ABSTRACT. Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting many children worldwide. They face challenges in multiple cognitive, behavioral, and emotional functions. It is well established that engaging in physical exercise enhances physical capacities and is associated with improved cognitive performance in children. Objective:This systematic review aimed to examine the role of physical activity as a non-pharmacological approach for enhancing the cognitive, and consequently, academic and behavioral, performance in children with ADHD.Methods:Clinical trials from the last 10 years were searched in the PubMed, LILACS, and Cochrane databases, with 11 studies included in this review.Results:All studies demonstrated improvements in cognitive domains, including memory, attention, and inhibition, as well as behavioral benefits.Conclusion:Published data indicate that physical activity positively impacts the cognitive, academic, and behavioral performance of children with ADHD.

ABSTRACT.Dementia cases are rising globally, particularly in low- and middle-income countries like those in Latin America.Objective:The aim of the study was to enhance diagnostic accuracy in diverse populations; modifications to brief cognitive tools may be necessary.Methods:This cross-sectional study involved 197 participants who underwent neurocognitive assessments with both the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) and a modified version of RUDAS-PE (mRUDAS-PE). Statistical analyses, including chi-square tests and receiver-operator curves, were used to compare the diagnostic performance of the original and modified RUDAS.Results:The mRUDAS-PE showed improved performance in the visuospatial construction domain, with more participants achieving top scores, especially among controls and Alzheimer’s disease patients. The judgment domain also yielded higher scores for controls. Only the judgment domain modifications do not change the diagnostic accuracy.Conclusion:Judgment modifications could be considered to improve the diagnostic performance of RUDAS-PE. Further testing in populations with different educational levels from rural areas is needed to assess their broader impact.

ABSTRACT. Dementia prevalence is increasing globally, especially in low- and middle-income countries like Peru. Evidence has shown that a trained caregiver improves the patient’s quality of life, reduces behavioral symptoms, and decreases the likelihood of the caregiver developing burnout. Objective:The aim of the study was to measure the level of knowledge of caregivers attending monthly training compared to untrained caregivers in Lima, Peru.Methods: A cross-sectional study was conducted involving 102 informal caregivers of dementia patients, split evenly into trained (n=51) and untrained (n=51) groups. The training program ("Lonchecito para cuidadores") consists of 10 virtual meetings per year, where the main topics are: types of dementia, management of behavioral symptoms, application of non-pharmacological measures, and caregiver well-being. Dementia knowledge was assessed using the Spanish version of the Dementia Knowledge Assessment Scale (DKAS-S). Data were analyzed using Student’s t-test to compare group scores, with a significance threshold of p<0.05. Results: The trained caregivers scored higher [mean=18, standard deviation (SD)=2.72] than the untrained group (mean=16, SD=2.6) (p=0.001). Higher education was moderately correlated with better DKAS-S scores. Notably, questions on early dementia symptoms, advanced care, and management of behavioral symptoms had the highest error rates, with up to 70% incorrect responses on some items. Conclusion:Caregivers with dementia training performed better than the general population, underscoring the need for improved community access to quality dementia information.

ABSTRACT.Caregiving for older adults with Alzheimer's disease (AD) has intensified in Brazil, highlighting the emotional and physical burden faced by caregivers. Understanding the factors contributing to this burden is essential for developing more effective and sustainable support strategies.Objective:The aim of this study was to analyze the relationship between coping strategies, caregiver burden, and perceived stress using network analysis.Methods:This was a quantitative, analytical, observational, and cross-sectional study with a final sample of 126 formal and informal caregivers from different regions of Brazil. Data were collected via an online questionnaire, using the Perceived Stress Scale, Zarit Burden Interview, and the Coping Strategies Inventory (EMEP). Statistical analysis was conducted with JASP software. Data showed non-parametric distribution, and Spearman's correlation and LASSO network analysis were applied.Results:Results revealed weak but significant positive correlations (p<0.05; r<0.40) among coping domains. Problem-focused coping was negatively correlated with burden (r=-0.34) and stress (r=-0.60), while emotion-focused coping showed positive correlations with both (r=0.40; r=0.42). Religious/fantasy coping and seeking social support were also positively associated with burden. The LASSO network highlighted emotion-focused and religious coping as central nodes. Problem-focused coping was negatively associated with stress, while emotional and religious strategies were linked to increased burden and stress. Centrality indices indicated emotional coping and religious practices as highly influential.Conclusion:These findings underscore the protective role of problem-focused coping and the need for targeted interventions to foster adaptive strategies and support caregiver well-being.

ABSTRACT. Hospitalizations related to Alzheimer’s disease (AD) impose a growing burden on health systems, but recent, nationally representative estimates for Brazil are limited. Objective:To describe the epidemiological profile of hospital admissions due to AD in Brazil from 2018 to 2024.Methods:Ecological time-series study using the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), accessed via the Department of Informatics of the SUS (DATASUS). We included all regions and states from January 2018 to December 2024. Admissions were identified by the International Classification of Diseases, 10th Revision (ICD-10) codes G30.0–G30.9 and F00.0–F00.9. Variables comprised sex, age group, race/color, admission type (urgent/elective), in-hospital mortality, length of stay, and hospital costs. Temporal trends were evaluated with linear regression.Results:From 2018 to 2024, 11,212 AD-related hospitalizations were recorded; 79.4% were urgent. The Southeast had the highest absolute number (47.8%), followed by the South (25.1%), Northeast (17.2%), Midwest (6.5%), and North (3.4%). Females accounted for 65% of admissions and 64.7% of in-hospital deaths. Older adults, especially those ≥80 years, represented most hospitalizations (59.3%) and deaths (69.7%). Total hospital expenditures exceeded R$ 14 million, with the Southeast concentrating >60% of national costs. No significant linear trend was detected in annual rates.Conclusion:Urgent admissions comprised the majority of AD hospitalizations nationwide, with the Southeast presenting the highest numbers. The predominance of older female patients and high in-hospital mortality underscore the need for targeted clinical and public health strategies. Rising expenditures reinforce investment in health infrastructure and long-term dementia-care policies in Brazil.

