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ABSTRACT. The concept Awareness of Age-Related Change (AARC) is defined as a person’s awareness that their behavior, level of physical, cognitive and social performance, and ways of experiencing life have changed as a consequence of having grown older, and not because of disease. Objective: A psychometric study investigating evidence of construct validity and internal consistency of the Portuguese version of the AARC Short Scale was carried out. Method: A convenience sample of 387 individuals aged≥60 years with no deficit suggestive of dementia were recruited at venues frequented by older persons and at households. Participants answered the Portuguese version of the scale, along with questionnaires collecting sociodemographic and frailty variables and self-rated health based on personal criteria and relative to peers. Results: Exploratory and confirmatory factorial analyses derived a structure with two orthogonal factors representing the latent variables gains and losses, invariant for age group, thus replicating the original scale. The factors explained a large proportion of item variability (58.6 to 51.8%) and exhibited high loadings (0.886 to 0.432) and good communality [0.787 for item 4 (better sense of what is important) and 0.369 for item 6 (less energy)]. The hypotheses of covariance between the new instrument and the parallel measures of frailty and self-rated health were confirmed. The levels of internal consistency were high (α>0.700). Conclusion: Evidence confirmed the factor and convergent (construct) validity and internal consistency of the new scale in Portuguese.

ABSTRACT Alzheimer's disease (AD) is a progressive and degenerative condition affecting several cognitive areas, with a decline in functional abilities and behavioral changes. Objective: To investigate the association between neuropsychiatric symptoms in older adults with AD and caregiver burden and depression. Methods: A total of 134 family caregivers of older people diagnosed with AD answered a questionnaire with sociodemographic data and questions concerning the care context, neuropsychiatric symptoms, caregiver burden, and depressive symptoms. Results: Results revealed that 95% of older adults had at least one neuropsychiatric symptom, with the most common being: apathy, anxiety, and depression. Among the 12 neuropsychiatric symptoms investigated, 10 were significantly associated with caregiver burden, while 8 showed significant correlations with depressive symptoms. Conclusions: Neuropsychiatric symptoms were related to caregiver burden and depressive symptoms. In addition to the older adult with AD, the caregiver should receive care and guidance from the health team to continue performing quality work.

Abstract Although the prevalence of depressive disorders among the elderly is lower than among the younger population, the presence of significant symptoms of depression is common in this group. Studies report that participation in social, educational and leisure activities is related to fewer depressive symptoms in this population. Objective: The aim of this study was to examine the prevalence of depression among elderly participants of an Open University for the Third Age, in terms of the time studying. Methods: The study had a cross-sectional design and the participation of 95.2% (n=184) of total enrollers in the first half of 2010 on the activities of the Third Age Open University's School of Arts, Sciences and Humanities of the University of São Paulo. All participants answered a socio-demographic questionnaire and the Geriatric Depression Scale (GDS-15). Results: An association between studying time of over one semester at the University of the Third Age and a lower rate of depressive symptoms, was observed. Conclusion: Study time of over one semester was associated with less depressive symptoms, acting as a possible protective factor against depression.

ABSTRACT Introduction: Diagnosing neurocognitive disorders is challenging in low-educated individuals. Objective: To report normative data for the Brief Cognitive Screening Battery (BCSB) and to assess the association of age and education with performance on the BCSB in 240 community-dwelling elderly from Ermelino Matarazzo, São Paulo city. Methods: The inclusion criteria were scoring above the education-adjusted cut-off points on the Mini-Mental State Examination (MMSE) and below six points on the Geriatric Depression Scale (GDS). Results: Age was associated with performance on the Naming, Incidental Memory, Verbal Fluency, Clock Drawing Test, Delayed Recall and Recognition subtests. Education was associated with performance on Naming, Recognition, Verbal Fluency and the Clock Drawing Test. Conclusion: The normative values reported are relevant for diagnosing neurocognitive disorders in low-educated elderly.

Previous studies have suggested that performance prediction, an aspect of metamemory, may be associated with objective performance on memory tasks. OBJECTIVE: The objective of the study was to describe memory prediction before performing an episodic memory task, in community-dwelling older adults, stratified by sex, age group and educational level. Additionally, the association between predicted and objective performance on a memory task was investigated. METHODS: The study was based on data from 359 participants in the FIBRA study carried out at Ermelino Matarazzo, São Paulo. Memory prediction was assessed by posing the question: "If someone showed you a sheet with drawings of 10 pictures to observe for 30 seconds, how many pictures do you think you could remember without seeing the sheet?". Memory performance was assessed by the memorization of 10 black and white pictures from the Brief Cognitive Screening Battery (BCSB). RESULTS: No differences were found between men and women, nor for age group and educational level, in memory performance prediction before carrying out the memory task. There was a modest association (rho=0.11, p=0.041) between memory prediction and performance in immediate memory. On multivariate linear regression analyses, memory performance prediction was moderately significantly associated with immediate memory (p=0.061). CONCLUSION: In this study, sociodemographic variables did not influence memory prediction, which was only modestly associated with immediate memory on the Brief Cognitive Screening Battery (BCSB).

