Evaluación mediante actigrafía de la efectividad de la luminoterapia sobre el sueño en personas mayores con demencia institucionalizadas

ResumenXunta de Galicia; ED431C2017/49Xunta de Galicia; IN607C2016/08Xunta de Galicia; IN607C2017/0

Effectiveness of a Chess-Training Program for Improving Cognition, Mood, and Quality of Life in Older Adults: A Pilot Study

Financiado para publicación en acceso aberto: Universidade da Coruña/CISUG[Abstract] Background. Regular practice of a cognitively stimulating activity, such as chess, can help maintain a healthy cognitive, social, and psychological state during the aging process. Objective. To evaluate the effects of a chess-training program on cognitive status, mood, and quality of life (QoL) in a sample of institutionalized and semi-institutionalized older adults. Method. A nonrandomized, controlled pilot study with repeated measures (pre- and post-intervention) was conducted. Results. Analyses revealed a positive impact of the chess program on general cognitive status (p < 0.001) and promising evidence (p < 0.043) of an impact on attention, processing speed, and executive functions. The participants in the intervention group also showed significant improvement in QoL scores (p < 0.021). Conclusions. A 12-week chess-training protocol with two 60-minute sessions per week improved cognition and QoL in a sample of institutionalized and semi-institutionalized older adults. Further research with larger samples is needed to explore its effects in depth.Xunta de Galicia; ED431C 2017/49Xunta de Galicia; ED431F 2017/09This work was supported by Xunta de Galicia (ED431C 2017/49, ED431F 2017/09). Laura Lorenzo-López is supported by the “Ramon y Cajal” Postdoctoral Senior Grant (RYC-2015-18394) from the Spanish Ministry of Economy, Industry, and Competitiveness, co-financed by the European Social Fund. Julia Blanco-Fandiño is supported by a pre-doctoral grant from the Autonomous Government of Galicia (ED481A-2017/219). Funding for open access charge: Universidade da Coruña/CISU

Application of light therapy in older adults with cognitive impairment: A systematic review

[Abstract] This systematic review aims to assess the efficacy of light therapy on behavioural and psychological symptoms of dementia (BPSD), cognition, functional status, and quality of life in older adults with cognitive impairment; and secondarily, to identify the optimal characteristics of light therapy to establish an adequate protocol for its clinical application. We searched Web of Science and Medline databases through December 2019, resulting in 36 included articles: 3 evaluated the effects on BPSD, 25 on sleep, 12 on agitation, 10 on mood, 4 on neuropsychiatric symptoms, 4 on cognition, 2 on quality of life and 2 on functional status. Literature has shown potential evidence for positive effects of light therapy on managing sleep, behavioural and mood disturbances in people with cognitive impairment, but a limited effect on cognition, quality of life and functional status. This review provides guidelines for intervention protocols with light therapy in older people with cognitive impairment.Xunta de Galicia; ED431C 2017/49Xunta de Galicia; ED431F 2017/09Xunta de Galicia; IN607C 2016/08Xunta de Galicia; IN607C 2017/0

Dysphagia and its association with other health-related risk factors in institutionalized older people: a systematic review

[Abstract] Background: Dysphagia is considered a geriatric syndrome that is characterized by inability to or difficulty in safely and effectively forming or moving the food bolus toward the esophagus. This pathology is very common and affects approximately 50% of institutionalized older people. Dysphagia is often accompanied by high nutritional, functional, social, and emotional risks. This relationship implies a higher rate of morbidity, disability, dependence, and mortality in this population. This review is aimed at studying the relationship between dysphagia and different health-related risk factors in institutionalized older people. Method: We conducted a systematic review. The bibliographic search was performed in the Web of Science, Medline, and Scopus databases. Data extraction and methodological quality were evaluated by two independent researchers. Results: Twenty-nine studies met the inclusion and exclusion criteria. A clear relationship between the development and progression of dysphagia and a high nutritional, cognitive, functional, social, and emotional risk in institutionalized older adults was found. Conclusions: There is an important relationship between these health conditions that shows the need for research and new approaches to considerations such as their prevention and treatment as well as the design of protocols and procedures that will help reduce the percentage of morbidity, disability, dependence, and mortality in older people.Ministerio de Ciencia e Innovación (España); MCIN/AEI/10.13039/501100011033Ministerio de Fomento y Competitividad (España); RYC-2015-1839

