível observar uma relação estatisticamente significativa entre o desempenho cognitivo e o QRC, nomeadamente entre as provas de fluência semântica e as pontuações totais do QRC total e do indicador relativo às atividades de lazer. Foi ainda possível confirmar que quanto maior a RC, melhor desempenho dos participantes, sendo que isso se verificou naqueles que têm RC Média alta.
Discussão: O QRC parece ser um instrumento útil e válido para avaliar a RC de uma forma objetiva, permitindo recolher informação relativamente a grande parte do percurso de vida do indivíduo, ao contrário de outras medidas que apenas se focam no estilo de vida atual. Para além disso, o QRC permite-nos comparar a RC de indivíduos com idades diferentes. O envelhecimento não é forçosamente acompanhado por um declínio cognitivo.
Theoretical Background: The aging process is related with the lack of skills of several order, which the executive functions are the first ones to be affected. The Cognitive Reserve (CR) model holds that differences in cognitive processing and neural compensation mechanisms mean that some people can deal better with cognitive aging than others. Cognitive Reserve (CR) is a hypothetical construct used to obtain information about cognitive aging, which describes the capacity of the adult brain to cope with the effects of neurodegenerative processes and it is conceived as a dynamic construction. This study aims to study the relationship between CR and cognitive functions in aging, to verify which of the indicators of cognitive reserve (education, work occupation or leisure activities) is the best predictor. Method: A convenience sample of 40, 65-87year old individuals, with no relevant history of psychiatric or neurologic disease, took part in this cross-sectional study. Each subject completed the MoCA test, the Stroop test, verbal fluency test (semantic and phonetic), Memory I and II of Wechsler memory Scale and also the Geriatric depression scale. A brief clinical interview was also carried out. Results: It was possible to observe a statistically significant correlation between cognitive performance and QRC_total, specifically between the TFV_S and another one between TFV_F and IRC leisure activities. It was also possible to confirm that, the higher the CR, better the performance of the participants, and this was observed in those with high average CR. Discussion: Conceptually, the QRC seems to be a useful tool to assess CR in an objective manner, gathering information relative to an individual’s lifespan, as opposed to other tools that only consider current lifestyles. CR as measured by the QRC seems to have a protective effect that cannot be explained by education alone, for which reason we conclude that other factors such as professional occupation and participation in leisure activities seem to contribute towards explaining differences in cognitive performance. These results reinforce the need to consider other factors besides education when promoting active aging.
Theoretical Background: The aging process is related with the lack of skills of several order, which the executive functions are the first ones to be affected. The Cognitive Reserve (CR) model holds that differences in cognitive processing and neural compensation mechanisms mean that some people can deal better with cognitive aging than others. Cognitive Reserve (CR) is a hypothetical construct used to obtain information about cognitive aging, which describes the capacity of the adult brain to cope with the effects of neurodegenerative processes and it is conceived as a dynamic construction. This study aims to study the relationship between CR and cognitive functions in aging, to verify which of the indicators of cognitive reserve (education, work occupation or leisure activities) is the best predictor. Method: A convenience sample of 40, 65-87year old individuals, with no relevant history of psychiatric or neurologic disease, took part in this cross-sectional study. Each subject completed the MoCA test, the Stroop test, verbal fluency test (semantic and phonetic), Memory I and II of Wechsler memory Scale and also the Geriatric depression scale. A brief clinical interview was also carried out. Results: It was possible to observe a statistically significant correlation between cognitive performance and QRC_total, specifically between the TFV_S and another one between TFV_F and IRC leisure activities. It was also possible to confirm that, the higher the CR, better the performance of the participants, and this was observed in those with high average CR. Discussion: Conceptually, the QRC seems to be a useful tool to assess CR in an objective manner, gathering information relative to an individual’s lifespan, as opposed to other tools that only consider current lifestyles. CR as measured by the QRC seems to have a protective effect that cannot be explained by education alone, for which reason we conclude that other factors such as professional occupation and participation in leisure activities seem to contribute towards explaining differences in cognitive performance. These results reinforce the need to consider other factors besides education when promoting active aging.
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Keywords
Envelhecimento Envelhecimento cognitivo Reserva cognitiva Mecanismos cognitivos