Análise de indicadores biocomportamentais em idosos com e sem doença de Alzheimer: contributo do exercício físico. Efeitos de um programa de intervenção
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2016-02-03
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Com o envelhecimento, verifica-se uma deterioração em várias funções cognitivas e físicas que comprometem a manutenção da independência do indivíduo.
O objetivo geral deste trabalho foi comparar o nível de independência funcional de
idosos com doença de Alzheimer (DA) e sem demência (SD), tendo em consideração a sua
aptidão funcional e cognitiva. A amostra foi constituída por 41 idosos de ambos os sexos
(masculino n=13 e feminino n=28), dos quais 28 têm a DA diagnosticada há pelo menos três
anos (idade média=81,36±6,2 anos), e 13 idosos não têm diagnóstico de qualquer demência
(idade média=81,85±4,7 anos). Foram realizados três estudos para analisar a intervenção e
a eficácia de programas de exercício físico em idosos com DA. Num 1º estudo foi avaliada a
função cognitiva e autonomia funcional em idosos com DA e SD, num 2ºestudo avaliado o
efeito de um programa de exercício em idosos com DA e num 3º estudo avaliado os efeitos
de um programa de exercício físico nos Danos de DNA na DA.
O programa de treino físico teve a duração de 16 semanas, 2 vezes por semana, e
com a duração de 60 minutos. Após as 16 semanas de exercício, houve um aumento
significativo em alguns parâmetros da funcionalidade. O nível de independência funcional na
realização das atividades de vida diária (AVD) foi estimado a partir do score total do teste de
Barthel; a capacidade cognitiva a partir do score total do Mini Mental State; e a capacidade
funcional a partir da bateria Fullerton’s Functional Fitness Test (FFFT). Procedeu-se ainda, a
uma colheita sanguínea, antes e após a aplicação do programa de exercício, que poderiam
influenciar a independência e a funcionalidade dos idosos institucionalizados.
Após as 16 semanas de exercício, houve um aumento significativo da maioria dos
parâmetros de funcionalidade, como a Caminhada (Antes: 119,64±130,90); (Após:
301,70±229,80); a Força (Antes: 3,71±3,64); (Após: 8,00±6,04); Sentar e Levantar e Voltar a
Sentar (Antes: 3,82±3,84) (Após: 6,89±5,62); e na flexibilidade inferior (Antes: -5,25±6,93)
(Após: -1,61±4,63). Na função cognitiva, verificou-se uma melhoria significativa no MMS, na
evocação (Antes: 1,18±1,33) (Após: 1,96±1,29) e nas AVD na mobilidade/deambulação.
A comparação entre os grupos foi feita através do t-test para amostras
independentes, tendo o nível de significância sido estabelecido em 0,05. A distribuição dos
dados por meio do teste de Shapiro Wilk e utilizou-se também, o teste de Wilcoxon para a
comparação entre os momentos. Foram constatadas diferenças significativas entre os
grupos nas AVD, na capacidade cognitiva e na maioria dos parâmetros de capacidade
funcional (Caminhada, Força, Sentar-levantar e Voltar a Sentar). Há um maior declínio
funcional e cognitivo dos indivíduos idosos com DA, comparativamente aos idosos sem demência, com reflexo na sua autonomia e independência. Um programa regular de exercício físico, pode manter e/ou melhorar a funcionalidade e a cognição em idosos com
DA.
Quanto aos Danos de DNA, o programa de exercício induziu a uma redução
significativa dos Danos de DNA em DA.
