Objective: To assess the relationship between cognitive function, balance, risk of falls and functionality in elderly persons with impaired cognitive function and verify if those with mild cognitive impairment had better balance, functionality and a lower risk of falls than those with dementia. Methods: An analytical cross-sectional study of 33 elderly persons of both genders, aged over 60 years, were evaluated using the Mini Mental State Examination (MMSE), Timed Up and Go (TUG) test, Berg Balance Scale (BBS), Clinical Dementia Rating Scale (CDR) and Barthel Index. Four groups were considered: mild cognitive impairment (MCI; n=9), mild dementia (MID; n=12), moderate dementia (MOD; n=7) and severe dementia (SD; n=5). Data comparison was performed by the Mann Whitney U-test and correlation by Spearman's rank Correlation Coefficient, whit a significance level of ( p<0.05). Results: There was a statistically significant difference in the risk of falls and functionality between the MID and MOD groups, functionality between the MOD and SD groups, and balance, functionality and risk of falls between the MID and SD groups. A moderate correlation between MMSE and BBS (r=0.543; p=0.006) was observed in the MCI group, and a moderate negative correlation between p<0.001) and a strong correlation between MMSE and Barthel (r=0.708; p<0.001) were observed in the dementia group. Conclusion: The deterioration in cognitive function was associated with greater impairment of functionality, balance and an increased risk of falls in elderly persons with dementia, compared to elderly subjects with mild cognitive impairment.

-Idiopathic Parkinson's disease (PD) is characterized by reduced nigrostriatal and cortical dopaminergic influence, with changes in movement and, subsequently, behavioral and cognitive disturbances. We studied cognitive impairment in Parkinson's disease by assessing a group of 30 idiopathic Parkinson's disease patients with an average age of 64.23 years (PG group) and compared our findings with those for a control group of 30 patients (CG group). All the patients were submitted to the following assessments: motor function, using the UPDRS; staging, using the Hoehn-Yahr scales (PG group only); depression, using the Montgomery-Asberg scale; attention impairment; verbal fluency (FAR and animals); cognitive function, using the Mini Mental State Examination; visuospatial and executive functions; and clock drawing. In addition to altered motor function in PD patients, we found statistically significant differences between PD patients and controls in terms of cognitive function, verbal, executive and visuospatial functions, and attention deficits. Depression was more prevalent in the PG group.KEY WORS: depression, idiopathic Parkinson's disease, cognitive function. Avaliação da função cognitiva em doença de Parkinson idiopáticaRESUMO -A doença de Parkinson idiopática (DP) caracteriza-se pela redução da influência dopaminérgica nigroestriatal e cortical, com alterações em movimentos e posteriormente, comportamentais e cognitivas. Estudamos o comprometimento cognitivo de pacientes portadores de DP, avaliando 30 pacientes com doença de Parkinson idiopática (GP) com média de idade de 64,23 anos e os comparamos com um grupo controle (GC) de 30 pacientes. Todos os pacientes foram submetidos as seguintes avaliações: motora pela escala de UPDRS; estadiamento pela escala de Hoehn-Yahr (somente GP); depressão pela escala de Montgomery-Asberg; comprometimento da atenção; fluência verbal (FAR e animais); função cognitiva pelo Mini Exame do Estado Mental; funções visuoespaciais e executivas e desenho do relógio. Concluímos que na DP os pacientes apresentam além das alterações motoras diferenças estatisticamente significativas a nível cognitivo, na função verbal, funções executivas, visuoespaciais e distúrbios de atenção. Depressão foi mais prevalente no GP. PR -Brasil. E-mail: werneck@hc.ufpr.br Although the original description by James Parkinson 1 did not consider cognitive disturbances to be an integral part of the symptomatology of Parkinson's disease (PD), but Charcot and Vulpian 2,3 describe such disturbances for the fi rst time, and their fi ndings were confi rmed in recent studies 4,5 . Postmortem neuropathological studies and the use of in vivo PET scans show that nigrostriatal dopaminergic neuronal degeneration is the main physiopathological mechanism in Parkinson's disease 5,6 . The nigrostriatal dopaminergic system is part of one of the fi ve frontostriatal circuits 7 . Disruption of dopaminergic infl uence in these circuits has consequences for other circuits and thus explains a number of cognitive symptom...

Alzheimer's disease (AD) is a neurodegenerative disorder in which there is a decline of cholinergic function. The symptomatic AD treatment involves the use of ChEIs (cholinesterase inhibitors) as rivastigimine, a dual inhibitor. The human butyrylcholinesterase (BChE) is an enzyme that has specific roles in cholinergic neurotransmission and it has been associated with AD. In the serum, BChE is found in four main molecular forms: G1 (monomer); G1-ALB (monomer linked to albumin); G2 (dimer); and G4 (tetramer). The interaction between the products of BCHE gene and CHE2 locus results in CHE2 C5+ and CHE2 C5- phenotypes. CHE2 C5+ phenotype and BChE-K are factors that influence on BChE activity. This work aimed to verify the proportions of BChE molecular forms, total and relative activity in 139 AD patients and 139 elderly controls, taking into account K variant, CHE2 locus, rivastigmine treatment and clinical dementia rating (CDR) of AD patients. Phenotypic frequencies of CHE2 C5+ and frequency of the carriers of the K allele were similar between groups. Total BChE activity in plasma was significantly lower in AD patients than in elderly controls. Furthermore, we found that reduction on plasma BChE activity is associated directly with AD progression in AD patients and that rivastigmine treatment has a stronger effect on BChE activity within the CDR2 group. The reduction in BChE activity did not occur proportionally in all molecular forms. Multiple regression analysis results confirmed that AD acts as the main factor in plasma BChE activity reduction and that severe stages are related with an even greater reduction. These findings suggest that the reduction of total plasma BChE and relative BChE molecular forms activity in AD patients is probably associated with a feedback mechanism and provides a future perspective of using this enzyme as a possible plasmatic secondary marker for AD.

Butyrylcholinesterase (BChE) is an enzyme encoded by BCHE gene, responsible for secondary hydrolysis of the acetylcholine. K and -116A BCHE variants were associated with decrease in plasma BChE activity, and their influence has been investigated in diseases with a cholinergic deficit such as Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). In order to check the influence of BCHE genetic variants on enzymatic activity, all patients and controls were genotyped for K and -116A variants. We found lower plasma BChE activity in DLB patients compared to elderly controls and to AD independent of the presence of K or -116A variants. Our results suggest that the reduction of total plasma BChE activity is probably associated with a feedback mechanism and provides a future perspective of using this enzyme as a possible plasmatic marker for differential diagnosis between AD and DLB.