The increase in life expectancy can influence the prevalence of dementias in the population. Instruments that evaluate cognitive functions such as the Mini Mental State Examination (MMSE) are necessary for the investigation of dementia. The supposition that patient score on the MMSE can be influenced by academic level points to the need for establishing cut-off values that take into account educational level. The aim of this study was to review MMSE cut-off values adjusted for schooling in a large southern Brazilian sample.MethodDemographic data and MMSE scores of 968 subjects, of which 162 were dementia patients and 806 healthy participants, were analyzed. The sample was grouped according to education. The cut-off values were established by ROC Curve analysis.ResultsThe total sample mean age was 70.6±7.3 years, and the mean years of education was 7.2±5.3. The cut-off score of 23 points (sensitivity=86%, specificity=83%) was observed as the optimal level to detect dementia on the MMSE instrument for the overall sample. Regarding level of schooling, the cut-off values were: 21 for the illiterate group (sensitivity=93%, specificity=82%), 22 for the low education group (sensitivity=87%, specificity=82%), 23 for the middle education group (sensitivity=86%, specificity=87%) and 24 for the high education group (sensitivity=81%, specificity=87%).ConclusionsThe cut-off values revealed by this analysis, and adjusted for level of schooling, can improve the clinical evaluation of cognitive deficits.

Background Brain volume assessment has become an important outcome within research and treatment of multiple sclerosis (MS). MSmetrix (Icometrix) has been developed specifically for patients with MS. The original healthy, 'normal' population used for determination of the acceptable brain volume data consisted mainly of Europeans. Methods In the present study, results from 295 completely normal magnetic resonance imaging scans from Brazilian subjects were plotted against the original results in MSmetrix. Results With regard to whole brain volume, only 2% of the healthy adult subjects from Brazil were below the 5th percentile of the graph, and for grey matter volume, only 3% of the subjects were below the 5th percentile of MSmetrix standards. Conclusion MSmetrix may be used across different populations.

Background: Social interaction is a lifestyle factor associated with a decreased risk of dementia in several studies. However, specific aspects of these social factors influencing dementia are unknown. This study aimed at evaluating the role of the distinct aspects of social support on the incidence of dementia in acommunity-based cohort of older people in Brazil. Methods: A total of 345 healthy and independent elderly subjects living in the community were followed by 12 years. Incident cases of dementia and probable Alzheimer's disease were defined by DSM-IV criteria and NINCDS-ADRDA criteria, respectively. Social variables evaluated were marital status, living arrangement, living children, living sibling, confidant and attending recreational groups. Sex, age, education, Mini-Mental State Examination (MMSE) score, depressive symptoms and family income were entered as co-variates in a Cox proportional hazard model. Results: The absence of confidant was the only social variable associated to higher risk of developing dementia (HR = 5.31; p < 0.001), even after adjustment for age (HR = 1.08; p = 0.048) and baseline MMSE score (HR = 0.79; p = 0.002). Conclusions: Our data suggest that to have a confidant could be an important lifestyle factor associated with dementia.

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The aging of the population is a universal phenomenon with direct consequences upon the public health system. One of the main repercussions of the growth in this sector of the population is the increased prevalence of disorders such as dementia and depression which are very frequent among the elderly. The relationship between cardiovascular risk factors, dementia and depression have been addressed in many recent investigations.ObjectivesTo evaluate the relationship of cognitive performance and depressive symptoms with cardiovascular risk in the elderly.Methods94 high cardiovascular risk elderly patients and 160 healthy community elderly were evaluated cross-sectionally. The Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15) were used as the main measures. The cutoff for presence of depression was 6 on the GDS.ResultsThe high cardiovascular risk elderly group showed significantly lower scores on the MMSE (p<0.001) and was significantly associated to depression (p<0.001), independently of education. The logistic regression analysis for depression as the dependent variable, age and group (healthy community or high cardiovascular risk elderly) were kept in the final equation. Higher age (Odds Ratio=0.92; 95% CI 0.86–0.98) and high cardiovascular risk elderly (OR=2.99; 95% CI 1.36–6.59) were associated to depression.ConclusionsThe present findings corroborate the different cognitive performance of elderly with high cardiovascular risk factors and the association of depressive symptoms with this group.