V11S01 RPDA.Indd

ISSN 1980-5764

Volume 11 • Suppl 1 December 2017 Dementia São Paulo • Brazil Neuropsychologia&

OFFICIAL JOURNAL OF THE COGNITIVE NEUROLOGY AND AGING DEPARTMENT OF THE BRAZILIAN ACADEMY OF NEUROLOGY AND OF THE BRAZILIAN ASSOCIATION OF GERIATRIC NEUROPSYCHIATRY

1 e 2 de dezembro de 2017 Campinas/SP - Brazil VoVolumelume 11 11 • Number• Suppl 31 SeptemberDecember 2017 Dementia São Paulo • Brazil Neuropsychologia&

OFFICIALOFFICIAL JOURNAL JOURNAL OF OF THE THE COGNITIVE COGNITIVE NEUROLOGY NEUROLOGY AND AND AGING AGING DEPARTMENT DEPARTMENT OF OF THE THE BRAZILIANBRAZILIAN ACADEMY OF NEUROLOGYNEUROLOGY AND AND OF OF THE THE BRAZILIAN BRAZILIAN ASSOCIATION ASSOCIATION OF OF GERIATRIC GERIATRIC NEUROPSYCHIATRY NEUROPSYCHIATRY

Editor Ricardo Nitrini University of São Paulo, São Paulo SP, Brazil Associate Editors Letícia Lessa Mansur Sonia Maria Dozzi Brucki University of São Paulo, São Paulo SP, Brazil University of São Paulo, São Paulo, SP, Brazil Section Editors History Note Neuroimaging through clinical cases Eliasz Engelhardt Fabio Henrique de Gobbi Porto Leandro Tavares Lucato Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil University of São Paulo, São Paulo SP, Brazil University of São Paulo, São Paulo SP, Brazil Advisory Editorial Board José Luiz Sá Cavalcanti Renato Anghinah Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil University of São Paulo, São Paulo SP, Brazil André Palmini Márcia Lorena Fagundes Chaves Wilson Jacob Filho Catholic University of Rio Grande do Sul, Porto Alegre RS, Brazil Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil University of São Paulo, São Paulo SP, Brazil Claudia Sellitto Porto Paulo Caramelli University of São Paulo, São Paulo SP, Brazil Federal University of Minas Gerais, Belo Horizonte MG, Brazil Jerson Laks Paulo Henrique Ferreira Bertolucci Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil Federal University of São Paulo, São Paulo SP, Brazil Editorial Board João Carlos Barbosa Machado M.-Marsel Mesulam Faculty of Medical Sciences of Minas Gerais, Belo Horizonte MG, Brazil Northwestern University, Chicago, USA Alexandre Castro-Caldas John R. Hodges Orestes Vicente Forlenza Portuguese Catholic University, Lisbon, Portugal University of New South Wales, Sydney, Australia University of São Paulo, São Paulo SP, Brazil Alfredo Ardila John C. Morris Orlando Francisco Amodeo Bueno Florida International University, Miami, USA Washington University School of Medicine, Saint Louis, USA Federal University of São Paulo, São Paulo SP, Brazil Andrew Lees Jorge Lorenzo Patricio Fuentes University College London, London, UK University of the Republic, Montevideo, Uruguay University of Chile, Santiago, Chile Benito Pereira Damasceno Jorge Moll Neto Paulo R. de Brito Marques University of Campinas, Campinas SP, Brazil Cognitive and Behavioral Neuroscience Unit, Rio de Janeiro RJ, Brazil State University of Pernambuco, Recife PE, Brazil Bruce L. Miller Kenichi Meguro Ricardo F. Allegri University of California, San Francico, USA Tohoku University, Sendai, Japan University of Buenos Aires, Buenos Aires, Argentina Cláudia da Costa Leite Leila Maria Cardao Chimelli Ricardo de Oliveira Souza University of São Paulo, São Paulo SP, Brazil Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil Cognitive and Behavioral Neuroscience Unit, Rio de Janeiro RJ, Brazil Dora Selma Fix Ventura Leonardo Ferreira Caixeta Sandra Weintraub University of São Paulo, São Paulo SP, Brazil Federal University of Goiás, Goiânia GO, Brazil Northwestern University, Chicago, USA Facundo F. Manes Leonel Tadao Takada Sérgio Luís Blay Institute of Neurology, Buenos Aires, Argentina University of São Paulo, São Paulo SP, Brazil Federal University of São Paulo, São Paulo SP, Brazil Francisco de Assis Carvalho do Vale Marcia Radanovic Sergio Teixeira Ferreira Federal University of São Carlos, São Carlos SP, Brazil University of São Paulo, São Paulo SP, Brazil Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil Giacomo Rizzolatti Marcio Luiz Figueredo Balthazar Tânia Marcourakis University of Parma, Parma, Italy University of Campinas, Campinas SP, Brazil University of São Paulo, São Paulo SP, Brazil Helenice Charchat-Fichman Maria Alice Mattos Pimenta Parente Tales A. Aversi-Ferreira Estácio de Sá University, Rio de Janeiro RJ, Brazil Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil Federal University of Goiás, Catalão GO, Brazil Howard Chertkow Maria Rita Passos Bueno Thomas H. Bak McGill University, Montreal, Quebec, Canada University of São Paulo, São Paulo SP, Brazil University of Edinburgh, Edinburgh, UK Ivan Izquierdo Mayana Zatz Vilma Regina Martins Catholic University of Rio Grande do Sul, Porto Alegre RS, Brazil University of São Paulo, São Paulo SP, Brazil Ludwig Institute of Research, São Paulo SP, Brazil Jamary Oliveira Filho Michael D. Geschwind Yves Joanette Federal University of Bahia, Salvador BA, Brazil University of California, San Francisco, USA University of Montreal, Quebec, Canada Jerusa Smid Mônica Sanches Yassuda University of São Paulo, São Paulo SP, Brazil University of São Paulo, São Paulo SP, Brazil Junior Editors Henrique Cerqueira Guimarães Moyses Chaves Federal University of Minas Gerais, Belo Horizonte MG, Brazil Federal University of Goiás, Goiânia GO, Brazil Andrea Camaz Deslandes Jesângeli Sousa Dias Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil Federal University of Bahia, Salvador BA, Brazil

AFanuncio-21x28cm-cv.indd 1 13/04/17 11:57 VoVolumelume 11 11 • Number• Suppl 31 SeptemberDecember 2017 Dementia São Paulo • Brazil Neuropsychologia&

AFanuncio-21x28cm-cv.indd 1 13/04/17 11:57 ASSOCIAÇÃO NEUROLOGIA COGNITIVA E DO COMPORTAMENTO Rua Itapeva, 538/132 – 01332-000 São Paulo SP – Brasil Indexed in Fones: (55 11) 3288-8684 e 3288-9923 QUALIS/CAPES (Classificação de E-mail: [email protected] Periódicos, Anais, Jornais e Revistas) LATINDEX (Sistema Regional de Información en Línea para Revistas Científicas de América Latina, el Caribe, Dementia & Neuropsychologia (ISSN1980-5764), España y Portugal) the official scientific journal of the Cognitive LILACS (Literature on the Health Neurology and Aging Department of the Brazilian Sciences in Latin America and the Academy of Neurology and of the Brazilian Caribbean) Association of Geriatric Neuropsychiatry, is published PsycINFO (American Psychological by the “Associação Neurologia Cognitiva e do Association) Comportamento”, a non-profit Brazilian association. Scopus (The Largest Abstract and Regularly published on March, June, September, and Citation Database of Peer-reviewed December since 2007. Literature) SJR (SCImago Journal Rank) Dementia & Neuropsychologia / Brazilian Academy of Neurology / SciELO (Scientific Electronic Library Associação Neurologia Cognitiva e do Comportamento. -- v. 1, n. 1 Online) (2007). -- São Paulo: Cognitive Neurology and Aging Department of the Brazilian Academy of Neurology and of the Brazilian Association of Geriatric Neuropsychiatry, 2007- Full texts available electronically at www.demneuropsy.com.br v.: il. www.abneuro.org Published in English, 4 times per year. Copydesk ISSN 1980-5764 Área Visual Comunicação Gráfica Ltda [email protected] 1. Neurology 2. Neuropsychology 3. Neuropsychiatry 4. Periodic publications I. Brazilian Academy of Neurology II. Brazilian Association Manuscripts revised by of Geriatric Neuropsychiatry III. Associação Neurologia Cognitiva e do Andrew Clifford Davis Comportamento English Language Consultant 1 e 2 de dezembro de 2017 Campinas/SP - Brazil ASSOCIAÇÃO NEUROLOGIA COGNITIVA E DO COMPORTAMENTO Rua Itapeva, 538/132 – 01332-000 São Paulo SP – Brasil Indexed in Fones: (55 11) 3288-8684 e 3288-9923 QUALIS/CAPES (Classificação de E-mail: [email protected] Periódicos, Anais, Jornais e Revistas) LATINDEX (Sistema Regional de Información en Línea para Revistas Científicas de América Latina, el Caribe, Dementia & Neuropsychologia (ISSN1980-5764), España y Portugal) the official scientific journal of the Cognitive LILACS (Literature on the Health Neurology and Aging Department of the Brazilian Leonardo Cruz de Souza Sciences in Latin America and the Academy of Neurology and of the Brazilian Organizing Committee Caribbean) Association of Geriatric Neuropsychiatry, is published Marcio Luiz Figueredo Balthazar Marcia Lorena Fagundes Chaves PsycINFO (American Psychological by the “Associação Neurologia Cognitiva e do Association) Leonardo Cruz de Souza Comportamento”, a non-profit Brazilian association. Marcio Luiz Figueredo Balthazar Scopus (The Largest Abstract and Regularly published on March, June, September, and Jerusa Smid Citation Database of Peer-reviewed December since 2007. Literature) Norberto Anizio Ferreira Frota

SJR (SCImago Journal Rank) Paulo Henrique Ferreira Bertolucci Dementia & Neuropsychologia / Brazilian Academy of Neurology / SciELO (Scientific Electronic Library Associação Neurologia Cognitiva e do Comportamento. -- v. 1, n. 1 Online) (2007). -- São Paulo: Cognitive Neurology and Aging Department Scientific Committee Paulo Caramelli of the Brazilian Academy of Neurology and of the Brazilian Association Eliasz Engelhardt of Geriatric Neuropsychiatry, 2007- Full texts available electronically at Ricardo Nitrini www.demneuropsy.com.br Francisco de Assis Carvalho do Vale v.: il. www.abneuro.org Sonia Maria Dozzi Brucki Ivan Hideyo Okamoto Published in English, 4 times per year. Copydesk ISSN 1980-5764 José Ibiapina Siqueira Neto Jerusa Smid Área Visual Comunicação Gráfica Ltda [email protected] 1. Neurology 2. Neuropsychology 3. Neuropsychiatry 4. Periodic publications I. Brazilian Academy of Neurology II. Brazilian Association Manuscripts revised by of Geriatric Neuropsychiatry III. Associação Neurologia Cognitiva e do Andrew Clifford Davis Comportamento English Language Consultant 1 e 2 de dezembro de 2017 Campinas/SP - Brazil 01 de dezembro de 2017 (Sexta-feira)

07h30-08h30 – Abertura da secretaria e inscrições

Bloco 1

08h30-09h00 – Aula 1: Atualização dos critérios diagnósticos da doença de Alzheimer para fins de pesquisa: 2018 NIA-AA Research Framework.Dr. Ricardo Nitrini

09h00-10h00 – Apresentações orais 1: (4 apresentações de 10 minutos + perguntas) • Effects of aerobic exercise on progression of brain atrophy and cognition in amnestic mild cognitive impairment due to ad. Camila Vieira Ligo Teixeira • Cognitive reserve as a modifier in Alzheimer’s Disease.Marina Weiler • Microparticles derived from leucocytes, neurons and expressing tissue factor are associated with Alzheimer’s Disease. Karina Braga Gomes Borges • Neuropsychiatric symptoms in community-dwelling older adults: from normal cognition to dementia. Monise Caroline Schwarzer

10h00-10h30 – Coffee Break

Bloco 2

10h30-11h00 – Aula 2: Avanços em Biomarcadores sanguíneos e liquóricos na doença de Alzheimer. Dr. Orestes Forlenza

11h00-11h40 – Apresentações orais 2: (3 apresentações de 10 minutos + perguntas) • Higher metabolic and functional activity in the hippocampus of superagers: an MRI and pet imaging study. Lucas Porcello Schilling • Annexin A1 in frontotemporal dementia and alzheimer’s disease: impairment in resolution of inflammation?Vanêssa Gomes Fraga • Variables related to successful brain aging in an oldest-old community-based sample. Karoline Carvalho Carmona

11h40-12h00 – Aula 3: Diagnóstico das doenças priônicas: novos critérios e diagnóstico in vivo. Jerusa Smid

12h00-13h00 – Almoço

13h00-14h00 – Visitas aos pôsteres (o apresentador deve estar ao lado do pôster)

Bloco 3

14h00-14h30 – Aula 4: Marcadores cognitivos de Declínio Cognitivo Subjetivo. Dra. Mônica Yassuda

14h30-15h30 – Apresentações orais 3: (4 apresentações de 10 minutos + perguntas) • Neuropsychiatric Symptoms Related to Neuropathologic vs. Clinical Diagnosis of Dementia. Letízia Gonçalves Borges • Neuropathological study of 96 cases of CDR 0.5 cases. Ricardo Nitrini • Structural and functional papez circuit integrity in amyotrophic lateral sclerosis. Ana Paula Arantes de Andrade Bueno • Clinical predictors of dementia in patients with late-life depression. Camila Truzzi Penteado

15h30-16h00 – Coffee Break

Bloco 4

16h00-16h30 – Aula 5: Avanços em Neuroimagem na DA: Ressonância Magnética e Imagem Molecular. Dr. Marcio Balthazar

16h30-17h30 - Apresentações orais 4: (4 apresentações de 10 minutos + perguntas) • Neuropsychological characterization of early- and late- onset alzheimer’s disease with CSF biological confirmation: preliminary data.Viviane Amaral Carvalho • Retinal neural loss in patients with mild cognitive impairment detected by swept-source optical coherence tomography. Ana Laura Maciel Almeida • Alzheimer’s pathology in the cerebrospinal fluid of patients having mild cognitive impairment and depression.Florindo Stella • Transcultural adaptation of an instrument about knowledge towards dementia by elderly’s caregivers. Marcelo Piovezan

17h30-18h00 – Coffee Break

18h00-19h00 – Mesa Redonda 1: ADNI Brasil: onde estamos e pra onde vamos. Apresentadora: Sonia Maria Dozzi Brucki Debatedores: Márcia Lorena Fagundes Chaves, Paulo Caramelli, Iscia Lopes-Cendes

20h00 – Evento Social - Coquetel - Bouquet Garni Restaurante 02 de dezembro de 2017 (SÁBADO)

Bloco 5

08h30-09h00 – Aula 6: O que os estudos epidemiológicos nos ensinam sobre comprometimento cognitivo e demência no Brasil? Paulo Caramelli

09h00-10h00 – Apresentações orais 5: (4 apresentações de 10 minutos + perguntas) • Frequência e perfil cognitivo de comprometimento cognitivo vascular (CCV) pós-AVC isquêmico em 90 dias de seguimento.Marcia Lorena Fagundes Chaves • Levels of inactive ADAM10 in Alzheimer’s disease: a pilot study using cerebrospinal fluid samples.Rafaela Peron Cardoso • Effects of the tailored activity program in Brazil (TAP-BR) for persons with dementia. Marcia Maria Pires Camargo Novelli • Inflammatory biomarkers are not associated with apathy symptoms across a broad spectrum of neurodegenerative disorders.Henrique Cerqueira Guimarães

10h00-10h30 – Coffee Break

Bloco 6

10h30-11h00 – Aula 7: Atualização em genética das Demências. Leonel Takada

11h00-12h00 – Apresentações orais 6: (4 apresentações de 10 minutos + perguntas) • Performance in dual-task walking tests: correlations with education and association with falls in elderly: the pietà-study. Thaís Bueno Dias Albuquerque • Brazilian aging and memory study (Brams): baseline characterization and follow-up. Sonia Maria Dozzi Brucki • Addenbrooke’s Cognitive Examination-Revised and Montreal Cognitive Assessment: data for seniors with heterogeneous educational level in Brazil. Karolina Gouveia César • Entorhinal and cingulate cortical thickness predict episodic memory and global cognition in mild alzheimer’s disease. Ana Flávia Mac Knight Carletti Cassani

12h00-13h00 – Almoço

13h00-14h00 – Visitas aos pôsteres (o apresentador deve estar ao lado do pôster)

Bloco 7

14h00-14h30 – Aula 8: Manejo farmacológico dos sintomas comportamentais e psicológicos das demências. Ivan Okamoto

14h30-15h30 – Apresentações orais 7: (4 apresentações de 10 minutos + perguntas) • Corticobasal syndrome: clinical features and metabolic imaging pattern. Jacy Bezerra Parmera • Amnestic complaint in primary health care: clinical, neuropsychological and functional characterization. Marcos Leandro Pereira • Impact of schooling, modality and number of sessions in efficacy of working memory training. Paula Schimidt Brum • Disease Staging in Frontotemporal Dementia and in Alzheimer’s Disease: The Contribution of the Frontotemporal Dementia Rating Scale (FTD-FRS) in a 12-Month Follow-up Study. Thais Bento Lima da Silva

15h30-16h00 – Coffee Break

Bloco 8

16h00-16h30 – Aula 9: Ensaios Clínicos terapêuticos nas demências: panorama atual e perspectivas. Leonardo Cruz de Souza

16h30-17h30 – Apresentações orais 8: (4 apresentações de 10 minutos + perguntas) • Prospective evaluation of cognition in a Brazilian Huntington’s disease cohort. Raphael Machado de Castilhos • An assessment of direct and indirect costs of dementia in Brazil. Ceres Eloah L. Ferretti • In dementia, what’s holography can do for us ? Yolanda Eliza Moreira Boechat • Behavioural but not cognitive measures of disinhibition can effectively differentiate frontotemporal dementia from alzheimer’s disease. Luciano Inácio Mariano

17h30-17h45 – Intervalo

18h00-19h00 – Mesa Redonda 2: Plano Nacional de Demência: necessidade e formas de implantação. Apresentador: Dr. Paulo Bertolucci Debatedores: Dr. Rodrigo Schultz, Dr. Norberto Frota

19h00 – Encerramento

Oral presentations Dement Neuropsychol 2017 December;11(Suppl 1):1-76

EFFECTS OF MULTICOMPONENT EXERCISE ON PROGRESSION OF BRAIN ATROPHY AND COGNITION IN AMNESTIC MILD COGNITIVE IMPAIRMENT DUE TO AD Camila Vieira Ligo Teixeira, Thiago Junqueira Ribeiro Rezende, Thamires N.C. Magalhães, Marina Weiler, Ana Flavia M.K.C. Cassani, Debora Queiroz de Almeida, Thiago Quinaglia A.C. Silva, Helena Passarelli Giroud Joaquim, Leda Leme Talib, Orestes Vicente Forlenza, Mariana Pires Franco, Pedro Eduardo Nechio, Paula Fernandes, Fernando Cendes, Marcio Luiz Figueredo Balthazar

Background: Increasing evidence demonstrates that physical exercise is an important modifiable factor not only for cardiovascular fitness, but also for brain health and dementia prevention. However, it is not clear how supervised physical exercise can affect cognition and biomarkers in patients with amnestic mild cognitive impairment (aMCI) due to Alzheimer’s disease (AD). In this study, we aimed to evaluate six months of multicomponent exercise training on cortical thickness and hippocampus volume in aMCI subjects with CSF positive AD biomarkers (lowAβ142 and/or low Aβ142/ ptau). Methods: 40 aMCI (68.3 ± 4.8 years old) subjects were diagnosed using the core criteria of the NIA/AA for MCI and presented positive CSF AD biomarkers. All patients underwent neurocognitive tests, which included Functional Pfeffer Scale (FPS), Mini Mental State Examination (MMSE) and Rey Auditory Verbal Learning Test (subitens: total, A7and Recognition, and a structural MRI at 3.0 Tesla. Hippocampal volume and cortical thickness were analyzed using FreeSurfer software (https://surfer.nmr.mgh.harvard.edu/). A graded maximal exercise test on a motordriven treadmill assessed aerobic fitness (measured by VO2maximun). Participants were divided into training group (T, 20 patients with supervised exercise 3 times per week for 6 months) and non-training group (NT, 20 patients with nonsupervised exercise). The groups were controlled for age, sex, and education. Results: ANOVA for repetitive measures showed a significant between-groups interaction for VO2maximun (F = 15.7, p = 0.004), indicating a significant decreased for the NT (p = 0.00002). For the cognitive tests, an interaction could be seen in PFS, RAVLT A7 and RAVLT Rec (F = 5.7, p = 0.034; F = 4.6, p = 0.045; F = 7.8, p = 0.018, respectively). While T improved in RAVLT A7, NT presented worse performance in FPS and RAVLT Rec. ANOVA demonstrated a significant interaction for both left and right hippocampi (F = 13.7, p = 0.00003; F = 8, p = 0.001, respectively), showing a significant increase in volume for. Analysis in cortical thickness did not show any difference after correcting for multiple comparisons (False discovery rate). Conclusions: Six months of supervised aerobic exercise seems to be effective on hippocampus volume and episodic memory and, maintaining aerobic fitness in aMCI subjects due to AD.F unding: Fapesp 2014/02359-9.

COGNITIVE RESERVE AS A MODIFIER IN ALZHEIMER’S DISEASE Marina Weiler1,2, Raphael Fernandes Casseb1,2, Brunno Machado de Campos2, Camila Vieira de Ligo Teixeira2, Ana Flávia Mac Knight Carletti-Cassani2, Jéssica Elias Vicentini2, Thamires Magalhães2, Débora Queiroz de Almeida2, Leda L. Talib3, Orestes Vicente Forlenza3, Marcio Luiz Figueredo Balthazar2, Gabriela Castellano1,4

Introduction: The cognitive reserve (CR) hypothesis has been proposed to explain the discontinuity between pathophysiological and clinical expression of AD, suggesting that CR modifies the effects of pathology on clinical expression and cognition. Objectives: We aimed to investigate the relationship between CR proxies, network efficiency and pathophysiological levels, and the modifier effect of CR on the association between pathophysiology and functional network efficiency in aMCI and mild AD patients (i.e., can cognitive reserve modify the effects of pathology on network efficiency?). Methods: 14 mild AD, 31 aMCI, and 28 controls were scanned on a 3.0T MRI scanner, and CSF samples were obtained from aMCI and mild AD patients. Education and premorbid IQ were used as proxies of CR. We used the UF2C and GraphVar toolboxes to obtain ten graph metrics as estimators of network efficiency, and results were network-based statistics corrected for multiplicity. We used interaction terms between CR proxies the CSF biomarkers to identify the modifier effect of CR on network efficiency.R esults: Controls, aMCI and mild AD with higher CR (education and premorbid IQ) had more efficient networks, and higher pathophysiological levels related to disruption in network efficiency in aMCI and mild AD. No relationship was found between CSF biomarkers and CR proxies. The interaction terms between education*p-tau level, and education*t-tau and p-tau added to regression models in the aMCI and mild AD group, respectively. Conclusions: Although CR may not be protective against the development of AD pathophysiology, individuals with higher CR present more efficient networks. Moreover, educational level could modify the effects of tau-related pathology in network efficiency in aMCI and mild AD groups, meaning that subjects

8 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 with higher CR are better able to cope with the effects of pathology in terms of network efficiency.F unding: FAPESP #2015/06163-4, #2013/07559-3 and CNPq #304442/2015-1.

1N europhysics Group, Institute of Physics Gleb Wataghin, UNICAMP, Brazil. 2N euroimaging Laboratory, School of Medical Sciences, UNICAMP, Brazil. 3Laboratório de Neurociências (LIM-27), USP, Brazil. 4Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Brazil.

MI CROPARtiCLES DERIVED FROM LEUCOCYTES, NEURONS AND EXPRESSING TISSUE FACTOR ARE ASSOCIATED WITH ALZHEIMER’S DISEASE Carolina Antunes Magalhães1, Maria das Graças Carvalho1, Cristina de Mello Gomide Loures1, Marco Túlio Cintra2, Maria Aparecida Bicalho2, Vanêssa Gomes Fraga1, Leonardo Cruz de Souza2, Henrique Cerqueira Guimarães3, Lirlândia Pires de Sousa1, Paulo Caramelli2, Fernanda Freire Campos1, Karina B. Gomes1

Introduction: Microparticles (MPs) are small extracellular cell-derived vesicles, ranging from 0.1 to 1 μm, released by a diverse population of cells upon activation or apoptosis, under conditions of stress or injury. MPs are important messengers in cell-cell communication and contribute to the induction of endothelial damage and inflammation, since they carry signaling and adhesion molecules, as well as chemokines, cytokines, receptors, and mRNAs. Aim: To evaluate the levels of MPs derived from platelets (PMPs), leukocytes (LMPS), neurons (NMPs) and MPs expressing tissue factor (TFMPs) in Alzheimer’s disease (AD) patients compared with cognitively healthy individuals. Material and Methods: This study included patients with probable AD (n = 29) and cognitively healthy individuals (n = 25). Blood samples were collected and MPs were measured by flow cytometry. Statistical analyses were performed on SPSS program version 13.0. Values of p < 0.05 were considered significant.R esults: LMPs (109.74 ± 65.51 MPs/µL), NMPs (429.95 ± 321.65 MPs/µL) and TFMPs (94.50 IQR 110.73 MPs/µL) levels were significant increased in AD when compared to control group - LMPs (43.82 ± 30.68 MPs/µL, p = 0.004); NMPs (95.36 ± 99.74 MPs/µL, p = 0.002); TFMPs (38.53 IQR 11.60 MPs/µL, p = 0.029), respectively. PMPs levels showed only a tendency to be higher in AD group (260.27 IQR 360.97) than in control group (135.47 IQR 225.87, p = 0.081). Conclusions: The results suggest that MPs derived from leukocytes, neurons and MPs expressing tissue factor could be associated with the pathophysiology of AD. These MPs are potential auxiliary tools for monitoring patients with cognitive decline. Acknowledgments: CAPES, CNPq and Fapemig.

1Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais. 2Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais.

Neuropsychiatric symptoms in community-dwelling older adults: from normal cognition to dementia Monise Caroline Schwarzer2, Paula Villela Nunes1,2, Renata Elaine Paraizo Leite1, Renata Eloah de Lucena Ferretti-Rebustini1, Roberta Diehl Rodriguez1, Carlos Augusto Pasqualucci1, Ricardo Nitrini1, Jose Marcelo Farfel1, Kátia Cristina de Oliveira1, Lea Tenenholz Grinberg1,3, Wilson Jacob1, Beny Lafer1, Claudia Kimie Suemoto1

Introduction: There is a continuum of increase of Behavioral and Psychological Symptoms (BPSDs) from non-demented individuals to those in preclinical stages of dementia and with the various forms of dementia. BPSDs can be a pro- drome of dementia. Thus, the importance of this study. Objectives: The aims of this study were to establish the cutoff for the Neuropsychiatric Inventory (NPI), a widely used scale that evaluates 12 BPSDs in a large community sample of older adults without dementia, with Mild Cognitive Impairment (MCI) and dementia. This study also examined which of the BPSD best discriminate these groups. Methods: 1,565 participants aged 50 years or older who died from natural causes were included in this study. Information was obtained from a knowledgeable informant. Neuropsy- chiatric symptoms and cognitive performance 3 months prior to death were accessed with the NPI, and the Clinical Dementia Rating (CDR). Results: The group without dementia (CDR = 0) had 1,062 individuals, the group MCI (CDR = 0.5) had 145 individuals and the group dementia (CDR ≥ 1.0) had 358 individuals. Comparing individuals with and without dementia, the NPI cutoff was 11 (AUC = 0.755). When comparing MCI with normal cognition, a more discrete result: the NPI cutoff was 10 (AUC = 0.563). All NPI symptoms discriminated the groups with and without dementia,

9 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 with greater odds for delusions, hallucinations, disinhibition, and motor behavior. When comparing MCI with those without dementia, fewer symptoms were discriminative, and better results were also found for the same symptoms. Conclusions: This is the first study that compares in the large community sample individuals with MCI and dementia with normal cognition. An increase of BPSDs was found across the continuum of cognitive impairment, but yet the clinical picture of MCI is closer to those individuals without dementia.

1University of São Paulo Medical School, São Paulo, Brazil. 2Faculty of Medicine of Jundiai, Brazil. 3Memory and Aging Center University of California, San Francisco, USA.

HIGHER METABOLIC AND FUNCTIONAL ACTIVITY IN THE HIPPOCAMPUS OF SUPERAGERS: AN MRI AND PET IMAGING STUDY Lucas Porcello Schilling, Wyllians Vendramini Borelli, Paula Kopschina Feltes, Ricardo Trentin, Michele Alberton Andrade, Cristina Sebastiao Matushita, Ana Maria Marques, Cristina Moriguchi-Jeckel, Louise Mross Hartmann, Luciana Borges Ferreira, Nathalia Esper Bianchini, Mirna Wetters Portuguez, Alexandre Rosa Franco, Jaderson Costa da Costa

Introduction: SuperAgers is a term used for some older adults that seem to resist age-related cognitive decline. The mechanisms associated with maintaining the excellent cognitive functioning of these individuals it remains unclear. Objectives: Herein, we aimed to analyze the metabolic and functional activity in the hippocampus of SuperAgers. Methods: Seven SuperAgers (SA) and 5 controls underwent clinical and neuropsychological evaluation, including the Rey Auditory-Verbal Learning Test (RAVLT). Subsequently, they performed an MRI scan followed by Positron Emis- sion Tomography (PET) with [18F]Fluorodeoxiglucose ([18F]FDG). The SA group was composed by individuals with or over 80 years old with the delayed-recall memory score similar to individuals between 50-60 years. The control group included individuals with or over 80 years old with memory scores average for their age, within 1 standard deviation. Statistical analysis was performed through a two-tailed t-test and Pearson’s correlation when adequate. Data is depicted as mean ± standard deviation. Results: The SA group showed higher hippocampal Standardized Uptake Value (SUV) of [18F]FDG, corrected for the mean uptake of the whole brain, when compared to controls (0.83 ± 0.06 vs. 0.73 ± 0.02, p = 0.03). A very strong and moderate correlation of [18F]FDG hippocampal uptake correlation was found with the delayed-recall memory scores in SA (r2 = 0,558) and controls (r2 = 0,935). The functional connectivity between the hippocampus and posterior cingulate cortex was also higher in the SA compared to controls (p < 0.05). Results also showed a tendency (p < 0.05, uncorrected) of a negative correlation of the functional connectivity of hippocampus with the inferior frontal gyrus and the delayed-recall memory score. Conclusions: In summary, the hippocampus exhibited higher functional connectivity and higher metabolic activity, as measured through [18F]FDG PET in the SA group when compared to controls. Higher memory ability of the SA may be accounted by compensatory activation of frontal cortex.

ANNEXIN A1 IN FRONTOTEMPORAL DEMENTIA AND ALZHEIMER’S DISEASE: IMPAIRMENT IN RESOLUTION OF INFLAMMATION? Vanêssa Gomes Fraga1, Lirlândia Pires de Sousa1, Fernanda Silva Carneiro1, Carolina Antunes Magalhães1, Cristina de Mello Gomide Loures1, Cláudia Natália Ferreira2, Maria das Graças Carvalho1, Henrique Cerqueira Guimarães3, Leonardo Cruz de Souza3, Paulo Caramelli3, Karina Braga Gomes1

Introduction: Annexin A1 (ANXA1) is a protein that exhibits important pro-resolutive and anti-inflammatory actions, such as reduction of proinflammatory mediators releasing and inhibition of recruitment of neutrophils. In central nervous system, ANXA1 reduces microglial activation, ameliorates neuroinflammation and enhances the phago- cytosis and degradation of beta-amyloid peptide. Interestingly, ANXA1 loses its pro-resolutive and anti-inflammatory properties when cleaved and may act in a proinflammatory way, favoring the production of eicosanoid. Aim: To evaluate the levels and the integrity of ANXA1 in peripheral blood of patients with Alzheimer’s disease (AD, n = 15) and frontotemporal dementia (FTD, n = 7), comparing to healthy age and gender matched controls (n = 14). Material

10 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 and Methods: ANXA1 levels were assessed by ELISA (Cloud-Clone Corp.TM) in EDTA plasma. ANXA1 protein profile was obtained by Western Blotting (WB) using a mononuclear cell lysate from peripheral blood collected in heparin. Statistical analyzes were performed on SPSS v17 and p < 0.05 was considered significant. Results: Plasma ANXA1 levels in FTD group were lower [median (IQ) = 0.043 (0.077)] when compared with controls [0.256 (0.37)] (p = 0.020). No difference was observed in ANXA1 levels between AD group [0.106 (0.20)] and controls (p = 0.063) or between FTD and AD groups (p = 0.162). However, patients with AD or FTD presented ANXA1 in cleaved form, while the control group showed non-cleaved ANXA1. Conclusions: These data suggest that lower ANXA1 levels seem to be associated only with FTD while its cleaved form could be associated with AD and FTD. Consequently, impairment in resolution of inflammation may play an important role in these dementing diseases.A cknowledgments: CAPES, CNPq and Fapemig.

1Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais. 2Colégio Técnico, Universidade Federal de Minas Gerais. 3Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais.

Variables related to successful brain aging in an oldest-old community-based sample Karoline Carvalho Carmona, Elisa de Paula França Resende, Thaís Helena Machado, Viviane Amaral Carvalho, Maira Tonidandel Barbosa, Henrique Cerqueira Guimarães, Paulo Caramelli

Background: Successful aging is a condition in which there is little or no decline compared to younger adults. Thus, beyond the mere absence of disease and preserved functionality, there are individuals who stand out for outperforming what is considered normal for age on cognitive tests. We still do not have sufficient studies investigating the sociodemographic and biological variables that favor such elderly. Objectives: To investigate sociodemographic and lifestyle aspects of individuals aged 75+ years and cognitive performance similar to younger healthy elderly (60-69 years). Methods: In the Pietà study, a population-based investigation conducted in Caeté (MG), we evaluated 639 elderly individuals aged ≥ 75 years. After cognitive screening using the Mini-Mental State Examination, Brief Cognitive Battery and the Pfeffer Questionnaire, 132 healthy elderly subjects were identified (age: 79.8 ± 4.5 years; education: 3.0 ± 2.6 years; gender: 83F / 49M), who also underwent demographic and lifestyle questionnaires and extensive clinical and neuropsychological assessment, including the Rey Auditory-Verbal Learning Test (RAVLT). We considered successful brain aging individuals without cognitive or functional impairment who scored ≥ 9 points in subsection A7 (delayed recall) from the RAVLT, and usual brain aging, cognitively healthy and independent individuals who scored < 9 points in the same task. We investigated possible associations between clinical variables, demographics and lifestyle habits with SBA. Results: Among the healthy elderly subjects, 18 (age: 77.3 ± 2.6 years; education: 4.9 ± 3.6 years; gender: 15F / 3M) had a RAVLT delayed recall score ≥ 9, while the remaining 114 (age: 79.8 ± 4.5 years; education: 3.0 ± 2.6 years; gender: 69F / 45M) scored < 9 points. Variables significantly associated with SBA in multivariate analysis were younger age (OR: 0.672 - 95% CI 0.462-0.979 for each year less; p = 0.037) and lower scores on the geriatric depression scale (OR: 0.831 - 95% CI 0.688-0.989; p = 0.038). Conclusions: These data suggest an association between younger age and less depressive symptoms with better cognitive performance in this community sample of oldest-old and low schooling individuals.

Neuropsychiatric Symptoms Related to Neuropathologic vs. Clinical Diagnosis of Dementia Letizia G. Borges, Alfred W. Rademaker, Eileen H. Bigio, M-Marsel Mesulam, Sandra Weintraub

Objective: Amnestic dementias of the Alzheimer-type (DAT) and behavioral dementias of the frontal-type (FTD) can be associated with the neuropathology of either Alzheimer’s Disease (AD) or frontotemporal lobar degeneration (FTLD). The primary aim of the present study was to compare the frequency of apathy and disinhibition in DAT and FTD caused by either AD or FTLD. Background: Neuropsychiatric symptoms such as apathy and disinhibition are associated with the clinical syndromes of both DAT and FTD. Clinical studies suggest apathy alone or in combination with disinhibition is the most common initial symptom in FTD and more prevalent than in DAT. The differential frequencies of these features alone or in combination in AD vs FTLD have not been determined. Methods: Retrospective analysis of

11 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 data from 1304 cases with autopsy confirmed disease in the National Alzheimer Coordinating Center (NACC) database. The frequencies of apathy, disinhibition, or the combination of both were compared in 4 groups DAT/AD (n = 1055), DAT/FTLD (n = 51), FTD/AD (n = 57), FTD/FTLD (n = 141). Chi-square analyses were used. Results: In AD neuropathology, the most common symptom was apathy without disinhibition (33%; p < 0.001). FTLD neuropathology was more frequently associated with the combination of apathy and disinhibition (44%; p < 0.001). Conclusions: Neuro- psychiatric symptoms such as apathy, disinhibition or the combination of the two have differential associations with AD and FTLD neuropathology. In this sample of 1304 patients, AD pathology was more frequently associated with apathy alone, whether the clinical syndrome was DAT or FTD. In contrast, FTLD pathology was more frequently associated with the combination of both neuropsychiatric symptoms in its clinical manifestations of either DAT or FTD.

Cognitive Neurology and Alzheimer’s Disease Center (CNADC). Northwestern University – Chicago, IL.