ABSTRACT. Background: There are few studies on the qualitative variables derived from the animal category verbal fluency test (VF), especially with data originating from low-income samples of community-based studies. Objective: To compare elderly with and without hypertension (HTN) and diabetes mellitus (DM) regarding the total number of animals spoken, number of categories, groups and category switches on the VF test. Methods: We used the database of the FIBRA (Frailty in Brazilian Elderly) community-based study. The variables number of Categories, Groups and Category Switches were created for each participant. The total sample (n = 384) was divided into groups of elderly who reported having HTN, DM, both HTN and DM, or neither of these conditions. Results: There were no significant differences between the groups with and without these chronic diseases for VF total score or for the qualitative variables. Conclusion: Among independent community-dwelling elderly, the qualitative variables derived from the VF animal category may not add information regarding the cognitive profile of elderly with chronic diseases. Total VF score and the qualitative variables Category, Group and Switching did not differentiate elderly with and without HTN and DM.

Abstract Objectives: The present study sought to characterize the degree of general satisfaction with life and degree of satisfaction on four domains: health, physical capacity, mental capacity and social involvement, and to determine the characteristics of self-reports of individuals enrolled on the program in relation to their psychological well-being focusing on the dimensions: autonomy, personal growth, control, positive relationships with others, purpose, personal acceptance and generativity, and to analyse the effect of time studying on level of well-being. Method: A total of 140 elderly students of a University for the Third Age took part in the study. The Global Satisfaction With Life Scale and the Self Development Scale (with six psychological well-being subscales) were applied. Continuous variables for the two groups were compared using the Mann-Whitney test. Spearman's correlation coefficient was used to analyze the relationship among numeric variables. Internal consistency of the instrument scales was analysed by calculating Cronbach's alpha coefficient. Results: Results showed that students who had attended the University of the Third Age for six months or longer had a higher level of satisfaction with life and greater psychological adjustment compared with new entrants to the same institution. Conclusion: The study results confirmed the positive effects of continuing education on the well-being of elderly and its contribution to successful aging.

Abstract Objective: The present study was to investigate the status of the family relationships of elderly patients with Alzheimer's disease from a caregiver's perspective. Methods: A total of sixteen relatives/caregivers of AD patients were assessed by applying a semi-structured questionnaire about family relationships. Frequency tables containing categorical variables (gender, schooling, personal income and current occupation) were compiled. Descriptive statistics were calculated of continuous variables such as age. Answers to open questions were submitted to Bardin's content analysis. The data were held on the Epidata program and statistical analysis was performed using the SPSS v.17.0 software package. Results: In line with the literature, the family was the main source of caregivers and the typical caregiver profile was female. In contrast to other studies, emotional burnout was not a major complaint in the sample studied. The ties created among family members and the life experience of each individual influences how interviewees cope with AD. Conclusion: The family relationships of caregivers of AD patients represent a constant challenge, due to changes in roles within the family structure as well as to disease progression. However, participation in psychological and socio-educational activities run by pioneering institutions in Brazil, act as a mediator of stress in the lives of both caregivers and patients.

ABSTRACT Communication with patients with dementia may be a difficult task for caregivers. OBJECTIVE: The aim of this study was to produce a Brazilian transcultural adaptation of an instrument developed in Canada, called the Small Communication Strategies Scale, composed of 10 items constructed from 10 communicative strategies most recurrent in a literature survey. METHODS: Drawing on understanding of the construction of the Small Communication Strategies Scale (SCSS), a Brazilian Portuguese version of the instrument was devised through the following steps: translation, back-translation and semantic-cultural adaptation by a specialized linguist in English-Portuguese translations and application of the comprehension test for the version produced in a group of caregivers of elderly individuals with dementia. RESULTS: The transcultural equivalence process was performed and two items of the SCSS needed adapting to the Brazilian context. After changes suggested by a specialized linguist, the final version was applied to 34 caregivers and the transcultural equivalence considered satisfactory. CONCLUSION: The Brazilian version of the instrument was successfully transculturally adapted for future validation and application in Brazil.

Abstract Psychoeducational activities are a way of promoting help for caregivers of patients with Alzheimer's disease, representing a forum for knowledge sharing, and in which the primary focus is on psychological themes aimed at carers developing coping skills and strategies. Objective: The main objective of this study was to gauge perceptions about care and its impact among family caregivers of patients with AD participating in a psychoeducational group intervention, as well as the possible positive and negative aspects associated with this role. The subjective impact of AD on the lives of these caregivers was assessed on each of the dimensions of the Caregiver Burden Scale using a semi-directed interview on perceptions about care. Methods: This was a prospective study, in which information was collected twice, before and after, psychoeducational intervention. Through the application of the scale, benefits were evident for all dimensions assessed in the instrument (general strain, isolation, disappointment, emotional involvement and environment). Results: The results showed that after the psychoeducational intervention, caregivers felt less burdened by care compared to pre-intervention. Conclusion: These findings confirm that expanded implementation of psychoeducational interventions for caregivers of patients with AD can be beneficial for both caregivers and patients.