OBJECTIVE: To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden. DESIGN: This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms. SETTING: The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly. SUBJECTS: Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences). INTERVENTIONS: Aerobic exercises (flexibility, strength, and agility) and functional balance exercises were conducted over six months for 60 minutes three times per week. MAIN MEASURES: Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA) was applied to observe interactions (pre- vs. post-intervention; participants vs. controls). RESULTS: Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F: 11.12; p = 0.01; Cornell Depression scale: F: 11.97; p = 0.01). The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01). CONCLUSIONS: Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study.

Este estudo analisa as barreiras percebidas à prática de atividade física e os estágios de mudança de comportamento de idosos institucionalizados preservados cognitivamente. Trinta participantes responderam ao Mini-Exame do Estado Mental, ao Questionário sobre Estágios de Mudança de Comportamento e ao Questionário sobre Barreiras à Prática de Atividade Física. Os resultados mostraram que poucos idosos institucionalizados apresentam uma alta percepção de descrença nos benefícios da atividade física. Entretanto, muito poucos praticam atividades físicas e a maioria não pretende incluí-las em seu estilo de vida. O estágio de comportamento no qual se encontram pode estar sendo mediado pela percepção de barreiras. Conclui-se, coerentemente com as principais barreiras reportadas, que a promoção de atividade física para o idoso institucionalizado deve, prioritariamente, enfatizar a conscientização sobre os riscos do sedentarismo e os benefícios da prática mesmo na presença de doenças, bem como preparar um ambiente seguro e sem gasto financeiro individual.

This study analyzes the barriers perceived in relation to the practice of physical activity and stages of behavior changes in institutionalized and cognitively preserved elderly. Thirty volunteers answered to the Mini-Exam of Mental State, the Questionnaire on Stages of Behavior Changes, and the Questionnaire on Barriers to Physical Activity. The results showed that few institutionalized elderly present a high perception of disbelief on physical activity benefits. However, very few of them are engaged in it and the majority of them do not intend to include it in their lifestyle. The current stage of behavior can be mediated by the perception of barriers. It was concluded, according to the main reported barriers, that the promotion of physical activity to institutionalized elderly should emphasizes, as priorities, the awareness of the risks of a sedentary lifestyle and the benefits of physical activity even in the presence of diseases, in addition to the preparation of a safe environment and without individual costs.

Resumo Introdução: Instrumentos capazes de aferir as funções cognitivas vêm ganhando importância com o aumento na incidência e prevalência de quadros demenciais. O desafio consiste em criar instrumentos que não sofram influência dos níveis de escolaridade. Objetivo: Analisar comparativamente a influência do nível de escolaridade na Bateria Breve de Rastreio Cognitivo (BBRC) em idosos com e sem declínio cognitivo. Métodos: Participaram do estudo 176 idosos, sendo 60 (idade de 73,6±9,3 anos e escolaridade de 5,7±0,7 anos) com declínio cognitivo e 116 (idade de 73,4±0,6 anos e escolaridade de 5,6±0,5 anos) sem queixas cognitivas. Foram aplicados a BBRC em todos os sujeitos. O tratamento dos dados consistiu na aplicação de estatística descritiva e do teste t-Student independente, admitindo-se um intervalo de confiança de 95%. Resultados: Os dados indicaram que a BBRC consiste em um instrumento apropriado para a identificação da condição cognitiva em idosos normais, bem como, para confirmar declínio cognitivo em idosos comprometidos do nosso meio. Os itens da BBRC não sofreram influência significativa dos anos de escolaridade, fator que favorece sua aplicação em diferentes grupos, compostos por indivíduos iletrados, bem como por sujeitos com pouca ou elevada escolaridade. Conclusão: A BBRC mostrou-se um instrumento útil para rastreio cognitivo em idosos, independentemente de serem ou não letrados.

Abstract Introduction: Tests for screening cognitive functions are gaining importance with the increasing incidence and prevalence of demential syndromes. For our elderly population, the challenge is to develop neuropsychological tests independent from the influence of educational level. Objective: To compare the influence of education on the elderly with or without cognitive decline, on the Brief Cognitive Screening Battery (BCSB). Methods: We studied 176 elderly people: 60 with cognitive decline (aged 73.6±9.3 years and with 5.7±0.7 years of education) and 116 without cognitive impairments (aged 73.4±0.6 years and with 5.6±0.5 years of education). The BCSB was applied in all subjects. The data were submitted to descriptive statistics and analyzed by Independent Student test with 95% confidence intervals. Results: The data showed that the BCSB is an appropriate battery for identifying cognitive status in normal elderly individuals, as well as cognitive decline in our elderly sample. The BCSB items were not significantly influenced by schooling years, making this test favorable for different groups characterized by illiterate individuals, as well as by those with low or high levels of formal education. Conclusion: The BCSB proved to be a useful cognitive screening test for old people with or without cognitive decline independent of their educational level.