Net uropa hological study of 96 cases of CDR 0.5 cases Ricardo Nitrini, Renata P. Leite, Roberta Diehl-Rodrigues, Mariana Molina, Lea T. Grinberg, Sonia M.D. Brucki, Eduardo Bergamaschi, Claudia Ramos, Daniel k. Amado, Conrado Borges, Luciana Soterio, Claudia Suemoto, Carlos A. Pasqualucci, Wilson Jacob-Filho

Clinical Dementia Rating (CDR) 0.5 is a clinical diagnosis meaning questionable dementia, but has been considered as equivalent to mild cognitive impairment by many studies. CDR 0.5 cases usually have a high incidence of Alzheim- er’s disease (AD), but more recent neuropathological studies have shown that other diagnoses may also be highly frequent. Objectives: To investigate the neuropathological diagnoses of CDR 0.5 cases. Methods: In the Brain Bank of the Brazilian Aging Study Group we evaluated 96 cases with CDR 0.5 after exclusion of cases with blindness, severe hypoacusia, severe stroke or other conditions that could impair activities of daily living. There were 49 women and 47 men; mean age was 72.9 (± 11.0); mean schooling years 3.6 (± 2.7) and mean sum of the boxes 2.0 (± 1.0). The neuropathological diagnosis was established by immunohistochemistry, but data on the presence of diffuse amyloid plaques and anti-TDP-43 immunohistochemistry were not included yet. Results: The main neuropathological diagnoses were: 18 (18.7%) with mixed dementia [14 with AD neuropathological changes (ADNC) and 9 with cerebrovascular disease (CVD)]; 18 (18.7%) with CVD; 16 (16.7%) with ADNC; 7 (7.3%) with argyrophilic grain disease; 4 (4.2%) with Lewy body disease (including Parkinson Disease); 3 (3.1%) with other diseases; 2 (2.0%) with normal examination and 28 (29.1%) with undetermined diagnosis. Conclusions: In this ongoing study, CVD was a frequent cause of CDR 0.5, although ADNC isolated or associated with other conditions was slightly more frequent.

B rain Bank of the Brazilian Aging Study Group and Behavioral & Cognitive Neurology Unit, University of São Paulo School of Medicine, University of São Paulo .

Structural and functional Papez circuit integrity in amyotrophic lateral sclerosis Ana Paula Arantes de Andrade Bueno1, Walter H. L. Pinaya1, Luciana M. Moura1, Maxime Bertoux2, Ratko Radakovic3-5, Matthew Kiernan6, Antonio L. Teixeira7, Leonardo C. de Souza7, Michael Hornberger2, João R. Sato1

Background: Cognitive impairment is now recognized in amyotrophic lateral sclerosis (ALS). However, despite reports of temporal lobe changes in ALS, episodic memory deficits have been controversial.Objectives and Methods: We explored how the hippocampus and associated Papez circuit structures are structurally (cortical volume, voxel-based mor- phometry, diffusion tensor imaging) and functionally (resting state functional connectivity) affected in ALS patients (n = 20) compared with controls (HC, n = 15) and whether the changes correlated with a common clinical measure of episodic memory (ACE-R). Results: ALS patients and HC did not differ on age. Spearman coefficient did not show significant correlation between disease duration and brain damage. Our results show reduced gray matter (GM) in left hippocampus (p = 0.03), left entorhinal cortex (p = 0.01) and right posterior cingulate (p = 0.02) of patients, decreased white matter (WM) fractional anisotropy (p = 0.04) and increased mean diffusivity (p = 0.02) in left cingulum bundle of patients. Thalamus, mammillary bodies and fornix were preserved. Finally, we report decreased functional connec-

12 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 tivity (FC) in patients in bilateral hippocampus, bilateral anterior and posterior parahippocampal gyri and posterior cingulate (all p-FDR≤0.04). GM atrophy and mean diffusivity correlated with memory measures (all p≤ 0.04).D iscussion and Conclusion: Patients showed significant GM, WM and FC changes across the Papez. Decreased FC suggests this change could be used to assess risk or assist early detection of memory symptoms in ALS even before structural changes are established. Future studies investigating changes of the Papez circuit integrity and memory deficits should explore this further. Funding: AB is supported by São Paulo Research Foundation (FAPESP) Grant 2016/19376-9.

1Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil. 2Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK. 3School of Health Sciences, Norwich Medical School, University of East Anglia, Norwich, UK. 4Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK. 5Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. 6Brain & Mind Centre and Sydney Medical School, University of Sydney, NSW, Australia. 7Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Clinical predictors of dementia in patients with late-life depression Camila Truzzi Penteado¹, Lucas Francisco Botequio Mella¹, Paulo Dalgalarrondo¹

Introduction: Late-life depression is associated with increased risk for dementia, in particular secondary to Alzheimer’s and cerebrovascular diseases. Recent findings suggest neurobiological mechanisms linking depression and dementia, but there is no evidence about clinical characteristics of patients with late-life depression which may predict incipient dementia. Objectives: To study possible clinical predictors of dementia in patients with late-life depression. Methods: A longitudinal and retrospective research was conducted with 67 patients with initial diagnosis of late-life depression and no dementia, evaluated at Geriatric Psychiatry and Neuropsychiatry Outpatient Clinic of State University of Campinas (UNICAMP), between 1991 and 2014. These subjects were divided in two groups: those who developed dementia and those who did not develop, after an average follow-up time of 4 years. We compared sociodemographic and clinical variables presented at the beginning of the follow-up of these patients. Results: Forty-three (64.17%) patients converted to dementia, while twenty-four (35.83%) remained cognitively stable. There is no differences between groups, regarding sociodemographic variables, phenomenological characteristics of depression, prevalence of treatment-resistance, mini-mental score, prevalence of abnormalities in neurological examination and neuroimaging abnormalities. Depressed patients who developed dementia presented more memory (p = 0.001), executive functions (p = 0.013) and orientation complaints (p = 0.044) at the beginning of the follow-up than depressed patients who remained cognitively stable. Also, dyslipidemia (p = 0.007), higher levels of systolic blood pressure (p = 0.032), higher weight (p = 0.023) and higher TSH levels (p = 0.043) were related to progression to dementia. After Cox regression adjustment, there is no variable which could predict dementia independently. Conclusions: Cerebrovascular risk factors and presence of cognitive symptoms may be predictors of dementia in patients with late-life depression. Elevated TSH levels in patient who converted to dementia could be related to HPA axis misbalance, which is present in both conditions, depression and dementia. However, none of these factors predicted dementia independently. Moreover, cerebrovascular risk factors and mild cognitive symptoms are already known predictors of dementia in general elderly population, not specifically in late-life depression.

¹Hospital de Clínicas - UNICAMP.

NeuropsychologICAL characterization of early- and late- onset Alzheimer’s Disease with CSF biological confirmation: Preliminary data Viviane Amaral-Carvalho, Etelvina Lucas dos Santos, Luciano Inácio Mariano, Michele Gomes Ferreira, Patrícia Regina Henrique Peles, Natália Pessoa Rocha, Érica Leandro Vieira, Henrique Cerqueira Guimarães, Leonardo Cruz de Souza, Paulo Caramelli

Background: Alzheimer’s disease (AD) occurs more frequently after the age of 65 years. However, early-onset AD (EOAD; disease onset before 65 years) is also observed and may present a different cognitive profile than late-

13 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 onset AD (LOAD; disease onset after 65 years). Few studies have compared these groups with biological confirmation of the diagnosis. Objectives: To compare the neuropsychological profile between EOAD and LOAD, in patients with cerebrospinal fluid (CSF) biological confirmation.M ethods: 27 patients were recruited. All patients had low

CSF levels of Aβ42 and high levels of tau and P-tau. Groups were matched for sex, education and duration of symptoms. EOAD group included 11 patients (6 males; 12.1 ± 4.4 years of schooling; 3.3 ± 2.7 years of symptoms), while LOAD group was composed by 16 patients (10 males; 10.1 ± 5.2 years of schooling; 2.2 ± 3.6 years of symptoms). Age was different between groups (EOAD: 60.0 ± 4.1 years; SG: 70.1 ± 4.3, p < 0.001). The evaluation included the Mattis Dementia Rating Scale (DRS), Rey Auditory Verbal Learning Test (RAVLT), Verbal Fluency (phonological and semantic), Boston Naming Test (15-item Short Version), Block Design Test, Digit Span Task and Disability Assess- ment for Dementia Scale, Neuropsychiatric Inventory, and Cornell Depression Scale. Results: LOAD patients performed better than EOAD in DRS-Construction (EOAD: 4.5 ± 1.6; LOAD: 5.9 ± 0.3; p = .008); RAVLT sum of learning trials (A1:A5) (EOAD: 24.3 ± 6.9; LOAD: 31.6 ± 7.7; p = .044), immediate recall (A6) (EOAD: 2.6+1.7, LOAD: 4.7+2.4; p = .034); and in the Block Design Test (EOAD: 7.0 ± 1.1, LOAD: 9.4 ± 2.8; p = .034). In this sample, functionality and neuropsychiatric profiles were similar between groups. Conclusions: Visual-constructive abilities, verbal learning curve and immediate recall were worse in EOAD group. These results are in agreement with previous data suggesting more parietal dysfunction in EOAD. These preliminary results highlight the importance of better characterizing each group.

RETINAL NEURAL LOSS IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT DETECTED BY SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY Ana Laura Maciel Almeida1, Leonardo Provetti Cunha1,2, Patrícia Cheker Lopes1, Luciana Virginia Ferreira Costa-Cunha1, Mário Luiz Ribeiro Monteiro2

Introduction: Mild Cognitive Impairment(MCI), especially the amnestic type, a condition in which patient presents with a cognitive decline higher than expected for the age group, but without impairment of functional activities, is considered by many authors to be a very early stage of Alzheimer’s disease. Diagnostic investigation that identifies early changes in MCI patients can contribute to more effective treatments and better prognosis for these patients. Objectives: The aim of this study is to evaluate and compare the ability of swept-source optical coherence tomography(OCT) to detect retinal neural loss in MCI patients when compared to normal controls. Methods: An observational, cross-sectional and descriptive study was carried out, in which 50 eyes were included, 22 eyes of 11 MCI patients and 28 eyes of 14 normal controls. The acquisition protocol captured high resolution images of the optic disc and the macula. The thickness parameters of the peripapillary retinal nerve fiber layer (RNFL), the macula and the internal retinal layers were automatically calculated by the device software. OCT parameters of MCI eyes and controls were compared using generalized estimation equations. Values o f p < 0.05 were considered significant.R esults: The mean age ± SD was 66.81 (± 4.93) years for MCI patients and 71.21 (± 7.67) years for controls (p = 0.18). There were 3 men in each group. There was no significant difference in the parameters of the peripapillary RNFL (in the 4 quadrants) and in the total macular thickness (9 sectors) when compared to the patients and controls. However, the thickness of the ganglion cell layer (GCL) of the retina was significantly lower in MCI group (p = 0.003). Conclusions: The thickness of retinal GCL in the macular area obtained by the swept-source OCT was significantly lower in MCI patients when compared to controls. In agreement with what has already been demonstrated in patients with AD, the preferential involvement of retinal GCL may be an early indicator of retinal neural loss in patients with MCI. The OCT swept-source may be a useful diagnostic tool and serve potentially as a biological marker in vivo in patients with MCI.

1Universidade Federal de Juiz de Fora. 2Universidade de São Paulo.

Alzheimer’s pathology in the cerebrospinal fluid of patients having mild cognitive impairment and depression Florindo Stella1,2, Marcia Radanovic1, Júlia C. Loureiro1, Paulo R. Canineu1,3, Marcos V. Pais1, Leandro C.L. Valiengo1, Leda L. Talib1, Orestes V. Forlenza1

14 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Background: An intriguing issue regards whether depression reflects a prodromal manifestation of Alzheimer’s disease (AD) at least in a group of patients. Aim: To estimate the correlation between AD biomarkers and depression in individuals with MCI. Methods: We examined 67 individuals with MCI that underwent the CSF analyses for determination of AD pathology. They were divided into three groups (with early depression, n = 22; late depression, n = 22 and without depression, n = 23). Cognitive status was assessed by a comprehensive neuropsychological examination. CSF samples were drawn from all subjects to identify the levels of Aβ1-42 peptide, total tau (t-Tau), phosphorylated tau (p-Tau), and

Aβ1-42/p-Tau ratio. Laboratorial procedures were performed by the INNo-Bia AlzBio3 assay (Innogenetics, Ghent, Bel- gium), a multiplex microsphere-based LuminexxMAP platform that allows simultaneous analysis of these biomark- 1 ers. The Aβ142/p-Tau ratio < 9.53 was established as a cut-off reference for AD pathology. Intergroup comparisons of biomarker concentrations were performed by ANOVA; general linear model was used to determine the influence of

Aβ1-42 and tau on diagnosis. Results: In comparison with patients having MCI, but not depression, those presenting

MCI plus early or late depression revealed significant correlations with Aβ142, p-Tau, and with the Aβ142/p-Tau ratio. There was no significant correlation between diagnostic group and T-tau considered a variable alone. Conclusions and Comments: MCI plus depression were significantly correlated with CSF Alzheimer’s pathology. A remaining question concerns if early or late onset depression in patients with MCI and AD neuropathology could anticipate or accelerate the disease deterioration. 1Forlenza et al., Cerebrospinal fluid biomarkers in Alzheimer’s disease: Diagnostic accuracy and prediction of dementia. Alzheimers Dement, 2015;1:455-63.

1Laboratorio de Neurociências LIM27, Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. 2UNESP Universidade Estadual Paulista, IB, Campus of Rio Claro, SP, Brazil. 3Gerontology Program, PUC-SP, São Paulo, SP, Brazil.

TRANSCULTURAL ADAPTATION OF AN INSTRUMENT ABOUT KNOWLEDGE TOWARDS DEMENTIA BY ELDERLY’S CAREGIVERS Marcelo Piovezan1, Evelise Saia Rodolpho1, Fernanda Nascimento Costa1, Kaoana Maria Vieira de Almeida1, Thaíssa Bessa2, Alessandro Ferrari Jacinto1

Introduction: Ageing of the population increases the incidence of chronic diseases as dementia. The prevalence of dementia doubles every five years from 60 years of age. Previous studies have shown the knowledge towards dementia by elderly’s caregivers is low and that fact leads to low quality of care given to elderly as well as burden among caregivers. To evaluate knowledge on dementia among caregivers allows setting up strategies of better care. The study involved the cross-cultural adaptation of an Australian instrument (Dementia Knowledge Assessment Tool, Version 2). The instrument evaluates the knowledge on dementia by caregivers of elderly with dementia. The scores of the DKAT2 ranges from 0 (less knowledge) to 21 (greater knowledge). Methods: The translation of the instrument was carried out by two Brazilian speakers of the English language and one version was chosen to be back translated to the original language. The back translation was carried out by two native English language speakers. The final version of the transcultural adaptation was administered to 28 caregivers of elderly individuals diagnosed with dementia. Demographic factors of the caregivers and clinical factors of the elderly with dementia were obtained. Results: 92.9% of the participants were female caregivers, with a mean age of 56.5 years (12.3 SD); 60.7% were married, 60.7% were elderly’s offspring, 25% were spouses and 67.8% showed some level of burden. The mean age of the elderly (N = 28) was 81.9 (6.8 SD) years, 57.1% had Alzheimer’s disease and 67.8% had some level of dependence on basic activities of daily living. The average score related to the level of knowledge by caregivers was 14.8 (2.4 SD). Conclusions: The findings are in line with those from developing countries, being the family the main source of attention and care for the elderly, mainly offspring or spouses. The results are similar to the original Australian research. In the present study, the caregivers obtained an average of 14.8 correct answers. It was observed that there is a lack of knowledge about the types of dementia, its symptoms and stages among caregivers.

1Faculdade de Medicina de Botucatu-UNESP. 2Universidade Federal de Santa Catarina.

15 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Frequência e perfil cognitivo de comprometimento cognitivo vascular (CCV) pós-AVC isquêmico em 90 dias de seguimento Edla Silva da Silva, Sheila Martins, Márcia L. F. Chaves

Background e Objetivos: Demência é uma complicação comum após AVC afetando em torno de 1/3 dos pacientes e mais de 60% tem algum comprometimento cognitivo após o evento. Estima-se que o comprometimento cognitivo nestes pacientes progrida 10% por ano. O objetivo do estudo foi avaliar a ocorrência e o perfil cognitivo de comprometimento cognitivo em pacientes que apresentaram 1º AVC e sem comprometimento prévio. Métodos: 100 pacientes consecutivos preencheram os critérios de inclusão e exclusão do estudo no período de recrutamento de 11 meses durante os anos 2013/2014, dos quais 37 foram submetidos a tratamento trombolítico. IQCODE foi utilizado para excluir pacientes com comprometimento prévio, além da história ou registro em prontuário de diagnóstico de CCL ou demência. Depres- são e afasia também foram exclusões. A primeira avaliação cognitiva foi realizada em 90 dias pós evento isquêmico. A medida de desfecho foi a escala CDR. Uma bateria de testes cognitivos também foi aplicada. Características clínicas relacionadas ao AVC também foram registradas (escala NIHSS, dados de imagem, escala Rankin e Barthel). Resultados: Em 90 dias pós AVC isquêmico, 38 dos 100 pacientes apresentavam CDR ≥ 0,5. Não houve diferença significativa entre os grupos (com e sem comprometimento) para as variáveis: sexo, idade, escolaridade, território vascular afetado, e sintomas depressivos medidos pela Beck. Não houve associação significativa com o tratamento trombolítico (CCV 47% × 53%). Os grupos diferiram significativamente quanto ao NIHSS da chegada e em 30-90 dias (mais graves), na escala Rankin (mais graves) e na escala Barthel (mais dependência). Diferiram significativamente nos escores do MEEM, fluên- cia verbas (FAS), e no desenho do relógio. Não apresentaram diferença nos escores de nomeação da Boston, fluência verbal semântica, e nos dígitos (forward, backward e total). Conclusões: A frequência de CCV em 90 dias foi de 38%, não havendo relação com o tratamento na fase aguda (trombolíticos). Os pacientes com CCV tinham maior gravidade de apresentação do AVC e apresentaram mais comprometimento de funções executivas do que outros aspectos cognitivos.

Serviço de Neurologia, HCPA e PPG em Medicina – Ciências Médicas, UFRGS.

Levels of inactive ADAM10 in Alzheimer’s disease: a pilot study using cerebrospinal fluid samples Rafaela Peron1, Patricia Regina Manzine1, Thamires Naela Cardoso Magalhães2, Camila Vieira Ligo Teixeira2, Márcio Luiz Figueredo Balthazar2, Márcia Regina Cominetti1

Introduction: Active and mature ADAM10 is an transmembrane protein with α-secretase function that acts on β-amyloid peptide (Aβ) inhibition, which is an important neuropathological marker of Alzheimer’s disease (AD). We and others have demonstrated in previous studies that active ADAM10 platelet protein levels were reduced in AD patients, compared to cognitively healthy subjects. In platelets it is possible to evaluate the levels of the ADAM10 active and inactive forms, since this protein is active when anchored to the membrane. In the cerebrospinal fluid (CSF), only the presence of a soluble inactive form (detached from membrane) is found. Here, we investigated the levels of inactive ADAM10 in CSF, in order to corroborate our previous results, found in platelets. Objectives: To analyze and compare soluble and inactive ADAM10 protein in CSF samples from patients with amnestic MCI (aMCI) or mild to moderate AD compared to controls without cognitive impairment. Materials and Methods: n = 24 elderly subjects (n = 7 controls, n = 6 aMCI, n = 6 mild AD and n = 2 moderate AD) were blindly analyzed in two independent experiments. CSF proteins [10µg/µl] were analyzed using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and inactive and soluble ADAM10 was identified by western blot using anti-ADAM10 antibody (ProScience, 1:1000), that recognizes the inactive band of the protein (~50kDa). Mann-Whitney test was performed between all groups. Results: There were no significant differences between ADAM10 levels from aMCI and control subjects. However, increased CSF inactive ADAM10 levels were found in mild and moderate AD, compared to controls (p = 0.055 and p = 0.025, respectively). Con- clusions: Together with other clinical criteria, inactive CFS ADAM10 seems to be a relevant biomarker tool for accurate AD diagnosis, corroborating with our previous findings. Studies with a high number of subjects must be conducted in order to prove these findings. Acknowledgments/Financial Support: CNPq (401506/2016-9) and FAPESP (2015/24940-8).

1UFSCar – Universidade Federal de São Carlos, Departamento de Gerontologia. 2UNICAMP – Universidade Estadual de Campinas, Dep. de Neurologia.

16 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

EFFECTS OF THE TAILORED ACTIVITY PROGRAM IN BRAZIL (TAP-BR) FOR PERSONS WITH DEMENTIA Marcia Maria Pires Camargo Novelli1,2, Styfany Batista Corrêa Machado1, Gabriela Balestra Lima1, Lais Cantatore1, Barbara Pereira Sena1, Renata Savino Rodrigues1, Camila Izys Baptista Rodrigues1, Mariana Boaro Fernandez Canon1, Catherine Verrier Piersol3, Ricardo Nitrini4, Monica Sanches Yassuda4, Laura N. Gitlin5

Objectives: Evaluate effects of the Tailored Activity Program, translated and adapted for the Brazilian context (TAP- BR), on behavioral and psychological symptoms (BPSD) and quality of life of persons with dementia and caregiver burden and quality of life. TAP-BR involves 8-home sessions in which occupational therapists develop activities that match capabilities and interests of persons with dementia and train caregivers in their daily use at home. Methods: A two-group randomized controlled trial with 30 dyads was conducted: the experimental group (EG, n = 15) received TAP-BR over 4-months whereas a wait-list control group (WL, n = 15) received TAP-BR following conclusion of the 4-month follow-up. Dyads were recruited from the community of Santos city, Brazil. Results: For persons with dementia, 50% were female, average age was 81.37 (± 7.57), educational level was 9.97 (± 5.32) years and cognitive level (MMSE) was 17.93 (± 6.43). For caregivers, 83.33% were female, average age was 65.97 (± 10.13) and educational level was 12.10 (± 4.44) years. At posttest, in comparison to WL, EG caregivers reported greater reductions in number (p < .001; Cohen’s d = 0.93), frequency (p < .001; Cohen’s d = 1.12), and intensity (p < .001; Cohen’s d = 0.77) of BPSD, and caregiver distress (p < .001; Cohen’s d = 0.87). Caregivers also reported improvement in their own quality of life (p < .05, Cohen’s d = 0.57) and that of the person with dementia (p < .01, Cohen’s d = 0.56); no differences were found in ratings of quality of life by the person with dementia themselves. Conclusions: The program can be applied in a different cultural context and is a feasible strategy to address BPSD and support dementia caregivers. Financial support received by São Paulo Research Foundation, process number 2013/02489-7.

1Inter Professional Nucleus of Aging Research and Attendance (NIPAE) - Federal University of São Paulo, Santos, Brazil. 2Associate Professor of the Department of Occupational Therapy – Thomas Jefferson University School of Health Professions, Philadelphia, PA, USA. 4 Neurology Department - University of São Paulo, São Paulo, Brazil. 5Director of the Center for Innovative Care in Aging, School of Nursing – Johns Hopkins University, Baltimore, EUA.

Inflammatory biomarkers are not associated with apathy symptoms across a broad spectrum of neurodegenerative disorders Henrique Cerqueira Guimarães, Erica Leandro Marciano Veira, Leandro Boson Gambogi, Luciano Inácio Mariano, Natalia Pessoa Rocha, Paulo Caramelli, Antonio Lucio Teixeira, Leonardo Cruz de Souza

Background: Lack of motivation is a core feature of sickness-behavior: a coordinated set of behavioral adaptations that also includes a neurovegetative dimension (fatigue, loss of appetite and sleep disorders), and a psychological dimension (depressed mood, anxiety and cognitive dysfunction), that are supposed to reorganize the organism’s priorities to cope with infectious pathogens. Inflammatory mechanisms play a relevant role in neurodegenerative pathophysiology. Objectives: To test if the sickness behavior hypothesis could at least partially explain the severity of apathy symptoms within the spectrum of frontotemporal lobar degeneration (FTLD) and Alzheimer’s disease (AD). Methods: Participants meeting established diagnostic criteria for AD, behavioral variant frontotemporal dementia (bvFTD) and Progressive Supranuclear Palsy (PSP) were consecutively recruited from a tertiary referral Cognitive and Behavioral Neurology Unit. Several cytokines (IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-33,TNF-α), a few related receptors (sTNFR1, sTNFR2, TWEAK) and adipokines (leptin, resistin, adiponectin) levels were analyzed in blood samples according to standard procedures. These measures were correlated with apathy symptoms according to scores obtained with the Apathy Scale (AS). Results: Forty six participants (22 male; 24 female), with available aforementioned evaluations, were recruited as follows: AD (n = 15); PSP (n = 10); bvFTD (n = 21). The whole sample had a median age of 68 years (IQR:61-75), displayed a median disease duration of 3 years (IQR:2-4),had a median education of 11 years (IQR:9- 16), scored a median of 26 points (IQR:24-27) in MMSE and 20.5 points in AS (IQR:17-29). Spearman rank correlation coefficients were calculated within the whole group (n = 46) and separately in the following sets: bvFTD, FTLD (FTD+PSP) and AD. Considering Bonferroni correction for multiple comparisons (p < 0.004), no biomarker correlated with apathy symptoms in any of the analyzed sets. AS scores also did not correlate with disease duration. Acknowl-

17 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 edging the exploratory nature of these preliminary findings we found an inverse moderate correlation between AS scores and IL-33 levels (rho = -0.38 ; p = 0.01), and a direct one with resistin levels (rho = 0.36 ; p = 0.015) in the whole sample. Conclusions: These results do not support the sickness behavior theory as a suitable explanation for apathy symptoms in neurodegenerative disorders.

PERFORMANCE IN DUAL-TASK WALKING TESTS: CORRELATIONS WITH EDUCATION AND ASSOCIATION WITH FALLS IN ELDERLY: THE PIETÀ-STUDY Thaís Bueno Dias Albuquerque1, Fernando Liberato1, Lílian Viana dos Santos Azevedo1, Mauro César Quintão e Silva Cunningham1, Débora Palma Maia1, Maira Tonidandel Barbosa1, Paulo Caramelli1, Henrique Cerqueira Guimarães1

Introduction: The dual-task walking test (DTWT) is an activity in which the individual walks and simultaneously performs a cognitive task. DTWT in low educated-elderly is associate with clinical outcomes such as falls have been scarcely studied so far. Objectives: 1) To investigate correlations between performance in several DTWTs paradigms and educational attainment in cognitively healthy community-dwelling elderly; 2) To investigate the association between DTWT performance and history of falls in the preceding 12 months in community-dwelling elderly within a spectrum of cognitive status, from normality to mild dementia. Methods: Participants were consecutively recruited from the Pietà-Study. A total of 119 individuals including participants without cognitive impairment (n = 62), with cognitive impairment no dementia (CIND, n = 46), and mild dementia (n = 11) were tested in five types of dual tasks in a 10 meter round trip walk while: (1) praying, (2) singing, (3) counting forwards from zero, (4) counting backwards from 20, (5) counting backwards from 50. Time to accomplish the task and number of steps were recorded. The sample was splitted into two groups: participants (n = 24) with a history of fall (≥ 1) in the past 12 months and those without falls (n = 94). Spear- man rank correlation coefficients were calculated between educational level (years) and several parameter from the five DTWTs in those without cognitive impairment. Mann-Whitney test was used for comparisons between groups. Results: The sample had a female predominance (F/M:74/45), with a median age of 79 years (IQR:76-81) and median education of 3 years (IQR:2-4). Education correlated only with counting backwards from 20 DTWT performance (p = 0.003 for speed; p = 0.007 for speed × steps; p < 0.0001 for DT cost) No DTWT paradigm was associated with a history of falls in the preceding 12 months. Conclusion: Only counting back from 20 dual-task walking parameters correlated with educational level. No DTWT paradigm was statistically associated with history of falls in the preceding 12 months.

1Universidade Federal de Minas Gerais (UFMG).

BRAZILIAN AGING AND MEMORY STUDY (BRAMS): BASELINE CHARACTERIZATION AND FOLLOW-UP Sonia M.D. Brucki, Maira O. Oliveira, Eduardo S. Trés, Silvia S. Merlin, Daniel K. Amado, Breno José A.P. Barbosa, Fábio H.G. Porto, Ricardo Nitrini

Introduction: Mild cognitive impairment (MCI) prevalence has varied among studies. The BRAMS is a single-center population-based initiative to address memory and cognitive impairment in Brazil. Objective: to perform a descriptive characterization of patients evaluated for inclusion and follow-up data. Methods: Healthy individuals with memory complaints were referred to our outpatient clinic. Exclusion criteria in the screening interview included dementia, anxiety and/or depression. Eligible candidates were then referred to neuropsychological evaluation. All patients were analyzed with respect to demographic characteristics, comorbidities and neuropsychological tests. Based on clinical and NPS evaluation they were classified. Results: 489 individuals were screened for eligibility between November 2011 and June 2017. Mean age was 70.7 years (SD + 6.3), with 373 female patients (76.3%), 11.3 years of education (SD + 5), almost 40% between 12 to 18 y of schooling; 78% had intellectual or general non manual workers; analysis by socioeconomic class depicted 61% on B and 25% on C classes. Auto referred medical antecedents were: 18.2% of diabetes, 49.2% of hypertension, 44% of dyslipidemia, 3.1% of myocardial infarction, and 20.7% of hypothyroidism. They had on the first evaluation (median values): MMSE – 28 points; delayed recall (10 drawings) – 9; animal VF – 15;

18 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

P letter VF –11; clock design – 9 points; and QAF of zero. After a comprehensive NPS evaluation, 295 subjects were classified into: 43.5% as amMCImd; 8.2% as amMCIsd; 10.9% namMCImd; 13.2% as namMCIsd; 1.7% as normal controls; 21.4% as subjective cognitive decline (SCD) and 3 patients (1%) as dementia. Healthy and demented subjects were excluded for final classification. The median time of follow-up was 11 months (mean of 21.4 ± 23.1), 105 subjects had available data. The final classification was: 50.5% as amMCImd; 5.7% as amMCIsd; 7.6% as namMCImd; 9.5% as naMCIsd; 22.8% as SCD; 1.9% normal; and 1.9% as dementia. Conclusions: MCI is a heterogeneous and fluctuating status. A larger sample could give us more information.

Centro de Referência em Distúrbios Cognitivos (CEREDIC), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo, Brazil

Addenbrooke’s Cognitive Examination-Revised and Montreal Cognitive Assessment: data for seniors with heterogeneous educational level in Brazil Karolina Gouveia César, Mônica Sanches Yassuda, Fábio Henrique Gobbi Porto, Sonia Maria Dozzi Brucki, Ricardo Nitrini

Background: Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Adden- brooke’s Cognitive Examination – Revised (ACE-R) and Montreal Cognitive Assessment (MoCA) have been used to detect cognitive impairment. Objectives: The aim of the study was to provide ACE-R and MoCA norms and accuracy for seniors within a lower education, including illiterates. Methods: Data originated from an epidemiological study conducted in the municipality of Tremembé, Brazil. The Brazilian version of ACE-R and MoCA were applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia and 135 were classified as having cognitive impairment no dementia (CIND). Results: ACE-R and MoCA norms were provided with the sample stratified into age and education bands. The total scores varied significantly according to age, education and sex. To distinguish CN from dementia, an ACE-R cutoff of 64 points was established (sensitivity 91%, specificity 76%) and a MoCA cutoff of 15 points (sensitivity 90%, specificity 77%). To differentiate CN from CIND the best ACE-R cutoff was 69 points (sensitivity 73%, specificity 65%) and MoCA cutoff was 19 points (sensitivity 84%, specificity 49%). Cutoff scores varied according to the educational level. Conclusions: ACE-R could be a good tool to detect dementia and CIND, if cutoff scores were adjusted according education. MoCA test did not have a good accuracy for detect CIND in this population with low educational level.

ENTORHINAL AND CINGULATE CORTICAL THICKNESS PREDICT EPISODIC MEMORY AND GLOBAL COGNITION IN MILD ALZHEIMER’S DISEASE Ana Flávia Mac Knight Carletti Cassani, Camila Vieira de Ligo Teixeira, Thiago Junqueira Ribeiro Rezende, Thamires N.C. Magalhães, Marina Weiler, Debora Queiroz de Almeida, Fernando Cendes, Marcio Luiz Figueredo Balthazar

Introduction: Hippocampal atrophy is a potential biomarker for Alzheimer disease (AD). However, there are other atrophic areas during the development of this disease. Amnestic Mild Cognitive Impairment (aMCI) is a clinical condition where the patient presents a memory impairment but with normal daily activities. It is important to analyze what areas are impaired in AD and aMCI compared to controls, and also see if the atrophic areas could influence the cognitive performance of this population. Therefore, we aimed to analyze if cortical thickness may influence a global cognitive test (Mini Mental State Exam, MMSE) and verbal episodic memory (Rey Auditory Verbal learning test, RAVLT). Materials and Methods: 67 voluntaries were evaluated: 18 with mild AD, 22 with aMCI and 27 controls (CTL) matched for aged and education. We used MMSE for global cognitive status and RAVLT for verbal episodic memory. MRI data were acquired on a 3.0T MRI Philips Achieva scanner. FreeSurfer program (https://surfer.nmr.mgh. harvard.edu/fswiki) was used to analyze cortical thickness of the population. We compared cortical thickness between the groups and performed multiple regressions to check the possible associations between cortical thickness and the

19 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 cognitive scores. Results: One-Way ANOVA, using age as covariant, showed that mild AD group had significant difference in cortical thickness compared to aMCI and CTL in the left areas: entorhinal, fusiform, inferior temporal, insula, lingual, medial temporal, posterior cingulate, and right areas: inferior parietal, isthmus cingulate, lateral occipital, lateral orbito-frontal, precuneus, superior temporal and supramarginal (p < 0.05, corrected for multiple comparisons.. Regression models revealed that left entorhinal thickness predicts MMSE scores (R2 = 0.32) and right isthmus cingulum thickness predicts RAVLT (immediate - R2 = 0.32 - and delayed recall - R2 = 0.34). Conclusions: The present study shows only mild AD patients differed from controls. In terms of cortical thickness, entorhinal and isthmus cingulate cortex have a relative strong predicting power on MMSE and RAVLT, respectively.

CORTICOBASAL SYNDROME: CLINICAL FEATURES AND METABOLIC IMAGING PATTERN Jacy Parmera1, Mateus Aranha2, Artur Coutinho2, Adalberto Studart1, Carla Ono2, Carlos Buchpiguel2, Egberto Barbosa1, Ricardo Nitrini1, Sonia M.D. Brucki1

Introduction: Corticobasal Syndrome (CBS) was first considered a motor disorder with parkinsonism, dystonic and myo- clonic movements. It is now also recognized as a cognitive disorder associated with several cortical features. The term CBS denotes the phenotype of multiple pathologies, including Corticobasal Degeneration and Alzheimer’s disease (AD). New diagnostic methods are being developed to predict the pathology. Objectives: To investigate the clinical core of cases with CBS, describe the brain metabolism patterns and compare the clinical features of patients with a pattern suggestive or not of AD. Methods: Fifteen patients with probable CBS assessed with motor and cognitive tests were submitted to brain Fluordeoxyglicose-Positron emission tomography (FDG-PET) or Single-photon emission tomography (SPECT). They were compared based on the movement disorders and cortical symptoms. According to the scans were distributed into two groups: CBS related to AD(AD) and CBS unrelated to AD(non-AD). Results: Mean age at presentation and schooling were 65.33 (± 8.50) and 4.67 (± 3.09) years. Thirteen patients were submitted to FDG-PET and two realized SPECT. Eleven had a non-AD pattern and four had an AD-pattern. There were significant differences on Mini Mental Score Examination(MMSE) (AD = 5.25 ± 7.54 vs non-AD = 15.82 ± 7.11 p = 0.026) and Hoehn and Yahr (HY) scale (AD = 1.75 ± 0.86 vs non-AD = 3.64 ± 1.48 p = 0.034). Parkinsonism was present in 100% of the patients, myoc- lonus in 53.3% and dystonia in 53.3%. Apraxia was the most prevalent cognitive feature (86.7%). Aphasia and cortical sensory loss were noted in 53.3% and 40%, respectively. One patient had alien limb phenomena. Only dystonia demonstrated a significant difference between groups as 100% presented a non-AD pattern (p = 0.026). Apraxia of speech also showed a tendency to correlate to the non-AD group, as 100% had a non-AD pattern (p = 0.154). Conclusions: All patients presented akinetic-rigid parkinsonism and apraxia was the most prevalent cognitive feature. Lower MMSE and HY scores were linked to the AD pattern group, as well as dystonia to the non-AD group.

1Department of Neurology – University of São Paulo. 2Center of Nuclear Medicine – University of São Paulo.

