Delirium was underdiagnosed in this urgent care hospital setting.

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A higher level of educational attainment constitutes a protective factor against cognitive decline in the elderly. Nevertheless, the elements underpinning this association are yet not fully understood.ObjectiveThe primary aim of this study was to compare cognitively impaired illiterate elderly subjects with cognitively preserved counterparts, according to demographics, comorbidities, lifetime habits and APOE genotype.MethodsThis is a cross-sectional analysis of the illiterate subset of participants (n=174) from the Pietà study, a community-based survey of successful brain aging conducted in Caeté (MG), Brazil. Subjects were categorized into three diagnostic groups: cognitively normal (CN), cognitive impairment no-dementia (CIND) and dementia. The groups were then compared according to selected variables.ResultsSubjects with dementia were older and had an increased prevalence of reported stroke or transient ischemic attack. The three groups did not differ in relation to demographics, prevalence of comorbidities, socioeconomic level, previous occupation profile and APOE-ε4 allele frequency. Qualitatively evaluated lifetime habits, such as alcohol consumption, smoking and physical activity engagement were also similar across groups.ConclusionNo associations were found between cognitive impairment/dementia and the variables evaluated in this community-based sample of illiterate elderly.

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Abstract Objective: to investigate the frequency of falls and clinical and physical-functional factors associated with falls, and the accuracy of such factors to identify the risk of falling in cognitively impaired older adults. Method: a cross-sectional study with cognitively impaired older adults was carried out using the Mini-Mental State Examination. The dependent variable was a history of falls in the previous six months. The independent variables were self-reported mental confusion, hearing and visual impairment, physical fatigue, muscle weakness, dizziness, body imbalance, insecurity when walking, diagnosed depression, hospitalizations, continuous use medications (form from study used), muscle mass (calf circumference) and handgrip strength (dynamometry), functional capacity (Pfeffer) and mobility (SAM-Br). Descriptive statistics were applied. The groups were compared using the Mann Whitney U test, the risk factors were identified by univariate and multivariate logistic regression, and the area under the ROC curve (AUC) was calculated for the associated factors. Results: 216 cognitively impaired older adults were included in the analysis, 41.7% of whom were fallers. Multivariate regression analyzes indicated that complaints of visual impairment (OR=2.8; p=0.015) and body imbalance (OR=2.7; p=0.004), and greater medication use (OR=1.1; p=0.038) were associated with a history of falls. The AUC found poor accuracy for quantity of medications as a screening tool for fallers (AUC=0.6 [0.5; 0.7]; p=0.028). Conclusion: cognitively impaired older adults had a high frequency of falls. Complaints of visual impairment, body imbalance and polypharmacy were predictors of falls. The early assessment of these factors can contribute to the identification of cognitively-impaired older adults at risk of falling in clinical practice and research.