ABSTRACT. There is a gap in the literature regarding popular knowledge about dementia. Although dementia affects older individuals more frequently, it does not belong to senescence. Lack of awareness contributes to the normalization of cognitive decline, delaying the search for healthcare services, diagnosis, and treatments. Objective:Assess the population’s knowledge about dementia and its relationship with socioeconomic characteristics.Methods:Cross-sectional study with a semi-structured questionnaire administered in person to a convenience sample of residents of Ribeirão Preto, São Paulo, Brazil. Descriptive and inferential statistical analyses were conducted. Significance level: p<0.05.Results: Three hundred residents were interviewed. Among them, 189 (63%) were unaware of the meaning of dementia. In a multivariable regression, higher income increased the odds of knowing what dementia is compared to the lowest income group (adjusted Odds Ratio [aOR]=4.29, 95% confidence interval [95%CI] 1.40–14.11, p=0.013). Working in healthcare (aOR=3.30, 95%CI 1.24–9.66, p=0.021) or having relatives in this sector (aOR=2.16, 95%CI 1.16–4.07, p=0.016) increased the probability of awareness. Limited awareness of risk factors was observed, along with the normalization of dementia signs and symptoms, which were commonly perceived as part of normal aging. Conclusion: Significant lack of knowledge on the subject was observed, particularly among socioeconomic vulnerable individuals. Dementia was not widely recognized as a pathological and preventable condition. Given an aging society, this study provides a critical foundation for future public health initiatives and research aimed at improving dementia literacy and promoting early intervention.

ABSTRACT.Dementia is a leading global health challenge. Despite its burden, data from American countries remain scarce and fragmented. This lack of robust evidence impedes regional planning and policy-making.Objective:The aim of the study was to evaluate the temporal trends of dementia’s mortality in America with a local and regional approach.Methods:This ecological time-series study analyzed age-adjusted dementia mortality rates across American countries between 2000 and 2019. Data were obtained from Pan American Health Organization and cross-validated with national and international sources. Joinpoint regression was used to estimate annual percent change, identifying significant temporal trends in mortality.Results:Between 2000 and 2019, dementia mortality rates were highest in the Insular Americas and varied widely across countries. The United States, Canada, and several Central and South American nations exhibited elevated rates, while others, such as Paraguay and Venezuela, reported consistently low values. National trends were heterogeneous, with some countries showing steady declines and others persistent or erratic increases.Conclusion:This study highlights significant temporal trends in American dementia mortality, identifying critical areas for public health intervention and offering a foundation for future research on healthcare equity and cancer outcomes.

ABSTRACT.With population aging, the growing concern about cognitive decline and dementias highlights the need for early and accessible cognitive assessment. In this context, a telephone-adapted version of the Mini-Mental State Examination, the Brazilian Telephone Version of the Mini-Mental State Examination (Braztel-MMSE), was developed.Objective:The aim of the study was to compare cognitive performance assessed by the Braztel-MMSE, administered by telephone, with the traditional Mini-Mental State Examination (MMSE), administered in person, in highly educated older adults without diagnosed dementia or depression, and who are socially engaged.Methods:This is a descriptive cross-sectional study. The initial sample consisted of 578 older adults who completed the Braztel-MMSE during the screening phase of a clinical trial. Of these, a subsample of 190 older adults completed the traditional MMSE after 18 months. Data were analyzed descriptively and inferentially to compare scores obtained from both instruments.Results:The results showed a significant correlation between scores on the Braztel-MMSE and the traditional MMSE (Spearman's rho=0.354, p<0.001). Bland-Altman analysis revealed satisfactory agreement between the two cognitive assessment methods, with a mean difference of 0.002 between scores.Conclusion:This study demonstrates that the telephone-administered Braztel-MMSE shows good agreement with the traditional face-to-face MMSE. These findings suggest that the Braztel-MMSE can be a useful and valid tool for cognitive screening in contexts where in-person evaluation is not feasible, including long-term clinical trials.

ABSTRACT. Cerebral amyloid angiopathy is a common cause of intracerebral hemorrhage, most often occurring in older adults and in patients with dementia. One of its main differential diagnoses is hypertensive intracerebral hemorrhage. This is a case report of a hypertensive male patient who presented to the emergency department with short-term amnesia and Broca’s aphasia. The initial diagnosis was hemorrhagic stroke of hypertensive etiology. However, subsequent diagnostic tests revealed that the bleeding was due to amyloid angiopathy. This case highlights the similarities and differences in the diagnosis and management of both etiologies, emphasizing the importance of establishing an accurate and timely differential diagnosis.