AMNESTIC COMPLAINT IN PRIMARY HEALTH CARE: CLINICAL, NEUROPSYCHOLOGICAL AND FUNCTIONAL CHARACTERIZATION Marcos Leandro Pereira1,2, Ronaldo Pereira Caixeta1, Paulo Caramelli2, Leonardo Cruz de Souza2

Background: Memory complaints are frequent in the elderly. There are different causes of memory impairment, such as age-related cognitive decline, depression, mild cognitive impairment (MCI), or a neurodegenerative disease. Objectives: To characterize the memory complaint in primary health care in Patos de Minas (Minas Gerais), in terms of clinical, cognitive and functional profiles.M ethods: This study was carried out with patients aged ≥ 50 years, with memory complaints (spontaneous or inquired). The study was conducted in a primary health center from March to September, 2016. Patients who scored ≥ 25 in the Memory Complaint Questionnaire (MAC-Q) or who had spontaneous memory complaints were included. Patients underwent a semi-structured interview, Mini Mental State Examina- tion, Figures Test (visual episodic memory test), Clock Test, Semantic Fluency (Animals), the Neuropsychiatric Inven- tory, and functional assessment (Katz and Pfeffer scales for activities of daily living). Patients were classified into the following categories: subjective cognitive impairment (SCI), amnestic MCI (aMCI), non-amnestic MCI (naMCI)

20 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 and dementia. Results: 432 patients were initially assessed. 25% of them (n = 108) had memory complaints. The final sample consisted of 91 patients (73.6% were women; mean age 67.6 ± 9.76 years; mean educational level of 4 for 8 years). 14.3% had spontaneous complaints and 85.7% had inquired complaints. The most common comorbidities were hypertension (69.2%), diabetes mellitus (36.3%), dyslipidemia (24.2%) hypothyroidism (21.9%), anxiety (17.6%) and depression (12.1%). Low levels of vitamin B12 and hypothyroidism were found in 26.4% e 16.5%, respectively. 13.2% were classified as SCI, 23.5% as naMCI, 29.7% as aMCI and 34.1% as dementia. Patients who presented spontaneous complaints had worse performance in MMSE, 5 ‘evocation (memory test) and higher score on MAC-Q. There was no correlation between MAC-Q and cognitive tests. Conclusions: MCI and dementia are underdiagnosed. Cardiovascular risk and reversible causes of cognitive decline were frequent in our population, reinforcing the need of appropriate medical screening. Patients with spontaneous memory complaint had worse performance than patients with inquired memory complaint. Key words: Memory complaint, primary health care, neuropsychological.

1Centro Universitário de Patos de Minas – UNIPAM. 2Universidade Federal de Minas Gerais – UFMG.

IMPACT OF SCHOOLING, MODALITY AND NUMBER OF SESSIONS IN EFICACY OF WORKING MEMORY TRAINING Paula Schimidt Brum1, Erika Borella, Bárbara Carretti, Mônica Sanches Yassuda1

Introdution: Questions regarding the impact of schooling, number of sessions and intervention modality (individual versus group) on the training effect have not been answered in previous studies.Objectives: 1. to examine the influence of schooling (four versus eight years and more), 2. dose of training (three vs. six sessions); and 3. modality (individual vs. group) on the effects of verbal WM training offered to older adults.M ethods: 129 older adults participated of different experiments. Experiment 1 (replication) included 11 older adults randomized in the training condition and 15 in the active control condition, all with more than eight years of schooling. Experiment 2 (effect of schooling) included the participants in the replication study and older adults with four years of schooling. The interventions in Experi- ment 1 and Experiment 2 had three individual sessions. In Experiment 3, 23 older adults were randomized in the training condition and 27 in the active control condition both with six sessions and this new sample was compared to the respective conditions of Experiments 1 and 2 united in a single sample. Finally, the sample of Experiment 1 was compared to 16 older adults in the training condition and 17 in the active control condition, who underwent three group sessions. Results: Only the training condition increased performance in WM, executive function and processing speed tests, maintained after six months. Participants with four years of schooling showed similar gains to the training group with eight or more years of schooling in evaluations. The results indicated that training with three or six sessions generates equivalent cognitive gains. There is no difference between the modalities in the outcome variables in evaluations. Conclusions: Three and six sessions showed similar effects for the outcome variables, as well as individual and group training, and for participants with four and eight years of schooling. Agência Financiadora: Comissão de Aper- feiçoamento de Pessoal do Nível Superior.

1Faculdade de Medicina da Universidade de São Paulo.

Disease Staging in Frontotemporal Dementia and in Alzheimer’s Disease: The Contribution of the Frontotemporal Dementia Rating Scale (FTD-FRS) in a 12-Month Follow-up Study Thaís Bento Lima-Silva1, Valéria Santoro Bahia1, Mário Amore Cecchini1, Luciana Cassimiro1, Leonardo Cruz de Souza2, Henrique Cerqueira Guimarães2, Leandro Boson Gambogi2, Paulo Caramelli2, Márcio L.F. Balthazar3, Benito Damasceno3, Sônia M. D. Brucki1, Ricardo Nitrini1, Eneida Mioshi4, Mônica Sanches Yassuda1

Background: Staging of dementia allows better management of the clinical condition and can help reduce caregiver dependency and burden. Instruments to stage dementia progression are usually based on Alzheimer’s disease (AD) and do not include the specific symptoms of frontotemporal dementia (FTD). The the Frontotemporal Dementia

21 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Rating Scale (FTD-FRS) was elaborated to stage FTD and recently an extended version of the Clinical Dementia Rat- ing scale included Language and Behavior domains (CDR-FTLD). Objectives: We aimed to investigate disease progression during a 12-month period using the FTD-FRS and the CDR-FTLD sum of boxes (SOB) in FTD compared to AD. Methods: Participants were 71 individuals, aged 40+ years with at least two years of schooling: 31 received the diagnosis of behavioral variant (bv)FTD, 12 of Primary Progressive Aphasia (PPA) (8 semantic variant and 4 non-fluent variant) and 28 of AD. Family members or caregivers who had frequent contact with the patients completed the FTD-FRS. The CDR-FTLD was completed by physicians. Patients completed the Addenbrooke’s Cognitive Examination-Revised. To determine annual progression, the 12-month follow up assessments were used. Results: There were significant changes in FTD-FRS and CDR-FTLD scores from baseline to follow-up for all groups. After 12 months, there was significant decline on most group scores. The FTD-FRS and the CDR-FTLD captured transitions to more severe stages from baseline to follow-up in all groups, except for the PPA group. Conclusions: The FTD-FRS and the CDR-FTLD can aid in staging and determining progression in FTD. This study provides clinicians and researchers with a valid instrument with which to classify and follow up on patients diagnosed with FTD. The drafting of a severity scale adapted to the disorders typical of FTD may facilitate early identification of these patients and reduce delays between symptom onset and symptom detection. It would also favour both proper selection and timely use of drug treatments, and promote providing carers with up-to-date information and advice. The FTD-FRS is a tool able to improve clinical attention to patients (and their family members), whether in the initial or terminal stages of FTD.

1Cognitive and Behavioral Neurology Research Group, Faculdade de Medicina and Hospital das Clínicas, Neurology Department, University of São Paulo, São Paulo, Brazil. 2Cognitive and Behavioral Neurology Research Group, Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. 3Department of Neurology, University of Campinas, São Paulo, Brazil. 4School of Health Sciences, University of East Anglia, Norwich, UK.

Prospective evaluation of cognition in a Brazilian Huntington’s disease cohort Raphael Machado de Castilhos1,11,12, Marina Coutinho Augustin6,11, José Augusto dos Santos6,11, José Luiz Pedroso7, Orlando Barsottini7, Roberta arb Saba7, Henrique Ballalai Ferraz7, Fernando Regla Vargas8, Maria Luiza Saraiva-Pereira1-4,9-11, Laura Bannach Jardim1,5,6,9-12, on behalf of Rede Neurogenética

Introduction: Huntington’s disease (HD) is a neurodegenerative disease characterized by movement disorders (specially chorea), behavioral changes and cognitive decline. Cognitive impairment occurs since early stages of the disease and is characterized by executive dysfunction and slower processing speed. Although the natural history of HD is well described in European and North American cohorts, there are no data from Brazilian cohorts. Objectives: To verify the progression of the cognitive tests in symptomatic HD subjects in a Brazilian cohort. Methods: Symptomatic HD subjects were selected. Age, age of onset (AO), gender, disease duration (dd), CAG expansion and UHDRS scores were obtained. Cognitive tests performed were Stroop Color and Word Test, Symbol Digit Modalities Test, phonemic verbal fluency (FAS). Cross-sectional analyzes were performed at baseline and longitudinal measurements after 12 months. Subjects who scored 0 on baseline or follow-up were considered missing. Results: Cognitive evaluation was performed in 74 symptomatic patients, 37 (50%) female. Mean (sd) age at baseline was 50.3 (11.2) years, AO was 41.5 (11.2) years; expanded CAG median (IQR) of 44 (43-46.25) repeats and 8 (4-11.25) years of dd. Cognitive scales did not correlate with AO or CAG expansion. All cognitive scales showed mild to moderate correlation with age and dd at baseline (Spearman). Cognitive scales correlate strongly with other UHDRS subscales. In 42 (24 female) symptomatic subjects, a prospective evaluation was performed on average 12 months later. Mean (sd) of all cognitive tests remained very similar at follow-up and there was no significant difference (GEE): Stroop/color (baseline 28.5 (12.3), follow-up 29.5 (12.5), p = 0.63); Stroop/word (baseline 32.2 (13.4), follow-up 34 (19.4), p = 0.63); Stroop/interference (baseline 15.9 (9), follow-up 15.9 (8.3), p = 0.85); SDMT (baseline 14.6 (7.9), follow-up 14.8 (8.5), p = 0.27); FAS (baseline 12.3 (8.3), follow-up 16.6 (6.5), p = 0.84). Conclusions: Although the small number of individuals in the prospective assessment has prevented significance, cognitive scales correlate with other UHDRS subscales. Knowledge of the natural history of various aspects of HD is critical, especially if disease modifying therapies are available in the future.

22 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

1Programa de pós-graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul. 2Programa de pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Sul. 3Programa de pós-graduação em Biologia Molecular e Celular, Universidade Federal do Rio Grande do Sul. 4Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul. 5Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul. 6Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. 7D isciplina de Neurologia Clínica, UNIFESP – Escola Paulista de Medicina, Universidade Federal de São Paulo. 8Hospital Graffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro. 9Laboratório de Identificação Genética, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre. 10Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre. 11Rede Neurogenética, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre. 12Instituto Nacional de Genética Médica Populacional (INAGEMP).

An assessment of direct and indirect costs of dementia in Brazil Ceres Eloah L. Ferretti1,2, Flávia M. Sarti3, Ricardo Nitrini1, Fernando F. Ferreira3, Sonia M.D. Brucki1,4

Background: To analyze costs associated with dementia based on a cross-sectional study in the Brazilian health system. Methods: Direct and indirect costs were estimated by conducting comprehensive interviews on the use of resources in a sample of 156 patients with dementia treated at an outpatient memory clinic of a tertiary hospital. A regression model was used to determine the main determinants of costs associated with dementia. Results: Global costs of dementia were US$ 1,012.35; US$ 1,683.18 and US$ 1,372.30 per patient/month for mild, moderate and severe stages, respectively. Indirect costs ranged from US$ 536.62 to US$ 545.17 according to severity. Dementia costs were influenced by medication, FAST score, and educational level of caregiver.D iscussion: The study represents an original contribution toward establishing direct and indirect costs of dementia in Brazil. Results indicate significant economic impacts, including projection of annual costs of US$16,548.24 per patient. Key words: Dementia, ageing, cost of illness, economics, productivity loss.

1Department of Neurology. Cognitive and Behavioral Neurology Unit. School of Medicine. Universidade de São Paulo. SP – Brazil. 2Department of Nursing and Nutrition of Universidade de Taubaté. Taubaté - São Paulo Brazil. 3Universidade de São Paulo, USP Leste, Escola de Artes, Ciências e Humanidades. São Paulo, SP – Brasil. 4Hospital Santa Marcelina. São Paulo, SP – Brasil.

IN DEMENTIA, WHAT’S HOLOGRAPHY CAN DO FOR US ? Yolanda Eliza Moreira Boechat, Julio Cesar R. Dal Bello, Tayssa Boechat Moreira, Natalia C. Fernandes, Eduardo Rodrigues Valle, Ricardo C. Carrano, Rene Prestes Filho, Jaqueline A.Tonelli, Jamaci A.C.Lima, Licinio Esmeraldo da Silva, Neiva R. Mendes, Mabel A.O.Dal Bello, Mariana L. Olimecha Carvalho, Gustavo Bentemuller Pereira

Introduction: The provision of medical services, especially in the most remote places in Brazil, is a challenge. In general, there is a shortage of professionals and, in particular, specialists, causing a large part of the population to suffer from the absence of adequate medical care. This situation becomes worse when you think of dementia diagnosis. Objective: Given this scenario, the idea of supplanting this need for a specialist doctor through a remote support to the care emerged. This idea was converted into a project by the University through our Nucleus of Studies and in 2012 we began the search for practical ways of overcoming this deficiency in Brazil. Our premise was to create a Virtual Health Office through Telepresence and Holography for online consultations on time.M ethods: Through a development grant, it was possible to create our prototype. In this proposal, what moved us was the perception that the doctor to do a good remote assistance would need to have the sensation of being in the same place as the patient, being able to see it integrally from the face perceiving movements, reactions and other factors sensitive to accomplishment of a good service. Discussion and Conclusions: The first phase of the project consisted in the validation of the idea by the implantation of a Holographic Health Center. At this location, the Remote Virtual Health Office was designed by hologram. This prototype has been extensively tested and adapted to the construction of a holographic service. After the success of this prototype, we started the second phase of the project, currently underway. In this phase, the pilots of the Virtual Health Offices are being installed in distant locations, allowing assisted assistance with specialized professionals from different areas of the University Hospital. This project contains an innovation that can change health care because in places where the specialist does not go, the holography allows him to arrive, diagnose a case of dementia and guide the

23 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 professional who is in the field of action, avoiding public health expenses with unnecessary transfers reducing suffering and bringing knowledge, giving a financial and public health solution for cases that require specialized diagnosis and treatment. In this way, this project proposes to allow the early diagnosis of dementias to be performed in remote locations through holographic consultation on line on time, improving the quality of life of patients living in these areas.

Behavioural but not cognitive measures of disinhibition can effectively differentiate frontotemporal dementia from Alzheimer’s disease Luciano Inácio Mariano1, Henrique Cerqueira Guimarães1, Leandro Boson Gambogi1, Michael Hornberger2, Claire O’Callaghan3, Thaís Bento Lima da Silva4, Mônica Sanches Yassuda4, Juliana Septímio Amaral1, Antônio Lúcio Teixeira1, Paulo Caramelli1, Leonardo Cruz de Souza1

Background: The differential diagnosis between behavioural-variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD) is a challenge in clinical neuropsychology. As disinhibition is a hallmark of bvFTD, inhibitory function and impulsivity, like intertemporal choice, may be valuable for differential diagnosis. Methods: Three groups participated in this study: 25 mild AD dementia patients (age 74.6 ± 9.7, 13 males), 27 mild bvFTD patients (age 67.8 ± 9.8, 14 males) and 24 healthy controls (age 70.8 ± 8.3, 18 females). Groups were matched for sex, education and income. The protocol comprised 10 cognitive tests, focusing on inhibitory capacity or impulsivity (e.g.: Stroop, Hay- ling tests and a Delay Discounting Task (DDT)) and two behavioural measures (Starkstein’s Apathy Scale – AS – and Barratt Impulsiveness Scale – BIS-11). Results: There was no difference between AD and bvFTD in any of the neuropsychological measures of inhibitory control (Hayling Test: bvFTD 18.2 ± 13.2 vs. AD: 17.4 ± 9.6, p = 1.00; DDT: bvFTD 0.053 ± 0.09 vs. AD: 0.058 ± 0.07, p = 1.00). Behavioural evaluation, however, was different between clinical groups (BIS-11: bvFTD 76.1 ± 9.5 vs. AD 62.9 ± 13.5, p = 0.001; AS: bvFTD 28.1 ± 7.8 vs. AD 16.9 ± 9, p < 0.001). ROC curve analysis, between AD vs bvFTD, demonstrated that BIS-11 and AS had higher diagnostic accuracies than inhibitory/ impulsivity neuropsychological tests: BIS-11: 80% specificity and 68.2% sensitivity; AS: 77.8% specificity and 78.3% sensitivity. Conclusions: Neuropsychological tests of inhibitory control and impulsivity were not useful for the differential diagnosis between AD and bvFTD. Nonetheless, BIS-11 did demonstrate diagnostic ability to distinguish the clinical groups, reinforcing that behavioural impulsivity is a hallmark of bvFTD. The dissociation between cognitive and behavioural measures may be considered for the development of new tests for the early diagnosis of bvFTD.

1Universidade Federal de Minas Gerais – Brasil 2University of East Anglia, Norwich – UK. 3University of Cambridge, Cambridge – UK. 4Universidade de São Paulo – Brasil.

24 Poster presentations Dement Neuropsychol 2017 December;11(Suppl 1):1-76

1. APPLICATION OF REM SLEEP BEHAVIORAL SCREENING QUESTIONNAIRES AS A DIAGNOSTIC AID TOOL IN THE DIFFERENTIATION BETWEEN ALZHEIMER’S DISEASE AND LEWY BODY DEMENTIA Verônica Tavares Aragão1, Norberto Anízio Ferreira Frota1,2, Emmanuelle Tavares Sobreira1, Manoel Alves Sobreira2, Mariana Bruno Soares1

Introduction: Alzheimer’s disease (AD) and Lewy body dementia (LBD) are the two main causes of degenerative dementias in the elderly population. The diagnostic difference between these two diseases is not always easy, especially in the most incipient cases and when parkinsonism is not present. In the new diagnostic criteria for LBD, REM sleep disorders were included as a major criterion for this disease. In order to diagnose RBD, polysomnography (PSG) is required, but such test may not be easily available on a day-to-day basis. In this scenario, the use of questionnaires to diagnose RBD can be useful. Objectives: To evaluate the ability to differentiate a group of patients with LBD and AD through a screening questionnaire of RBD at the General Hospital of Fortaleza. Materials and Methods: We selected patients with probable or possible diagnosis of AD or LBD, who were followed at the HGF Neurology service, who met the eligibility criteria for the survey: MMSE ≥ 10; exclusion of differential diagnosis (with neuroimaging and laboratory tests); absence of vascular dementia of the strategic type or multi-infarct. The Participants were assessed using the RBD questionnaire and the Epworth Sleepiness Scale (ESS). Initially, we performed a descriptive analysis of the data from the two groups, then we compared the categorical variables using Chi-square and the continuous variables through Mann-Whitney. A ROC curve was used to assess the accuracy of the RBDSQ. Results: All patients’ records were analyzed in the cognitive outpatient clinic from March to July 2017, and 42 patients were selected. Twenty-nine patients diagnosed with AD (69%) and thirteen with probable/possible Lewy body dementia (31%). The patients with LBD had a higher score in the RBDSQ and a greater tendency to daytime sleepiness. The cutoff point in the TCSREM questionnaire of 6 had sensitivity of 84,6% and specificity of 88,5%.Conclusions: The present study shows that the use of a 13-item sleep questionnaire can help in cases of diagnostic doubt with great accuracy, serving as a screening tool. Final: Financiamento próprio (autor).

1Hospital Geral de Fortaleza. 2Universidade de Fortaleza.

2. The effects of gender, age, schooling and cultural background on the identification of facial emotions: a transcultural study Leonardo Cruz de Souza1-3, Maxime Bertoux4, Ângelo Ribeiro Vaz de Faria3, Laiane Tábata Souza Corgosinho3, Ana Carolina de Almeida Prado3, Izabela Guimarães Barbosa1,3,5, Paulo Caramelli1,2, Enrico Colosimo6, Antônio Lúcio Teixeira1,2,3

Background: Social cognition tasks, such as identification of emotions, can contribute to the diagnosis of neuropsychiatric disorders. The wide use of Facial Emotion Recognition Test (FERT) is hampered by the absence of normative dataset and by the limited understanding of how demographic factors such as age, education, gender and cultural background may influence the performance on the test.M ethods: We analyzed the influence of these variables in the performance in the FERT from the short version of the Social and Emotional Assessment. This task is composed by 35 pictures with seven different emotions presented five times each. Cognitively healthy Brazilian participants (n = 203; 109 females and 94 males) underwent the FERT. We compared the performance of participants across gender, age and educational subgroups. We also compared the performance of Brazilians with a group of French subjects (n = 60) matched for gender, age and educational level. Results: There was no gender difference regarding the performance on total score and in each emotion subscore in the Brazilian sample. We found a significant effect of aging and schooling on the performance on the FERT, with younger and more educated subjects having higher scores. Brazilian and French participants did not differ in the FERT and its subscores. Normative data for employing the FERT in Brazilian population is presented. Conclusions: Data here provided may contribute to the interpretation of the results of FERT in different cultural contexts and highlight the common bias that should be corrected in the future tasks to be developed.

1Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais (MG), Brazil. 2D epartamento de Clínica Médica, Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil. 3Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina

26 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 da UFMG, Belo Horizonte, MG, Brazil. 4Université de Caen Normandie, INSERM-EPHE-UNICAEN U1077, Caen, France. 5Departamento de Saúde Mental, Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil. 6Departamento de Estatística, UFMG, Belo Horizonte, MG, Brazil.

3. Cognitive Stimulation Therapy for dementia, adaptation and validation in Brazil Valeska Marinho1, Renata Naylor2, Elodie Bertrand2,3, Jerson Laks1,3, Aimee Spector4, Daniel Mograbi2,5

Introduction: Cognitive Stimulation Therapy (CST) is a 14-session group intervention for people with mild to moderate dementia (PWD), developed in UK and recommended by NICE guidance. It aims to stimulate PWD through complex psychological techniques (e.g. implicit learning, multi-sensory stimulation) embedded in structured group activities (e.g. word association, current affairs). Group Sessions typically run twice weekly, actively stimulating and engag- ing PWD in a learning environment which also provides the social benefits of a group. A robust evidence-based data proves its efficacy in improving cognition and quality of life (QoL) in PWD.Objectives: We hypothesize that the benefits found in UK could be replicated in a Brazilian sample. The current work describes the process to adapt and validate the CST in Brazil. Methods: The study is following a five-phase model based on the formative method for adapting psycho- therapy, which includes engagement with stakeholders, a forward and back translation method and pilot-testing. A feasibility study with 50 PWD, randomized to receive intervention vs. treatment as usual, will be conducted after the initial adaptation. Results: Results from focus groups with stakeholders, including healthcare professionals, patients and caregivers, will be presented with a discussion on how the materials and procedures are being adapted for a developing country. Conclusions: The main features of CST are applicable to our sample, but adjusting the procedures to participants with heterogeneous educational level should be taken into account. A point reinforced by stakeholders’ was the absence of any evidence based non-pharmacological intervention for dementia in our country. An effective and validated psychological approach aiming to improve QoL and cognition in PWD is an urgent need in our country.

1Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria (IPUB/UFRJ); 2Pontifícia Universidade Católica – Rio (PUC-Rio), Department of Psychology; 3University of Grande Rio (Unigranrio), Department of Psychology; 4University College London, Division of Psychology and Language Sciences; 5King’s College London, Institute of Psychiatry, Psychology & Neuroscience.

4. Inflammatory profile and functional concectivity in patients with amnestic Mild Cognitive Impairment and mild Alzheimer’s disease Thamires N. C. Magalhães1, Marina Weiler1, Brunno M. de Campos1, Camila V. L. Teixeira1, Thaís Hayata1, Adriel S. Moraes2, Vínicius O. Boldrini2, Leonilda M. dos Santos2, Helena P. G. Joaquim3, Leda L. Talib3, Orestes V. Forlenza3, Fernando Cendes1, Marcio L. F. Balthazar1

Background: There is increasing evidence suggesting that Alzheimer’s disease (AD) pathogenesis is associated with immunological mechanisms. The term “inflammaging” brought the idea that peripheral inflammation was associated with adverse effects on cognition and brain structure in the aging. Objectives: We aimed to verify differences in Default Mode Network functional connectivity (DMN FC) in mild AD, aMCI and normal aging, considering the detection, or lack thereof, of peripheral cytokines. Methods: All images were acquired in a 3T scanner (Philips Achieva) from 42 healthy controls, 55 aMCI and 33 mild AD patients. We performed the FC analysis using the UF²C toolbox. DMN mask was used as a template to extract each patients FC value of the DMN sub regions. Blood samples were collected from all participants. We used a BD Cytometric Bead Array (CBA) to quantify the following cytokines: IL-1β, IL-6, IL-10, IL-12 and TNF-α. We considered the cytokines variable as categorical and compared with DMN sub regions within groups considering cytokine “detection” vs “non-detection”. Results were controlled for age and education. Results: We found significant differences across groups in FC of the right temporal region (aMCI < controls) and mild AD patients presented disrupted DMN FC. In intra-group comparison, aMCI and mild AD with detectable levels of cytokines (IL- 1β, IL-10, IL-12 and TNF-α) had decreased DMN FC. Conclusions: According to our findings, we observed that systemic inflammation profile could possibly be involved with decreased FC of DMN in our aMCI and mild AD patients. Finals: grant 133343/2015-4, CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico).

1Neuroimaging Laboratory (LNI), Department of Neurology, University of Campinas (Unicamp) – SP, Brazil; 2Institute of Biology – University of Campinas (Unicamp); 3Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, University of São Paulo (USP) – SP, Brazil.

27 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

5. VALIDatiON AND APPLICABILITY OF MINI-ADDENBROOKE’S COGNITIVE EXAMINATION AS A BRIEF COGNITIVE EVALUATION INSTRUMENT IN MILD COGNITIVE IMPAIRMENT AND MILD ALZHEIMER’S DISEASE Diane da Costa Miranda1, Sonia Maria Dozzi Brucki1

Introduction: The Mini-Addenbrooke’s Cognitive Examination (M-ACE) is a brief cognitive assessment test composed of five items that aim to evaluate four main cognitive domains (orientation, memory, language and visuospatial function) with a maximum score of 30 points and an administration time of five minutes.Objectives: To evaluate the performance of cognitively healthy elderly, MCI and probable mild AD patients in the Brazilian version of M-ACE. Methods: The test was applied in a group of 21 cognitively healthy elderly, 31 MCI, 21 mild probable AD patients. All participants included were aged ≥ 60 years. Were excluded moderate or severe dementia, dementia of another etiology, severe comorbidities with potential to compromise cognition (advanced chronic and hepatic renal disease, decompen- sated depression, psychiatric illness) and use of psychotropic medication. The sensitivity and specificity of the test were evaluated using Receiving Operator Characteristic Curve (ROC). Spearman correlation coefficients were used to analyze the relationship between the M-ACE scores and the other cognitive tests applied. Results: 73 individuals were evaluated, 21 AD patients, 31 MCI, 21 healthy control with a mean educational level of 8.7, 11.5, 13.8, respectively. The results indicated that M-ACE had good accuracy in discriminating controls of AD patients (cut-off point of 24.5, sensitivity = 95.2, specificity = 100), as well as separating MCI from AD (cut-off point 20.5, sensitivity = 90.3, specificity 95.2).Conclusions: The Brazilian version of M-ACE proved to be a good instrument for cognitive evaluation in our setting. It was able to discriminate mild AD patients from controls as well as MCI from AD.

1University of São Paulo, São Paulo, Brazil.

6. IS IT RELEVANT TO SCREEN FOR COGNITIVE, MOOD AND ANXIETY DISORDERS IN PRIMARY CARE ELDERLY USERS? Francisco Assis Carvalho Vale1, Estela Barbosa Ribeiro1, Mariana Luciano de Almeida2, Daniela Dalpubel1, Renata Bezerra Araújo1, Caio Freitas Ramos1

Introduction: The populational ageing has caused an increase in prevalence of dementia syndromes, which impacts sub- stantially in public health budgets. Mild cognitive deficits may not be noticed by clinicians and that hinders early diagnoses of dementia. Objectives: To screen cognitive and mood changes in a sample of the elderly people with the purpose of justifying the implementation of a routine screening in the basic health units of São Carlos city. Methods: Cross-sectional study with the application of the Memory Complaint Scale (MCS), Addenbrooke’s Cognitive Exami- nation – Revised (ACE-R), Mini-Mental State Examination (MMSE); Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Pfeffer Functional Activity Questionnaire (FAQ). Results: Were assessed 95 elderly individuals aged 65+ years. The majority of them was of women, married, with mean schooling of 5.3 ± 2.9 years and mean age of 72 ± 4.7 years. It was found that 41% had MC. Sixty-six percent had cognitive deficit according to ACE-R and 22% according to MMSE. Depressive and anxious symptoms were found in 33% and 39%, respectively. Only 3% showed some degree of dependence according to FAQ. The following correlations were found: MCS × BAI (p = 0.02 / ρ = 0.23); MCS × GDS (p = 0.00 / ρ = 0.38); MCS × BDI (p = 0.00 / ρ = 0.39); MCS × FAQ (p = 0.02 / ρ = 0.23); MCS × GDS (p = 0.00 / ρ = 0.31); MCS × MMSE (P = 0.00 / ρ = –0.29); FAQ × ACE-R Attention and Orientation (p = 0.02 / –0.22); FAQ × ACE-R Memory (p = 0.01 / ρ = –0.24) and BDI × ACE-R Memory (p = 0.02 / ρ = –0.23). Conclusion: memory complaint, cognitive deficit and mood and anxiety symptoms were frequent in this sample of elderly people who do not have diagnoses of cognitive, mood or anxietey disorders. That may justify the implementation of a systematic brief assessment in primary care units.

1Federal University of São Carlos. 2University of São Paulo.

28 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

7. Decision Making Capacity in Alzheimer’s disease: relation with sociodemographic and clinical factors Marcia Cristina Nascimento Dourado1, Raquel Luiza Santos de Carvalho1, José Pedro Simões Neto2

Introduction: Decreased cognitive function and the presence of neuropsychiatric symptoms may impair competence to consent to treatment even in people with mild Alzheimer’s disease (PwAD). Objectives: Using the Brazilian version of the MacArthur Competence Assessment Tool for treatment (MacCAT-T), we investigate the relation of the decisional abilities (Understanding, Apreciation, Reasoning, Expression of a choice) with PwAD sociodemographic, clinical and cognitive factors. Methods: We consecutively included 102 PwAD. They were assessed on competence to consent to treatment, dementia severity, global cognition, functional activities, neuropsychiatric symptoms, mood, awareness of the disease and quality of life. Results: The linear regressions showed that Comprehension was associated to preserved awareness of disease (p ≤ 0.001), lower severity of disease (p ≤ 0.01), categorical verbal fluency (p ≤ 0.05), PwAD self- report quality of life (p ≤ 0.05) and language (p ≤ 0.01). Appreciation was associated to better orientation (p ≤ 0.001) and to PwAD lower age (p ≤ 0,001). Reasoning was associated to PwAD self-report quality of life (p ≤ 0.01), better cognition (p ≤ 0.05) and higher orientation (p ≤ 0.01). Expression of a choice was associated to PwAD self-report quality of life (p ≤ 0,01). Conclusion: PwAD with awareness of disease are capable of make a decision about their treatment. Decision making capacity is related to PwAD quality of life. Funding: This work was supported by the Foundation for Research from the Government of the State of Rio de Janeiro, Brazil – Fundação Carlos Chagas de Apoio a Pesquisa do Estado do Rio de Janeiro (FAPERJ) – (Grant Number 201.777/17).

1Center for Alzheimer’s Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ). 2Department of Sociology and Political Science, Universidade Federal de Santa Catarina (UFSC).

8. EFFECTS OF COGNITIVE TRAINING WITH IPAD® A PPLICAtiONS FOR MILD ALZHEIMER’S DISEASE Flavia Aramaki Gabrieli, Juliana Francisca Cecato, Ivan Aprahamian, Mônica Sanches Yassuda, José Eduardo Martinelli

Background: Alzheimer’s disease (AD) causes progressive impairment of cognitive functions. Non-pharmacological interventions such as cognitive training for elderly with AD have improved performance and behavior in daily living activities. The aim of this study is to describe the effects of a cognitive training using iPad® applications on the overall cognitive performance of elderly with AD. Methods: 76 patients diagnosed with mild AD were randomly assigned to Control Group – CG, Experimental Group – EG and Active Control Group – AG. Participants underwent detailed clinical anamnesis and pre and post intervention neuropsychological evaluation. The EG received 24 cognitive training sessions over 6 months. They were encouraged to train cognitive skills through 9 different applications. The CG -par ticipated in the pre and post evaluation, and the AG received 24 sessions of psychoeducational information on health and current issues. Results: After the intervention, EG performed better on cognitive tests in relation to language, attention, praxis and perception, when compared to the other groups. Regarding memory and abstract thinking, all groups presented worse performance in the second evaluation. Conclusions: Data suggest that cognitive training with iPad® may generate cognitive gains in mild AD.

9. MILD COGNITIVE IMPAIRMENT (MCI) DIAGNOSIS ACCORDING TO THREE DIFFERENT CRITERIA Maira Okada de Oliveira, Eduardo S. Trés, Silvia S. Merlin, Daniel K. Amado, Breno José A.P. Barbosa, Ricardo Nitrini, Sonia Maria Dozzi Brucki

Introduction: In literature there are some forms of MCI classification. It is questionable which criteria most clearly identify MCI patients. In the present study we used three types of classification; Petersen/Winblad criteria: > 1.5 SD from means in a single cognitive test per domain; Jak/Bondi criteria: > 1 SD bellow norms in two tests per domain, and the Brazilian Age Memory Study (BRAMS) criteria: both Petersen/Winblad or Jak/Bondi criteria. Objectives: To verify the neuropsychological assessments according to three types of criteria. Methods: A total of 131 BRAMS participants

29 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 with 72.84 (± 6.41) age, 11.53 (± 5.05) school, 103 women, were classified the neuropsychological assessments by three criteria: The BRAMS criteria, Petersen/Winblad criteria and Jak/ Bondi criteria.R esults: BRAMS criteria classified 44.3% as amnestic MCI multiple domains (amMCImd); 12.2 % as amnestic MCI single domain (amMCIsd) 10.7% non-amnestic MCI multiple domain (namMCImd), 9.2% non-amnestic MCI single domain (namMCIsd) and 23.6% controls; a total of 76.4% as MCI The Petersen/Winblad criteria classified 38.9% as amMCImd, 13.8 % as amMCIsd, 13% as naMCImd, 8.4% naMCIsd and 26% as controls. The Jak/ Bondi criteria classified 37.4% as amMCImd, 10.7 % as amMCIsd, 12.2% as naMCImd, 6.9% as naMCIsd and 32.8% controls. Conclusions: BRAMS criteria have depicted 76.4% of our sample as MCI, Petersen/Winblad and Jak/Bondi criteria have classified 74.1% and 67.2%, respectively, as MCI. Follow-up with a larger sample is necessary to confirm which criteria is ore sensitive to conversion to dementia.

Centro de Referências em Distúrbios Cognitivos (CEREDIC), Hospital das Clínicas, Universidade de São Paulo.

10. DISCRIMINATING INHIBITORY CONTROL AND COGNITIVE FLEXIBILITY PERFORMANCE BETWEEN MILD COGNITIVE IMPAIRMENT AND NORMAL CONTROL INDIVIDUALS Gláucia Nunes Pacheco1, Maila Holz1, Renata Kochhann1, Rochele Paz Fonseca1

Introduction: Executive functions (EF) are a functional system composed by cognitive abilities necessary to perform complex behaviors directed to a certain objective, as well as the ability to adapt to diverse demands of the environment. Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) dementia type may present change in EF processing, such as in inhibition and cognitive flexibility, at the onset of the condition. Recently, the Five Digits Test (FDT) was validate to evaluate the processes of cognitive flexibility and inhibitory control, based on the Stroop paradigma, however, it is not limited to only readers and schooled individuals, since it only requires the individual to be able to count from 1 to 5. Objectives: To verify if individuals with MCI are different from healthy controls regarding inhibition and mental flexibility, establishing preliminary FTD cut-off points between these groups.M aterials and Methods: The study included 50 elderly people, of whom 11 controls (7 (64%) women, age 67.18 ± 2.48, schooling 16.18 ± 5.95) and 39 MCI (27 (69%) women, age 68.44 ± 5.64, schooling 10.56 ± 4.81). The inhibition score (calculated using the Choice minus Reading tasks’ scores) and the cognitive flexibility (calculated by the Alternance minus Reading tasks’ scores) of the FDT were used. Descriptive analyzes were performed to characterize the sample and the cut-off points were established from the ROC curve. Results: There was a difference in schooling (p = 0.003), but there was no difference in the age (p = 0.655) and sex distribution (p = 0.728) between groups. The FDT cut-off point for inhibition was 18.69 (Area under the curve = 0.699, Sensitivity = 0.744, Specificity = 0.636) and for cognitive flexibility was 30.79 (Area under the curve = 0.767, Sensitivity = 0.821, Specificity = 0.636).Conclusions: FDT seems to be a discriminative tool to differentiate the components of EF, such as inhibitory control and cognitive flexibility between healthy and MCI elderly. We suggest the evaluation in larger samples, controlling the schooling, and to identify if the FDT will also be discriminating for dementia such as Alzheimer’s disease. As well as in MCI subtypes amnestic and non-amnestic.

1Pontíficia Universidade Católica do Rio Grande do Sul.