With aging, there is deterioration in multiple cognitive and physical functions, which does not enable the continuation of the independence of the individual. The aim of this study was to compare the level of functional independence of older adults with and without Alzheimer disease (AD), taking into consideration their functional and cognitive fitness. The sample consisted of 41 patients of both sexes (male n =13 and n=28 females), of which 28 have AD diagnosed at least three years (average = 81,36±6,2 years), and 13 seniors have no diagnosis of any dementia (average = 81,85±4,7 years). Three studies were conducted to analyze the intervention and the effectiveness of exercise programs in elderly patients with AD. In a first study was evaluated the cognitive function and functional autonomy in elderly patients with AD and SD, in a second study was evaluated the effect of an exercise program in elderly with AD and in a third study was evaluated the effects of an exercise program on DNA damage in AD. The physical training program lasted 16 weeks, twice per week, with the duration of 60 minutes. After 16 weeks of exercise, there was a significant increase in some of the function parameters. The level of functional independence in performing activities of daily living (ADL) was estimated from the total score of Barthel test; cognitive ability from the total of the Mini Mental State score; and functional capacity from the battery's Fullerton Functional Fitness Test (FFFT). It was also done a blood collection before and after the implementation of the exercise program, to estimate possible nutrient deficits that could influence the independence and functionality of the institutionalized elderly. After 16 weeks of exercise, there was a significant increase in the functionality of most of the parameters such as walk (Before: 119,64±130,90); (After: 301,70±229,80); Strength (Before: 3,71±3,64); (After: 8,00±6,04); Sit back and Raise and Back to sit (Before: 3,82±3,84) (After: 6,89±5,62); and lower flexibility (Before: -5,25±6,93) (After: -1,61±4,63). In the cognitive function, there has been a significant improvement in the MMS, in evoking (Before: 1,18±1,33) (After: 1,96±1,29) and ADL mobility / gait. The comparison between groups was performed using the t-test for independent samples, and the significance level was set at 0,05. The data distribution was done by using the Shapiro-Wilk test and it was also used the Wilcoxon test for comparing times. Significant differences were found among the groups in the ADL,in the cognitive ability and functional capacity in most parameters (Hiking, Strength, Sit-up and Sit Back to). There is a greater functional and cognitive decline in elderly individuals with AD compared to older people without dementia, reflected in its autonomy and independence. A regular program of physical exercise, can maintain and / or improve the functionality and cognition in AD patients. As for DNA damage, the exercise program induced a significant reduction of DNA damage in AD.
With aging, there is deterioration in multiple cognitive and physical functions, which does not enable the continuation of the independence of the individual. The aim of this study was to compare the level of functional independence of older adults with and without Alzheimer disease (AD), taking into consideration their functional and cognitive fitness. The sample consisted of 41 patients of both sexes (male n =13 and n=28 females), of which 28 have AD diagnosed at least three years (average = 81,36±6,2 years), and 13 seniors have no diagnosis of any dementia (average = 81,85±4,7 years). Three studies were conducted to analyze the intervention and the effectiveness of exercise programs in elderly patients with AD. In a first study was evaluated the cognitive function and functional autonomy in elderly patients with AD and SD, in a second study was evaluated the effect of an exercise program in elderly with AD and in a third study was evaluated the effects of an exercise program on DNA damage in AD. The physical training program lasted 16 weeks, twice per week, with the duration of 60 minutes. After 16 weeks of exercise, there was a significant increase in some of the function parameters. The level of functional independence in performing activities of daily living (ADL) was estimated from the total score of Barthel test; cognitive ability from the total of the Mini Mental State score; and functional capacity from the battery's Fullerton Functional Fitness Test (FFFT). It was also done a blood collection before and after the implementation of the exercise program, to estimate possible nutrient deficits that could influence the independence and functionality of the institutionalized elderly. After 16 weeks of exercise, there was a significant increase in the functionality of most of the parameters such as walk (Before: 119,64±130,90); (After: 301,70±229,80); Strength (Before: 3,71±3,64); (After: 8,00±6,04); Sit back and Raise and Back to sit (Before: 3,82±3,84) (After: 6,89±5,62); and lower flexibility (Before: -5,25±6,93) (After: -1,61±4,63). In the cognitive function, there has been a significant improvement in the MMS, in evoking (Before: 1,18±1,33) (After: 1,96±1,29) and ADL mobility / gait. The comparison between groups was performed using the t-test for independent samples, and the significance level was set at 0,05. The data distribution was done by using the Shapiro-Wilk test and it was also used the Wilcoxon test for comparing times. Significant differences were found among the groups in the ADL,in the cognitive ability and functional capacity in most parameters (Hiking, Strength, Sit-up and Sit Back to). There is a greater functional and cognitive decline in elderly individuals with AD compared to older people without dementia, reflected in its autonomy and independence. A regular program of physical exercise, can maintain and / or improve the functionality and cognition in AD patients. As for DNA damage, the exercise program induced a significant reduction of DNA damage in AD.
Descrição
Tese de Doutoramento em Ciências do Desporto
Palavras-chave
Exercícios físicos , Cognição , Doença de Alzheimer