Academic literature on the topic 'Fragilità cognitiva'

Steven Stich's The Fragmentation of Reason will get the adrenalin pumping. At least it will for-reactionaries (like me) who cling to truth, reason and knowledge as cognitive values.Steve Stich sets himself to undermine the entire analytic tradition in epistemology. His book is infused with the spirit of the “radical epistemic reformer.” I do not think he succeeds. Reformations are hard to launch in philosophy. Nonetheless, he raises some deep and troubling issues.

Context: the fragility of the elderly served in a community health area and to characterize elderlies according to fragility criteria. Objective: to characterize the functional state in fragile bigger adults from the medical practice. Material and Methods: a descriptive, cross-sectional investigation with a quantitative approach was carried out between April 2017 and April 2018. Results: prevailed the alterations of mobility and balance in 54,8 %, only 16,1 % was alterations of the emotional state and 29,0 % was alterations functional cognitive. Conclusion: the presence of several fragility criteria such as elderlies older female sex with associated pathologies as hypertension.

Relacionar a fragilidade com variáveis clínicas de pacientes com Insuficiência Renal Crônica. Pesquisa transversal de caráter analítico, de abordagem quantitativa, com pacientes portadores de Insuficiência Renal Crônica em tratamento hemodialítico. Como instrumento de avaliação utilizou-se o prontuário físico funcional, e questionários para avaliação de fragilidade, função cognitiva, atividades de vida diária, depressão e atividade física no lazer, sendo os mesmos analisados por estatística descritiva e teste de correlação linear de Spearman, considerou-se p≤0,05. O aumento da fragilidade relacionou-se com o avanço da idade, com a redução da força de membros inferiores e da flexibilidade, além da redução da função cognitiva, dependência para a realização das atividades básicas de vida diária, bem como de sintomas depressivos. A fragilidade é uma síndrome frequente em paciente em HD, dessa forma, a avaliação e monitoramento das condições de saúde é essencial a fim de proporcionar uma melhor qualidade de vida a esta população.Descritores: Insuficiência Renal Crônica, Fragilidade, Hemodiálise. Relationship of fragility with clinical variables of patients with chronic kidney insufficiencyAbstract: To relate frailty with clinical variables of patients with Chronic Renal Failure. Cross-sectional research of an analytical character, with a quantitative approach, with patients with chronic renal failure undergoing hemodialysis. As an assessment instrument, the functional physical record and questionnaires were used to assess frailty, cognitive function, activities of daily living, depression and leisure-time physical activity, which were analyzed using descriptive statistics and Spearman's linear correlation test, considered up p≤0.05. The increase in frailty was related to advancing age, with the reduction of strength of the lower limbs and flexibility, in addition to the reduction of cognitive function, dependence for performing basic activities of daily living, as well as depressive symptoms. Frailty is a frequent syndrome in HD patients, so the evaluation and monitoring of health conditions is essential in order to provide a better quality of life for this population.Descriptors: Chronic Kidney Failure, Fragility, Hemodialysis. Relación de fragilidad con variables clínicas de pacientes con insuficiencia crónica de riñónResumen: Relacionar la fragilidad con las variables clínicas de pacientes con insuficiencia renal crónica. Investigación analítica transversal, con un enfoque cuantitativo, con pacientes con insuficiencia renal crónica sometidos a hemodiálisis. Como herramienta de evaluación, el registro físico funcional y los cuestionarios se utilizaron para evaluar la fragilidad, la función cognitiva, las actividades de la vida diaria, la depresión y la actividad física en el tiempo libre, que se analizaron mediante estadística descriptiva y la prueba de correlación lineal de Spearman arriba p≤0.05. El aumento de la fragilidad se relacionó con el avance de la edad, con la reducción de la fuerza de las extremidades inferiores y la flexibilidad, además de la reducción de la función cognitiva, la dependencia para realizar actividades básicas de la vida diaria, así como los síntomas depresivos. La fragilidad es un síndrome frecuente en pacientes con EH, por lo que la evaluación y el monitoreo de las condiciones de salud son esenciales para proporcionar una mejor calidad de vida a esta población.Descriptores: Insuficiencia Renal Crónica, Fragilidad, Hemodiálisis.

RÉSUMÉLa fragilité met les individus à un risque accru de mauvaise santé. Les personnes âgées consomment une quantité disproportionnée des ressources du service des urgence [SU]. Afin d’étudier la relation entre les marqueurs de fragilité et l’effet sur l’utilisation des services des urgence par les personnes âgées vivant dans les communautés, nous avons mené une analyse secondaire d’un essai prospectif randomisé contrôlé de 22 mois à Montreal, au Canada, en utilisant la base de données du Système de services intégrés pour personnes âgées en perte d’autonomie (SIPA). Nous avons evalué un échantillon de 565 individus, avec cinq marqueurs de fragilité : l’activité physique, la force, la cognition, l’énérgie et la mobilité. Une régression logistique univariée et multivariée a été réalisée afin d’évaluer la relation potentielle entre les marqueurs de fragilité et les visites aux urgences. Les résultats ont révelé que 70 pour cent des participants avaient au moins trois marqueurs de fragilité. Cependant, aucune relation n’a été trouvée entre les marqueurs de fragilité et les visites aux urgences. Ces résultats suggèrent, donc, que parmi les personnes âgées fonctionellement sévèrement handicapés au sein des communautés, la présence de marqueurs de fragilité ne semble pas prévoir les visites aux urgences.