11. APOE4 STATUS CORRELATES WITH LOWER LEVELS OF Ab1-42 AND Ab1-42/P-TAU IN HEALTHY CONTROLS, MCI INDIVIDUALS AND AD PATIENTS Júlia C. Loureiro1, Marcia Radanovic1, Florindo Stella1,2, Marcos V. Pais1, Paulo Canineu1,3, Leandro Valiengo1, Leda L. Talib1, Orestes V. Forlenza1

Introduction: APOE4 is a major genetic risk for Alzheimer’s disease (AD). It has been associated with increased amyloid burden, and earlier emergence of clinical symptoms of AD. Objectives: To estimate the correlation between AD biomarkers, cognitive diagnosis and APOE status in healthy controls (HC), individuals with MCI and AD patients. Methods: 130 individuals underwent CSF analyses for AD biomarkers, APOE genotyping, and clinical assessment through a comprehensive neuropsychological examination in order to determine cognitive status (HC, MCI, or AD). CSF

30 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

was examined for amyloid-β1-42, total tau (T-tau), phosphorylated tau (P-tau), and Aβ1-42/P-tau ratio. APOE status was defined according to the presence of the e4 allele. Laboratorial procedures were performed by the INNO-BIA AlzBio3 assay. Intergroup comparisons of biomarker concentrations, cognitive diagnosis and APOE e4 status were statistically performed by general linear model (GLM). Results: 128 individuals were included. 53 were classified as HC (41.4%); of which 40 were APOE e4 non-carriers (75.4%) and 13 had one allele (24.5%). 64 subjects were considered MCI (50%); with 42 APOE e4 non-carriers (65.6%), 19 APOE4 heterozygotes (29.7%) and 3 APOE4 homozygotes (4.7%). Finally, 11 patients received diagnosis of AD (8.5%); accounting for 7 APOE e4 non-carriers (63.6%) and 3 with APOE e4/e4

(27.3%). Aβ1-42 mean levels in APOE e4 non-carriers, heterogygotes and homozygotes were, respectively, 427.7; 393.4 and 367.7. Additionally, Aβ1-42/P-tau mean ratios in the three above cited APOE groups were 14.7 (non-carriers), 11.9 (e4/-), and 10.4 (e4/e4). Statistical analysis showed that not only the presence of the APOE e4 alelle, but also cognitive diagnosis and the interaction of both influenced biomarkers’ levels; especially regarding Aβ1-42 (F-ratio = 5.207; p = 0.007) and the Aβ1-42/P-tau ratio (F-ratio = 11.027; p < 0.001). Conclusions: Our study showed correlation of APOE4 status with lower levels of Aβ1-42 and Aβ1-42/P-tau in all three cognitive groups HC, MCI individuals and AD patients.

1L aboratório de Neurociências LIM-27, Instituto de Psiquiatria, HC-FMUSP, São Paulo, SP, Brasil. 2UNES P, Rio Claro, SP, Brasil. 3P- UC SP, Sorocaba, SP, Brasil.

12. Is the specific memory binding deficit in Alzheimer’s disease task-dependent? Comparing the change detection and free recall modalities Mario Amore Cecchini, MÔNICA SANCHES Yassuda, VALÉRIA SANTORO Bahia, Leonardo Cruz de Souza, HENRIQUE CERQUEIRA Guimarães, PAULO Caramelli, MARIA TERESA Carthery-Goulart, Patrocínio F, MARIA PAULA Foss, VITOR Tumas, Thaís Bento Lima-Silva, LUCIANA Cassimiro, SONIA MARIA DOZZI Brucki, RICARDO Nitrini, Della Sala S, Parra MA

Introduction: The short-term memory binding (STMB) test assesses the ability to hold temporarily integrations of colors and shapes into unified representations. STMB tests have shown not to be affected by ageing, education or practice effects. In addition, STMB tests seem to capture a specific deficit in AD patients when compared with other dementias, depression and controls, suggesting that the ability to hold integrations in short-term memory are specifically affected in AD. There are different paradigms to assess the STMB, and two of them were used in clinical settings. One is the visual recognition (VR) task, in which participants are asked to recognize changes in colors or shapes (unbound condition) or their combination (bound condition) across two consecutives screens. The other is the free recall (FR), in which participants are required to verbally recall objects and colors individually (unbound) or the integration object- color (bound). Objectives: The objective of this study was to investigate whether these different tasks can capture the same specific deficit in AD patients when compared with behavioral variant frontotemporal dementia (bvFTD) and controls. Methods: The sample comprised of 81 participants: 28 controls, 34 patients diagnosed with probable dementia due to AD and 19 diagnosed with probable bvFTD, according to international criteria, based on clinical, cognitive, and neuroimaging findings. Participants were assessed with the Mini-Mental State Exam (MMSE) and the STMB tests. Results: Participants were similar in age (Controls: M = 67.64, SD = 7.57; AD: M = 71.88, SD = 7.75; bvFTD: M = 69.74, SD = 8.45; p = 0.113), education (Controls: M = 13.04, SD = 4.10; AD: M = 10.18, SD = 5.10; bvFTD: M = 11.00, SD = 5.54; p = 0.074) and dementia groups were in similar disease stage (CDR 0.5 or 1 only, p = 0.405). AD and bvFTD showed similar performance on MMSE total score (p = 0.182), both with significantly worse performance than controls. In the FR task, AD patients showed significantly lower performance than the other groups (Controls = bvFTD > AD), while in the VR task, both AD and bvFTD showed deficits (Controls > AD = bvFTD).Conclusions: The specificity of the STMB for AD seems to depend on the paradigms used to assess it. The VR task could differentiate bvFTD and AD from the control group, but not between the dementia groups. The FR task deficits, on the other hand, showed to be specific for AD patients, as only this group showed significant lower performance on it.

13. MULTISENSORY INTERVENTIONS FOR PATIENTS WITH MODERATE AND ADVANCED DEMENTIA – PRELIMINARY STUDY Larissa da Silva Serelli1, Marcella Guimarães Assis2, Paulo Caramelli1

31 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Introduction: Behavioral and psychological symptoms (BPSD), such as aggression, apathy and sleep disorders, are common over the course of dementia, being more frequent and severe in moderate and advanced stages. These symptoms increase the caregiver burden and the chances of sending the elderly to long-term care (LTC), affecting their quality of life. Nonpharmacological interventions are the preferred first-line treatment and the main objective is to contribute to the improvement of the quality of life of people with dementia. Multisensory stimulation (MSS) is one of these interventions. MSS is conducted by stimulating one or all five senses (hearing, sight, touch, smell, and taste) through pleasant sensory experiences without the need of intellectual activity. Objectives: To present preliminary results of a MSS intervention protocol administered to elderly with intermediate and advanced dementia, residents in LTC phil- anthropic institutions. Methods: The project was carried out with 44 elderly people with dementia in intermediate and advanced stages (Clinical Dementia Rating 2 or 3 and Mini-metal state examination ≤ 17). The elderly participated in 16 individual 30-minute sessions over eight weeks, in a quiet room. Their caregivers underwent comprehensive assessment about the residents’ change of behavior with dementia, including Cohen-Mansfield Agitation Inventory (CMAI), Apathy Scale, Neuropsychiatric Inventory (NPI) and Cornell Scale for depression in dementia, pre- and post- trial. Results: A significant improvement in depressive symptoms, as assessed by the Cornell Scale, was found (P < 0.031), and a trend for apathy improvement (P < 0.056), as assessed by the Apathy Scale. No differences were found for NPI and CMAI scores. Conclusions: The preliminary results suggest that MSS may be a simple and effective intervention to improve depression and may turn out to be helpful in managing apathy in moderate and advanced dementia. Financial support: Scholarship by CAPES.

1Department of Internal Medicine, Post-Graduate Program in Adult Health Applied Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 2Department of Occupational Therapy, Post-Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

14. Performance of subjects with amnestic and non-amnestic mild cognitive impairment on inferential text comprehension tasks Leticia Lessa Mansur1, Marcela Lima Silagi1, Eduardo Sturzeneker Trés2, Maira Okada de Oliveira2, Sonia Maria Dozzi Brucki2

Introduction: Mild cognitive impairment (MCI) has been studied in language tasks with high cognitive demand, like the processing of inferences, which requires preserved memory and executive functions. Objectives: To compare the performance of amnestic MCI (aMCI), non-amnestic MCI (naMCI) subjects and healthy individuals (control group – CG) in a task of inferential text comprehension. Methods: The sample consisted of 100 subjects, aged between 60-82 years, divided into three groups paired according to age and education: aMCI (N = 35), naMCI (N = 15), and CG (N = 50). The subjects were classified after comprehensive neuropsychological and functional evaluations. The patients with aMCI had episodic memory impairments and those with naMCI had executive functions impairments. The Brazilian Portu- guese version of the “Management of Implicit Test was used for inference assessment. The task requires the reading of 20 short texts and includes 60 questions that demand different levels of inferential reasoning, divided into five types: explicit (comprehension of paraphrases or literal translation of utterances, logical (use of formal and deductive reasoning), distracting (ability to ignore non-relevant information), pragmatic (contextualization and respect to discursive rules), and other (concurrent management of logical and pragmatic operations). Results: Patients with aMCI presented worse performance than CG in logical, pragmatic, distracting, and other questions. Patients with naMCI presented lower scores than the CG in logical and pragmatic questions. The aMCI and naMCI groups did not differ from each other in the performance of the test. Conclusions: Inference comprehension tasks could differentiate normal subjects from those with MCI, but not between subtypes of MCI. Inferential reasoning requires complex cognitive abilities that depend on memory and executive functions in an integrated manner, which seems relative and equality impaired in MCI patients. Key words: mild cognitive impairment, reading, comprehension, inferences. Funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

1Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da FMUSP. 2Departamento de Neurologia da FMUSP.

32 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

15. A cohort of elderly with and without subjective cognitive decline: preliminary results Adalberto Studart Neto, Natália Cristina Moraes, Jacy Bezerra Parmera, Raphael Ribeiro Spera, Omar Jaluul, Mônica Sanches Yassuda, Sonia Maria Dozzi Brucki, Ricardo Nitrini.

Background: Several epidemiological studies have shown that individuals with subjective cognitive decline experience a higher risk of progression to dementia. In addition, there is a higher prevalence of positive biomarkers for Alzheimer’s disease (AD). Objectives: To compare the neuropsychological profile of seniors with and without subjective cognitive decline. Methods: The sample consisted of elderly, with four or more years of schooling, recruited from a Geriatric outpatient clinic and a healthy aging center. Dementia, mild cognitive impairment, major psychiatric disorder or use of psychotropic drugs were the exclusion criteria. Subjects were divided into two groups: control vs SCD groups. The volunteers were evaluated with the Clinical Dementia Rating scale (CDR), Functional Activities Questionnaire, Mini Mental Status Examination (MMSE), Montreal Cognitive Assessment (MOCA), Brief Cognitive Screening Battery and a standard neuropsychological battery. SCD evaluation was made through the Cognitive Function Instrument (CFI). The Geriatric Anxiety Inventory and Geriatric Depression Scale were applied for the screening of anxious and depression symptoms. Results: Initially 55 elderly individuals were evaluated. Thirty with at least one cognitive test z-score at –1.5 SD or less. In all, 25 elderly individuals (20 females) were included, with 17 in SCD group. For the whole sample, mean age and schooling were 71.36 (± 5.42) and 12.04 (± 3.99) years, respectively, without significant differences between the groups. The CFI score was higher in the SCD group (SCD 4.33 ± 3.09 vs control 0.81 ± 0.88, p 0.001). The SCD group had more anxiety symptoms (p 0.001). No differences were found between groups in the MMSE (SCD 29.25 ± 0.71 vs control 29.00 ± 1.00, p 0.621) and MOCA (SCD 23.88 ± 3.13 vs control 23.76 ± 2.36, p 0.464). There were also no significant differences in specific cognitive tests,.Conclusions: Preliminary results suggest that SCD elderly have higher anxiety symptoms. The study is still recruiting volunteers and AD neuroimaging biomarkers will be used to assess participants.

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Neurology. São Paulo, Brazil.

16. DUAL-TASK DURING FUNCTIONAL MOBILITY TEST IN OLDER ADULTS WITH AND WITHOUT COGNITIVE DEFICIT Amanda Azevedo Fumagalli1, Sheila de Melo Borges1

Introduction: The dual-task is an important aspect in the evaluation of mobility and cognition, as a primary action can be interfered by the second one. Therefore cognitive deficit can promote decline in the functional mobility in older adults, generating impact on their quality of life. Objectives: To evaluate the dual-task during functional mobility between older adults with and without cognitive deficit. Materials and Methods: A cross-sectional study was conducted with 284 older adults assisted by Basic Health Unit of the Santos City, São Paulo, Brazil. These older adults were divided in two groups, according Mini-Mental State Examination (MMSE) [Study Group (SG): 139 elders with cognitive deficit suggestive and Control Group (CG): 145 elderly without cognitive impairment]. We examined functional mobility using the Timed Up and Go test –TUG (participants were instructed to stand up from a chair, walk 3 meters at a comfortable speed, cross a line on the floor, turn around, walk back, and sit down again to ensure that they were able to perform the task) under three experimental conditions: TUGsingle task (performance of the TUG test alone), TUGcognitive

(TUG test combined with a verbal fluency task, animal category), TUGmanual (performing the TUG test while carrying a full cup of water). Mann-Whitney test was used to compare the mean time of execution (in seconds) in the three modalities of the TUG test between test groups. Results: Statistically significant differences in mean time of execution were observed in TUGmanual: (CG: 13.53 ± 5.9 and SG 15.40 ± 8.2; P = 0.027). No significant differences was observed during the TUGonly and TUGcognitive between groups. Conclusions: Our results indicate that elderly with cognitive deficit has an impairment in functional mobility tasks with “divided attention”, only in manual dual-task in this population.

1Faculty of Physical Therapy, Santa Cecilia University, Santos, São Paulo, Brazil.

33 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

17. Diagnosis of executive dysfunction in dementia Leonardo Zancan3, Mônica Sanches Yassuda1, Mário Amore Cecchini1, Luciana Cassimiro1, Thaís Bento Lima-Silva1, Leonardo Cruz e Souza2, Henrique Cerqueira Guimarães2, Paulo Caramelli2, Valéria Santoro Bahia1,2

Introduction: Executive dysfunction is very common in patients with dementia, then its detection may be useful in the diagnosis. Objective: To verify the accuracy of the Hayling part B-errors test (HBE) and the summary version of the Hayling test included in the INECO Frontal Screening (HIFS) battery in the diagnosis of executive dysfunction in patients with Alzheimer’s disease (AD) and behavioral variant Frontotemporal Dementia (bvFTD) compared with healthy controls (HC). Methods: Thirteen patients with AD, 16 with bvFTD and 19 controls were evaluated. Patients presented CDR between 0.5 and 1.0. The mean age of patients with AD was 71.7 ± 7.9 years, 70.2 ± 8.7 years for patients with bvFTD and 67.7 ± 7.3 years for HC. The mean educational level was 10.5 ± 5.2 years for patients with AD, 11.0 ± 5.4 years for patients with bvFTD and 13.4 ± 4.1 years for HC. Results: Both HBE and HIFS distinguished patients with dementia (AD + bvFTD) from HC (p <0.005). But the tests did not distinguish AD from bvFTD (p > 0.05). Both tests had equivalent area under the curve (AUC) value in the the ROC curve analysis comparing dementia patients with controls: 0.81. For HBE the cut off of 9.5 generated a sensitivity of 86% and specificity of 63%. For the HIFS, the cut off of 2.5, the sensitivity was 89% and the specificity was 62%. There was a high correlation between HBE and HIFS (Spearman) with r = –0.77 and p <0.001. Conclusions: Compared with HBE, HIFS showed similar accuracy, with higher sensitivity and lower specificity, and has the advantage of faster application. HIFS showed to be a useful screening test to identify executive dysfunction.

1Group of the Cognitive and Behavioral Neurology - Neurology Department, University of São Paulo. 2Behavioral and Cognitive Neurology Unit, Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte. 3University of Cidade de São Paulo .

18. Knowledge About Alzheimer’S Disease Among Brazilian Population Daniel Krempel Amado1, Sonia Maria Dozzi Brucki2

Introduction: Dementia is a very frequent disease, but the general population’s knowledge about its main etiology, Alzheimer’s Disease (AD), is still scarce, leading to late seek for healthcare services, less prevention of disease by lifestyle changes and more difficulty on managing the care of demented.Objective: To measure knowledge about AD among a Brazilian sample, taking into account some demographic variables. Methods: A link to a self-administered online questionnaire at Google Forms platform was sent by e-mail and via other social media for anyone older than 18 years old. Our questionnaire contained some sociodemographic questions (about age, sex, level of education, pro- fession and the presence of a family member with dementia or being a caregiver) and “Alzheimer’s Disease Knowl- edge Scale” (ADKS), a well established scale composed of 30 “true or false” questions regarding AD. Results: Between november, 2016 and March, 2017, 1414 people (1076 females), with a mean age of 42.3 years (SD = 14.1) and more than eleven years of schooling in 87.4%, from 26 federative units of Brazil, answered the online questionnaire. The mean total score for ADKS was 21.6 (SD = 3.73) (maximum = 30 points), however when we excluded health professionals (36.4% of the sample), it drops to 20.5 (SD = 3.51). The scores were positively influenced by educational level, professional skills (better for health professionals, mainly physicians) and by age (less than 65 years). Being caregiver or family member did not influence on knowledge about disease. The analysis of individual questions revealed more than 25% of wrong answers in 12 of them (about risk factors, and course of disease). Discussion: Despite the high prevalence, visibility and growing literature concerning AD, few studies were driven in Brazil regarding the population’s knowledge about the disease. Our study revealed a lack of information about AD in our country, even in relatives and caregivers of demented patients. Therefore, more public policy is necessary in order to spread information about dementia, especially AD, consequently improving diagnosis, treatment and management of those who suffer from the disease.

1Ambulatório de Neurologia Cognitiva – HCFMUSP. 2Hospital Santa Marcelina.

34 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

19.A F CTORS ASSOCIATED WITH COGNITIVE IMPAIRMENT AFTER CEREBRAL VENOUS THROMBOSIS Vívia Linhares Mesquita1, Francisco José Arruda Mont’Alverne1, Davi Said Araújo1, Fernanda Martins Maia Carvalho1,2, Rogerio Pinheiro Costa1, Milena Sales Pitombeira1, Fabrício Oliveira Lima1,2, Norberto Anízio Ferreira Frota1,2

Introduction: Cerebral venous thrombosis (CVT) is a rare form of venous thromboembolic disease. Almost 80 % regain functional independence, but 75% of patients remain with residual symptoms. Cognitive impairment is often under- estimated and should, therefore be actively investigated. Objectives: To identify long-term neurological and cognitive outcomes in patients with CVT and to evaluate factors associated with this condition. Methods: We evaluated ambu- latory patients with a confirmed diagnosis of CVT followed at our service over the years 2015-2017. The presence of cognitive function was assessed with the Addenbrookes Cognitive Examination Revised (ACE-R) and 78 was the cut-off. Depression of mood was investigated with Beck’s Depression Inventory. We compared the group with low ACE-R score and the group with good performance. Linear regression model served to identify factors associated with cognitive performance. Results: 54 patients were analyzed (45 women), 30 (55%) was cognitive impairment. Compar- ing the group with cognitive decline and the patients without, we have respectively: mean age 35.5 (± 9.81) × 32.62 (± 9.16) years; educational level 8.55 (± 3.76) × 12.75 (± 2.99) years; time for reassessment 15.4 (± 15.16) × 10.71 (± 8.81) months; ACE-R punctuation 60.27 (± 13.99) × 84.24 (± 4.47); Beck punctuation 13.30 (± 11.75) × 6.55 (± 5.11). In the linear regression ACE-R have a positive association with high educational education (β 0.348; IC 0.49-2.26 p = 0.003) and a negative association with Beck (β –0.309; IC –0.851-0.091 p = 0.017) and only single sinus involvement (β –0.226; IC –42.567- –1.407; p = 0.037. The use of antiepileptic drugs (β –0>182; IC –12.748-1.448; p = 0.115), RANKIN scale (β –0.183; IC –6,07- –0.633; p = 108) and assessed late after CVT ( β –0.230; IC –0,539- –0.018; p = 0.066) lost statistical significance after correction in this model. The initial symptoms have no statistical association with cognitive performance. Conclusion: In CVT Patients, low education, more depressive symptoms and single sinus involvement are associated with a worse cognitive performance.

1Hospital Geral de Fortaleza. 2UNIFOR.

20. SENSE OF PRESENCE AND TOLERABILITY IN TWO SPATIAL ORIENTATION TASKS IN AN IMMERSIVE VIRTUAL ENVIRONMENT Raquel Quimas Molina da Costa1, José Eduardo Pompeu1, Michelle Didone dos Santos1, Fernanda Zillig Rodrigues1, Daniel Donadio Mello1, Emerson Moretto1, Ricardo Nitrini1, Sonia Maria Dozzi Brucki1

Introduction: Spatial orientation is a cognitive domain frequently impaired in Alzheimer’s disease and mild cognitive impairment patients. However, lack of standard psychometric evaluation of spatial orientation abilities and the need to assess it in a more ecological way support the development of new and more realistic forms of assessment, such as virtual reality tasks in immersive environments. Objective: To describe the first results of tolerability and sense of presence in two immersive virtual reality tasks for spatial orientation assessment. Methods: 31 healthy adult participants (age 18 to 59, mean age 32 years old) were recruited to perform an egocentric-focused (SOIVET-Maze) and an allocen- tric-focused (SOIVET-Route) spatial orientation task using Samsung Gear VR® headset. Tolerability was investigated with the use of a checklist for cybersickness symptoms after each task. Sense of presence was investigated using Witmer and Singer Presence Questionnaire after each task. Results: No significant tolerability differences were found between SOIVET Maze task (M = 4.19, SD = 5.576) and SOIVET Route task (M = 3.52, SD = 6.418); t(30) = 1.037, p = 0.308, as measured by the cybersickness symptoms questionnaire after the performance of each task. Cybersickness scores on both tasks appear to be significantly related to personal vulnerability and motion sickness history. Witmer and Singer Presence Questionnaire scores indicated high levels of presence and immersion for both tasks, (Median scores of 128 and 143 for SOIVET Maze and SOIVET Route, respectively). Both tolerability and sense of presence scores were not influenced by age, sex or technology use profile. Conclusions: Both SOIVET Maze and SOIVET Route tasks appear to produce a strong sense of presence and immersion, which is crucial for an ecological task, and to be somewhat independent from technology use profile. Even though both tasks have shown similar tolerability profiles

35 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 and individual vulnerability, this matter should be further investigated and refined for use in the elderly population. Apoio Financeiro: FAPESP Processo 2016/04984-3.

1Universidade de São Paulo.

21. PERFORMANCE ON THE FCSRT BETWEEN MILD COGNITIVE IMPAIRMENT PATIENTS AND HEALTHY ELDERS: PRELIMINARY DATA Renata Kochhann1, Nicole Zimmermann2, François Jean Delaere2, Maila Holz1, Márcia L.F. Chaves3, Rochele Paz Fonseca1

Introduction: The Free and Cued Selective Reminding Test (FCSRT) have been used to discriminate healthy elders from Alzheimer’s disease (AD) patients through semantic cueing in episodic memory assessment. Studies have shown that AD patients are not able to beneficiate from the semantic cues. Same characteristic might be observed in subjects with Mild Cognitive Impairment (MCI) due to AD. Objectives: To compare the performance between healthy elders and amnestic MCI patients in a Brazilian version of the FCSRT. Materials and Methods: The sample was composed of 36 subjects, 25 amnestic MCI patients (15 female (60%), age 68.76 ± 5.8 and 10.04 ± 5.3 years of education) and 11 healthy elders (7 female (64%), age 67.18 ± 2.5 and 16.18 ± 5.9 years of education). All subjects were assessed through a comprehensive neuropsychological evaluation and the Brazilian version of the FCSRT. The impairment in episodic memory was defined through a score of ≤ 1.5DP in the delayed recall of the Rey Auditory Verbal Learning Test (RAVLT). A MANCOVA, controlling age and years of education was conducted to analyze the performance of the codification, free and total scores, recognition and errors of the FCSRT between the subjects. Mann-whitney and chi-square were used to evaluate the distribution of sex, age and years of education between the groups. Results: There were no differences on the distribution of sex (p = 0.837) and age (p = 0.761) between the groups. Healthy elders presented higher levels of education (p = 0.005), higher scores in all four FCSRT free recalls (p = 0.004, p = 0.003, p = 0.004 and p = 0.005), as well as higher scores in the FCSRT total recall from the third trial (p = 0.038) than MCI patients. There were non differences in the performance of codification, total scores (trials 1, 2 e 4), recognition and errors between the subjects. Conclusions: Preliminary data of the Brazilian version of the FCSRT have been demonstrated that it might be useful to discriminate healthy to pathological aging. Longitudinal studies should be conducted to evaluate predictive factors and the comparison between AD patients.

1Pontifícia Universidade Católica do Rio Grande do Sul. 2Instituto Estadual do Cérebro Paulo Niemeyer. 3Universidade Federal do Rio Grande do Sul.

22. Demographic effects on Wechsler Memory Scale Fourth Edition Flexible Approach from a Brazilian population-based cohort: Preliminary data Carina Tellaroli Spedo1, Maria Paula Foss1, Diego Alves Ferreira1, Maria Júlia SILVA Sverzut1, Mariele Roberta Capareli1, Beatriz Francé1, Beatriz Maran1, Vitor Tumas1, Amilton Antunes Barreira1

B ackground: Is well recognized that scores of memory tests can be affected by age, education, mood disorder and cause selection bias. Thus, the tests with demographic adjusted norms is more sensitive to detect cognitive impairment. Objectives: This study examined preliminar data of demographic variables on the Wechsler Memory Scale Fourth Edi- tion Flexible Approach Logical Memory-Visual Reproduction (WMS-IV LMVR) in a population-based cohort. Methods: Randon sample of 30 individuals aged from 18 to 70 years was drawn from an urban Brazilian community. The age (37.9% from 18-39 years; 34.5% from 40-59 years and 27.6% aged > 59) and schooling level (34.5% from 1 to 10 years and 65,5% up to 10 years) were stratified. All sample obtaining age and education-corrected scores ≥ 21/30 on the Mini-Mental State Examination were included. After combining individual test scores into cognitive domain compos- ite scores, multiple linear regression models were used to examine associations of cognitive test performance with age, education and mood disorder. Results: Younger age and higher education were associated with better performance in all WMS domains. Higher educational level was significantly correlated (p < .05) with better performances on all

36 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

WMS-LMVR index scores, except in copy and delayed reccal of VR. Education were associated with large effect sizes on WMS-LMVR, particularly on auditory-verbal subtest (LM-I, s² = 244,365) and index (AMI, s² = 456,601). Conclusions: Older age and lower education associates with worse performance on almost measures of WMS-LMVR. The distribution of scores in these participants suggests the necessity of demographic adjusted norms by age and educational level in Brazilian context.

(1)Ribeirão Preto Medical School, University of São Paulo (FMRP-USP).

23.S ANALY IS OF THE RELATIONSHIP BETWEEN COGNITIVE FUNCTIONS AND MUSCLE FORCE IN OLDER MEN WITH MILD COGNITIVE IMPAIRMENT AND NO COGNITIVE COMPROMISE Thayná S. Bueno1, Paulo G. Rossi1, Bianca F. Carnavale1, Elie Fiogbè1, Anielle C. M. Takahashi1, Larissa P. Andrade1

In addition to the natural cognitive and behavioral changes of mild cognitive impairment (MCI), an important clinical view has been given to the motor alterations of these patients. Recent studies have investigated changes in kinematic gait and balance parameters in elderly with MCI, however, understanding about strength and its relation to cognition in this population has yet to be investigated. Objective: To analyze the relationship between cognitive functions (CF) and muscular strength performance in the elderly without cognitive impairment and MCI. Methods: Evaluation of CF through Mini Mental State Examination (MMSE), and muscle strength of knee flexors and extensors through the isokinetic dynamometer (Biodex Multi-Joint System 3, Biodex Medical System Inc., NY,USA). The Pearson test was used to analyze the correlation between cognitive functions and strength. For the comparison between the groups the ANOVA One Way test was performed. The significance level was set at p = 0.005 and the statistical program used was SIGMAPLOT 11.0. Results: The sample consisted of 20 elderly people in the cognitively preserved (CP) 74.3 ± 6.3 years and in the MCI 74.0 ± 6.3 years of age. In relation to the study years the CP 8.55 ± 5.43 years and the MCI 5.43 ± 3.51 years. In the MMSE performance, the elderly of the CP scored 27.2 ± 2.0; MCI 22.8 ± 2.5. Peak extensor torque (PET) CP = 131.1 ± 46.1; MCI 112.2 ± 25.7. The peak of flexor torque (PFT): CP 58.0 ± 22.7; MCI 56.5 ± 11.6. There was a moderate magnitude correlation between the cognitive functions and the peak of extensor torque in the CP (R = 0.47; p = 0.03) and between the cognitive functions and the peak flexural torque (R = 0.42; p = 0.05). There was no significant correlation of CF with peak torque in the elderly with MCI PET (R = 0.257, p = 0.538), CF × PFT (R = -0.104, p = 0.825). No differences were found between the CP and MCI with respect to the PET p = 0.288, PFT p = 0.782. Conclusion: There was a moderate magnitude correlation between CF and muscle strength of knee extensors and flexors in the CP elderly. More studies are needed for strength research in elderly individuals with cognitive impairment even in the early stages. Apoio financeiro:Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).

1Universidade Federal de São Carlos.

24. The contrast scaled scores of Visual Reproduction subtest alows to detect encoding impairment in right middle cerebral arthery stroke patients Diego A. Ferreira1, Carina Tellaroli Spedo1, Maria Paula Foss1, Octávio Marques Pontes-Neto¹, Amilton Antunes Barreira1

Background: Memory dysfunction is a required condition to diagnosis dementia in patients who suffered stroke. The prevalence of memory dysfunction after stroke in non-demented patients can vary from 13 to 50% in the first week and, 11 to 31% after one year, indicating that memory impairments can be reversible. The neuropsychological assessment post-stroke dementia is strongly recommended and gold standard instruments are important tools to a reliable differential diagnosis.Objectives: To investigate the visual memory performance of patients with might middle cerebral artery stroke (RMCS). Methods: RMCS (n = 26) and healthy controls (n = 31) were evaluated by the Mini Mental State Exam (MMSE) and Visual Reproduction subtest (VR) of Wechsler Memory Scale – Fourth Edition (WMS-IV). Results: VR1 (immediate recall) and Copy (VR2 Copy) scores showed statistical difference (p <0.001) and statistical power (1-α = 0.8) in the differentiation between controls and post stroke patients. The absolute amount of immediate and

37 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 delayed recall was significantly associated with poor organizational strategy scores.Conclusions: These findings suggest that visual memory impairments after RMCS are due deficits in constructive ability, praxis and attention to details, affecting the encoding and the learning processes rather than the memory storage.

1Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Brazil.

25. THE USE OF SECOND GENERATION RT-QUIC ASSAY FOR THE DIAGNOSIS OF CREUTZFELDT JAKOB DISEASE IN BRAZIL: A PILOT COLABORATION STUDY Breno J.A.P. Barbosa1, Tuane C.R.G. Vieira2,3, Helio R. Gomes1, Michele C. Landemberger4, Vilma R. Martins4, Jerson L. da Silva3,5, Ricardo Nitrini1, Jerusa Smid1

Introduction: The recent development of IQ-CSF, the second generation of Real time quaking-induced conversion (RT- QuIC) using cerebrospinal fluid (CSF), for the diagnosis of Creutzfeldt Jakob Disease (CJD) represents a major diagnostic advance in the field. High accuracy results have been reported with encouraging reproducibility among different centers. However, availability is still insufficient and only a few research centers have access to the method in developing countries. Objectives: to report the pilot use of IQ-CSF in a small cohort of patients with possible or probable CJD from a reference center. Methods: We stored CSF samples from four patients with probable (3 sporadic CJD) or genetic CJD (one case) during the timeframe of December 2016 through June 2017. All CSF samples were processed according to standardized protocols without access to the clinical data. Results: Four patients presented to our team with a rapidly progressive dementia and typical neurological signs. One case had E200K mutation. One of the sporadic cases was a 72-years old woman with an atypical presentation characterized by a rapidly progressive dementia associated with visual hallucinations and thalamic asthasia. We used CSF samples from three patients with other neurological conditions for controls. Three out of four cases had a positive IQ-CSF testing, with the highest diagnostic signals belonging to the genetic E200K positive sample. There was one false-positive among controls. Conclusions: The occurrence of false-positive RT-QuIC detection weakens our diagnostic accuracy and underscores the need of improvements in the protocols. Despite having an extremely high specificity, IQ-CSF false-positive results have been reported in the literature. Our pilot results illustrate the feasibility of having CJD CSF samples tested in Brazilian centers and highlight the importance of inter-institutional collaboration to pursue a higher diagnostic accuracy in CJD.

1Department of Neurology, Faculdade de Medicina da USP. 2Instituto Federal do Rio de Janeiro. 3Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem. 4A. C. Camargo Cancer Center. 5Medical Biochemical Institute Leopoldo de Méis, UFRJ.

26. RELAtiONSHIP BETWEEN HOPE AND COGNITIVE DOMAINS OF OLDEST OLD CAREGIVERS Érica Nestor Souza1, Nathalia Alves de Oliveira1, Bruna Moretti Luchesi2, Allan Gustavo Brigola1, Ana Carolina Ottaviani1, Aline Cristina Martins Gratão1, Sofia Cristina Iost Pavarini1

Introduction: The number of oldest-old who care for other elderly has increased significantly. Cognition of caregivers can affect the care provided, as the caregiving routine requires judgment and problem-solving skills. In this context, with aging, psychological and existential aspects are as important as the physical aspects for quality of life, thus, hope can be a psychosocial resource of caregivers to deal with difficulties in the care experience. Objective: Analyze the relationship between hope and cognitive domains of oldest old caregivers. Materials and Methods: A cross-sectional correlational study, composed of a sample of 36 caregivers aged 80 years and over, registered in Family Health Units of a municipality in the interior of the state of São Paulo. Data were collected through an individual interview with the following instruments: Sociodemographic Characterization; Herth Hope Index (HHI) and The Addenbrooke’s Cogni- tive Examination Revised (ACE-R). The present study was approved by the Research Ethics Committee. Results: The majority were female (n = 23) with mean age of 84.1 (± 4.2) years and literacy of 2.5 (± 3.3) years. As for the correlation analysis, it was positive and of low magnitude between the HHI and the domains: total ACE-R (rho = 0.426; p = 0.00), orientation/attention (rho = 0.415; p = 0.01), memory (rho = 0.400; p = 0.01) and language (rho = 0.347; p = 0.05).

38 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Conclusions: There was a positive correlation between hope and most of the cognitive domains in the oldest old caregivers, so that the higher the level of hope, better the performance of the domains of orientation/attention, memory, verbal fluency and language of ACE-R, showing relevance to stimulate positive variables to face the demands of care. Financial support: Capes e CNPq (304067/2015-6).

1Universidade Federal de São Carlos. 2Universidade Federal do Mato Grosso do Sul.

27. HOMONYMOUS HEMIANOPIA PRECEDING THE DEVELOPMENT OF FULL-BLOWN POSTERIOR CORTICAL ATROPHY Mari Nilva Maia da Silva1, Merle James-Galton1, Gordon T Plant1

Introduction: Visual field defects (VFDs) were not among the cardinal features of posterior cortical atrophy (PCA) when it was first described, and their absence was critical for the very formulation of PCA as a higher-order visual disorder. Homonymous hemianopia (HH) was since reported in several series and was included as a core feature of PCA in the recent consensus. Nevertheless, the significance of this deficit has not been established.Presentation of the case: A 69-year-old right-handed female doctor was found to have a subtle peripheral field loss in the left hemifield of her right-eye on routine assessment at her optician. She was then referred to ophthalmology and followed-up for suspected normal tension glaucoma. Two years later, visual loss in the right eye had progressed and there was decreased sensitivity in the homonymous hemifield of the left eye, which was not followed by typical glaucomatous changes in the optic discs. In the following year, an incomplete left HH was evident and she was referred to neurology for investigation. Her cognitive status was then preserved; she had no memory or language disturbance, but complained of difficult seeing. At neuropsychological assessment she failed to read incomplete letters. MRI of the brain did not review any structural lesion, but showed mild atrophy in the parieto-occipital regions. The diagnosis of PCA was made. Over the following two years, her left HH expanded and object and space perception deteriorated markedly. Discussion: A recent classification recognizes a primary visual variant of PCA, which this patient could initially fit. This PCA subtype is thought to be rare and the most distinct from typical AD. In this case, however, the VFD was initially very mild, so that it could hardly be diagnosed if not by routine assessment; when it became pronounced, the higher-order visual disorder had fully developed and the clinical picture was very similar to the classical PCA phenotype. Conclusion: PCA may present as isolated HH, a finding that challenges the classical definition of the disorder. It is not clear whether these patients differ from more typical PCA patients or an initial HH may go overlooked because patients are not seen early enough or not appropriately assessed.

1The National Hospital for Neurology and Neurosurgery, London.

28. Sentence comprehension and VERBAL working memory in non-demented subjects with Parkinson’s disease Marcela Lima Silagi, Leticia Lessa Mansur

Introduction: Difficulties in sentence comprehension and working memory abilities are frequently reported in patients with Parkinson’s disease (PD). However, the nature of these changes is controversial. Objectives: To compare the performance of non-demented patients with PD and cognitively healthy subjects in a sentence comprehension and verbal working memory task. Methods: The sample consisted of 30 subjects, divided into two groups: 15 subjects with PD (PDG) and 15 healthy subjects for the control group (CG). To screen for dementia, all participants were submitted to the Mini Mental State Examination (MMSE) and to the Pfeffer Functional Activities Questionnaire (PFAQ). The groups were paired for age (PDG: M = 62.8; SD = 5.3 / CG: M = 64.5; SD = 3.5 / p = 0.618), education (PDG: M = 11.6; SD = 3.1 / CG: M = 10.2; SD = 1.9 / p = 0.086), cognitive status (PDG: M = 26.7; SD = 1,7 / CG: M = 27.4; SD = 0.9 / p = 0.068) and functionality (PDG: M = 0.1; SD = 0.5 / CG: M = 0.3; SD = 0.5/ p = 0.089). The instrument used was the Listening Span Test of Verbal Working Memory (Daneman and Carpenter, 1980). The subjects listened to a series of sentences and judged whether it was true or false, to verify comprehension of short and syntactically simple sen-

39 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 tences. The participants also had to recall the last word of each sentence. The test begins with sets of two sentences and finishes with set of 5 sentences, recruiting increasing demands on working memory.R esults: In the judgment task, the performance of both groups was similar in all blocks of the test. In the recalling task, as number of sentences for each level increased, performance of both groups declined. In the comparison of groups, the PDG showed significantly lower performance than the GC in all levels of the test. Conclusions: Non-demented subjects with PD do not present deficits in auditory comprehension of simple sentences; however, the difficulty in verbal working memory is evident. The physiological basis for this deficit appears to be associated with the disruption of the fronto-striatal brain network. Key words: Parkinson’s disease, sentence comprehension, working memory.

Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da FMUSP.

29. STATIC BALANCE IN OLDER ADULTS WITH AND WITHOUT COGNITIVE DEFICIT Vitória de Almeida Ramos1, Sheila de Melo Borges1

Introduction: Older people with cognitive deficits tend to present worse motor performance, being able to lead to a balance loss. This fact is important because the loss of balance can be determinant for occurrence of falls, resulting in the loss of independence and autonomy, especially if it is associated with cognitive deficit. Objectives: To compare the static balance measurement between the elderly with and without cognitive impairment. Materials and Methods: A cross- sectional study was conducted with 256 older adults assisted by Basic Health Unit of the Santos City, São Paulo, Brazil. These older adults were divided in two groups, according Mini-Mental State Examination (MMSE) [Study Group (SG): 126 elders with cognitive deficit suggestive and Control Group (CG): 130 elderly without cognitive impairment]. Bal- ance measurement was evaluated by three positions: side-by-side, semitandem (heel of one foot along side the big toe of the other foot) and tandem (heel of one foot directly in front of and touching the other foot). Mann-Whitney test was used to compare the mean time (in seconds) in three positions of balance between groups. A covariance model (ANCOVA) was used to assess the potential confounding impact of age in balance tests. Results: No significant differences were observed between groups for age, gender and educational level, but the groups are different in age (SG: 73.54 ± 7.50 and CG: 71.56 ± 7.16 years; P = 0.03). There was a significant difference by analyzing the balance tests in the semitandem (SG: 29.39 ± 3.25 and CG: 30.0 ± 0.00; P = 0.022), and tandem position (SG: 23.64 ± 10.41 and CG: 26.72 ± 7.38; P = 0.039). Age did not interfere with in balance performance between groups according ANCOVA (semitandem: P = 0.041; tandem: P = 0.027). No differences were noted in the feet side by side position. Conclusions: In this study, the elderly with cognitive impairment presented worse performance in balance, especially in semi-tandem and tandem position compared to the elderly without cognitive impairment.

1Faculty of Physical Therapy, Santa Cecilia University, Santos, São Paulo, Brazil.

30.t Fa ores cognitivos e sua relação com as características sociodemográficas e de saúde de pacientes com doença renal crônica em hemodiálise Gabriela Dutra Gesualdo, Juliana Gomes Duarte, Nathalia de Oliveira Alves, Daniela Dalpubel, Erica Nestor, Luciana Kusumota, Fabiana de Souza Orlandi

Introdução: O comprometimento cognitivo e demência ocorrem comumente em indivíduos com doença renal crônica (DRC), principalmente em fase avançada, mas ainda são pouco diagnosticados. A avaliação da cognição dos indivíduos com DRC é fundamental, uma vez que muitas informações são oferecidas, devido à complexidade da doença, cuja ade- são às orientações depende da compreensão da mensagem transmitida. Objetivo: Relacionar os fatores cognitivos com as características sociodemograficas e de saúde de adultos e idosos com doença renal crônica em hemodiálise.M étodos: Trata-se de um estudo correlacional, de corte transversal desenvolvido em uma Unidade de Terapia Renal Substitutiva de um município do interior do estado de São Paulo. A amostra atendia os seguintes critérios de inclusão: Ter 18 anos ou mais; ter diagnóstico de DRC e estar em hemodiálise no mínimo 6 meses. Foram avaliados 107 pacientes através do Instrumento de Caracterização dos Participantes e Exame Cognitivo de Addenbrooke – Versão Revisada (ACE-R).

40 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Resultados: Os 107 participantes caracterizavam-se pela diferença entre os gêneros, sendo 67,28% (n = 72) do sexo masculino, com média de 54,28 (± 14,85) anos, variando de 20 a 85 anos. Com relação a avaliação cognitiva 78,50% (n = 84) apresentaram pontuação abaixo do esperado, sugerindo a presença de algum déficit. Houve correlação posi- tiva de fraca magnitude entre cognição e nível de hematócrito (r = 0,20; p = 0,037) e correlação negativa de moderada magnitude entre cognição e fragilidade (r = -0,30; p = 0,002). Conclusão: Verificou-se relação entre os fatores cognitivos, nível de hematócrito e fragilidade. Também foi possível observar um elevado número de pacientes com comprometimento cognitivo. Torna-se imprescindível avaliar a cognição dos pacientes com doença renal crônica em estágio avan- çado. A identificação dos pacientes com alterações cognitivas é importante para melhorar a qualidade de vida e reduzir a morbidade associada a essa condição.

31. COMPONENTS OF METABOLIC SYNDROME, LIFE HABITS AND COGNITIVE DISORDER IN THE ELDERLY Renata Bezerra de Araújo1, Estela Barbosa Ribeiro1, Daniela Dalpubel Campanari1, Caio Freitas Ramos1, Michel Bessani2, Carlos Dias Maciel2, Francisco Assis Carvalho do Vale1.

Introduction: Metabolic Syndrome (MS) and its components individually are considered a public health problem and have been associated with Cognitive Disorder (CD). However, such association had not been fully understood yet. Objectives: To investigate the relationship between CD and MS in a sample of elderly users of primary care units. Methods: Cross-sectional, quantitative and correlational study. Were assessed 200 participants who are 65+ years old in an inner city of São Paulo State. The instruments used were: Memory Complaint Scale (MCS), Addenbrooke’s Cogni- tive Examination – Revised (ACE-R), Mini-Mental State Examination (MMSE), the set of criteria for MS by Interna- tional Diabetes Federation (IDF) and a sociodemographic questionnaire specific to the study.R esults: The majority of participants was women (60.5%), mean schooling of 4.6 ± 3.8 years, mean age of 71.82 ± 6.0 years, and 38.5% were overweight considering their Body Mass Index (BMI). According to ACE-R, 26.0% of participants presented CD, and MS was diagnosed in 64.6%. Around one-fifth (22.8%) of subjects presented both CD and MS. There was no correlation between CD and MS (p-value = 0.402). We found low correlations between ACE-R × Weight (ρ = 0.152/p-value = 0.031), ACE-R × MCS (ρ = –0.52/p-value = 0.000), and ACE-R × physical activity (ρ = 0.186/p-value = 0.008). There was no difference between CD and non-CD groups in reference to MS. Also, there was no difference between MS and non- MS groups in reference to CD. However, there was has an association between physical activity and MMSE (p-value = 0.020), total ACE-R (p-value = 0.001) and ACE-R memory (p-value = 0.003). Conclusions: In this sample, we were not able to demonstrate an association between cognitive disorder and metabolic syndrome. However, we observed association between physical activity and cognition in the elderly.

1UFSCar – Federal University of São Carlos – UFSCar –São Carlos (SP), Brazil. 2USP – University of São Paulo – São Carlos, Brazil.

32. Performance of hypertensive subjects in Montreal Cognitive Assessment Cláudia Maia Memória1, Henrique Muela1, Monica sanches Yassuda1, Natália Moraes1, Valeria Cost-Hong1, Michel Machado1, Eduardo Nakano2, Ricardo Nitrini1, Luiz Bortolotto1

Introduction: Hypertension (HTN) has been associated with cognitive decline and dementia (Birns & Kalra, 2009). Cog- nitive assessment may be useful to differentiate healthy subjects from those with mild cognitive impairment among adults with HTN (Webb et al., 2014). The Montreal Cognitive Assessment is a one-page cognitive schedule (Nasred- dine et al., 2005) to screen for Mild Cognitive Impairment (MCI). In patients with hypertension, lower MoCA test scores were predicted (Koski, 2012). Objectives: To study the cognitive profile of patients in different stages of HTN severity compared to normotensives on the MoCA Test. Materials and Methods: Subjects: in a cross sectional study, 156 individuals with HTN (from Hypertension Unit of the Heart Institute (Incor), University of São Paulo, Brazil) were compared with a group of 75 normotensives. The control group was originally recruited from community sources. Patients were divided in three HTN stages according to their blood pressure (BP) levels or medication use (HTN-1: BP 140-159/90-99 or use of one antihypertensive drug; HTN-2: BP 160-179/100-109 or use of two drugs and HTN-3: BP

41 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

≥ 180/110 or use of three or more drugs). HTN diagnosis was based on the consensus criteria from European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Statistics analysis: data were analyzed with SPSS for Windows 21.0. Analysis of Variance (ANOVA) were performed to assess mean differences for continuous data (age, years of education, scores on MoCA). The MOCA scores were compared between normotensive and hypertensive subjects by an ANCOVA (analysis of covariance) considering education as a covariate, as HTN groups differed.R esults: There were no statistical differences for age and sex among the groups. In the MoCA test (total score), patients with more severe HTN differed from the control group and the other HTN levels. Higher systolic blood pressure values were significantly correlated with lower scores in the MoCA (r = –0.221; p = 0.001). There was no significant difference between the normotensive group and HTN 1 and HTN 2. Conclusions: The results suggest HTN may be associated with vascular-origin cognitive impairment. Use of the MoCA in clinical settings should improve the detection of cognitive impairment and facilitate the implementation of treatment strategies to prevent cognitive decline.

33. OVERLOAD AND EMOTIONAL DISORDERS EVIDENCED BY FAMILY CAREGIVERS OF ELDERLY WITH ALZHEIMER’S DISEASE Carlene Souza Silva Manzini, Isabela Thais Machado de Jesus, Larissa Martins Cordeiro, Fabiana de Souza Orlandi, Francisco Assis Carvalho Vale

Introduction: The aim of the study was to evaluate symptoms of overload, stress, depression and anxiety in caregivers of elderly people with Alzheimer’s disease. Objectives: This is a cross-sectional, descriptive, comparative, correlational and quantitative study. Materials and Methods: the sample consisted of family caregivers followed at the Neurology Outpatient Clinic of the Federal University of São Carlos. Results: We interviewed 66 caregivers of elderly people with Alzheimer’s disease. The most overloaded caregivers are from the advanced Alzheimer’s disease subgroup, of which 47.3% were assessed with severe overload; 86.4% of the caregivers had significant stress levels; 57% presented severe anxiety and 36.9% of the relatives who cared for the elderly in the advanced stage presented with symptoms of mild depression. Conclusions: Caring for relatives with chronic and neurodegenerative disease generates overload as well as symptoms of stress, anxiety and depression. The findings of the study point to the importance of establishing policies and actions that strengthen the health of caregivers regardless of the level of attention of public health services. Key words: Alzheimer’s disease, caregivers, dementia, family. Agradecimentos: A primeira autora agradece à Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), pelo apoio na forma de bolsa de mestrado, possibilitando a realização desta pesquisa.

34. Sensitivity of Bender Gestalt Test in screening for Vascular Dementia and Alzheimer’s disease Juliana Francisca Cecato, Lívia Galeote, José Eduardo Martinelli

Diagnostic investigation for dementia is based on a series of tests, including neuropsychological evaluations. Praxia deficiency may be one of the first symptoms manifested by dementia, primarily by cortical dementias. Bender Gestalt test (BGT) is one of the most important psychological evaluation, but little is known about BGT’ sensitivity in the diagnostic investigation for Alzheimer’s disease. The aim of this study was to analyze sensitivity and specificity of BGT in elderly with cognitive impairment and healthy controls. We evaluated 149 subjects over 60 years old, with at least one year of schooling. The subjects were submitted to Cambridge Cognitive Examination (CAMCOG), Mini Mental State Exam (MMSE) and Pfeffer Functional Questionnaire (PFQ). Criteria inclusion for Alzheimer’s disease (AD) (n = 97) and Vascular dementia (VD) (n = 17) were considering DSM-5. Normal control (NC) (n = 35) was formed by the elderly with a score above the cut-off point in CAMCOG. The results indicated statistically significant differences (p < 0.001) among the three groups for BGT. The sensitivity and specificity of BGT were higher in DV group, respectively, 100 and 94.3. The sensitivity in AD group was 90.7. The cut-off point for both diagnoses was 4 points. BGT performance was significantly correlated with MEEM (r = –0.70, p <0.001), CAMCOG (r = –0.78, p < 0.001) and PFQ (r = 0.60, p < 0.001). It can be concluded that BGT differentiated the three diagnostic groups (AD, VD and NC) and correlates with the instruments usually used for the early detection of dementia. Tests such as MMSE and CAMCOG pres-

42 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 ent limitations in the evaluation of visuoconstructive skills. BGT may contribute to neuropsychological assessments, especially in cases of suspected cortical and subcortical dementia.

35. COGNITION OF OLDER CAREGIVERS AND THE RELATIONSHIP WITH THE CONTEXT OF CARE Ana Carolina Ottaviani1, Allan Gustavo Brigola1, Bruna Moretti Luchesi2, Elen Alves1, Érica Nestor Souza1, Fernanda Gomez de Moura1, Juliana Zacarin1, Nathalia Alves de Oliveira1, Mariélli Terassi1, Sofia Cristina Iost Pavarini3

Introduction: The number of elderly people who care for other elderly people grows in number. The task of caring can have negative effects on the mental and physical health of caregivers as there is evidence of a cognitive decline with aging, negatively interfering with the ability to care. Aim: To evaluate the relationship between cognition and care context variables of elderly caregivers. Materials and Methods: This was a cross-sectional and quantitative study carried out with a sample of 84 caregivers attended in the primary care of a municipality in the interior of the State of São Paulo, southeastern region of Brazil. The interviews included socio-demographic variables, variables of care context and cognitive evaluation (Addenbrooke’s Cognitive Examination Revised – ACE-R). Ethical care has been respected. Data analysis was performed using descriptive and correlational statistics (Pearson correlation test, significant for p ≤ 0.05). Results: Elderly caregivers were mostly women (84.5%), married (88.1%), mean age of 69.7 (± 5.8) years of age, mean of 3.9 (± 3.5) years of schooling and receiving a minimum wage (43.8%). The majority provided care to the spouse (88.1%), for an average of 5.9 (± 4.8) hours per day, 94.0% of elderly care recipients had partial dependence on the instrumental activities of daily living. Of the caregivers, only 11.9% reported that the task of caring interferes with sleep and 72.6% evaluated their health as good or even. Regarding cognition, the median of the ACE-R was 63, and 47.6% of the elderly caregivers presented inferior performance. There were significant correlations between cognition and schooling (0.588), caregiver income (0.399), subjective health evaluation (r = –0.271), sleep (r = –0.239), and partial dependence of the elderly for instrumental activities of daily living (r = 0.320), receiving affective / emotional help (r = –0.228). Conclusion: Since cognition is an important component related to caring tasks, knowing the factors associated to it can help in the planning of actions for caregivers attending Primary Health Care. Financial support: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

1Programa de Pós-Graduação em Enfermagem – Universidade Federal de São Carlos. 2Graduação em Medicina – Universidade Federal do Mato Grosso do Sul. 3Departamento de Gerontologia – Universidade Federal de São Carlos.

36. Cognitive performance, nutritional status and food consumption in elderly people with different cognitive profiles Silvia Regina Borgheresi Calil1, Ricardo Nitrini1, Sônia Maria Dozzi Brucki1, Mônica Sanches Yassuda1

Introduction: Dietary habits have become the subject of intense research in relation to cognitive aging, with the potential to protect and maximize cognitive function. Objective: The aim of this study was to investigate the relationship between the degree of adherence to the Mediterranean diet (MED) and the Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) with cognitive performance in elderly people with different cognitive profiles. Methodology: This was a cross-sectional study, with a sample composed of 96 individuals, aged 60 years and over, of both sexes, residents in the eastern region of São Paulo. Participants were classified into three groups according to their cognitive profile, 36 were classified as healthy controls, 30 as having mild cognitive impairment (MCI) and 46 with Alzheimer’s disease (AD). The instruments used were the Brief Cognitive Screening Battery, Mini Mental State Examination, anthropometry assessment and the application of a food frequency questionnaire with 98 items. Sub- sequently, the scores to indicate the degree of adherence to MED and MIND were calculated. Results: Participants were mostly women, with low schooling and low income. Diagnostic groups were similar for most of the evaluated characteristics, with the exception of age, income, and skin color. There were more older and white individuals among participants with AD and higher income in the MCI group. There were no significant differences among the groups as to level of adherence to the diets, however, only among healthy controls higher adherence to MED and MIND was positively associated with a higher score in the MMSE and in the BBRC Learning Score. The results suggest that even

43 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 a modest degree of adherence to MED and MIND dietary patterns may have an impact on the cognitive performance of seniors without cognitive impairment. Conclusions: Considering that people’s eating habits are strongly influenced by sociocultural factors, it is important that studies on the pattern of food consumption and cognition are conducted in different countries.

1Faculdade de Medicina - USP.

37. CHARACTERISTICS OF FALLS IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT AND MILD ALZHEIMER’S DISEASE Sheila de Melo Borges1,2, Márcia Radanovic1, Orestes Vicente Forlenza1

Introduction: Cognitive impairment is a risk factor for falls in older adults and their consequences are multiple, such as fractures, loss of independence, institutionalization and death. Recurrent falls are more prevalent in Alzheimer’s disease (AD) patients. However, there are few studies on this relationship in older adults diagnosed as having mild cognitive impairment (MCI). Objectives: To evaluate the frequency and characteristics of falls in older adults with MCI and mild AD. Materials and Methods: We examined the occurrence and number of previous falls (confirmed by their informants) and questions about the latest fall in 104 older adults [26 with mild Alzheimer’s disease (AD), 42 with mild cognitive impairment (MCI) and 36 cognitively healthy (controls)]. The Chi-squared test was used to compare categorical data between diagnostic groups. Results: MCI and AD patients reported a higher frequency of falls (n = 17, 65.4% and n = 25, 59.5% respectively) when compared to the control group (n = 09, 25%, P < .001). In MCI and AD groups, indoors falls predominated (n = 13, 52% and n = 14, 82.4% respectively), instead the elderly in the control group reported more outdoors falls (n = 06, 66.7%; P = 0.034). In contrast to the MCI and controls groups (n = 22, 88% and n = 09, 100% respectively) who fell more during the day, AD group fell more during the night (n = 09, 52.9%; P = 0.002). The remaining factors studied showed no significant difference between the groups.Conclusions: The prevalence of falls in older adults with MCI and AD is higher than in subjects cognitively healthy. In addition, older adults with AD and MCI had a higher occurrence of falls in the home environment compared to the control group, being more common the falls during the night in the AD group. These data show the importance of a more detailed assessment of falls in elderly people with cognitive impairment and a preventive approach focusing on the training of sensory integration, environmental modifications and guidance to the elderly and their caregivers to minimize the risk of falls in this population.

1Laboratory of Neuroscience(LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. 2Faculty of Physical Therapy, Santa Cecilia University, Santos, São Paulo, Brazil.

38. Bateria Cognitiva Breve em pacientes com epilepsia Glória Maria Tedrus1, Larissa Estela Ferreira Jacó de Menezes2, Maria Lina Giacomino de Almeida Passos2

Pacientes com epilepsia (PCE) podem apresentar comprometimento cognitivo. Objetivos: Estudar aspectos da cognição em PCE utilizando a Bateria Cognitiva Breve (BCB) e o MEEM e as relações com os aspectos clínicos e da qualidade de vida. Casuística e Procedimentos: Foram relacionados os dados da BCB e MEEM de 344 PCE com aos aspectos clínicos e com o QOLIE–31, com nível de significância p<0.05. Resultados: Idade média: 48.8 (± 16.5) anos e idade média na 1ª crise epiléptica (CE): 27.1; tempo de epilepsia de 21.6 e escolaridade formal média de 5.6 (± 3.8) anos. A epilepsia foi generalizada idiopática em 20 casos; provavelmente sintomática em 109 e sintomática em 215 casos. Houve diferença significativa no desempenho entre as síndromes no MEEM; desenho do relógio, memória imediata e na fluência verbal (FAS). Houve correlação negativa significativa entre escolaridade e desempenho inferior no MEEM e no BCB (Pear- son’s correlation; p<0.05). Foi observada correlação negativa entre a idade na ocasião da 1ª crise e o MEEM, e memória mediata, Memória tardia, Reconhecimento (escores e intrusão) e na fluência verbal – animal (Pearson’s correlation; p<0.05). Pior percepção de qualidade de vida correlacionou com comprometimento cognitivo no MEEM, e fluência verbal e na percepção e nomeação no BCB. Discussão e Conclusão: Aspectos clínicos e da qualidade de vida relacionam-se

44 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 com comprometimento de aspectos cognitivos avaliados no MEEM e no BCB em PCE. Palavras-chave: epilepsia, cogni- ção, bateria cognitiva breve.

MEEM 23.24 (±4.52) BCB Relógio 5.62 (±3.71) BCB percepção 9.96 (±0.18) BCB nomeação 9.86 (±0.44) Incidental 5.82 (±1.96) Imediata 7.44 (±1.90) Imediata 2 7.96 (±1.86) FV animais 11.79 (±5.69) FV FAS-F 5.13 (±3.87) FV FAS-A 3.79 (±3.93) FV FAS-S 3.72 (±3.93) Memoria tardia – escore 7.10 (±1.54) Memoria tardia- intrusões 0.03 (±0.18) Reconhecimento- escore 9.31 (±1.13) Reconhecimento- intrusões 0.03 (±0.18) TRSLP Identificação 15.93 (±0.36) Nomeação 15.2 (±1.47)

1Professor of Neurologia. Faculdade de Medicina. 2Graduando da Faculdade de Medicina. Pontifícia Universidade Católica de Campinas (PUC-Campinas), SP, Brazil.

39. COGNITIVE IMPAIRMENT AS AN ASSOCIATED FACTOR WITH DYNAPENIA IN ELDERLY PEOPLE LIVING IN A RURAL AREA COUNTRYSIDE BRAZIL Allan Gustavo Brigola1, Roberta de Oliveira Máximo2, Tiago da Silva Alexandre3, Sofia Cristina Iost Pavarini3, Danilo Henrique Trevisan de Carvalho2

Background: Cognitive impairment (CI) is wisely associated with greater muscle strength decline in ageing. However, there is a lack of studies about this association in rural areas in developing countries. Objectives: Investigate the prevalence and association between dynapenia and CI in elderly people living in rural area. Methods: Cross-sectional study with 166 elderly people (≥ 60 years) free dementia living in a medium-sized town in Sao Paulo state, Brazil. We used logistic regression to analyse the prevalence of dynapenia, according Laurentani et al.1 criteria, and to evaluate the association between dynapenia and CI, controlled by sex, age, schooling and unintentional weight loss (at least 4.5 kg or more than 5% of body weight in the previous 12 months). Grip strength was measured using a dynamometer (Jamar, Seahan SH5001, Korea). The Mini-Mental State Examination was used to evaluate the cognitive function, according Brazilian suggested points by schooling level2. Results: mean age was 70.54 (± 7.52), 52.90% of the sample were female, 92.35% had conjugal life and 72.35% had low education (until 4 years of schooling). The prevalence rates were 39.88% (95% CI: 32.40-47.36) for dynapenic, 31.35% (95% CI: 22.86-39.85) for dynapenic without CI and 60.41% (95% CI: 46.06-74.76) for dynapenic with CI. The adjusted model showed that poor cognitive function increased odds of dynapenia independently of any other factors (odds ratio [OR] 3.37; 95% CI: 1.61-7.05). Conclusions: cognitive impairment increased the prevalence and risk of dynapenia in elderly people living in rural areas. The changes in cognitive function may indicate lower muscle strength, that later may be confirmed by a specific physical exam. References: 1Lauretani F, Russo CR, Bandinelli S, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol (1985). 2003;95(5):1851-60.2 Brucki SMD,

45 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 2003; 61(3B):777-781. Key words: Aging, cognitive impairment, dynapenia, elderly, muscle strength. Financial Support: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Process 2013/26798-9 and Process 2014/23898-5.

1Department of Nursing, Federal University of Sao Carlos, Sao Carlos, Brazil. 2Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil. 3Department of Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil.

40. MAIN DEPRESSIVE SIMPTOMS IN THE STAGES OF DEMENTIA Jamaci de Almeida Machado Corrêa Lima1, Vilma Duarte Câmara1, Yolanda Eliza Moreira Boechat1, Licínio Esmeraldo da Silva1

Introduction: Screening for depression in the elderly has been clinically performed through Geriatric Depression Scale, in the reduced version of 15 items. The presence of the fifteen symptoms is not necessarily homogeneous; this insti- gates reflection on the most likely symptoms to be observed in aging, particularly among the elderly whose results of neuropsychological evaluation indicated their inclusion in categories 0.5, 1 and 2 of the Clinical Dementia Rating scale. Objectives: 1) To evaluate the presence of depressive symptoms in old persons classified in categories 0,5, 1 and 2 of the Clinical Dementia Rating (CDR) scale through the Geriatric Depression Scale (GDS-15); 2) To identify the most relevant symptoms in these categories. Methods: From a sample of 258 old persons neuropsychologically evaluated in a public health care service for the elderly, of whom 87 were classified as CDR 0.5, 85 were CDR 1 and 86 were CDR 2, the analysis of the chance of the presence of each symptom included in the GDS-15 was performed to search those of greatest relevance. The techniques of Item Response Theory (IRT) were implemented to evaluate the latent traits in each of the most relevant symptoms, in order to allow the analysis of the performance of the elderly in these symptoms in the CDR categories. Results: Home confinement and abandonment of interests and activities are the two depressive symptoms with the most significant presence in the elderly of the CDR 0.5, CDR 1 and CDR 2 stages. The analysis of the latent trait of these symptoms by methods of IRT showed that the elderly had low resistance to the installation of these symptoms in any of the stages of dementia considered in this study. Conclusions: Symptoms related to abandonment of interests and activities and resistance to absences from home are the main alerts for a possible presence of depressive state in all categories of dementia included in the study.

1Fluminense Federal University.

41. A pilot feasibility study on awareness and knowledge of dementia among Speech and Language Therapists Bárbara Costa Beber1, Adrià Rofes1, Vânia de Aguiar2, Márcia L. F. Chaves3, Brian Lawlor4

Introduction: Communication disorders is the main area of practice for the Speech and Language Therapists (SLT). Little is known about the training of Brazilian STLs to treat people with communication disorders due to dementia. It is necessary to determine the level of knowledge and awareness about dementia amongst Brazilian SLTs, and then to address the gaps to improve their training. Brazil is a large country and to implement a national survey will be challenging. For this reason, a pilot feasibility study would be important in order to deliver on a national survey in Brazil. Objectives: To conduct a pilot feasibility study amongst SLTs from the Republic of Ireland (RI) about knowledge and awareness of dementia. Methods: Section 1 of the survey tests the knowledge about dementia; section 2 measures the awareness about the participation of SLTs in dementia; and section 3 characterizes the participants. The Irish Associa- tion of Speech and Language Therapy (ASLT) shared the link to the survey on its website and social media. The survey was presented on-line with the 1KA tool and was open during two months. Results: 81 participants fulfilled inclusion criteria, representing 10% of the members of IALST. 56 participants completed the entire survey, corresponding to 69% of the included participants and 7% of the members of IASLT. The survey took 8 minutes to complete. The level of knowledge was higher for general concepts of dementia. In the awareness section, participants strongly agreed

46 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 with their importance in diagnosis and treatment of dementia, but presented lower confidence to assess and treat. Conclusions: To address the low response rate, additional ways of disseminating the survey must be addressed for the Brazilian study. The survey was relatively easy to complete in a short period of time. Given the low response rate, it is difficult to interpret the results with respect to awareness and knowledge.

1Atlantic Fellow for Equity in Brain Health. Global Brain Health Institute. Trinity College Dublin. Ireland. 2Department of Neurology, Johns Hopkins Medical Institute, USA. 3Department of Internal Medicine. Federal University of Rio Grande do Sul. Brazil. 4Global Brain Health Institute. Trinity College Dublin. Ireland.

42. The Short-term Memory Binding Test differentiates individuals with Subjective Cognitive Decline and Early and Late Mild Cognitive Impairment from healthy controls Natália Cristina Moraes, Adalberto Studart Neto, Mario Amore Cecchini, Jacy Bezerra Parmera, Raphael Ribeiro Spera, Omar Jaluul, Sonia Maria Dozzi Brucki, Monica Sanches Yassuda, Ricardo Nitrini, Mario Parra

Introduction: There is a significant need for developing reliable measures to detect subtle cognitive changes in people at risk for dementia that are not affected by age or education. Objectives: To compare the performance in the Short- term memory binding (STBM) test of healthy controls (HC) (n=07), participants with subjective cognitive decline (SCD) (n=14), early and late mild cognitive impairment (EMCI, LMCI) (n=23; n=13). Methods: Participants completed the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Complex Rey Figure (REY), Trail Making Test (TMT), Semantic and Phonemic Verbal Fluency (SFV, PVF), Digit Span (DS) and Boston Naming Test (BNT). Subjects with a single cognitive score below 1.5 standard deviations (SD) or with two scores below 1.0 standard deviations in the same domain were classified as having EMCI; subjects with two scores in the same domain below 1.5 standard deviations or two standard deviations in a single score were classified with LMCI. The elderly with SCD reported cognitive complaints but presented normal performance in all tests for age and schooling. Results: Participants were similar in age and education. Elderly with HC and SDC showed better performance than EMCI and LMCI in MMSE (HC = SDC >EMCI = LMCI). The STMB differentiated the elderly with EMCI from HC (EMCI: M = 10.91, SD = 2.35; HC: M = 13.42, SD = 1.39; p value = 0.014) and STMB unbound into objects shapes with LMCI from HC (LMCI: M = 11.38, SD = 2.29; HC: M = 14.14, SD = 1.57; p value = 0.037). Conclusions: The STMB differentiated only the EMCI from the HC group. The EMCI and LMCI groups presented similar performance, however, inferior to the performance of HC and SDC groups. The analyses are preliminary as data collection has not been concluded.

43. Relation between optimism with cognition and burden of the elderly who play the role of caregivers of the elderly in the family Nathalia Alves de Oliveira1, Érica Nestor Souza1, Allan Gustavo Brigola1, Marielli Terassi1, Bruna Moretti Luchesi2, Keika Inouye1, Sofia Cristina Iost Pavarini1

Introduction: The increase of the age is associated to the decrease of the cognitive functions and due to of social changes the number of elderly caregivers of the elderly grows. The daily care routine requires attention, concentration, judgment skills, and problem solving, and caregiver cognition can interfere in care. In addition, the level of daily activities may lead to overload of care, impairing the physical and cognitive health of caregivers. Optimism is a personality trait that assists in the management of onerous situations, the at search for adaptation strategies, and is capable of improving physical and cognitive health. Objective: To evaluate the relationship between optimism, cognition and burden of elderly caregivers. Methods: A cross-sectional and quantitative study conducted with 345 elderly caregivers attended in the primary care of a city in the interior of the State of São Paulo, Brazil. For the data collection, it was used the Addenbrooke’s Cognitive Examination (Revised) (ACE-R), Zarit’s Bruden Scale, and the “Hope and Optimism” dimension it was used to estimate the positive meaning of life, guided by the perspective of the future with the hope of Scale of Spirituality of Pinto and Pais-Ribeiro. All ethical cares have been respected. Data analysis was performed using descriptive statistics and Spearman’s correlation test. Results: Most of the caregivers were female (76.8%), with mean

47 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 of 69.5 years of age (± 7.0) and mean 3.9 years (± 3.5) of schooling. Regarding the context of care, the majority cared for the spouse (85.2%), with an average of six hours of care per day (± 4.8), taking care of seven days a week. The correlation analysis was positive for optimism and cognition-total ACE-R (r = 0.17, p = 0.00) and the domains: attention and orientation (r = 0.16, p = 0.00), memory (r = 0.15, p = 0.00) and language (r = 0.18, p = 0.00). In the correlational analysis of optimism and overload, there was a negative correlation, showing that the higher the level of optimism the lower the overload (r = –0.19, p = –0.00). Conclusions: Optimism was positively related to cognitive performance and decreased overload in elderly caregivers. This research demonstrates the importance of studying positive variables in the assessment of the cognitive health of elderly caregivers, since the results can contribute to the planning of care actions for caregivers in primary health care services. Funding: Fundação de Amparo a Pesquisa do Estado de São Paulo (processo nº 2014/01092-9).

1Universidade Federal de São Carlos – UFSCar. 2Universidade Federal do Mato Grosso do Sul – UFMS.

44. RELAtiON BETWEEN COGNITIVE FUNCTIONS AND DOUBLE TASK TEST PERFORMANCE IN ELDERS OF THE COMMUNITY Daniela Dalpubel Campanari1, Paulo Giusti Rossi1, Juliana Hotta Ansai2, Renata Bezerra de Araújo1, Mariana Luciano de Almeida3, Estela Barbosa Ribeiro1, Larissa Pires de Andrade1, Anielle Cristhine de Medeiros Takahashi1, Francisco Assis Carvalho do Vale1

Introduction: Due to several factors associated to aging process, a big portion of elders feel some degree of change in their cognitive performance. Possibly linked to an aftermost cognitive decay, the motor skill either in march and in double task can be prejudiced. Objective: Explore possible associations between the ACE-R cognitive screening test in all its domains and the “Timed Up and Go” (TUG) and “Timed Up and Go Dual Task” (TUG-DT). Methods: This is a transversal study, quantitative and correlational. With age starting in 65 years, 51 participants were measured by the Addenbrooke’s Cognitive Examination - Revised (ACE-R), “Timed Up and Go” (TUG), “Timed Up and Go Dual Task” (TUG-DT), Geriatric Depression Scale (GDS) and sociodemographic questionnaire. Results: Being the majority of females, 51 elders of the community were measured, they had age median of 71 years, scholarship median of 4 years and married or being in common-law marriage. Regarding the tests performance, the ACE-R Total median was 74 points, ACE-R Attention/Orientation 16 points, ACE-R Memory 17 points, ACE-R Fluency 7 points, ACE-R Lan- guage 22 points, ACE-R Visuospatial 12 points. The TUG – Time median was 16 seconds and TUG – DT Time median was 20.6 seconds. There were found statistically significant correlations between the TUG – Time and ACE-R Total (p = –0,009), ACE-R Fluency (p = –0,001), when it comes to TUG–DT Time were found with ACE-R Total (p = –0,000), ACE-R Memory (p = –0,002), ACE-R Fluency (p = –0,000), ACE-R Language(p = –0,000) e ACE-R Visuospatial (p = –0,005). All correlations were moderate. Conclusions: There were important correlations between cognitive screening tests and tests that measure marching and functionality in elders, therefore including mobility tests in cognitive assessments of elders can be of great value for a better reliability in diagnoses.

1UFSCar - Federal University of São Carlos – UFSCar – São Carlos (SP), Brazil. 2UFMS – Federal University of Mato Grosso do Sul, INISA – UFMS – Campo Grande (MS), Brazil. 3USP - University of São Paulo – USP – Ribeirão Preto (SP), Brazil.

45. HIPPOCAMPAL VOLUME AND FUNCTIONAL CONNECTIVITY PREDICTS FUNCTIONAL DECLINE IN MILD AD AND AMCI Natalie Lecce1, Camila Vieira de Ligo Teixeira2, Thamires N.C. Magalhães2, Ana Flavia M. K. C. Cassani2, Brunno Machado de Campos2, Thiago Junqueira Ribeiro Rezende2, Marina Weiler3, Marcio Luiz Figueredo Balthazar2

Introduction: The study of biomarkers in mild Alzheimer’s disease dementia (AD) and amnestic mild cognitive impairment (aMCI) is essential for the improvement of early diagnosis. However, it is not completely known the usefulness of different biomarkers for tracking the progression of the disease. The aim of this study is to evaluate if cerebrospinal fluid (CSF) biomarkers (Aβ42, p-tau and t-tau), hippocampal volumes (HV) and Default Mode Network (DMN) func-

48 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 tional connectivity (FC) could predict the cognitive and functional evolution of mild Alzheimer’s disease dementia and amnestic mild cognitive impairment patients. Objectives: Compare the dosage of beta-amyloid, total tau and phosphorylated tau proteins in patients with AD and aMCI at the onset of the disease; Compare the hippocampal volume in patients with AD and aMCI at the onset of the disease; Compare the Default Mode Network (DMN) functional connectivity (FC) in patients with AD and aMCI at the onset of the disease; Verify if the biomarkers described are correlated with the progression of cognitive (MMSE) and functional (Pfeffer Questionnaire and CDR sum of boxes) measures. Method: We evaluated 32 mild AD and aMCI due to AD during 9 months. All subjects underwent neuropsychological assessment, MRI at 3 Tesla for structural and FC evaluation, and CSF biomarkers. All aMCI subjects had evidence of AD pathophysiology (hippocampal atrophy and/or low CSF Aβ42 and/or low Aβ42/ptau). HV was obtained by Freesurfer software. We performed the FC analysis using the UF²C toolbox (http://www.lni.hc.unicamp. br/app/uf2c/). We estimated an average DMN map that was divided in eight DMN subparts: the prefrontal cortex; medial parietal cortex; left and right parietal lobe, left and right temporal lobe, left and right hippocampus. The average values were converted to zscores that were used for statistical analysis. Dosages of Aβ42, t-tau and p-tau were obtained from INNOTEST® kits (Fujirebio).We performed multiple regressions considering changes (Δ) in cognition (Mini Mental Status Examination MMSE) and in functional status (Pfeffer’s Questionnaire of daily living) as dependent variables and, age, sex, education, CSF biomarkers, HV and DMN subparts FC as independent variables. Results: We did not find any significant result concerning these variables and changes in MMSE over time. However, we found that hippocampal volume and FC predicted changes in Pfeffer’s Questionnaire: left HV (adjusted R2 = 0.79, F = 5.75; t = 5.73, p = 0.029); right hippocampal FC: (adjusted R2 = 0.84, F = 12.06; t = 5.13, p = 0.004). All testes were corrected for multiple comparisons. Conclusion: Hippocampal structure and functional connectivity (but not CSF biomarkers) predict changes over time in functional activities in patients with mild AD and aMCI. Interestingly, we found a direct relationship between hippocampal FC and the worsening of our patients, what could mean that initial high connectivity might be compensatory.

