Desempenho cognitivo de idosos residentes em cidade do interior de Minas Gerais

Abstract

Investigation of health impairments in older adults has increased its relevance to guide interventions and policies for prevention, habilitation or rehabilitation on different functions of the body, including cognition. It is relevant to know cognitive performance at this stage of development and the personal and environmental factors that influence it, to reduce the impact on functionality and increase the social participation and quality of life of elderly. The objective of this dissertation was to investigate the cognitive functioning of older adults in Uberaba, Minas Gerais. Two studies were conducted. Study 1 sought to investigate sociodemographic factors associated with cognitive performance of older adults. The sample size was calculated for a systematic random sample, considering an error of 5% and 95% confidence. Two hundred and thirty older adults met the inclusion and exclusion criteria and, of these, 130 older adults answered the Neupsilin, a brief neuropsychological assessment instrument, to verify their cognitive performance, and constituted the study sample. Descriptive analyses, a bivariate analysis (chi-squared) between the variables of the sample and cognitive variables, and a multivariate analysis, binary logistic regression, were adopted. Those associated (p < 0.05) or close to statistical significance (p < 0.20) in bivariate analysis were included in multivariate analysis. Those with p < 0.05 in the final model were considered factors associated with cognitive deficits. The results indicated that having a physical illness is associated with deficits in temporospatial orientation and attention. It was evidenced that having visual impairments is associated with arithmetic and praxic deficits. It is concluded that there are personal factors associated with a greater chance of cognitive deficits among the elderly. These results can guide the management of these factors in interventions to prevent deficits. Faced with recent evidence of cognitive differences between the sexes, Study 2 aimed to verify possible cognitive differences in the elderly by gender. It had the same participants, sampling and instruments as Study 1. The Mann-Whitney Test was performed between the means of the groups (male and female) in the cognitive tasks. They were also compared in the frequency of deficits (chi-square), with p < 0.05. A better male performance was observed in working memory (in general and in the lowest level of education) and in oral language (in the highest education level). Men had significantly more deficits in semantic memory in general and more praxic deficits in the lower age and schooling ranges. It is concluded that there are cognitive differences by sex among the elderly, varying according to education and age group. This can help to guide the provision of services for the specific improvement of people of the sex with more evidence of deficit or lower performance.