Any global structure comprises of ideational and material elements. To put the idea into practice, members of the global community formulate rules and regulations and marshal resources to build capacities and institutions that can affect states and societies. Although the effects of the global structures on the state fragility are increasingly being recognized, the pathways through which they can affect the states contributing to its fragility or strengthening its resilience have been rarely examined. This paper aims at filling the void in the literature by offering a structural explanation of state fragility. The post 9/11 structure of the Global War on Terrorism (GWoT) has been taken as a proxy to theorize the pathways. It argues that the ideational and material factors of the GWoT operate through: (i) the cognitive pathway shaping the states’ thinking, interpreting and reasoning process (ii) the regulatory pathway creating demand for policy coordination, cooperation and compatible legal and procedural instruments for counter terrorism (CT) and their compliance (iii) the capability pathway shaping the states’ coercive capability, institutions and CT alliance building. The theorized pathways are illustrated through schematic diagrams showing how they can impact the states’ legitimacy and capacity dimensions contributing to the increase or decrease of the state fragility to facilitate their tracing in individual case studies. Finally, the paper makes comparative analysis of the cognitive, regulatory and capability pathways highlighting their relationship and relative significance.

Nutrition is an important factor for health, physical and cognitive function, vitality, quality of life and longevity. Elderly people oft en have low food intake, induced by multifactorial causes, as a result, malnutrition is an independent risk factor for increased morbidity and mortality, regardless of the underlying pathologies (chronic organ failure, cognitive impairment, cancer, cardiovascular disease, type 2 diabetes etc.) including overweight or obese subjects.The prevalence of malnutrition varies from 4% to 10% in the elderly population from the community, from 15% to 38% for institutionalized elderly people and from 30% to 70% for hospitalized ones. The purpose of this study was to assess the nutritional status of institutionalized elderly people and establish correlations between the determinants of malnutrition and fragility syndrome.Th e epidemiological study is part of the project 20.80009.8007.25 “Fragility: diagnosis and prophylaxis in relation to medicopsychosocial problems of the vulnerable elderly”, included 50 patients institutionalized in the Republican Asylum for the Disabled and Retired in Chisinau.All persons were examined by the complex geriatric evaluation, approved by the order of the Ministry of Health no. 619 of 07.09.2010. According to the results, both malnutrition and the risk of malnutrition were high in institutionalized elderly people.Among the determinants of malnutrition, the highest association had the number of concomitant diseases, decreased functionality of the elderly, the presence of depression syndrome and cognitive disorders. At the same time, the malnutrition syndrome correlated with the fragility criteria but also with the degree of severity of frailty of the institutionalized elderly people.

RÉSUMÉCette étude visait à déterminer (1) si des mesures de position sociale sont associées à la fragilité, (2) si une association observée entre la position sociale et la fragilité est un effet de seuil ou de gradient, et (3) si une relation observée est indépendante des facteurs de confusion possibles. Les données ont été tirées d’un échantillon de 1 751 adultes, habitants des communautés, âgés de 65 ans et plus, habitant la province canadienne de Manitoba en 1991. On a utilisé, comme mesures de la position sociale l’éducation, et la suffisance et la satisfaction du revenu selon auto-évaluation personnelle. La précarité a été classée selon la perte fontionnelle, la cognition et l’incontinence urinaire. Des analyses de régressions multiples ont révelés, après ajustement pour les facteurs possibles de confusion, que toutes les mesures de la position sociale étaient fortement associées à la fragilité par gradient d’effet, plutôt que d’effet de seuil. Nous concluons que les gradients sociaux de la fragilité sont présents chez les adultes âgés, même si un mécanisme causatif n’est pas encore clair.

Introduction: Cognitive impairment can hinder a fracture patient’s capacity to consent to surgery and negatively impact their postoperative recovery and rehabilitation. National guidelines recommend screening for cognitive impairment upon admission, and the Abbreviated Mental Test Score (AMTS) is a commonly used tool for this. This project aimed to assess current practice regarding documentation of AMTS among frail fracture patients upon admission and to improve AMTS documentation following a simple intervention. Methods: Baseline data were obtained by inpatient chart review throughout November to December 2018 in a district general hospital with emergency fracture services. All patients admitted with a fragility hip fracture and patients over 65 years with any fracture were included. National guidelines and baseline results were then distributed among junior doctors. Following an intervention, further data were collected throughout January to February 2019. Results: Preintervention, 40 suitable patients (mean age: 82 years) were identified; 9 (22.0%) of whom had an AMTS recorded upon admission. Among the hip fracture subgroup (n = 25), 7 (26.9%) had an AMTS recorded. Postintervention, 39 patients (mean age: 80 years) were identified; 15 (38.5%) of whom had an AMTS recorded. Among the hip fracture subgroup (n = 30), 11 (36.7%) had an AMTS recorded. Statistical analysis demonstrated a significant improvement in AMTS documentation both among the overall cohort ( P = .001) and hip fracture patients ( P = .019). No significant association was found between AMTS documentation and patient age ( P = .566), grade of admitting doctor ( P = .058), or prior cognitive/mental health disorder ( P = .256). Discussion: A small yet significant improvement in AMTS documentation among elderly/hip fracture patients was observed following distribution of educational material. Further work should explore the effect of cognitive impairment on outcomes related to orthopedic injuries beyond hip fractures.