1Pontifícia Universidade Católica de Campinas. 2Unicamp. 3National Institute of Health, Baltimore, MD, USA.

46. CSF biomarkers and cognition are related to white matter integrity in amnestic aMCI and mild AD Christian Luiz Baptista Gerbelli1, Thamires Naela Cardoso Magalhães1, Mariana de Abreu1, Luciana Ramalho Pimentel-Silva1, Camila Vieira Ligo Teixeira1, Thiago Junqueira Ribeiro de Rezende1, Fernando Cendes1, Marcio Luiz Figueredo Balthazar1

Background: AD pathophysiological process, including amyloid-beta peptide (Aβ1-42) and phospho tau protein (p-tau), affect primarily grey matter structures and their relations with white matter (WM) is not completely known. In the same way, the role of WM in cognition in aMCI and mild AD is not fully understood. Objectives: To analyze the relationship between WM integrity, CSF biomarkers (Aβ1-42, t-tau and p-tau) and neuropsychological evaluation in patients with aMCI and mild AD. Methods: 23 patients with mild AD and 25 with aMCI underwent: lumbar puncture to analyze

Aβ1-42, p-tau and t-tau levels; Magnetic Resonance Imaging in a 3T scanner; and a broad neuropsychological evaluation (MMSE, memory, executive functions, language and visuospatial skills). To analyze WM integrity, we used an automated segmentation method – MultiAtlas, which evaluates Diffusion Tensor Imaging (DTI) data and extract Fractional anisotropy (FA) values. We verified if there were significant correlations between FA from 30 regions of interest with CSF biomarkers and cognitive scores (COG). Results: COG and Aβ1-42 showed a positive correlation mainly with left WM structures, while t-Tau and p-Tau correlated mainly with right regions. COG showed a strong correlation with WM regions close to GM structures classically related to clinical AD symptoms, like medial temporal and cingulum in the aMCI group. Conclusion: We found significant relations between WM integrity and CSF biomarkers, what could mean that AD pathophysiology affects not only GM. Also, WM is related to cognition even in the early phase of AD spectrum. Funding: grant 2017/01286-6, São Paulo Research Foundation (FAPESP).

1Neuroimaging Laboratory, Department of Neurology, University of Campinas (Unicamp), Brazil.

49 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

47. SERUM IL-18 IS RELATED WITH WHITE MATTER INTEGRITY IN AD AND MCI Mariana de Abreu1, Thamires N. C. Magalhães1, Christian L. B. Gerbelli1, Luciana R. P. Silva1, Camila V. L. Teixeira1, Thiago J. R. de Rezende1, Fernando Cendes1, Marcio L. F. Balthazar1

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disease whosepathophysiologic mechanisms are not completely understood. New evidences demonstrate that inflammation may play an important role in the pathogenesis of AD. Interleukine-18 (IL-18) is a pro-inflammatory cytokine that may be related with AD pathogenesis. Previous findings in literature indicate that IL-18 could mediate aninflammatoryprocess in early stages of amyloid-beta (Aβ) cascade as well as affect cerebral white matter integrity.Objectives: To evaluate the relation of serum

IL-18 with AD cerebrospinal fluid (CSF) biomarkers(Aβ1-42, p-tau and t-tau)and white matter (WM) integrity in mild AD and MCI. Methods: 20 patients with mild AD, 20 withMCI and 20 controls underwent: blood analyses to quantify

IL-18levels (Invitrogen Human Interleukin-18 ELISA kit);lumbar puncture to analyze Aβ1-42, p-tau and t-tau levels; and Magnetic Resonance Imaging in a 3T scanner. To analyze WM integrity, we used an automated segmentation method – MultiAtlas, which evaluates Diffusion Tensor Imaging (DTI) data. Correlations between levels of IL-18, CSF biomarkers and fractional anisotropy (FA) of WM from regions of interest were performed. To analyze the data, it was used the program SPSS. Results: We found a significant positive correlation (p = 0.397) of IL-18 and WM in the entorhinal area in all groups. In MCI group, we found a positive correlation in two regions –right genu of Corpus Callosum (GCC) (p = 0.600) and left hippocampal cingulum bundle (p = 0.666). In AD group, we only found significant correlations in the right GCC (p = 0.434). We did not find significant correlations with CSF biomarkers.Conclusions: Peripheral IL-18 levels are related to WM integrity in AD and MCI. These findings highlight the importance of systemic inflammation in AD pathophysiological process. Funding: Grant 2017/04637-4, São Paulo Research Foundation (FAPESP).

1Neuroimaging Laboratory, Department of Neurology, University of Campinas (Unicamp), Brazil.

48.S PHY ICAL VULNERABILITY AND ITS RELATIONSHIP WITH COGNITIVE DISORDER AND DEPRESSIVE AND ANXIOUS SYMPTOMS IN ELDERLY Estela Barbosa Ribeiro1, Daniela Dalpubel1, Mariana Luciano de Almeida2, Renata Bezerra Araújo1, Caio Freitas Ramos1, Francisco Assis Carvalho Vale1

Introduction: Since physical vulnerability consists of greater chances of exposure of people to illness and with the elderly we have increase in the prevalence of chronic diseases such as depression, anxiety and dementia syndromes. Consider- ing the elderly people, it is relevant clinically to evaluate if exist a relationship between this factores. Objectives: To verify whether physical vulnerability is associated with the cognitive and mood changes. Methods: Cross-sectional study. Instruments used were Vulnerable Eldery Survey (VES-13); Addenbrooke’s Cognitive Examination - Revised (ACE-R); Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Results: Were assessed 100 elderly people aged 65+ y. The majority of them were female, married, with mean schooling of 4.9 ± 2.9 years and mean age of 74.3 ± 4.7 years old. Physical vulnerability was detected in 58% of the elderly by VES-13 and cognitive deficit in 66% by ACE-R- global. In ACE-R domains there were deficits as follows: 48% in ACE-R Memory, 69% in ACE-R Attention and Orientation, 60% in ACE-R Fluency, 51% in ACE-R Language and 59% in ACE-R Visual and Spatial. Thirty-three percent had depressive symptoms and 39% had anxiety symptoms. The following correlations were found: VES-13 x ACe-R (p = 0.00 / ρ = –0.35); VES-13 × GDS (p = 0.00 / ρ = 0.33); VES-13 × MMSE (p = 0.00 / ρ = –0.31); VES-13 × ACe-R Attention and Orientation (p = 0.02 / –0.22); VES-13 × ACE-R Memory (p = 0.00 / ρ = –0.37); VES-13 × ACE-R Fluency (p = 0.00 / ρ = –0.28) and VES-13 × ACE-R Language (p = 0.00 / ρ = –0.34). Conclusion: The results demonstrate an association of physical vulnerability with cognitive and mood disorders. It is possible that subsequent studies to understand cause and effect relationships between these variables can establish perspectives for interventions.

1Federal University of São Carlos. 2University of São Paulo.

50 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

49. RESISTANT PSYCHOTIC DEPRESSION AS FIRST SYMPTOM IN LEWY BODY DEMENTIA Bruno Rabinovici Gherman, Ivan Abdalla Teixeira, Valeska Marinho Rodrigues

Introduction: Lewy Body Dementia (LBD) is the second leading cause of degenerative dementia. LDB typically presents as dementia syndrome associated with atypical parkinsonism, REM sleep behavior disorder, visual hallucinations and cognitive fluctuations (Mc Keith et al., 2017). Psychiatric symptoms may precede motor signs and a pure psychiatric manifestation in early LBD have been described previously (Kobayashi et al., 2009). Advancing in biomarkers for recognizing LBD has provided a better diagnostic accuracy, as brain Scintigraphy with Trodat and myocardial metaiodobenzylguanidine scintigraphy have been proved to be useful, noninvasive techniques, which help recognizing LBD even at early disease stages. Case report: We present a 69-year-old man, with no history of previous psychiatric disease, presenting with depressive syndrome associated with persecutory delusions, agitation, and weight loss. He was referred to a psychiatric evaluation after hospitalization in a general hospital due to food and water refusal. Initial neurological examination was normal. His symptoms worsened despite pharmacological treatment and persecutory delusions were severe enough to bother his day-to-day life. At this time, drug therapy with olanzapine, venlafaxine and lorazepam was attempted without any response and then, by the severity of the condition, he was referred to elec- troconvulsive therapy (ECT). It was performed 34 ECT sessions, showing transient periods of improvement, followed by recurrence. In paralel, several drug augmentation strategies were attempted, with no success (quetiapine, aripipra- zole, lithium). Six months later, the neurological examination evidenced cogwheel rigidity in upper limbs and brady- kinesia, besides fluctuation of level of consciousness. Laboratory and clinical evaluation excluded neoplastic and rheu- matologic diseases. Brain MRI was normal. Mini Mental State Examination = 9 and CDR = 1. Brain Scintigraphy with Trodat showed marked hypocaptation in the basal ganglia and cardiac scintigraphy with metaiodobenzylguanidine demonstrated diffuse sympathetic denervation in the left ventricle, both corroborating the diagnostic hypothesis of Lewy body dementia. At the present moment, the patient shows significant improvement of the psychotic symptoms, maintaining moderate depressive symptoms and rigidity with axial predominance, medicated with clozapine 100 mg/ day, donepezil 10 mg/day, nortriptyline 125 mg/day and levodopa/benserazide 450 mg / day. Conclusions: LBD may initially present as pure psychiatric syndrome, as with classical phenotype of psychotic depression. Diagnosis may be mislead by use of antipsychotics, which masks motor symptoms, and by difficulty in evaluating function and cognition in severe psychotic patients. Biomarkers are useful tools to recognize LBD, even at early stages and in atypical presentations.

CDA – IPUB (UFRJ)

50. Living with the elderly in childhood can help in the task of being a caregiver? Bruna Rodrigues dos Santos1, Sofia Cristina Iost Pavarini1

Studies show that caregivers of elderly people with dementia present high levels of stress and overload, as well as difficulties in coping with situations related to care. The hypothesis of this research is that the conviviality with the elderly during childhood brings positive experiences to the caregiver as an adult. The main objective of this study is to compare the overload, perceived stress and coping of caregivers of elderly people diagnosed with some type of dementia who lived and who didn’t live with the elderly during their childhood. It is a quantitative, cross-sectional, descriptive and comparative study. The research was conducted with informal caregivers of elderly people with dementia (n = 102) enrolled in a neurology clinic of a Brazilian federal university. The instruments used to collect data were: caregivers’ characterization questionnaire, Coping Strategies Inventory (CSI), Zarit Burden Interview (ZBI) and Perceived Stress Scale (PSS). Data were analyzed through descriptive, correlational and comparative statistics. The evaluations were previously scheduled and performed at the caregiver’s home. All ethical care was respected (CEP Process nº 1.225.763/2015). The results showed that: 1-Most informal caregivers of elderly people with dementia are married women with a mean age of 57.1 (± 3.9) years. 2-Regarding aspects of care, the majority take care of the parents, reside in the same household as the elderly and are primary caregivers. The score obtained in the CSI presented a strong and inversely proportional relation with the score obtained in the ZBI (rho = –0.747, p < 0.01) and with the score obtained in the PSS (rho = –0.850, p < 0.01) . 4 - The group of caregivers of elderly people with dementia who lived with the

51 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 elderly during childhood presented better coping, less stress and less overload than the group of informal caregivers of elderly people with dementia who did not live with the elderly in childhood, with differences statistically significant. Therefore, for this sample of participants, living with the elderly in childhood had a positive influence on the experience of caring for an elderly relative in the future, confirming the hypothesis study.F inancial support: FAPESP (Process nº2015 / 11608-5).

1Universidade Federal de São Carlos.

51. RELAtiONSHIP BETWEEN EXECUTIVE FUNCTIONS AND FUNCTIONAL MOBILITY IN ELDERLY PERSONS WITH MILD COGNITIVE IMPAIRMENT Natália Oiring de Castro Cezar1, Juliana Hotta Ansai2, Thayná de Souza Bueno1, Maiary Martins de Souza1, Larissa Pires de Andrade1

Introduction: It is known that there is a relation between the executive functions and kinematic parameters of the gait in the elderly with Alzheimer disease. However, the relationship of these functions in elderly with mild cognitive impairment (MCI), the prodromal phase of dementia, still needs further investigation. Objectives: To verify the relationship between executive functions and functional mobility (FM) in elderly with MCI. Methods: This is a cross-sectional study with elderly community members with MCI. The executive functions were evaluated through the Clock-drawing Test (CDT) and Semantic Verbal Fluency (SVF) and phonemic (PVF). The FM was evaluated by the Timed Up and Go Test (TUG), in terms of test run times, number of steps and cadence. The collected data were analyzed by SPSS software in version 22.0. Results: A total of 37 elderly patients with MCI were evaluate, with a mean age of 75.8 years, 5 years of schooling and 85% of the female. Total TUG time averaged 14.4 seconds. There were significant correlations between TUG and CDT time (p = 0.001, R = –0.516), TUG and PVF time (p = 0.001, R = –0.524) and TUG and SVF time (p = 0.001, R = –0.522). There was also a significant correlation between number of steps versus CDT (p = 0.000, R = –0.572), PVF (p = 0.002, R = –0.501) and SVF (p = 0.003, R = –0.478). There was also a significant correlation between cadence and CDT (p = 0.013, R = 0.538) and between cadence and SVF (p = 0.048, R = 0.328). Conclusions: The study revealed that the FM presented a relation with the executive function in the elderly with MCI. It is worth mentioning that there was a greater correlation of the CDT test when related to the number of steps and the cadence than the PVF and SVF. The cognitive tests used are simple and quick to perform and may possibly help as indicative of motor decline along with the TUG in the elderly with MCI. In addition, cognitive tasks can be used as an intervention to improve mobility. We thank the Research Support Foundation of the State of São Paulo (FAPESP) for working conditions and financial support.

1Departamento de Fisioterapia, Universidade Federal de São Carlos, Brasil. 2Departamento de Fisioterapia, Universidade Federal do Mato Grosso do Sul, Brasil.

52. Oxford Cognitive Scale (OCS-Br) – Brazilian Portuguese version: a pilot study Conrado Regis Borges, Daniel Krempel Amado, Samila Gomes, Amanda Lira, Eduardo Bergamaschi, Cláudia Cristina Ferreira Ramos, Ricardo Nitrini, Sonia M.D. Brucki

Background: Cognitive impairment is very common in stroke patients. In this population, symptoms such as aphasia, apraxia, spatial, visuoconstructive and memory impairments are prominent and need to be rapidly assessed in order to provide fast and accurate rehabilitation care; which interferes in the global activities of daily living outcomes. The cognitive tests available in Brazil don’t address some specific characteristics of patients with stroke and have other important limitations. Objectives: To test a Brazilian population without known cognitive impairment with OCS-Br, a version of OCS, which was created in order to measure cognitive impairments in acute stroke patients. Methods: The English version was translated into Brazilian Portuguese by three independent Portuguese-English proficient speakers and a back translation was made by a native English speaker. Twenty-five neurologically healthy participants underwent the Br-OCS in this pilot study. They were enrolled from August to October 2017 at the Hospital das Clíni-

52 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 cas, Universidade de São Paulo. All participants were screened and were negative for cognitive impairment with the Mini Mental State Score and also for neurologic and psychiatric conditions. Results: We evaluated 25 subjects (68% were females) with a mean age of 60,53 (SD = 6.63) years (ranging from 46 to 72); education of 14.16 (SD = 4.85) years, ranging from 4 to 22 years. The mean score in each task was: naming: 3.52 (SD = 0.65) (maximum value of 4); semantics: 3 (SD = 0) (maximum of 3); orientation: 4 (SD = 0) (maximum of 4); visual field: 4 (SD = 0) (maximum of 4) points; sentence reading: 14.52 (SD: 1.08) (maximum of 15); number writing: 2.84 (0.62) (maximum of 3); calcula- tion: 3.84 (SD = 0.47) (maximum of 4); accuracy in the broken hearts test: 47.36 (3.52) (maximum of 50), space asym- metry: –0.04 (SD = 1.63), imitation: 11.08 (SD = 1.55) (maximum of 12); verbal recall: 2.84 (SD = 0.94) (maximum of 4); verbal recall and recognition: 3.88 (SD = 0.33) (maximum of 4); episodic recognition: 3.92 (SD = 0.27) (maximum of 4); mixed score: 10.8 (SD = 2.95) (maximum of 13) and executive score: 1.04 (SD = 2.92). Discussion: In this pilot study, we observed similar values in each separate OCS task in comparison to the original test, which makes the Bra- zilian Portuguese version of the test applicable in the Brazilian population. However, further studies with a greater number of patients, wider ranges of age and education and inclusion of patients in the setting of acute and chronic ischemic brain disease will be necessary to adequate validation of this test in the Brazilian population. Conclusion: The development of new screening cognitive tools that are specific to some disease categories is important because it may improve the patients’ diagnosis and care. OCS-Br comes to represent this role in the acute ischemic stroke setting.

53. Depressive Symptoms in Elders with memory complaint: A Longitudinal Study Caio Freitas Ramos, Estela Barbosa Ribeiro, Renata Bezerra de Araújo, Francisco Assis Carvalho Vale

Introduction: Memory complaint (MC) is frequent, especially in the elderly and may be associated with several factors, including mood and anxiety disorders. Methods: This was a longitudinal, descriptive, correlational and quantitative study. The instruments used were: Memory Complaint Scale - form A (MCS-A), Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE). The subjects were evaluated in two distinct moments with an interval of two years. Results: 100 subjects were assessed, the majority being female, married, with mean schooling of 4.9 and S.D. of 2.9 years and mean age of 74.6 years old with S.D. of 4.7 years. Depressive symptoms were screened in 12% of subjects. MCS mean score was 4.07 ± 3.32. In the analysis was observed correlation between depressive symptoms and MC assessment MCS × GDS (p = 0.312 / ρ = 0.002). Wasn’t observed correlation between GDS × MMSE (p = -0.82/ ρ = 0.418) and just a weakly correlation between MCS × MMSE (p = 0.235 / ρ = 0.018) was observed in the two years of the study. Comparing MC with non-MC groups by Kruskal-Wallis test it was possible to reject the null hypothesis (p = 0.009). Conclusions: The results indicate that there is an association between MC and depression. Elderly people with MC have more depressive symptoms, regardless whether the MC is referenced in the past or in the present.

UFSCar - Federal University of São Carlos - UFSCar - São Carlos (SP), Brazil.

54. STRUCTURAL VALIDITY OF THE VISUAL REPRODUCTION OF WMS-IV USING ITEM RESPONSE THEORY Maria Júlia Silva Sverzut¹, Carina Tellaroli Spedo¹, Lucas de Francisco Carvalho², Octávio Marques Pontes-Neto¹, Maria Paula Foss¹, Amilton Antunes Barreira¹

Introduction: The Understanding of the degree to which visual stimuli can be verbalized, particularly in certain neurological conditions, is important. Moreover, the interpretation of visual memory performance is also important. To this end, testing the reliability and validity of the construct used to assess visual memory performance is necessary. Methods: One hundred and fourteen volunteers including 29 post-stroke patients and 85 healthy examinees were administered the Visual Reproduction (VR) subtest of the Wechsler Memory Scale (WMS-IV) and their scores were evaluated using item response theory. Results: The memory construct variables explained 70.9 % of variance, and the eigenvalue was lower than 2.0 suggesting one-dimensionality. The optional copy task fit the criteria of another dimension. The mean of the adjusted model showed a 0.69 theta correlation coefficient, and reliability was 0.86. The easiest and the most difficult items were VR-I design one and VR -II design 5 (C and D), respectively. The Rasch method clearly

53 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 contributed to the understanding of the VR variables. A small gap in the measurement of the construct was identified, allowing for better knowledge about the items functioning. Conclusions: The assessment of memory using VR and the scaled scores items are reliable, although some minor adjustments are necessary.

¹ Department of Neuroscience and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto – SP, Brazil. ²Department of Psychology, University of São Francisco, Itatiba – SP, Brazil.

55. GAME AS COMPLEMENTARY TREATMENT: DIARY OF MY LIFE Gabrielle Alves de Oliveira1, Gabriela dos Santos1, Luilca de Souza Oliveira1, Pedro Pagaime Gonçalves1

Introduction: With the increase in life expectancy, new cases of the Alzheimer’s disease appear every year, 1.2 million in Brazil, affecting more the elderly, and greater investment in research is required. Faced with this problem, we created a game called Diary of My Life, which aims to stimulate the cognition of the elderly and improve the relationship between him and his family in the early stage of the disease. Objectives: To facilitate playful interaction between patient and caregiver/family, through stories of life told by the participants, stimulating the exchange of experience and rescue of memories. Materials and Methods: The game consists of: 1 Book-shaped tray; 6 cards: one of culture; one of environment; one of relationship; one of sensations; one of phases of life; a joker; 2 colored dice; 1 manual; Choose the category to be played; Roll the die; Read in the card the chosen category for the referred item; Ask the player to tell a story about that item. They can play from 2 to 6 people per game; It can play with up to 5 factors, and the combina- tions are free; The game was tested in the home of two elderly with Alzheimer’s one in the initial phase, and another already in the moderate phase. Then, in a Nursing Home in Sorocaba, with four participants also in the initial phase of the disease, and also four other dementia patients with a comparative character, each match lasted 40 minutes with 4 applicators. Results: We obtained positive aspects at the moment of the game, there was interest of the elderly and the family. Even though the disease was initially targeted by the test, we confirmed the theories, because of the patient’s lack of patience and much agitation. There was socialization among the elderly of Nursing Home. The test that was obtained in the house of the elderly was satisfactory, when you asked to play with the grandson, in relation to other dementias we saw the possibility of adaptation. Conclusions: The game is still undergoing tests but until now we find that socialization and exchange of experience were successfully achieved, the stories were told according to the cards released and the elderly remained interested. Reference: Bottino CMC, et al. Cognitive rehabilitation in patients with alzheimer’s disease multidisciplinary teamwork report.

1Universidade de São Paulo.

56. AVALIAÇÃO DO PROCESSO DE TOMADA DE DECISÃO EM IDOSOS COM ALZHEIMER E COMPROMETIMENTO COGNITIVO LEVE A PARTIR DOS INSTRUMENTOS IGT, GDT E AGP: UMA REVISÃO SISTEMÁTICA Alaise Silva Santos de Siqueira, Daniel Apolinário, Marina Maria Biella Silva, Juliana Emy Yokomizo, Ivan Aprahamian

A Doença de Alzheimer (DA) é a forma mais comum de demência. Atualmente sabe-se que, apesar das alterações em memória serem as mais frequentes no início da doença, outros domínios cognitivos podem ser afetados. Alterações em funções executivas específicas, como na Tomada de Decisão (TD) têm sido recentemente investigadas. Objetivos: Este estudo teve como objetivo realizar revisão sistemática sobre os efeitos da TD em idosos com CCL e DA, a partir de tarefas de jogo. IGT- Iowa Gambling Task (Bechara et al., 1997; Bechara, et al., 1998)., GDT- Game Dice Task (Brand et al., 2008) e AGP- Associated Gambling Probability (Sinz et al., 2008). Métodos: Os estudos foram coletados de acordo com os seguintes termos chave combinados: “disease Alzheimer” ou “dementia of Alzheimer” e “decision making”, “disease Alzheimer” ou “dementia of Alzheimer” e “Game task”, “mild cognitive impairment” e “decision making”, “mild cognitive impairment” e “Game task”, nas bases de dados PubMed e Scielo. Resultados: Foram encontrados 5 estudos. Sendo 2 comparando grupos controle e DA inicial, 2 comparando grupo controle e CCL e 1 estudo que avaliou CCL e DA.

54 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Conclusões: Esta revisão encontrou que, em relação à capacidade de TD em idosos com DA e CCL comparados com indi- víduos normais, pacientes com DA deslocam com mais frequência entre alternativas seguras e arriscadas e mostram padrões de respostas menos consistentes do que idosos saudáveis. Os pacientes parecem cometer muitas mudanças entre as estratégias, o que indica que as decisões são tomadas de forma aleatória, sem nenhuma estratégia vantajosa estabelecida e sem nenhum padrão de resposta consistente desenvolvido ao longo do tempo. Além disso, estes resultados indicam que tanto a TD de em cenário de ambiguidade, avaliada a partir do instrumento IGT, quanto a TD em cenário de risco, avaliada pelos instrumentos AGP e GDT, estão prejudicadas em DA provável e em CCL. A partir destes resultados, é possível hipotetizar que pacientes com DA provável e CCL estão em maior risco para TD desfavoráveis do que adultos saudáveis. Estas alterações podem ter um forte impacto no funcionamento diário tanto dos pacientes com DA provável quanto para os pacientes com CCL e devem ser melhores investigadas a fim de ajudar no diagnóstico precoce desta patologia que vem aumentando drasticamente todos os dias. Palavras-chave: Tomada de decisão, doença de Alzheimer, IGT.

57. CORRELATION BETWEEN FUNCTIONAL MOBILITY WITH COGNITIVE PERFORMANCE AND DEPRESSIVE SYMPTOMS IN PHYSICALLY ACTIVE ELDERLY Fernanda Grazielli Mendes1, Sergio Luiz Lopez Nusa1, Rubens Goulart2, Sheila de Melo Borges1

Introduction: Functional mobility in elderly can be negatively influenced by depressive symptoms and cognitive deficits, leading to loss of autonomy and independence. This factors associated may compromise gait and balance, but and can be attenuated with the regular practice of physical activity. Objectives: To evaluate the correlation between functional mobility with depressive symptoms and cognitive performance in physically active elderly. Materials and Methods: A cross-sectional study was conducted with 44 older adults who practice strength training, for at least 6 months, at “Recreational and Sports Complex Rebouças” in the Santos City, Sao Paulo, Brazil. We examined functional mobility using the Timed Up and Go test (TUG). The depressive symptoms was evaluated by Geriatric Depression Scale (GDS-15); and cognitive performance was tested by Mini-Mental State Examination (MMSE) and verbal Fluency (VF) – animals. Spearman’s correlation (r) was used to evaluate a possible relationship between performance in TUG and cognitive and depression assessment scores. Results: In our sample, the mean of the age was 70.11 ± 6.25 years, with a predominance of the women (n = 33; 75%), with 10.73 ± 5.18 years of education and 68.61 ± 68.21 months of the bodybuilding practice. The mean of TUG was 9.15 ± 1.81 seconds, with mean of 2.57 ± 2.60 points in GDS-15, 26.05 ± 2.49 points in MMSE and 15.53 ± 6.92 animals in VF. We found significant correlations between TUG and GDS-15 (r = 0.321; P = 0.033), but there was no correlation with MMSE (r = –0.144; P = 0.352) and VF (r = –0.105; P = 0.503). Conclusions: The results indicate that mobility functional correlated (low and positive) only to depressive symptoms. Therefore, our results revealed that worse functional mobility performance is associated with greater presence of depressive symptoms in physically active elderly, but not correlated to cognitive tests in this sample. Funding: Institu- tional Scholarship Program (PIBIC) - National Council for Scientific and Technological Development – CNPQ.

1Faculty of Physical Therapy, Santa Cecilia University, Santos, São Paulo, Brazil. 2Physical and Intellectual Rehabilitation Center, Municipal Health Department, Santos, São Paulo, Brazil.

58.S ANALY IS OF FUNCTIONALITY IN ELDERLY WITH DEMENTIA IN THE FIRST COGNITIVE EVALUATION Mariana Barbosa Gonçalves1,2, Natália de Cássia Horta2, Larissa da Silva Serelli1, Maria Dolores Lemos dos Santos1, Henrique Cerqueira Guimarães1, Leonardo Cruz de Souza1, Paulo Caramelli1

Background: The elderly population is growing worldwide and in Brazil it can exceed 30 million people by 2025. The incidence and prevalence of dementia also increases with advancing age and contribute to dependence and loss of functionality of the elderly, who often face day-to-day problems resulting from functional changes. Objectives: To evaluate the functionality of a patients’ sample with Alzheimer’s disease dementia (AD), behavioral variant frontotemporal dementia (bvFTD) and mixed dementia (MD) followed at the Behavior and Cognitive Neurology Unit. Methods: Cross-

55 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 sectional descriptive study with 50 elderly consecutively evaluated between 2014 and 2015. We analyzed the sociodemographic characteristics, age of onset, first symptoms and the scores on the Functional Assessment Questionnaire (PFAQ), Katz scale, Mini-Mental State Examination (MMSE), clock drawing, and verbal fluency (VF; animals/min). Non-parametric correlation analyzes were undertaken and the significance level was set at 0.05.R esults: Significant correlations were found between PFAQ scores and scores on MMSE (r = –0.562), VF (r = –0.484) and clock drawing (r = –0.495) (p < 0.001 for all variables). Memory symptoms were significantly associated with AD diagnosis and memory plus behavior symptoms were significantly associated with bvFTD diagnosis. MD diagnosis was not associated with any first symptom.Conclusions: PFAQ confirmed to be sensitive to determine functional loss in the initial stages of dementia, that is, in the first evaluation. The initial symptom was associated with the type of dementia in AD and bvFTD. Key words: dementia, geriatric assessment, daily living activity, elderly, occupational therapy

1Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Hospital das Clínicas da UFMG, Pontifícia Universidade Católica de Minas Gerais. 2Pontifícia Universidade Católica de Minas Gerais.

59. MILD COGNITIVE IMPAIRMENT (MCI) IDENTIFICATION IN LOW EDUCATION ELDERLY USING ADDENBROOKE´S COGNITIVE ASSESSMENT (ACER) José Wagner Leonel Tavares Júnior1, Pedro Braga Neto1, Janine de Carvalho Bonfadini1, Cândida Helena Lopes Alves2, Grazielle Caldas Dutra2, José Ibiapina Siqueira Neto1, Gilberto Sousa Alves1

Introduction: Prevalence rates of MCI oscillates between 12-18% among those above 65 years. In Northeast Brazil, there are limited epidemiologic data, besides that neuropshycological data interpretation in low education individuals is challenging. Objectives: To describe clinical, demographic and neuropsychological characteristics of an outpatient low education MCI population and to establish ACER accuracy in this population. Methods: Patients included are over 60 years of old and less than 5 years of formal study. They were examined by a multidisciplinary team. Absolute frequencies, percentages and 95% confidence intervals were calculated for nominal variables. Quantitative variables were summarized in central tendency measures (mean and median) and dispersion measures (standard deviation and interquartile range). Pearson (r) correlation coefficient was used to compare ACER subitems variability. Shapiro- Wilk test was applied to check the assumption of adherence to the normal distribution and subsequent application of Pearson (r) correlation coefficient to check linear relationship between ACER with age and Mini Mental State Exami- nation (MMSE). Due to the identification of non-adherence to the normal distribution, Spearman’s (rho) correlation coefficient was applied to verify the linear relationship between ACER and schooling.R esults: Twenty-eight patients were evaluated. Subjects did not present difficulties with ACER, and their application lasted, on average, 20 minutes. Mean score of the MEEM was 21.7 points, while the ACER showed an average of 54.1 points. ACER Verbal Fluency sub-item showed greater variability among all components (CV: 67%), while the sub-item Orientation was the most uniform in the sample (CV: 18%). ACER presented positive linear correlation with schooling and MMSE. Conclusions: ACER showed rapid and easy application. It presents sub-items with little variability, proving to be a useful tool for individuals of low schooling. It is important to emphasize that ACER offers us a greater power of information when compared to the MMSE.

1Universidade Federal do Ceará. 2Hospital Nina Rodrigues – São Luís/MA.

60. Diabetes autoreferido e cognição de idosos com diferentes faixas etárias de escolaridade Debora Lee Vianna Paulo1, Anita Liberalesso Neri1, Maria Elena Guariento1, Mônica Sanches Yassuda2

Diabetes Mellitus (DM) é uma desordem metabólica de múltiplas etiologias (Diabetes Care, 2003). Pesquisas sugerem que há conexão entre o DM e comprometimento cognitivo (Stracham et al, 1997). O objetivo deste estudo foi descrever o perfil cognitivo de idosos com DM auto-referido, avaliados por meio do Mini Exame do Estado Mental (MEEM) (Brucki et al, 2003), comparados com idosos sem diabetes ou outras doenças, que eram participantes do estudo FIBRA

56 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Pólo UNICAMP (Soares et al, 2012), de base populacional realizado em sete localidades brasileiras. 741 participantes sem déficit cognitivo e sem hipertensão de 5 localidades, foram divididos em dois grupos: 1) idosos que relataram ser diabéticos (n = 78) e 2) idosos que relataram não ter DM (n = 663). Dentre os 78 idosos que relataram ser diabéticos, 67 relataram fazer tratamento farmacológico para DM e 11 relataram não fazer tratamento para DM. Os 741 participantes foram divididos, ainda, em faixas de escolaridade (0 anos, 1 a 4 anos e 5 ou mais anos de escolaridade) para análises de regressão. Os resultados das análises comparativas para a amostra total mostraram que os idosos com DM apresentaram pior desempenho na pontuação total do MEEM e no subdomínio Linguagem. Entre os idosos que pos- suíam entre 1 a 4 anos de escolaridade, os que tinham DM apresentaram pior escore nos subdomínios Linguagem e Atenção no MEEM. Não houve diferença significativa entre os idosos que fazem ou não fazem tratamento para DM. Na análise de regressão multivariada, no grupo com 1 a 4 anos de escolaridade, houve associação significativa entre ter DM e pior desempenho no subdomínio Linguagem. Idosos com DM apresentaram pior desempenho cognitivo no MEEM, em especial no subdomínio Linguagem. Palavras-Chave: cognição, diabetes mellitus, idosos, meem.

1FCM-Unicamp. 2EACH-USP.

61. Performance on the Iowa Gambling Task in the behavioural variant Frontotemporal Dementia and Alzheimer´s Disease Luciana Cassimiro1, Mário Amore Cecchini1, Valéria Santoro Bahia1, Thaís Bento Lima-Silva1, Sônia M. D. Brucki1, Ricardo Nitrini1, Mônica Sanches Yassuda1

Background: Decision making (DM) can be defined as a process in which the individual attempts to maximize benefits through the selection of responses that lead to positive results. Neurodegenerative patients often show DM problems. Objectives: To investigate the pattern of DM in a sample of patients with behavioural variant Frontotemporal Dementia (bvFTD) and Alzheimer´s disease (AD) compared to heathy controls (HC) in the Iowa Gambling Task (IGT). Methods: We evaluated 49 elderly people, 14 had received the diagnosis of bvFTD, 16 AD and 20 were age and education matched HC. All participants underwent general cognitive screening using the Addenbrooke’s Cognitive Exami- nation Revised (ACE-R) to determine their overall cognitive status. The Clinical Dementia Rating (CDR) was used to determine the disease severity in patients and the IGT was used to assess DM. The IGT is a computer-administered task which involves making a choice between four decks of cards A, B, C and D in each trial. In total, 100 trials were completed by each examinee. Results: The three groups were equivalent in age (M = 67.86, 9.42 SD) and education (M = 12.08, 5.05 SD). The mean of the CDR was 1.42 (0.47 SD) and 1.09 (0.37 SD) for bvFTD and AD patients, respectively. In the ACE-R the mean was 70 (18.84 SD), 65.81 (12.91 SD) and 90 (8.13 SD) for bvFTD, AD patients and HC (HC > bvFTD > AD). In the IGT Netscore, the results were –1.69 (8.23 SD), 1.25 (9.11 SD) and 0.5 (15.83 SD) for bvFTD, AD patients and HC. There were no significant differences across groups (p > 0.1). Scores indicated that bvFTD patients exhibited more impulsive responses in the IGT, yet, due to lack of power (0.083), differences did not reach significance. Conclusions: The results showed that participants’ performance on the IGT was highly variable, with some participants performing well, while others were severely impaired. Future studies with larger samples may be able to better describe differences in IGT scores among dementia sub-types.

1Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.

62. Effect of music on the behavior of elderly people with severe dementia Larissa Correa1, Ana Júlia de Souza Caparrol1, Letícia Maria Brugnera1, Diana Quirino Monteiro1, Ludmyla Caroline de Souza Alves1, Gabriela Zenaro Manin1, Aline Cristina Martins Gratão1

Introduction: The demential syndrome represents one of the main causes of disability and dependence in old age. The literature shows that non-pharmacological interventions such as music can bring several benefits such as delayed disease damage, well-being, distraction, better communication and interaction between caregivers and the elderly. Objectives: To verify the effects of music in participants with severe dementia, residents of a long-term institution,

57 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 with evaluation of psychological and behavioral symptoms (SPCD) before and after intervention. Materials and Methods: almost experimental study, convenience sample (n = 19), without control group. Participants derived from a private ILPI, from a city in the interior of São Paulo. All of them with diagnosis of severe dementia due to several etiologies that, after approval by the Ethics Committee, were evaluated by the Neuropsychological Inventory (NPI-Q), applied to the caregiver. Participants experienced 4 sessions of music representative of the life trajectory of each elderly person, weekly, from May to July 2017. The analysis was performed by SPSS 20.0 applying the t test to analyze the difference before and after intervention. Results: Female (89.5%), longevity (± 85.2 years), widows (57.9%), and mean daily consumption of medications of 5.6 (polypharmacy). The most frequent SPCD’s were motor disorders (63.2%), Anxiety (57.9%), and restlessness, depression and apathy (52.6%). After the t-test analysis, the majority of the symptoms showed improvement, but only delirium was significant (p = 0.029), and the symptoms of hallucination and appetite were slightly worse. Conclusions: The results of this study suggest that only one weekly session of music may not be sufficient for the improvement of SPCDs in the elderly with severe dementia, since in this study only the delirium symptom improved significantly. It should be emphasized that despite these findings, the strategy with music with elderly in this profile is extremely relevant for the improvement of the relationships between the elderly dyad and caregiver. Key words: elderly, dementia, music, gerontology.

