BACKGROUND: Covert hepatic encephalopathy (CHE) is difficult to detect due to the lack of easily applicable screening tools. The Stroop EncephalApp is a smartphone application already validated for CHE screening. However, its applicability to the Brazilian population is not known. OBJECTIVE: To estimate the prevalence of CHE and evaluate the use of Stroop EncephalApp in a cirrhotic population in Brazil. METHODS: In this cross-sectional study, we evaluated 99 patients previously diagnosed with liver cirrhosis in a Private Hospital in Curitiba/PR. Patients were initially submitted to the mini mental state examination (MMSE) to exclude individuals with dementia. After, the Psychometric Hepatic Encephalopathy Score (PHES) test was performed and lastly, the Stroop EncephalApp test. Results were adjusted for age, sex and education levels to evaluate the accuracy of the app on detecting the disease, comparing its results with the gold standard method (PHES). Patients with one or more of the following were excluded: dementia, inadequate MMSE score, illiteracy, color blindness, history of drugs/alcohol abuse within the past 3 months and previous or actual episodes of encephalopathy. The statistical analysis was performed by SPSS 2.0 and the significance adopted by 5%. RESULTS: We included 82 individuals in the final analysis. Among these patients, 29 were diagnosed with CHE by the PHES test (35.36% prevalence) and 28 of those obtained equal diagnosis by the Stroop EncephalApp (96.6% sensitivity). A total of 53 patients obtained negative results for CHE by PHES, while the Stroop test classified 27 of them as having the disease. In the multivariate analysis, high levels of education were associated with better performance during the tests. No significant relationship was observed between age and sex with the probability of diagnosing CHE through the PHES test.

Introduction: Population aged >60 years compose the age group that grows the most disproportionately. Despite several positive individual and social aspects an increase in the prevalence of chronic non-communicable diseases, including OA is observed. Hypothesis: Whether physical activity (PA) levels and number of chronic diseases are associated with handgrip strength (HGS), chair stand test (CST) results, and difficulties to dressing among older adults presenting with hip pain and diagnosed with hip osteoarthritis (OA). Methods: We analyzed Wave 5 of the Survey of Health, Ageing and Retirement in Europe. We analyzed two age groups of individuals diagnosed with hip OA: 60-79 and 80-100 year groups. Univariate and multivariate logistic models were constructed considering the poor performance cut-offs in the strength, functioning, and mobility tests as the dependent variables, and physical inactivity, number of chronic diseases, body mass index (BMI), gender and education as the exposure variables. Results: We included 2.088 participants (mean age 73.1±8.5 years). The majority (89.3%) reportedly had two or more chronic diseases, the most prevalent being hypertension. The participants were mostly overweight or obese (69.8%); however, two of three (75%) participants reported moderate-to-vigorous daily activity. Low levels of moderate-to-vigorous PA were significantly and independently associated with muscle weakness, dysfunctioning, and poor mobility in both age groups (p<0.05). Having five or more chronic diseases was significantly associated with disability in individuals with hip OA aged ≥60 years (p<0.05). Conclusions: Low PA levels and chronic conditions are significantly associated with reduced functioning in individuals aged ≥60 years with symptomatic hip OA, especially in the 80-100 year subgroup. These findings are important for stakeholders to maintain adequate PA levels in older individuals despite their hip OA diagnoses.

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