Clinical and Neuropsychological Correlates of Prefrailty Syndrome

[Abstract] Physical frailty is closely associated with cognitive impairment. We aim to investigate the neuropsychological profiles of prefrail and non-frail dementia-free community-dwelling older adults using a comprehensive neuropsychological evaluation, and to examine the association between specific frailty criteria and clinical and neuropsychological scores. Participants completed a comprehensive standardized neuropsychological evaluation (covering cognitive domains such as memory, executive functions, language and attention), and frailty assessment. Frailty was assessed according to biological criteria: unintentional weight loss, exhaustion, low physical activity, slowness, and weakness. The sample comprised 60 dementia-free community-dwelling adults, aged 65 years or older (range 65–89 years; 60.0% women). Forty-two participants were classified as robust (no frailty criteria present), and 18 as prefrail (1 or 2 frailty criteria present). We explored neurocognitive differences between the groups and examined the association between specific criteria of frailty phenotype and clinical and neuropsychological outcomes with bivariate tests and multivariate models. Prefrail participants showed poorer cognitive performance than non-frail participants in both memory and non-memory cognitive domains. However, delayed episodic memory was the only cognitive subdomain that remained significant after controlling for age, gender, and educational level. Gait speed was significantly associated with general cognitive performance, immediatememory, and processing speed, while grip strength was associated with visual episodic memory and visuoconstructive abilities. Both gait speed and grip strength were negatively associated with depressive scores. Our results suggest that prefrailty is associated with cognitive dysfunction. The fact that specific cognitive domains may be susceptible to subclinical states of physical frailty may have important clinical implications. Indeed, early detection of specific cognitive dysfunctions may allow opportunities for reversibility.Xunta de Galicia; ED431C 2017/49Xunta de Galicia; ED431F 2017/0

Bright Light Therapy in Older Adults with Moderate to Very Severe Dementia: Immediate Effects on Behavior, Mood, and Physiological Parameters

[Abstract] Bright light therapy (BLT) has demonstrated positive short- and long-term effects in people with cognitive impairment or dementia; however, the immediate impact of BLT sessions has been scarcely investigated. In this study, we aimed to explore the immediate effects of BLT on behavior, mood, and physiological parameters (oxygen saturation/heart rate) in a sample of institutionalized older adults with moderate to very severe dementia, with a median age of 85.0 (interquartile range, IQR, 82.0–90.0), being higher in men (87.0 years, IQR 80.0–94.0) than in women (84.5 years, IQR 82.0–89.5). The BLT protocol consisted of 30-min morning sessions of 10,000 lux, Monday through Friday, for 4 weeks. The physiological parameters were recorded immediately before and after each session by pulse oximetry. Mood and behavior were assessed before, after, and during the sessions using the Interact scale. Post-session Interact scores showed a significant decrease in the items Tearful/sad and Talked spontaneously, and a significant increase in the items Enjoying self, active or alert, and Relaxed, content or sleeping appropriately. Interact scores during the sessions reflected a significant decrease in the speech-related items. Both physiological parameters changed positively from before to after sessions. Our results suggest that BLT provides immediate positive effects on mood, stimulation level, and physiological parameters, as well as a trend toward decreased speech. More robust research is needed to further explore the immediate impact of BLT. This study is registered with Clinicaltrials.gov (NCT04949984).Xunta de Galicia; ED431C 2017/49Xunta de Galicia; ED431F 2017/09Xunta de Galicia; IN607C 2016/08Xunta de Galicia; IN607C 2017/02This research was funded by the Xunta de Galicia (grant numbers ED431C 2017/49, ED431F 2017/09, FrailNet network IN607C 2016/08, and REGIDEM network IN607C 2017/02); and the Spanish Ministry of Economy and Competitiveness, co-financed by the European Social Fund (grant number RYC-2015-18394

Estudio longitudinal de las transiciones a un año entre estados de fragilidad en personas mayores que viven en la comunidad

Abstrac

Clinical and Neuropsychological Correlates of Prefrailty Syndrome

Physical frailty is closely associated with cognitive impairment. We aim to investigate the neuropsychological profiles of prefrail and non-frail dementia-free community-dwelling older adults using a comprehensive neuropsychological evaluation, and to examine the association between specific frailty criteria and clinical and neuropsychological scores. Participants completed a comprehensive standardized neuropsychological evaluation (covering cognitive domains such as memory, executive functions, language and attention), and frailty assessment. Frailty was assessed according to biological criteria: unintentional weight loss, exhaustion, low physical activity, slowness, and weakness. The sample comprised 60 dementia-free community-dwelling adults, aged 65 years or older (range 65-89 years; 60.0% women). Forty-two participants were classified as robust (no frailty criteria present), and 18 as prefrail (1 or 2 frailty criteria present). We explored neurocognitive differences between the groups and examined the association between specific criteria of frailty phenotype and clinical and neuropsychological outcomes with bivariate tests and multivariate models. Prefrail participants showed poorer cognitive performance than non-frail participants in both memory and non-memory cognitive domains. However, delayed episodic memory was the only cognitive subdomain that remained significant after controlling for age, gender, and educational level. Gait speed was significantly associated with general cognitive performance, immediate memory, and processing speed, while grip strength was associated with visual episodic memory and visuoconstructive abilities. Both gait speed and grip strength were negatively associated with depressive scores. Our results suggest that prefrailty is associated with cognitive dysfunction. The fact that specific cognitive domains may be susceptible to subclinical states of physical frailty may have important clinical implications. Indeed, early detection of specific cognitive dysfunctions may allow opportunities for reversibility

Calidad de vida y aspectos sociales como determinantes de fragilidad

ResumenXunta de Galicia; ED431C2017/49Instituto de Salud Carlos III; IN607C 2016/0