(1) Federal University of São Carlos, Gerontology Undergraduate course.

63. THE INFLUENCE OF NEUROPSYCHIATRIC SYMPTOMS ON THE LEVEL OF CAREGIVER BURDEN Andressa Hermes Pereira1, Patrícia Ferreira2, Ana Bresolin Gonçalves3, Rochele Paz Fonseca3, Renata Kochhann3, Márcia L. Fagundes Chaves1

Introduction: Neuropsychiatric symptoms are commonly associated to neurodegenerative illness and may arise in the early stages of the condition, such as apathy, depression, anxiety, aggressive behavior. The occurrence of this type of symptoms can lead to an increase in overload and depressive feelings in family members and/or caregivers. Objective: The aim of this study was to verify which neuropsychiatric symptoms influence the level of caregiver burden in patients with mild Alzheimer’s disease (AD). Materials and Methods: It was evaluated 28 caregivers (19 women (69%) and 9 men (31%)) with mean age of 57.40 (SD = 13.62), education of 12.26 (SD = 5.25), while the patients had mean age 74.40 (SD = 6.88), education of 7.29 (SD = 4.50), mean Mini Mental State Examination (MMSE) of 20.83 (SD = 3.86) and mean Daily Life Activity Questionnaire (ADL-Q) of 39.88 (SD = 13.35). The majority of the caregivers lived with the patient (n = 19, 68%), and were patient`s child (n = 14, 50%), spouse (n = 13, 46%) or have other relationship with the patient (n = 1, 4%). The instruments used were MMSE, ADL-Q, Burden Interview Scale (EBI) and the severity scale of the Neuropsychiatric Inventory (NPI). First, it was verified that the data were not parametric, Spearman’s correlation was performed and the three major neuropsychiatric symptoms correlated with the burden were included in the stepwise regression analysis (apathy, irritability and aggressiveness). Results: It was observed that apathy predicts 42% and irritability 12%; together they influence 54% in the level of caregiver burden.Conclusions: It is hypothesized that apathy better justified the burden because is a symptom that may persist longer than the others and require continuous management. Aggression may have been excluded from the final regression model because it is a case of patients with mild AD and aggression may manifest in more advanced stages of the disease. Further studies are suggested that evaluate the various neuropsychiatric symptoms and burden, in order to be able to develop interventions that improve the day-to-day of these caregivers and patients.

1Universidade Federal do Rio Grande do Sul. 2Universidade do Vale do Rio dos Sinos. 3Pontifícia Universidade Católica do Rio Grande do Sul.

64. CHARACTERIZATION OF LANGUAGE IN PATIENTS WITH ALZHEIMER’S DISEASE AND POSITIVE CEREBROSPINAL FLUID BIOMARKERS : A PRELIMINARY ANALYSIS Thais Helena Machado, Aline Carvalho Campanha, Henrique Cerqueira Guimarães, Leonardo Cruz de Souza, Paulo Caramelli

58 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Background: Impairment in lexical access is a common clinical feature in Alzheimer’s disease (AD). However, other linguistic symptoms may occur and interfere in the communication of these patients. Objectives: To characterize the language of patients with clinical diagnosis of probable AD and positive cerebrospinal fluid (CSF) biomarkers. Methods: Patients were selected in a tertiary outpatient clinic of a university hospital and had the diagnosis confirmed through neurological evaluation (clinical, neuroimaging and analysis of AD biomarkers in the CSF), neuropsychological and speech-language assessment. For the latter were used the Boston test (BT, including the naming test - BN), semantic verbal fluency (SVF-animals), phonemic fluency test (FAS), definition test (DT), Camels and Cactus test (CCT), Test for Reception of Grammar (TROG) and recognition of famous faces test (RFFT). Results: Seven subjects with mean age of 64 years (ranging from 54 to 75), average schooling of 10 years (from 4 to 15) and at different stages of the disease (4 mild and 3 moderate dementia), were included in the study. Two of them had a syndromic diagnosis of Primary Progressive Aphasia. Mean scores in the tests were as follows: SVF = 8.6, FAS = 12.8, RFFT = 7.8, CCT = 44, TROG = 43.4, DT = 11 and BN = 24.8. Patients were impaired in all BT subtests, in relation to standardization, with greater impairment in oral language than in written language. Conclusions: The patients were impaired in all linguistic parameters, with most prominent deficits in oral language.

Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG).

65. Correlation between forgetfulness and multicomorbidities in elderly: Cross-sectional transversal Vânia Ferreira de Sá Mayoral1, Mariana Gegenheimer Bremenkamp1, Ariane Maria Carmelin1, Fernanda Nascimento Costa1, Paulo José Fortes Boas1

Introduction: The prevention of cognitive impairment and dementia is an important public health goal. The aging population worldwide has increased the prevalence of psychiatric, cognitive impairment and chronic and degenerative diseases. Psychiatric diseases have been associated with dementias. For example, mood disorders and pseudo dementia. Studies have now focused on the early detection of cognitive complaints to decision and consequently, prevention of dementia. Objectives: Descriptive analysis of the elderly attended at an outpatient clinic of elderly cognitive complaints at a university of the interior of São Paulo. Methods: All elderlies were evaluated whit the Mini Mental State Examina- tion (MEEM), Katz index of independence in activities of daily (KATZ), Lawton instrumental activities (LAWTON), Patient Health Questionnaire (PHQ2/9) and the Charlson Comorbidity index. Results: Statistic analysis was realized with SPSS 22 software. 56 elderlies were evaluated between March 2016 and September 2017. The mean age of 75.34 (SD 6.72); 69.6% were female; 92.9% white, 57.1% with four years of schooling, 80.4% married, 76.8%. Charlson Comorbidity index was low (0). Most of the elderly were independent as shown by Katz index 96.4% and Lawton 80.4. The number of drugs used by the subjects was 3.38 + 3.27. The most frequent diagnoses were: 32.1% (18) benign forgetfulness; 19.6% (11) (Alzheimer disease, 1.8% (1) b12 deficiency, 7.1% (4) pseudo dementia, 10.7% (6) Mild Cognitive Imparment (MCI), Hypothyroidism and 26.8% (15) psychiatric disease (mood disorders, anxiety disorders, bipolar affective disorder and among others). In this sample the functionality tests (Pfeffer, Katz and Lawton) showed no association with diagnosis of MCI and dementia (p > 0.05). Conclusions: This study showed the importance of early detection of cognitive complaints. To diagnose reversible causes such mood disorders which increases the risk for dementia as well as Mild Cognitive Impairment.

1São Paulo State University (UNESP), Medical School, Botucatu.

66. NEW PREDICTORS OF EVOLUTION IN MILD COGNITIVE IMPAIRMENT ? Silvia Stahl Merlin1, Maira O. Oliveira1, Eduardo S. Trés1, Sonia M. D. Brucki1

Introduction: Mild cognitive impairment (MCI) is the term used for the transition period between normality and dementia. In this interval, disturbances that occur in brain functioning are presented with cognitive deficits and behavior changes that may evolution to dementia or return to normal. MCI have heterogeneous clinical, etiological and prog-

59 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 nostic characteristics. Studies have showing that there are many risk factors for unfavorable evolution of MCI and some protective factors for maintaining healthy aging. There is association between the worse evolution in patients with hypertension, diabetes, obesity, smoking and physical inactivity. In the same direction, the presence of neuropsychiatric symptoms increases the severity of cognitive dysfunction and some psychological characteristics determine behavioral patterns of the individual and contribute to better health throughout life. Objectives: Understand possible psychological and personality factors associated with evolution of normality to dementia in the Brazilian population with MCI. Methods: Cross-sectional observational study with 10 MCI patients with amnestic predominance, 10 patients with non-amnestic MCI and 10 normal individuals. We tested the cognitive function through standard neuropsychological test of the service. Also applied the Inventory International Neuropsychiatric Interview (Version 5.0 – DSM IV) and the revised Five-Factor Personality Inventory, for verify the prevalence of psychiatric symptoms and personality traits in participants. Results: Mean age was 72 years, 23% of the sample were men and 77% women. Aver- age scholarly was 12 years. Among the normal individuals, 70% presented complaints related to sleep. Among MCIs the psychiatric disorders occurred in 65% of the sample and anxious symptoms were the most prevalent. MCI patients presented with more marked neuroticism traits and less opening for new experiences when compared to normal individuals, indicating a higher risk for dementia. Conclusions: These data suggest the existence of association that allows strategic planning and investment in the protection of cognition in old age. Interventions to change personality traits and behaviors could transform lifestyle, and may be a tool for avoids the progression to dementia.

1Faculdade de Medicina Universidade de São Paulo – FMUSP.

67. Gait speed in elderly with mild cognitive impairment and Alzheimer’s disease: A longitudinal study Larissa Pires de Andrade, Fernando Arturo Arriagada Masse, Paulo Giusti Rossi, Juliana Hotta Ansai

Introduction: Among gait analysis parameters, gait speed (GS) has gained great importance and is considered the sixth vital sign of the elderly. The GS correlates with the functional abilities, with potential to precede the future state of health, besides reflecting functional and physiological changes. Some studies show that there is a strong relationship with the occurrence of falls in the elderly, that is, the lower the GS, the greater the chance of falls. Little is known about the progression of gait speed changes in longitudinal studies in elderly individuals with cognitive impairment in the early stages. The realization of studies of this nature may provide a better basis for the creation of measures of effective motor interventions for this population. Objectives: To identify if there are differences in gait speed between cognitively preserved elderly (CPE) with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in the mild phase over six months. Methods: 110 elderly people participated in the study. Of these 40 CPE, 36 with MCI and 34 with DA. Initially the 10-meter walk test was applied. After six months, the walking test was applied again. Results: The elderly of the MCI and AD groups had lower gait velocities when compared to the elderly CPE group, at both moments of evaluation (p < 0.001). There was no significant difference in gait velocity delta between the groups (p = 0.063).Conclusions: It was identified that the elderly with MCI and AD in the mild phase have lower gait velocities when compared with elderly CPE. The time of six months seems not to be sufficient to bring about substantial changes in the gait. However, it is important to carry out larger follow-up studies to provide greater knowledge on this subject and to subsidize fall prevention interventions for this population.

Federal University of São Carlos.

68. Cambridge Cognitive Examination in Alzheimer’s disease: analyzes of praxis subitems Lívia Galeote, Juliana Francisca Cecato, José Eduardo Martinelli, José Maria Montiel

Praxia deficiency may be one of the first symptoms manifested by dementia, primarily by cortical dementias. The present study aims to investigate the sensitivity and specificity of praxia (constructive, ideomotor and ideational)

60 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 sub-items from Cambridge Cognitive Examination (CAMCOG) in relation to the healthy elderly and Alzheimer’s disease (AD) patients. 158 elderly patients from January 2016 to April 2017 were evaluated. The instruments used were the Cambridge Cognitive Examination (CAMCOG), the Mental State Mini-Exam (MMSE) as part of the CAMCOG cognitive battery, the Geriatric Depression Scale and Pfeffer Functional Activities Questionnaire (PFAQ). ROC curve analysis was used to establish cutoff points and Spearman correlation coefficient in order to compare the praxia with CAMCOG, MEEM and PFAQ. Results showed praxia and subitems correlated with the instruments (CAMCOG, MMSE and PFAQ). The total score of praxia item and constructive subitem presented significance (p < 0.0001) in differentiating healthy elderly from those diagnosed with AD. Constructive praxia was the subitem with the area under the curve (AUC = 0.905), with sensitivity and specificity, respectively, 69% and 98%. Constructional subitem presented diagnostic efficacy in differentiating the normal elderly from AD patients, with a specificity value higher than the total Praxia item itself. The ideomotor and ideational praxis from CAMCOG did not show statistically significance between diagnostic groups, evidencing that only constructional subitem was relevant in investigating cortical dementia. For our considerations, it is possible to infer that the constructive subitem should be observed more carefully when using CAMCOG, since it can present, even in a subtle way, evidence of apraxia that may support the recognition of a dementia symdrome.

69. ALZHEIMER’S DISEASE: THE SENSE OF CARE AND DIFFICULTIES EXPERIENCED BY CAREGIVERS Glenda Dias dos Santos1, Jouce Almeida1, Orestes Vicente Forlenza1, Paula Villela Nunes1

Background: Caring for older adults with Alzheimer’s disease (AD) impacts many aspects of caregivers’ daily life. With the progression of AD new challenges emerge. The decrease in autonomy and health changes increases the need for care. Objectives: To identify perceptions of caregivers of older adults with AD regarding the caregiving and the difficulties experienced by caregivers providing care.M ethods: We studied 39 caregivers of AD patients attending a university-based psychogeriatric clinic, a semistructured interview was used and data was analyzed qualitatively using the “discourse of the collective subject” method. The guiding questions of the interview were: How do you feel about taking care of your family member? What are your greatest difficulties in relation to the care given to the elderly? Results: Caregivers’ perception of AD care was related to positive feelings such as well-being, satisfaction, rewarding experience and feeling empowered; negative feelings were stress, tiredness, obligation and sadness; ambiguous feelings (love and anger, patience and irritation) were also present. The difficulties reported by caregivers in patient care were related to neuropsychiatric symptoms (appetite changes and irritability), inattention to personal care/hygiene, repetitive questioning, diminished initiative and increased stubbornness of the patients; caregivers also reported the burden of daily tasks, continual oversight and lack of social support. Conclusions: Caring for older adult with AD is a complex process that can bring positive and negative feelings. Caregivers need psychoeducational interventions that provide information on the development of AD, management of behavioral symptoms and stress management training. Support for caregivers in specialized services and strengthening social relationships can reduce caregiver burden.

1Instituto de Psiquiatria HC FMUSP.

70. RELAtiONSHIP BETWEEN COGNITIVE PROCESSING AND SUPPORT OF SOCIAL OF ELDERLY CAREGIVERS OF PRIMARY HEALTH CARE Sofia Cristiana Iost Pavarini1, Ana Carolina Ottaviani2, Allan Gustavo Brigola2, Bruna Moretti Luchesi2, Érica Nestor Souza2, Fernanda Gomez de Moura2, Nathalia Alves de Oliveira2, Mariélli Terassi2, Wellinton Lucas Silva Almeida1, Francisco José Fraga4

Introduction: The chronicity of health problems and associated longevity of the population contribute to the increase in the number of elderly people with cognitive decline. It is known that social support aims at maintaining and promot- ing physical and psychological health, so they can reduce the negative effects of aging. Aim: To evaluate the relationship between cognitive processing and social support of elderly caregivers in primary health care. Materials and Methods: This

61 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 is a cross-sectional and quantitative study carried out with a sample of 76 elderly caregivers seen in the primary care of a city in the interior of the State of São Paulo, Brazil. Interviews included sociodemographic variables, cognitive processing assessment (P300) and evaluation of social support by the Medical Outcomes Study. For the P300, an electro- physiological evaluation device was used, the contact electrodes were fixed in the frontal (Fz), central (Cz) and parietal (Pz) regions, an electrode in the left and right ear lobe, electrodes of EOG capture and reference electrode, according to the 10/20 system. Ethical care has been respected. Data analysis was performed using descriptive and correlational statistics, Pearson correlation test, significant for p ≤ 0.05. Results: The elderly caregivers were mostly women (82,9%), with a mean of 69.5 (± 5.7) years of age and 3.9 (± 0.3) years of schooling. Regarding the cognitive processing, the mean latency for the Fz, Cz and Pz regions were 356.5 (± 41.5), 356.9 (± 42.5) and 356.5 (± 41.2) respectively. The amplitude values were Fz 5.0 (± 3.5), Cz 5.1 (± 4.0) and Pz 6.4 (± 3.6). The majority of the elderly had the support of approximately 5 people. The highest score was affective support with a mean of 89.4 (± 19.4) and the lowest was the positive social interaction support, with a mean of 85.1 (± 23.2). There was a significant correlation between latency Pz and material support (r = –0.301). Conclusion: It is concluded that the evaluation of cognitive processing indicates a good level of information processing, which correlated with material support. This research may contribute to the planning of actions among the elderly of primary health care. Financial support: CNPq (304067/2015-6) e FAPESP (2016/21521-7).

1Departamento de Gerontologia – Universidade Federal de São Carlos. 2Programa de Pós-Graduação em Enfermagem – Universidade Federal de São Carlos. 3Departamento de Medicina – Universidade Federal do Mato Grosso do Sul. 4Programa de Pós-Graduação em Neurociências – Universidade Federal do ABC.

71. Performance properties of the Pentagon Drawing test for the screening of older adults with Alzheimer’s dementia José Eduardo Martinelli, Juliana Francisca Cecato, Marcos Oliveira Martinelli, Brian Alvarez Ribeiro de Melo, Ivan Aprahamian

Background/Aims: The Pentagon Drawing Test (PDT) is a common cognitive screening test. The aim of this study was to evaluate performance properties of a specific PDT scoring scale in older adults with Alzheimer’s disease (AD) and healthy controls. Methods: Cross-sectional study of 390 elderly patients, aged 60 years or older with at least two years of education. All participants completed clinical and neuropsychological evaluation, including the Cambridge Cogni- tive Examination, the Mini-Mental State Examination (MMSE), and the Clock Drawing Test. All PDT were blindly scored with the scale of Bourke et al. Results: PDT analyses of the binary score in the MMSE (0 or 1 point) did not discriminate AD from controls (p = 0.839). However, when PDT was analyzed by Bourke et al. scale the two groups could be distinguished (p < 0.001). PDT was not affected by education, showed sensitivity of 85.5% and specificity of 66.9%, discriminated different clinical stages of dementia, and correlated with the other cognitive tests (p < 0.001). A 1-point difference at Bourke et al. scale was associated with odds ratio of 3.46 to AD. Conclusions: PDT can be used as cognitive screening for suspected cases for dementia, especially AD, irrespectively to the educational level. Key words: Alzheimer’s disease, cognitive assessment, screening instrument.

72. ILLITERACY AND DYSLIPIDEMIA, RISK FACTORS FOR ALZHEIMER’S DISEASE, BUT MARKERS OF BETTER CLINICAL EVOLUTION? Raul Raposo Pereira Feitosa, Norberto Anízio Ferreira Frota, Vanessa Luana Lima Silva, Gisele Collyer Alves, Mariana Rabelo de Brito, Flávia Timbó Albuquerque, Andréia Braga Mota, Yasmin Costa e Silva, Larissa Chagas Correa, Lorena Chérida Alves Vidal, Inessa Carvalho de Queiroz, Fabrício Oliveira Lima

Introduction: Illiteracy is a risk factor for the occurrence of dementia and is associated with a lower cognitive reserve, but patients with a higher educational level tend to have a faster cognitive decline. Methods: One hundred and fort three patients with Alzheimer Disease an outpatient clinic of cognitive disorders in the northeastern region of Brazil were followed retrospectively. All patients were a follow-up at least 1 year. Patients who presented stability or increase in the MMSE score between the first and last visit were considered good responders. Student T test, Mann-Whitney test

62 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 and Chi-square were used to compare good response and the group without good. A logistic regression analysis was performed to identify independent factors of good response. Results: The mean age of onset of symptoms was 73.4 (± 7.2) years, with a predominance of females of 99 (69.2%). The illiteracy rate was 25.9% (37) and 63% (90) had less than 4 years of study. The mean initial MMSE was 15.3 (± 5.6) points. The mean follow-up of the patients was 29.96 (± 16.2) months and the mean last MMSE was 12.79 (± 6.5) points. During this follow-up period, 39 patients (27.3%) had a good response to treatment. There was no difference between good and no responders according to age and follow-up time, but there was a tendency to lower initial MMSE 14.4 (± 4.8) × 16.4 (± 5.8) (p = 0.07) and lower initial score in Pfeffer scale 16.5(± 8.2) × 20.68 (± 8) (p = 0.05). There was a higher frequency of dyslipidemia 62.16 × 36.14 (p = 0.01) and illiteracy 51.42% × 21.11 (p = 0.02) in good responders. The presence of neuropsychiatric symptoms in follow up was more frequent in non responders (69.9% × 50%) p = 0.046. In the logistic regression, only illiteracy (OR 5.23 CI 1.87-14.77) and dyslipidemia (OR 4.53 CI 1.75-11.73) had an association with good prognosis. Conclusions: Illiteracy and dyslipidemia were associated with good evolution in a group of patients with AD and low educational level.

Hospital Geral de Fortaleza, Fortaleza, Brazil. Unifor, Fortaleza, Brazil.

73. CORRELATION OF THE AGE AND SCHOOLING WITH COGNITIVE TESTS IN PHYSICAL ACTIVE ELDERLY Sergio Luiz Lopez Nusa1, Fernanda Grazielli Mendes1, Rubens Goulart2, Sheila de Melo Borges1

Introduction: Cognitive impairment in adults and the elderly is a condition that has been associated with risk for Alzheimer’s disease and other dementias, especially when associated with lower schooling, longevity and sedentary lifestyle. However, are these correlations present in a physically active elderly population? Objectives: To evaluate the correlation between cognitive performance with age and schooling in physically active elderly. Materials and Methods: A cross-sectional study was conducted with 44 older adults who practice strength training, for at least 6 months, at “Recreational and Sports Complex Rebouças” in the Santos City, Sao Paulo, Brazil. We examined cognitive performance by Mini-Mental State Examination (MMSE), Verbal Fluency Test (VF) – animals, Wisconsin Card Sorting test (WCST) number of categories scored and total persevering errors, Digit Span Sub-test (forward and backward). Pear- son’s linear correlation (r) was used to evaluate a possible relationship of the age and schooling with VF. In addition, Spearman’s correlation (r) was used with MMSE and WSCT. Results: In our sample, the mean of the age was 70.11 ± 6.25 years, with a predominance of the women (n = 33; 75%), with 10.73 ± 5.18 years of education and 68.61 ± 68.2 months of the bodybuilding practice. The mean of MMSE was 26.05 ± 2.49 points, with 15.53 ± 6.92 animals in VF, with 2.72 ± 1.8 number of categories scored and 10.98 ± 9.9 total persevering errors in WCST, and 8.73 ± 2.0 complete sequences in forward and 4.46 ± 1.9 complete sequences in backward Digit Span. We found significant correlations between age to VF (r: –0.42; P = 0.005) and WCST (number of categories scored - r: –0.39; P = 0.009; and total persevering errors – r: 0.38; P = 0.01). We also found significant correlations between schooling to VF (r: 0.54; P < 0.001), WCST (total persevering errors - r: –0.48; P = 0.001), and Digit Span backward (r: 0.47; P = 0.001). Conclusions: In this sample of physically active elderly, age and schooling present correlation to specifics cognitive components such as language and executive function.

1Faculty of Physical Therapy, Santa Cecilia University, Santos, São Paulo, Brazil. 2Physical and Intellectual Rehabilitation Center, Municipal Secretary of Health, Santos, São Paulo, Brazil.

74. SOCIAL TIMES IN LONG-STAY INSTITUTIONS: BIOLOGICAL RHYTHMS IMPACT AND IMPLICATIONS IN DEPRESSION AND COGNITION OF ELDERLY Evany Bettine de Almeida1, Luiz Menna-Barreto1

Introduction: The homogenization of social times that long-term institutions for the elderly normally adopt can cause internal temporal desynchronization, which interferes in the body processes causing external temporal desynchro-

63 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 nization, that is, mismatches between environmental and physiological events, creating problems in wake / sleep cycles, which can impact the state of mood, accelerate depressive symptoms and declining cognitive performance. The incompatibility between internal rhythms and external demands mainly on the timing and duration of sleep can lead to disturbances that are included in the Diagnostic and Statistical Manual IV-TR (APA, 2002) in the category for Cir- cadian Rhythm Disorder of sleep that leads to problems in attention span, mood, and in the sleep / wake cycle itself. Objectives: To verify if the establishment of schedules of daily activities in asylum institutions can contribute to the states of dysthymia and depression, with impact on the cognition of the residents, taking into account chronobiologi- cal, historical and cultural aspects. Methods: Participated 21 women and 8 men, aged 75-99 years, from six institutions of two institutions for the elderly, in the of São Paulo. Instruments and techniques: Sociodemographic questionnaire; MEEM; Geriatric depression scale; Sleep diary, chronotype determination questionnaire - maturity / evening); Sta- tistical analyzes Recorded interview; Ethnographic technique of participant observation. Results: Residents have no criticism of routine and schedules and would not propose changes; the majority presented a tendency to dysthymia and major depression; even residents who have evening preferences sleep early; most reported having no appetite; only 10% live by their own choice; the temporal disorganization in the elderly was partially proven. Conclusions: Based on the discourses analyzed it was concluded that temporal rules are only one of the challenges, given the identification of innumerable factors that negatively influence life in an institution, such as not considering that it is a place of residence, indeterminate hospitalization and that depression and cognitive decline are not a fatality common to all.

1University of São Paulo – GMDRB (Chronobiology).

75. DIAGNOSTIC EVALUATION AND PHYSICAL EXERCISES IN ELDERLY ALZHEIMER’S DISEASE: SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS Marcos Paulo Braz de Oliveira1, Roberta de Fátima Carreira Moreira Padovez1, Natália Oiring de Castro Cezar1, Julimara Gomes dos Santos1, Larissa Pires de Andrade1

Introduction: Alzheimer’s disease (AD) is characterized by the progressive decline of cognitive domains, compromising the functionality and loss of autonomy of the elderly. Exercise has been shown to be an important ally as a non-pharmacological treatment for these patients. However, the understanding of the types of exercises available for this population, as well as the way the patients’ diagnoses are performed in these studies, still need to be better investigated. Objectives: To identify the criteria used for the diagnostic evaluation and to know the protocols of exercises most used for the elderly with AD. Materials and Methods: The studies were identified from bibliographic research in six databases: PubMed, Embase, Web of Science, Lilacs, Cochrane and PEDro. We used randomized clinical trials that defined the criteria for AD classification and used exercise protocols for the functional rehabilitation of elderly patients affected by the disease. To analyze the quality of the methodological studies, the Pedro scale was applied. The protocol of this systematic review was approved in PROSPERO 2017: CRD42017071455. Results: We found 895 relevant articles in the databases, 88 of which were duplicates. Of the 807 articles selected for evaluation, 709 were excluded by the titles and 98 selected for reading the abstract. We excluded 64 articles and 32 selected to read the text in its entirety. Of these, 16 randomized controlled articles were elected for this systematic review. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and three protocol of exercise for the functional rehabilitation of the elderly with AD were identified as a form of diagnostic prevalent, being they exercises with single components, multimodal exercises and home exercise. Conclusions: The most widely used criterion for the diagnosis of AD is DSM-IV, however, some studies are not clear about the classification of dementia and confirmation of diagnosis. The predominant exercises protocols in this population were the exercises with single components, being less prevalent the multimodal exercises and home exercise.

1Universidade Federal de São Carlos.

76. EKBOM SYNDROME IN MILD COGNITIVE IMPAIRMENT: A CASE REPORT Milena Lima Bortoti1, Julia Loureiro1,2, Luiz Fernando de A. Lima e Silva1

64 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

Case Report: A 75-year old female outpatient, two years of schooling was assessed in the psychiatry service of the UNI- CAMP general hospital due to complaints of a “fungal nail infection” which, in the last 3 years, supposedly had spread and contamined her whole body. The symptoms worsened over time and she reported detecting “insects” on her skin, nose, and hair, resulting in significant psychic distress. She was taken by her family to an appointment with a derma- tologist, who recommended psychiatric evaluation. During psychiatric assessment, she was examined for suspected cognitive decline and came forth with the following screening test results: MMSE 23/30 and MoCA 13/30. The laboratory screening tests showed no abnormalities. Cranial computed tomography (CT) displayed an age-compatible global brain atrophy, cerebrovascular disease rating Fazekas 1 and MTA/ Duara (scale for medial temporal lobe atrophy) graded 2. The patient is currently been submitted to a complete neuropsychological evaluation and the results will be available by the end of November. She received Haloperidol for 3 months with partial improvement before her first appointment at our service. We switched the medication to risperidone (2mg/day), with an 80% improvement in psychotic and mood symptoms. The patient showed no insight regarding her delusions and feared that the insects would come back if the medication was withdrawn. Discussion: Alzheimer’s disease is the major cause of dementia, and many patients manifest psychiatric symptoms in early clinical stages. We report here a case of an elderly patient with low test scores in screening instruments and mild atrophy in the CT, presenting with parasitosis delusion, which is also refered as Ekbom syndrome. Patients with this condition are undoubtedly convinced that there are insects infesting their bodies. The syndrome may be associated with clinical conditions such as brain tumors, diabetes, and depression. In the present case report we explore the occurrence of parasitosis delusions as an early neuropsychiatric manifestation in patients with incipient neurocognitive impairment.

1Departamento de Psiquiatria do Hospital das Clínicas da UNICAMP – Campinas, São Paulo, Brasil. 2Laboratório de Neurociências LIM-27, Instituto de Psiquiatria – HCFMUSP, São Paulo, SP, Brasil.

77. CLINICAL OUTCOMES OF COGNITIVELY PRESERVED ELDERLY, WITH MILD COGNITIVE IMPAIRMENT AND MILD ALZHEIMER DISEASE Anne Caroline Soares da Silva1, Juliana Hotta Ansai2, Fernando Arturo Arriagada2, Larissa Pires de Andrade1

Introduction: Longitudinal studies about the clinical evolution of individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) are important when potential interventions can be performed. However, the existing studies focus on the cognitive outcomes of AD, such as its progression to AD and phases. Objectives: To describe the clinical outcomes of cognitively preserved elderly (CPE), with MCI and mild AD over 6 months. Methods: Elderly ones aged ≥ 65 or and not institutionalized were recruited. For inclusion, it was necessary to be able to walk at least 10 meters alone and without the use of a gait aid device; and classified in any of the three groups according to the cognitive level. Were excluded the ones with motor sequel resulting from stroke, neurological disorders that compromised cognition and/or mobility, severe audiovisual disturbance that interfered with communication during the performance of the evaluations, and elderly individuals with moderate or advanced AD. At the initial moment, the volunteers were evaluated through anamnesis, with the assistance of the informant in MCI and AD cases. After 6 months, data were collected about deaths, number of falls, hospitalizations, physical activity, physiotherapy and/ or cognitive stimulation and diseases diagnosed at that time. Results: A total of 112 elderly people participated, 41 of there were patients CPE, 36 MCI and 35 mild AD. After 6 months, 2 elderly patients with MCI and 1 elderly with AD died. Of the ones who survived, 46% of CPE, 53% with MCI and 54% with AD fell at least once; 5% of CPE and 8% with MCI were hospitalized; 37% of elderly CPE, 36% with MCI and 26% with AD practiced physical activity; 22% of elderly CPE, 8% with MCI and 23% with AD performed Physiotherapy; 7% CPE, 31% with MCI and 6% with AD were cognitively stimulated; 7% CPE, 6% with MCI and 9% with AD had a new diagnosis. Conclusions: With this follow-up it was possible to identify clinical outcomes in a 6-month period, in order to highlight the importance of follow-up these subjects over time and to identify their clinical evolution.

¹Federal University of São Carlos. ²Federal University of Mato Grosso do Sul.

65 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

78. DIFFERENCES BETWEEN MEN AND WOMEN ON FUNCTIONAL ACTIVITY LIMITATIONS: A SURVEY WITH COGNITIVE IMPAIRED ELDERLY IN RURAL AREAS, BRAZIL Fernanda Gomez de Moura1, Danilo Henrique Trevisan de Carvalho2, Sofia Cristina Iost Pavarini3, Allan Gustavo Brigola1

Background: Functional limitation is strongly associated with cognitive impairment (1), however, the prevalence and its associations in gender differences in Brazilian elderly in rural context are little known.M ethods: Cross-sectional survey with 48 Brazilian rural elders (25 men and 23 women) with cognitive impairment [screened by Mini-Mental State Examination using Brazilian points-recommended by schooling level (2)]. Functional limitation was assessed by Katz scale of basic activities of daily living (BADLs: bathing, dressing, toileting, transferring, continence and feeding) and Lawton scale of instrumental activities of daily living (IADLs: using telephone, travelling, shopping, preparing meals, caring of the home, medication responsibility and handling money). Logistic regression was performed to examine the prevalence and the relationship between functional limitation and gender among cognitive impairment. Results: Men age ranged 61-86 and women age ranged 60-88. Higher prevalence of functional limitations in BADLs was on continence 25.0% (95% CI 12-38). About IADLs, higher functional limitations were on shopping 62.5% (95% CI 48-77), caring of the home 56.1% (95% CI 42-71), preparing meals 52.1% (95% CI 37-67) and handling money 52.1% (95% CI 37-67). Being men were associated with limitations in preparing meals and caring of the home [Odds ratio (OR) 14.4; 95% CI 3.5-58.0] and (OR 4.0; 95% CI 1.19-13.4), respectively. Being women were linked to limitation in continence (OR 0.21; 95% CI 0.04-0.92). Conclusions: these results shared findings in parts with another study in developing country (3). Men were more linked with two functional limitations in IADL and women with one in BADL. In Brazil context domestic responsibilities are performed more by women than men, but elderly cognitively intact may perform those activities if they need. Perhaps impaired women were not linked with those limitations because they had this practice on lifetime and still can perform these activities more independently compared to men. References: 1. Zheng J, Liu J, An R. Functional limitation and cognitive impairment among 80+ year old Chinese. Australas J Age- ing. Australia; 2016; 35(4): 266–72. 2. Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuro-Psiquiatr. Brazil; 2003; 61(3B):777–81. 3. Abdulraheem IS, Oladipo AR, Amodu MO. Prevalence and Correlates of Physical Disability and Functional Limita- tion among Elderly Rural Population in Nigeria. Journal of Aging Research. 2011. Key words: activities of daily living; elderly; rural populations; cognition.

79. METRICAL ASSESSMENT TO COMPARE DEPRESSION INTENSITY IN THE CATEGORIES OF CLINICAL RATING DEMENTIA SCALE Licínio Esmeraldo da Silva1, Vilma Duarte Câmara1, Yolanda Elisa Moreira Boechat1, Jamaci de Almeida Machado Corrêa Lima1

Introduction: The investigation of the depression presence in subjects with suspicion diagnostic of dementia is essential in the neuropsychological assessment. The 15-items version of the Geriatric Depression Scale (GDS-15) proposed by Sheikh and Yesavage in 1986, with Portuguese version by Almeida and Almeida (1999), has been used to screen for depression in the elderly. Once identified the presence of depressive symptoms, it is possible to establish their intensity differently from the traditional ordinal categorization: mild, moderate or severe depressive state. According to the psychometric theory of latent trait, each person has the capacity for resistance (in the sense of lower vulnerability) to depressive state, which is impossible to be directly measured, but can be evaluated by the behavior of the answers in specific assessment instruments. This indirect measure through GDS-15 items is able to detect the degree of intensity of the depressive state of the elderly assessed on a continuous scale. Objectives: To evaluate the degree of intensity of depressive symptoms in the elderly classified in categories 0.5, 1 and 2 of the Clinical Dementia Rating scale.M ethods: The GDS-15 responses of 258 elderly subjects (87 CDR 0.5, 85 CDR 1 and 86 CDR 2), neuropsychologically evaluated in a public healthcare service, were submitted to Item Response Theory (IRT) techniques.R esults: The estimated degree

66 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 of intensity of the depressive state of each elderly indicated that, on average, there is no statistically significant difference in the intensity of the depressive state among the elderly of the CDR scale stages considered in the present study. Conclusions: Initial results showed that the degree of intensity of the depressive state is not associated with the impairment stage of Clinical Dementia Rating.

1Fluminense Federal University.

80. ETIOLOGICAL DISTRIBUTION OF NON-ALZHEIMER COGNITIVE IMPAIRMENT IN A TERTIARY COGNITIVE CENTER IN NORTHEAST BRAZIL Stephanie Suzanne de Oliveira Scott1, Jose Wagner Leonel Tavares Junior1, Patricia Gomes Damasceno1, Gilberto Sousa Alves1, Pedro Braga Neto1, Jose Ibiapina Siqueira Neto1

Background: Neurodegenerative diseases are becoming an important health problem due to an increase in the life expectancy of the population. Age is a major risk factor for dementia, also associated with low education level, and it is estimated that every four seconds there is one diagnosis of dementia in the world. Objectives: To describe the etiological distribution of non-Alzheimer’s cognitive impairment in a center specialized in cognition in the Northeast region of Brazil. Methods: Analysis of patient charts and mini mental state examination, clock drawing, verbal fluence, geriatric depression scale and figure memory battery tests were performed. Head magnetic resonance imaging and laboratory tests were also evaluated. Results: At our center, 219 patients with 17 distinct etiologies with the following prevalences were identified: Alzheimer’s Disease 40%, Mild Cognitive Impairment 13%, Mixed Dementia 12% Vascu- lar Dementia 12%, Parkinson’s Disease Dementia 9%, Frontotemporal Dementia 3% and Lewy Body Dementia 2%. Other etiologies, such as posttraumatic dementia, hypoxic ischemic encephalopathy, progressive supranuclear palsy, amyloid angiopathy, Wernicke/alcoholic dementia, among others, totaled 8%. Conclusions: Mild cognitive impairment is second only to Alzheimer’s disease, according to the literature, which, despite limited studies, shows a prevalence of approximately 10% in patients over 65 years of age.

