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O declínio cognitivo na Esclerose Múltipla Surto-Remissão
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Advisor(s)
Abstract(s)
A Esclerose Múltipla (EM) é uma doença crónica, inflamatória e degenerativa, com impacto no Sistema Nervoso Central (SPEM, 2018). A disfunção cognitiva, a presença de sintomatologia depressiva e ansiosa, a escolha de estratégias de coping disfuncionais e níveis mais reduzidos de qualidade de vida têm sido reportados nestes pacientes. Objetivo: O principal objetivo deste estudo foi analisar a influência da reserva cognitiva, da sintomatologia ansiosa e depressiva, da qualidade de vida e das estratégias de coping, no declínio cognitivo em pacientes portugueses de EM do tipo surto-remissão. Método: Esta investigação contou com 23 participantes com EM do tipo surto remissão. Cada participante foi sujeito a uma avaliação neuropsicológica direcionada para o funcionamento executivo e mnésico. O declínio cognitivo foi calculado pela subtração do índice de Inteligência Pré-Mórbida às pontuações obtidas em cada teste cognitivo. Resultados: Evidenciou-se um maior declínio nas funções executivas e mnésicas. É sugerido que os pacientes de EM que denotam um maior declínio cognitivo são os menos escolarizados, que se envolvem em menos atividades de lazer, que apresentam uma pior perceção de QV, maior sintomatologia depressiva e ansiosa e que adotam estratégias de coping menos focadas na resolução do problema. Complementarmente, uma melhor QV parece associar-se a um menor índice de sintomatologia ansiosa e depressiva, uma menor adoção de estratégias de coping que procuram evitar o problema e a uma maior RC. Conclusão: Uma deteção precoce de disfunção cognitiva e de sintomatologia ansiogénica e depressiva, revela-se essencial, bem como um acompanhamento atento que instrua o paciente e promova a sua qualidade de vida. Um maior envolvimento dos pacientes em atividades dinâmicas e sociais poderá ser uma mais valia.
Multiple Sclerosis (MS) is a chronic, inflammatory, and degenerative disease, with an impact on Central Nervous System (SPEM, 2018). It has frequently been reported in these patients, the presence of cognitive impairment, anxiety and depression, the adoption of maladaptive coping strategies and a lower quality of life. Objectives: The main aim of this study is to analyse the impact of cognitive reserve, anxiety, depression, quality of life and coping strategies on cognitive decline in Portuguese patients with relapsing remitting MS. Methods: 23 patients of relapsing remitting MS participated in this study. A neuropsychological evaluation focusing on executive function and memory was performed for every patient. The cognitive decline was calculated by subtracting the estimate of premorbid intelligence from the scores of each cognitive ability considered. Results: The executive functioning and memory were found to be the most declined abilities. It is suggested that more impaired MS patients are the ones less educated, that enrol in less leisure activities, present a worse perception of quality of life, higher levels of depression and anxiety and use coping strategies less focused on problem solving. Moreover, a better quality of life seems to be associated with lower levels of depression and anxiety, less adoption of coping strategies that avoid problem solving and to a higher cognitive reserve. Conclusion: An early diagnose of cognitive disfunction, anxiety and depression is shown to be crucial, as well as a careful monitoring that educates the patient and promotes his/her quality of life. A greater involvement of patients in dynamic and social activities could be beneficial.
Multiple Sclerosis (MS) is a chronic, inflammatory, and degenerative disease, with an impact on Central Nervous System (SPEM, 2018). It has frequently been reported in these patients, the presence of cognitive impairment, anxiety and depression, the adoption of maladaptive coping strategies and a lower quality of life. Objectives: The main aim of this study is to analyse the impact of cognitive reserve, anxiety, depression, quality of life and coping strategies on cognitive decline in Portuguese patients with relapsing remitting MS. Methods: 23 patients of relapsing remitting MS participated in this study. A neuropsychological evaluation focusing on executive function and memory was performed for every patient. The cognitive decline was calculated by subtracting the estimate of premorbid intelligence from the scores of each cognitive ability considered. Results: The executive functioning and memory were found to be the most declined abilities. It is suggested that more impaired MS patients are the ones less educated, that enrol in less leisure activities, present a worse perception of quality of life, higher levels of depression and anxiety and use coping strategies less focused on problem solving. Moreover, a better quality of life seems to be associated with lower levels of depression and anxiety, less adoption of coping strategies that avoid problem solving and to a higher cognitive reserve. Conclusion: An early diagnose of cognitive disfunction, anxiety and depression is shown to be crucial, as well as a careful monitoring that educates the patient and promotes his/her quality of life. A greater involvement of patients in dynamic and social activities could be beneficial.
Description
Keywords
Esclerose múltipla Declínio cognitivo Qualidade de vida Ansiedade Depressão Coping