1Hospital Universitário Walter Cantídio.

81. DEMENTIA AND URINARY INCONTINENCE: CONSIDERATIONS ABOUT POTENTIALLY INAPPROPRIATE MEDICATIONS Guaira de Nazareth Monteiro dos Santos da Silva1, Jamaci de Almeida Machado Corrêa Lima1, Yolanda Eliza Moreira Boechat1, Licínio Esmeraldo da Silva1

Introduction: Cognitive impairment and urinary incontinence are syndromes common to elderly, whose pharmacological treatments differ. The conjunction of medications may bring undesired effects if there are no human resources on possible drug interaction or even if there is a side effect altering the balance of another syndrome. Objectives: To investigate guidelines about inconveniences in the pharmacological treatment of both as syndromes. Methods: Analyze guidelines regarding the simultaneous and improper use of drugs in elderly people with dementia and also urinary incontinence. Results: The American Geriatrics Society maintains guidelines, known as Beers Criteria for potentially inappropriate medications, so prescriptions for the elderly are controlled. Initial results indicate that anticholinergics should be avoided in men in men with benign prostatic hyperplasia because they can decrease urinary flow and cause urinary retention (focus on incontinence) and also because they can adversely affect the central nervous system (focus on dementia). The STOPP/START documents are approved by the European Union Geriatric Medicine Society. Part of STOPP criteria for urogenital system quotes the improper use of antimuscarinic drugs in elderly people with dementia due the risk of increasing mental confusion and restlessness, and also quotes the improper use of analgesics such as long-acting opiates at the risk of increasing cognitive impairment. There is also the Priscus List, from Germany, that mentions alpha-blockers with effects on urinary incontinence and side effects on central nervous system. France and Norway also have their guidelines about it. Other undesirable effects of psychosocial nature emerge, for example, diuretics increase such effects, especially in long stay institutions.Conclusions: Professionals who medicate, treat, care

67 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 and rehabilitate elderly people with dementia and with urinary incontinence should be instructed thru the prescrip- tion about dosage and time management of medication, in aim to avoid impair quality of life in elderly people.

1Fluminense Federal University.

82. EXECUTIVE FUNCTIONS ON ELDERLY PEOPLE IN INITIAL PHASES OF DEMENTIA Anna Carolina Felix de Andrade1, Aline Bergmann de Carvalho1, Clara Regina de Aguiar Lobo1, Yolanda Elisa Moreira Boechat1, Jamaci de Almeida Machado Corrêa Lima1, Licínio Esmeraldo da Silva1

Introduction: The rapid Brazilian populational aging is a noted feature in other developing countries. Diseases having ageing as risk factor (for example, dementias) are becoming more frequent and need for continuous studies and dis- cussions on the subject, so that early diagnosis and intervention can be sought. By this view, the guiding question in this study focused on the existence of alterations in the executive functioning in the early stages of dementia that have already negatively impacted their autonomy and independence. Objectives: To compare the functional performance of elderly individuals classified in initial stages of dementia (CDR 0.5 and CDR 1).M ethods: An observational, retrospective, cross-sectional and comparative study was performed over records of neuropsychological assessments of 121 elderly attended at a geriatric service of a public hospital focusing main aspects of executive functions and daily life activities. The executive functioning of mild cognitive impairment patients (CDR 0.5) and mild dementia (CDR 1) and the losses in daily life activities were compared. It was also assessed the relation of losses of the executive functions with the activities of daily life in order to investigate functional decline. Results: Every patient of CDR 0.5 group without cognitive alterations in the executive functions presented no more than incipient dependence in daily life activities. All patients in the CDR 1 group presented, in all dimensions of the Lawton and Brody protocol, mild or moderate changes in executive functions. Comparison between dementia groups indicated a higher proportion of moderate changes in executive functions in the more compromised group (CDR 1: 61.9%) than in the CDR 0.5 group (16.7%). The inverse situation occurred with mild changes in executive functions: it was significantly higher (75.9%) in the CDR 0.5 group than in the CDR 1 group (38.1%). Conclusions: Significant correlations between CDR levels (0.5 and 1) and changes in executive functioning were found at the end of the study. Additionally, these changes in cognition implied interference, in significant ways, with the ability to perform life activities daily.

1Fluminense Federal University.

83. DEPRESSION IN DEMENTIA ASSESSED BY THE CORNELL SCALE Aline Bergmann de Carvalho1, Anna Carolina Felix de Andrade1, Jamaci de Almeida Machado Corrêa Lima1, Yolanda Eliza Moreira Boechat1, Licinio Esmeraldo da Silva1

Introduction: Currently, depression in older persons has a high prevalence and generates great suffering for the elderly and their relatives and/or caregivers. However, there are still a large number of underdiagnosed cases, preventing the treatment of the disease. In the elderly with installed dementia, the problem of depression’s diagnosis gets worse. This complaint may be related to the fact that dementia and their inherent cognitive changes are obstacle to the adequate collection of information with the patient. The Cornell Scale for Depression in Dementia (CSDD) was specifically formulated to assist in the definition of depressive symptoms in patients with dementia. It is believed that the understanding of the relationship between the depression factors can help in the therapeutic management of the elderly with dementia. Objectives: To discuss depression in dementia and its implications for the elderly and their caregivers, through the CSDD analysis. Methods: A retrospective, cross-sectional and observational study of 29 neuropsychological assessments in elderly patients with dementia evaluated by the Cornell Scale for Depression in Dementia (CSDD). Results: On the CSDD scale, which has a maximum of 38 points, scores has ranged from 0 to 27 points, with a mean value of 9.9 points (standard deviation of 7.3 points). More than half of the sample was classified into different degrees of depressive status based on the classification proposed by CSDD. The majority of these cases (about two-thirds) was

68 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 included in probable depression category. The other cases were divided equally into the neighboring categories: episodic depression and installed depression. Neither gender nor age were discriminatory factors of the degree of depressive status. Mood symptoms were present at greater intensity than those of the other dimensions, and ideational disorders dimension was the least prevalent. The other dimensions (behavior, physical signs and cyclical functions) were evenly represented in the depressive symptoms evaluated. Conclusions: The results point to the efficiency of the CSDD scale in the identification of depressive signs in elderly people with dementia, and it is a useful instrument for inclusion in neuropsychological evaluation batteries.

1Fluminense Federal University.

84. LANGUAGE ASSESSMENT IN FRONTOTEMPORAL DEMENTIA: A CASE REPORT Beatriz Raz Franco de Santana1, Adalberto Studart Neto1, Sonia Maria Dozzi Brucki1, Leticia Lessa Mansur1

Introduction: Frontotemporal dementia (FTD) is a heterogeneous disorder with distinct clinical phenotypes associated with multiple neuropathologic entities, the term FTD encompasses clinical disorders that include changes in behavior language, executive control, and often, motor symptoms. The changes in behavioral variant include new behavioral symptoms such as disinhibition new compulsions dietary changes, or symptoms like apathy and lack of empathy. Many of these initial symptoms are easily mistaken for a psychiatric illness, making bvFTD patients at high risk for misdiag- nosis. Studies showed that patients diagnosed with bvFTD have a higher deficit in macrolinguistics aspects(semantic- pragmatic) than the microlinguistic(phonological-syntatic-lexical). Objectives: The aim of the study is characterize the speech-language findings in a patient with bvFTD. Methods: A case study in a 61 year-old patient with bvFTD, cor- relating her comprehensive language study with imaging data and her behavioral manifestations.Results: She was a physician who complaints were word finding and lack of attention in conversations. Her brief cognitive examination, has depicted MMSE and MoCA scores of 26 and 19, respectively. Cerebral MRI showed cortical atrophy beyond that expected for age, especially in frontal regions, and molecular images (PET-FDG) intense bilateral frontotemporal hypo- metabolism. The oral expression is fluent, with anomia, speech comprehension compromised for complex sentences; repetition ability is compromised due to working memory impairment. In discourse analysis we observed confabula- tions, with more episodic than semantic details. In the denomination of verbs and nouns, the greater difficulty was with verbs. Conclusions: Studies have demonstrated a deficit affecting action knowledge and verb production in this kind of dementia. Such a pattern of bottom-up degradation for action related verbs has been described in other dementias. Even though the diagnosis of behavioral variant is characterized by the predominance of behavioral changes, this patient also has primary deficits of language.Key words: frontotemporal dementia, behavioral variant, language, speech.

1Universidade de São Paulo

85. ALZHEIMER’S DISEASE: THE UNIQUE EXPERIENCE OF FAMILY CAREGIVERS Emanuela Bezerra Torres Mattos1

Introduction: Across the world, longer life expectancy is increasing the number of people with dementia. Recently, dementia has been referred to as Major Neurocognitive Disorder (MND) (APA, 2014) by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). As dementia is a nosological entity, which is still recognized worldwide, we chose to maintain this term throughout the article. By 2015, approximately 46.8 million people were diagnosed with dementia, and by 2050 that number could reach 131.5 million (Alzheimer’s Disease International, 2016). Dementia is a syndrome caused by a number of slowly advancing, progressive, chronic diseases, where Alzheimer’s disease (AD) accounts for most diagnosed cases (Burlá, 2015). Although the concept of caregiver is widely discussed in world literature, there is still no consensus about its definition, and there are disagreements in the various studies that deal with this topic. The gradual, progressive and irreversible course of AD compromises not only the patient, but also their caregivers and families and promotes the construction of a chain of symbolic losses, defined by the international literature as anticipatory grief (Farran, Keane-H., Salloway, & Kupferer, 1991; Sanders & Corley, 2003; Holley, 2009).

69 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

The term ‘anticipatory grief’ was first used by Lindemann in 1944, when he published the article entitled, “Symptom- atology and Management of Acute Grief” (Fonseca, 2004). Rando (1986) proposed the Multidimensional Model of Anticipatory Grief that may be appropriate for chronic degenerative diseases, among them, dementia. In this context and from the perspective of the caregiver in the face of his relative’s cognitive losses, anticipatory grief involves the mourning experienced due to an unknown future and due to the changes in relation to the past and the present. In addition, it should be emphasized that this model postulates that the expression of anticipatory grief is influenced by social and physiological variables of those who provide the care. In contrast to the literature on grief experienced immediately before or after the death of a family member, relatively little is known about grief and dementia-related losses during the caregiving trajectory (Doka, 2004). Objectives: This study aims to learn about the caregiving experience from the perspective of family caregivers of elderly patients with AD. Methods: As such, the qualitative approach seems to be the most appropriate given its consideration of the analysis of the involved actors’ experiences, in addition to the researcher’s and the subjects’ subjectivity, the comprehensiveness of the investigated phenomenon, and to situ- ate and contextualize the other phenomena, be they social, cultural, economic, emotional and or psychological (Morais, 2011). In this way, the phenomenological method proposed by Giorgi and Sousa (2010) was chosen. Family caregivers, accompanied by support and support groups offered by the Dementia Care Service and by the Brazilian Alzheimer Association’s (ABRAz) participated in this study. Personal contacts were established with caregivers attending the groups, followed by telephone contact, when necessary, for further clarification regarding the objectives of the study, reporting procedures and ethical issues. The inclusion criteria of the collaborators were: to be the primary caregiver of the elderly patient with AD diagnosis, to be a family member, regardless of the degree of kinship or the stage of the disease, and, in the case of interviews after death, to have been the caregiver for at least 6 months in the last year of life. The exclusion criteria were: having been the caregiver for less than 6 months and having experienced the loss of their relative in the last 6 months. Twelve caregivers were pre-selected, and nine participated in the study. After the researcher attempted telephone contact on three occasions, two caregivers were unable to make themselves available for the interview. One chose not to collaborate due to the recent death of her mother and the experience of a painful mourning process. Of the nine family caregivers (FC) interviewed, four were wives and five daughters. Age ranged from 51 to 80 years old. Seven lived together with their relative, while two of the daughters did not sleep in the same residence as their relatives with AD. For the description and analysis of the reports, all caregivers were assigned a symbol from C1 to C9, according to the chronological order of the interviews. At the moment of the interview, two of the caregivers were caring for their relative with AD in the light phase, five in the moderate phase, one in the advanced and post-death phase, and only one in the post-death phase. After the study was approved by the Ethics Committee for Research on Humans, 647.560, the caregivers who agreed to participate in the study were contacted by telephone to schedule a time and place for the interview according to their availability. Only one of the nine caregivers chose to give her testimony outside the home environment and justified that it would not be a conducive environment due to the constant demands of her relative with AD. The others opted for a home interview while their relatives slept, rested or had outside activities. The ethical principles of secrecy, privacy, confidentiality, non-identification of participants, freedom of participation and guarantee of psychological support were respected, where applicable. All interviews were conducted by the researcher. She asked the caregivers to answer a single open-ended question, “How would you describe your feelings about caring for your family member (father, mother or sister) with Alzheimer’s disease?” Each of them spoke freely. There were only interruptions, in the form of questions, when necessary to understand or clarify what had been said. The average duration of the interviews was approximately 1 hour. All interviews were digitally recorded to allow for the natural flow of each participant’s narrative and later transcribed literally by the researcher. Interpreting the interviews followed by repetitive listenings of the recordings for later transcription favored emersion in the testimonies to raise the researcher’s awareness when adopting the first methodological steps proposed by Giorgi and Sousa (2010), which are: 1. Establish the meaning of the whole: At this stage, the researcher read the interviews several times, without generating interpretative hypotheses, rather achieving a general understanding. 2. Determina- tion of the parts/Division of meaning units: The researcher divided the statements into smaller parts called meaning units in order to capture the moments of transition or change of meaning for each situation. This proposed stage depends only on the analyzer’s perspective. 3.Transformation of the meaning units into expressions of psychological character: The researcher seeks to perceive a progressive deepening of the meaning of the collaborators’ descriptions. The everyday language of the subjects’ natural attitude is transformed into expressions that seek to clarify their psychological meaning. To transform the expressions of the collaborator implies removing aspects not directly related to

70 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 the studied phenomenon in question, but that are implicit in the declarations (Fujisaka, p.88, 2014). A set of 13 thematic units was established based on the analysis of the nine interviews, which were associated with the three phases/ stages of the disease the caregivers experienced. Nine family caregivers participated in the different stages of the disease and also after death. The guiding question for the interviews was, “How would you describe the experience of caring for your relative with Alzheimer’s disease?” The interviews were analyzed using the qualitative approach. Results: 13 thematic units were identified and related to the stages of the disease. 1. Initial stage: delay in diagnosis; the search for support and guidance; stigmatized disease; 2. Intermediate stage: absence in presence; if I don’t stay, who will take care of him or her; only I know how to take care of him/her; institutionalization as an ally or a villain; the burden of caring; multi-generational illness; positive aspects of caring; 3. Advanced stage: a lack of knowledge of the progression of the disease and the dying process and the lack of communication with professionals; 4. Cross-cutting themes for all stages: anticipatory grief and socially unrecognized grief. Conclusions: The characteristics of caring for dementia, which are identified throughout the caring process, can mark caregivers’ or families’ daily lives. These testimonies revealed the particular characteristics of the caregivers, described according to the stages of the disease. Other studies need to be conducted to better understand the experience of caring in different contexts.

1Federal University of São Paulo (UNIFESP).

86. AVALIAÇÃO E ESTIMULAÇÃO NEUROPSICOLÓGICA NUMA PACIENTE IDOSA COM A DOENÇA DE ALZHEIMER - CONTEXTO CLÍNICO NA CIDADE DE SÃO PAULO Breno Bezerra de Andrade

Introdução: A redução da natalidade e da mortalidade infantil, junto com o aumento da expectativa de vida, ocasiona aumento expressivo do número de idosos no Brasil (IBGE, 2000). Consequentemente, a maior sobrevida da popula- ção resulta no surgimento de doenças típicas do envelhecimento, como a demência da Doença de Alzheimer. Nessa doença observam-se comprometimento progressivo de memória episódica e sinais de desorientação no espaço. Obje- tivos: No início, ocorreu uma completa avaliação neuropsicológica, para conhecimento dos déficits cognitivos. Logo após a avaliação, se iniciaram as atividades de reabilitações semanais, com estimulações em áreas cognitivas (memória, funções atencionais, planejamento) da idosa, buscando o máximo de autonomia no cotidiano da paciente. Métodos: Foram promovidos encontros semanais estruturados em três momentos: conversa sobre uma notícia atual, uma ati- vidade principal diversificada a cada sessão e fechamento com outras atividades (normalmente tarefas em eletrônicos portáteis). Cada sessão teve duração de uma hora. Houve a confecção de materiais necessários para a execução das tarefas, sendo esses criados ou adaptados de materiais já existentes e publicados na área, sempre respeitando as espe- cificidades da idosa. Utilizaram-se jogos de artesanato, exercícios cognitivos, imagens, desenhos, jornais, revistas e equipamento portátil com a função de reorganizar a função cognitiva aproveitando os processos cerebrais mantidos pela idosa. Resultados: Puderam-se observar desempenhos satisfatórios nas atividades de estimulação neuropsicoló- gica, apesar da idosa relatar que está percebendo um prejuízo na memória recente. Percebeu-se que a paciente ainda possui capacidade de aprendizagem, demonstrando que pode se beneficiar de estratégias para compensar a perda de memória e as dificuldades de planejamento. As intervenções, também, possibilitaram alguma melhoria em funções que interferem nas ações do ambiente onde a idosa vive. Discussão: Todas as atividades promovidas pelo neuropsicó- logo foram apropriadas para a condição atual da paciente. As ações das atividades direcionaram-se, principalmente, para o retardamento e/ou prevenção de dificuldades relacionadas ao declínio cognitivo e de sua evolução e do risco de vulnerabilidade psicológica e social a qual a idosa com Alzheimer se encontra no seu dia a dia.

87. GERSTMANN’S SYNDROME AND UNILATERAL OPTIC ATAXIA IN THE EMERGENCY DEPARTMENT Marcelo Houat de Brito, Breno José Alencar Pires Barbosa, Jacy Bezerra Parmera, Ricardo Nitrini

Introduction: Gerstmann’s syndrome and optic ataxia are have been described in association with a wide range of neurological conditions, including neurovascular diseases. However these syndromes may have atypical presentations and

71 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 are not routinely tested in the emergency department. Objectives: To report a illustrative video recording of Gerstmann’s and incomplete Balint’s syndromes in a patient with acute stroke. Results: A 75 years-old right-handed woman presented to the emergency department with headache and mental confusion 6 hours before admission. She had 5 years of formal education and no prior medical history other than tobacco use for 50 years. Initial evaluation revealed a blood pressure of 220 × 120 mmHg and a mild pronator drift of the right upper limp. She was alert and oriented, with no language abnormalities. Testing was positive for a mild right spatial neglect. National Institute of Health’s Stroke Scale (NIHSS) was 1. Computed Tomography (CT) scan showed no relevant findings. Interestingly, a more detailed cognitive evaluation revealed unilateral right simultanagnosia and optic ataxia. Moreover, the patient had agraphy, acalculia, digital agnosia and right-left disorientation, compatible with a complete Gerstmann’s syndrome (video). A CT angiography showed diffuse atheromatosis, with a moderate stenosis of 50% in the left carotid bulb due to an ulcer- ated plaque. Difusion Weighted Imaging MRI revealed small hyperintense lesions in the territory of left middle cerebral artery, mostly posterior and cortical. The patient was treated with dual antiplatelet therapy and a high-potency statin at standard doses for secondary prevention. All cognitive deficits resolved spontaneously within 3 days of admission and she was discharged at day 4 with a modified Rankin-scale of 1 for outpatient follow-up, rehabilitation and smoking cessation. Conclusions: This case highlights the concurrence of Gerstmann’s syndrome, spatial right neglect and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke. The lateralization of optic ataxia (grasp system) with a relatively preserved ability to use objects (use system) in this case illustrates the complexity of the dorsal system in the left cerebral hemisphere in a clinical setting. We aim to highlight the importance of testing for cognitive syndromes such as Gerstmann’s and Balint’s in selected cases in the acute phase of neurovascular conditions.

Department of Neurology, Hospital das Clínicas, University of São Paulo Medical School – São Paulo, Brazil.

72 Authors index Dement Neuropsychol 2017 December;11(Suppl 1):1-76

ABREU M...... 49, 50 BICALHO MA...... 9 CARVALHO FMM ...... 35 AGUIAR V...... 46 BIGIO EH...... 11 CARVALHO LF...... 53 ALBUQUERQUE FT...... 62 BOAS PJF...... 59 CARVALHO MG...... 9, 10 ALBUQUERQUE TBD...... 18 BOECHAT YEM...... 23, 46, 66, 67, 68 CARVALHO MLO...... 23 ALEXANDRE TS...... 45 BOLDRINI VO...... 27 CARVALHO RLS...... 29 ALMEIDA ALM...... 14 BONFADINI JC...... 56 CARVALHO VA...... 11 ALMEIDA DQ...... 8, 19 BORELLA E...... 21 CASSANI AFMKC...... 8, 19, 48 ALMEIDA EB...... 63 BORELLI WV...... 10 CASSEB RF ...... 8 ALMEIDA J...... 61 BORGES C...... 12 CASSIMIRO L...... 21, 31, 34, 57 ALMEIDA KMV...... 15 BORGES CR...... 52 CASTELLANO G...... 8 ALMEIDA ML...... 28, 48, 50 BORGES LG...... 11 CASTILHOS RM...... 22 ALMEIDA WLS...... 61 BORGES SM...... 33, 40, 44, 55, 63 CECATO JF...... 29, 42, 60, 62 ALVES CHL...... 56 BORTOLOTTO L...... 41 CECCHINI MA...... 21, 31, 34, 47, 57 ALVES E...... 43 BORTOTI ML...... 64 CENDES F...... 8, 19, 27, 49, 50 ALVES GC...... 62 BRAGA NETO P...... 56, 67 CÉSAR KG...... 19 ALVES GS...... 56, 67 BREMENKAMP MG...... 59 CEZAR NOC...... 52, 64 ALVES LCS...... 57 BRIGOLA AG...... 38, 43, 45, 47, 61, 66 CHAVES MLF...... 16, 36, 46, 58 ALVES NO...... 40 BRITO MH...... 71 CINTRA MT...... 9 AMADO DK...... 12, 18, 29, 34, 52 BRITO MR...... 62 COLOSIMO E...... 26 AMARAL JS...... 24 BRUCKI SMD...... 12, 18, 19, 20, 21, 23, 28, 29, 31, COMINETTI MR...... 16 AMARAL-CARVALHO V...... 13 32, 33, 34, 35, 43, 47, 52, 57, 59, 69 CORDEIRO LM...... 42 ANDRADE ACF...... 68 BRUGNERA LM...... 57 CORGOSINHO LTS...... 26 ANDRADE BB...... 71 BRUM PS...... 21 CORREA L...... 57 ANDRADE LP...... 37, 48, 52, 60, 64, 65 BUCHPIGUEL C...... 20 CORREA LC...... 62 ANDRADE MA...... 10 BUENO APAA...... 12 COSTA E SILVA Y...... 62 ANSAI JH...... 48, 52, 60, 65 BUENO TS...... 37, 52 COSTA FN...... 15, 59 APOLINÁRIO D...... 54 CAIXETA RP...... 20 COSTA JC...... 10 APRAHAMIAN I...... 29, 54, 62 CALIL SRB...... 43 COSTA RP...... 35 ARAGÃO VT...... 26 CÂMARA VD...... 46, 66 COSTA RQM...... 35 ARANHA M...... 20 CAMPANARI DD...... 41, 48 COSTA-CUNHA LVF...... 14 ARAÚJO DS...... 35 CAMPANHA AC...... 58 COST-HONG V...... 41 ARAÚJO RB...... 28, 41, 48, 50, 53 CAMPOS BM...... 8, 27, 48 COUTINHO A...... 20 ARRIAGADA FA...... 65 CAMPOS FF...... 9 CUNHA LP...... 14 ASSIS MG...... 31 CANINEU P...... 30 CUNNINGHAM MCQS...... 18 AUGUSTIN MC...... 22 CANINEU PR...... 14 CVL TEIXEIRA...... 8 AZEVEDO LVS...... 18 CANON MBF...... 17 DAL BELLO JCR...... 23 BAHIA VS...... 21, 31, 34, 57 CANTATORE L...... 17 DAL BELLO MAO...... 23 BALTHAZAR MLF...... 8, 16, 19, 21, 27, 48, 49, 50 CAPARELI MR...... 36 DALGALARRONDO P...... 13 BARBOSA BJAP...... 18, 29, 38, 71 CAPARROL AJS...... 57 DALPUBEL D...... 28, 40, 50 BARBOSA E...... 20 CARAMELLI P...... 9, 10, 11, 13, 17, 18, 20, 21, DAMASCENO B...... 21 BARBOSA IG...... 26 24, 26, 31, 31, 34, 55, 58 DAMASCENO PG...... 67 BARBOSA MT...... 11, 18 CARLETTI-CASSANI AFMK...... 8 DELAERE FJ...... 36 BARREIRA AA...... 36, 37, 53 CARMELIN AM...... 59 DELLA SALA S...... 31 BARSOTTINI O...... 22 CARMONA KC...... 11 DIEHL-RODRIGUES R...... 12 BEBER BC...... 46 CARNAVALE BF...... 37 DOURADO MCN...... 29 BERGAMASCHI E...... 12, 52 CARNEIRO FS...... 10 DUARTE JG...... 40 BERTOUX M...... 12, 26 CARRANO RC...... 23 DUTRA GC...... 56 bertrand e...... 27 CARRETTI B...... 21 FARFEL JM...... 9 bessa t...... 15 CARTHERY -GOULART MT...... 31 FARIA ARV...... 26 BESSANI M...... 41 CARVALHO AB...... 68 FEITOSA RRP...... 62 BIANCHINI NE...... 10 CARVALHO DHT...... 45, 66 FELTES PK...... 10

74 Dement Neuropsychol 2017 December;11(Suppl 1):1-76

FERNANDES NC...... 23 JAMES-GALTON M...... 39 MÁXIMO RO...... 45 FERNANDES P...... 8 JARDIM LB...... 22 MAYORAL VFS...... 59 FERRAZ HB...... 22 JESUS ITM...... 42 MELLA LFB...... 13 FERREIRA CN...... 10 JOAQUIM HPG...... 8, 27 MELLO DD...... 35 FERREIRA DA...... 36, 37 KIERNAN M...... 12 MELO BAR...... 62 FERREIRA FF...... 23 KOCHHANN R...... 30, 36, 58 MEMÓRIA CM...... 41 FERREIRA LB...... 10 KUSUMOTA L...... 40 MENDES FG...... 55, 63 FERREIRA MG...... 13 LAFER B...... 9 MENDES NR...... 23 FERREIRA P...... 58 LAKS J...... 27 MENEZES LEFJ...... 44 FERRETTI CEL...... 23 LANDEMBERGER MC...... 38 MENNA-BARRETO L...... 63 FERRETTI-REBUSTINI REDL...... 9 LAWLOR B...... 46 MERLIN SS...... 18, 29, 59 FIOGBÈ E...... 37 LECCE N...... 48 MESQUITA VL...... 35 FONSECA RP...... 30, 36, 58 LEITE REP...... 9 MESULAM M-M...... 11 FORLENZA OV...... 8, 14, 27, 30, 44, 61 LEITE RP...... 12 MIOSHI E...... 21 FOSS MP...... 31, 36, 37, 53 LIBERATO F...... 18 MIRANDA DC...... 28 FRAGA FJ...... 61 LIMA E SILVA LFA...... 64 MOGRABI D...... 27 FRAGA VG...... 9, 10 LIMA FO...... 35, 62 MOLINA M...... 12 FRANCÉ B...... 36 LIMA GB...... 17 MONT’ALVERNE FJA...... 35 FRANCO AR...... 10 LIMA JAC...... 23 MONTEIRO DQ...... 57 FRANCO MP...... 8 LIMA JAMC...... 46, 66, 67, 68 MONTEIRO MLR...... 14 FROTA NAF...... 26, 35, 62 LIMA-SILVA TB...... 21, 31, 34, 57 MONTIEL JM...... 60 FUMAGALLI AA...... 33 LIRA A...... 52 MORAES AS...... 27 GABRIELI FA...... 29 LOBO CRA...... 68 MORAES N...... 41 GALEOTE L...... 42, 60 LOPES PC...... 14 MORAES NC...... 33, 47 GAMBOGI LB...... 17, 21, 24 LOUREIRO J...... 64 MOREIRA TB...... 23 GERBELLI CLB...... 49, 50 LOUREIRO JC...... 14, 30 MORETTO E...... 35 GESUALDO GD...... 40 LOURES CMG...... 9, 10 MORIGUCHI-JECKEL C...... 10, GHERMAN BR...... 51 LUCHESI BM...... 38, 43, 47, 61 MOTA AB...... 62 GITLIN LN...... 17 MACHADO M...... 41 MOURA FG...... 43, 61, 66 GOMES HR...... 38 MACHADO SBC...... 17 MOURA LM...... 12 GOMES KB...... 9, 10 MACHADO TH...... 11, 58 MUELA H...... 41 GOMES S...... 52 MACIEL CD...... 41 NAKANO E...... 41 GONÇALVES AB...... 58 MAGALHÃES CA...... 9, 10 naylor r...... 27 GONÇALVES MB...... 55 MAGALHÃES T...... 8 NECHIO PE...... 8 GONÇALVES PP...... 54 MAGALHÃES TNC...... 8, 16, 19, 27, 48, 49, 50 NERI AL...... 56 GOULART R...... 55, 63 MAIA DP...... 18 NESTOR E...... 40 GRATÃO ACM...... 38, 57 MANIN GZ...... 57 NITRINI R...... 9, 12, 17, 18, 19, 20, 21, 23, 29, 31, GRINBERG LT...... 9, 12 MANSUR LL...... 32, 39, 69 33, 35, 38, 41, 43, 47, 52, 57, 71 GUARIENTO ME...... 56 MANZINE PR...... 16 NOVELLI MMPC...... 17 GUIMARÃES HC...... 9, 10, 11, 13, 17, 18, MANZINI CSS...... 42 NUNES PV ...... 9, 61 21, 24, 31, 34, 55, 58 MARAN B...... 36 NUSA SLL...... 55, 63 HARTMANN LM...... 10 MARIANO LI...... 13, 17, 24 O’CALLAGHAN C...... 24 HAYATA T...... 27 MARINHO V...... 27 OLIVEIRA GA...... 54 HOLZ M...... 30, 36 MARQUES AM...... 10 OLIVEIRA KC...... 9 HORNBERGER M...... 12, 24 MARTINELLI JE...... 29, 42, 60, 62 OLIVEIRA LS...... 54 HORTA NC...... 55 MARTINELLI MO...... 62 OLIVEIRA MO...... 18, 29, 32, 59 INOUYE K...... 47 MARTINS S...... 16 OLIVEIRA MPB...... 64 JACINTO AF...... 15 MARTINS VR...... 38 OLIVEIRA NA...... 38, 43, 47, 61 JACOB W...... 9 MASSE FAA...... 60 ONO C...... 20 JACOB-FILHO W...... 12 MATTOS EBT...... 69 ORLANDI FS...... 42 JALUUL O...... 33, 47 MATUSHITA CS...... 10 ORLANDI FS...... 40

75 Dement Neuropsychol 2017 December;11(Suppl 1):1-76 Quando cresce a confiança,

OTTAVIANI AC...... 38, 43, 61 RODRIGUES CIB...... 17 SOUSA LP...... 9, 10 PACHECO GN...... 30 RODRIGUES FZ...... 35 SOUZA EN...... 38, 43, 47, 61 cresce também uma empresa. PADOVEZ RFCM...... 64 RODRIGUES RS...... 17 SOUZA LC...... 9, 10, 12, 13, 17, 20, 21, PAIS MV...... 14, 30 RODRIGUES VM...... 51 24, 26, 31, 34, 55, 58 PARMERA J...... 20 RODRIGUEZ RD...... 9 SOUZA MM...... 52 PARMERA JB...... 33, 47, 71 ROFES A...... 46 SPECTOR A...... 27 PARRA M...... 47 ROSSI PG...... 37, 48, 60 SPEDO CT...... 36, 37, 53 PARRA MA...... 31 SABA RA...... 22 SPERA RR...... 33, 47 PASQUALUCCI CA...... 9, 12 SANTANA BRF...... 69 STELLA F...... 14, 30 PASSOS MLGA...... 44 SANTOS BR...... 51 STUDART A...... 20 PATROCÍNIO F...... 31 SANTOS EL...... 13 STUDART NETO A...... 33, 47, 69 PAULO DLV...... 56 SANTOS G...... 54 SUEMOTO C...... 12 PAVARINI SCI...... 38, 43, 45, 47, 51, 61, 66 SANTOS GD...... 61 SUEMOTO CK...... 9 PEDROSO JL...... 22 SANTOS JA ...... 22 SVERZUT MJS...... 36, 53 PELES PRH...... 13 SANTOS JG...... 64 TAKAHASHI ACM...... 37, 48 PENTEADO CT...... 13 SANTOS LM...... 27 TALIB LL...... 8, 14, 27, 30 PEREIRA AH...... 58 SANTOS MD...... 35 TAVARES JÚNIOR JWL...... 56, 67 PEREIRA GB...... 23 SANTOS MDL...... 55 TEDRUS GM...... 44 PEREIRA ML...... 20 SARAIVA-PEREIRA ML...... 22 TEIXEIRA AL...... 12, 17, 24, 26, PERON R...... 16 SARTI FM...... 23 TEIXEIRA CVL...... 8, 16, 19, 27, 48, 49, 50 PIERSOL CV...... 17 SATO JR...... 12 TEIXEIRA IA...... 51 PIMENTEL-SILVA LR...... 49 SCHILLING LP...... 10 TERASSI M...... 43, 47, 61 PINAYA WHL...... 12 SCHWARZER MC...... 9 TONELLI JA...... 23 PIOVEZAN M...... 15 SCOTT SSO...... 67 TRENTIN R...... 10 PITOMBEIRA MS...... 35 SENA BP...... 17 TRÉS ES...... 18, 29, 32, 59 PLANT GT...... 39 SERELLI LS...... 31, 55 TUMAS V...... 31, 36 POMPEU JE...... 35 SILAGI ML...... 32, 39 VALE FAC...... 28, 41, 42, 48, 50, 53 PONTES-NETO OM...... 37, 53 SILVA ACS...... 65 VALIENGO L...... 30 PORTO FHG...... 18, 19 SILVA ES...... 16 VALIENGO LCL...... 14 PORTUGUEZ MW...... 10 SILVA GNMS...... 67 VALLE ER...... 23 PRADO ACA...... 26 SILVA JL...... 38 VARGAS FR...... 22 PRESTES FILHO R...... 23 SILVA LE...... 23, 46, 66, 67, 68 VEIRA ELM...... 17 QUEIROZ IC...... 62 SILVA LRP...... 50 VICENTINI JE...... 8 ATUAÇÃO GLOBAL RADAKOVIC R...... 12 SILVA MMB...... 54 VIDAL LCA...... 62 RADANOVIC M...... 30, 44 SILVA MNM...... 39 VIEIRA EL...... 13

RADANOVIC R...... 14 SILVA TBL...... 24 VIEIRA TCRG...... 38 • Presente em maiswww.torrentonline.com.br de 50 países RADEMAKER AW...... 11 SILVA TQAC...... 8 WEILER M...... 8, 19, 27, 48 RAMOS C...... 12 SILVA VLL...... 62 WEINTRAUB S...... 11 RAMOS CCF...... 52 simões NETO JP...... 29 YASSUDA MS...... 17, 19, 21, 21, 24, 29, 31, • Rigoroso controle de qualidade: credenciado nas principais agências RAMOS CF...... 28, 41, 50, 53 SIQUEIRA ASS...... 54 33, 34, 41, 43, 47, 56, 57 de saúde do mundowww.torrentonline.com.br como FDA, ANVISA e EMA RAMOS VA...... 40 SIQUEIRA NETO JI...... 56, 67 YOKOMIZO JE...... 54 RESENDE EPF...... 11 SMID J...... 38 ZACARIN J...... 43 REZENDE TJR...... 8, 19, 48, 49, 50 SOARES MB...... 26 ZANCAN L...... 34 • Ampla linha de produtos em estudos clínicos da Fase I a IV RIBEIRO EB...... 28, 41, 48, 50, 53 SOBREIRA ET...... 26 ZIMMERMANN N...... 36 ROCHA NP...... 13, 17 SOBREIRA MA...... 26 RODOLPHO ES...... 15 SOTERIO L...... 12 • São 15 anos de Torrent no Brasil com 49 produtos registrados

A Torrent do Brasil reforça o seu compromisso em disponibilizar produtos de qualidade mundial a preços acessíveis.

76 Quando cresce a confiança, cresce também uma empresa.

ATUAÇÃO GLOBAL

• Presente em maiswww.torrentonline.com.br de 50 países

• Rigoroso controle de qualidade: credenciado nas principais agências de saúde do mundowww.torrentonline.com.br como FDA, ANVISA e EMA

• Ampla linha de produtos em estudos clínicos da Fase I a IV

• São 15 anos de Torrent no Brasil com 49 produtos registrados

A Torrent do Brasil reforça o seu compromisso em disponibilizar produtos de qualidade mundial a preços acessíveis. 7902235 - Impresso em Dezembro/2017

AFanuncio-21x28cm-cv.indd 1 13/04/17 11:57