Psychological frailty in aging: Lifespan trajectories and emerging risks

In the study of aging, "frailty" is the state that increases the individual's vulnerability to stress factors. In the context of biomedical sciences, the concept of frailty has been operationalized differently, and the most used is the frailty phenotype. However, different constructs have emerged in recent decades complementing the traditional one of physical frailty. From a biopsychosocial, gerontological outlook, multidimensional and dynamic perspectives that include physical, functional, cognitive, and psychosocial domains (e.g., cumulative deficit model), are currently more relevant (Rockwood and Mitnitski, 2007; Gobbens et al., 2010)

Behavioral interventions in long-term care facilities during the COVID-19 pandemic: a case study

During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented here, our aim was to explain the effect that the strong confinement due to the spread of the first COVID-19 wave in Spain had on a 75-year-old resident in an LTC center, with cognitive and behavioral symptomatology compatible with a diagnosis of mixed dementia, as well as the measures that the center adopted to manage the lockdown situation in the best possible way, including personalized attention protocols and a video call program. Different nosological hypotheses are also raised using a semiological analysis, including the analysis of the initial and continuation diagnostic protocols, as well as the therapeutic optionsS

User-centered design of a dynamic-autonomy remote interaction concept for manipulation-capable robots to assist elderly people in the home

In this article, we describe the development of a human-robot interaction concept for service robots to assist elderly people in the home with physical tasks. Our approach is based on the insight that robots are not yet able to handle all tasks autonomously with sufficient reliability in the complex and heterogeneous environments of private homes. We therefore employ remote human operators to assist on tasks a robot cannot handle completely autonomously. Our development methodology was user-centric and iterative, with six user studies carried out at various stages involving a total of 241 participants. The concept is under implementation on the Care-O-bot 3 robotic platform. The main contributions of this article are (1) the results of a survey in form of a ranking of the demands of elderly people and informal caregivers for a range of 25 robot services, (2) the results of an ethnography investigating the suitability of emergency teleassistance and telemedical centers for incorporating robotic teleassistance, and (3) a user-validated human-robot interaction concept with three user roles and corresponding three user interfaces designed as a solution to the problem of engineering reliable service robots for home environments

Cognitive frailty: an update

This review article provides an update of the empirical research on cognitive fragility conducted in the last four years. The studies retrieved were classified in four different categories. The first category includes articles relating cognitive frailty to cognitive reserve and which continue to highlight the importance of educational level. The second category includes recent research on cognitive fragility biomarkers, involving neuroimaging, metabolism and, in a novel way, microbiota. The third category includes research on how cognitive frailty is related to motor development and physical functioning, exploring e.g. the use of technology to study motor markers of cognitive frailty. Finally, in the fourth category, research clarifying the difference between reversible frailty and potentially reversible cognitive frailty has led to new interventions aimed at reducing cognitive frailty and preventing negative health outcomes. Interventions based on physical activity and multicomponent interventions are particularly emphasized. In addition, recent research explores the long-term effects of dual interventions in older adults living in nursing homes. In summary, research on cognitive frailty has increased in recent years, and applied aspects have gained importanceThis work was financially supported through FEDER founds (A way to make Europe) by the Spanish AEI (doi: 10.13039/501100011033; Refs. PID2020-114521RB-C21 and PSI2017-89389-C2-1-R) and by the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; GI-1807-USC: Ref. ED431C 2021/04). CB was supported by a Research Initiation Grant from the University of Santiago de Compostela, co-financed by Banco Santander. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publicationS

Psychological, social and health-related challenges in spanish older adults during the lockdown of the COVID-19 first wave

The global pandemic of COVID-19 has required a population lockdown. Spain has one of the oldest/most aging populations in the world and was one of the most affected countries. We aim to describe the psychological and social implications as well as health-related behaviors as a result of the lockdown in community-dwelling older adults. Materials and Methods: Observational cross-sectional study. A total of 528 participants of over 60 years of age were recruited using snowball sampling technique during the lockdown of the COVID-19 first wave using an anonymous self-administered questionnaire composed of descriptive questions and validated scales for resilience (Brief Resilient Coping Scale) and emotions (Scale of Positive And Negative Experience). Results: Most participants (76.9%) live with other people and have an open space at home (64%). Only 33.7% continued doing activities to promote healthy aging, 65.7% did less physical activity and 25.6% increased their intellectual activity. Most of them (83%) used electronic communication with family and friends to a greater extent, and left the house to run basic errands. Greater scores on resilience showed significant negative correlations with age and negative feelings, and positive correlations with the size of the social network and positive feelings. Lacking an open space at home was associated with more negative feelings. Discussion: Older people are a vulnerable group severely affected by this pandemic crisis at multiple levels, requiring specific interventions to minimize the effects of changes in lifestyle that may be harmful. Detecting needs is essential to improve care and support from community health and social services, both nowadays and in future similar situationsS

Positive and Negative Feelings among Spanish Young–Old and Old–Old during the Lockdown of the COVID-19 First Wave

Objectives The COVID-19 pandemic required a population lockdown during the first wave in March 2020. Evidence has shown a circular relationship between perceived threat and the risk of developing negative mood, which might impact the affect balance of older adults. We aimed to investigate the positive and negative feelings expressed by young–old (60–70 years) and old–old (over 71 years) Spanish adults during the lockdown of the COVID-19 first wave, and the social and psychological variables associated. Methods Cross-sectional study conducted in 528 participants using a questionnaire composed of sociodemographic data and validated scales for resilience (Brief Resilient Coping Scale) and emotions (Scale of Positive and Negative Experience). Results We found a positive balance between positive and negative feelings with no differences between both groups. Regression analysis showed that social network and resilience, but not age, are significant predictors of both greater positive feelings and lower negative feelings. Conclusions Our results evidence the relevance of promoting targeted support psychological and social measures that effectively help older adults to cope with such a difficult scenario as the current pandemic. Clinical implications Health-care providers must develop targeted care strategies aimed at providing emotional support for older adults from a holistic perspectiveS

Prevalence of Cognitive Frailty, Do Psychosocial-Related Factors Matter?

Cognitive frailty (CF) is a topic of growing interest with implications for the study of preventive interventions in aging. Nevertheless, little research has been done to assess the influence of psychosocial variables on the risk of CF. Our objectives were to estimate the prevalence of CF in a Spanish sample and to explore the influence of psychosocial variables in this prevalence. Physical frailty and cognitive, functional, psychosocial, and socio-demographic aspects were assessed in a sample of 285 participants over 60 years. Univariate and multivariate logistic regression models were carried out. Aprevalence of 21.8% (95% CI 17.4-26.9) was established when both frail and pre-frail conditions were included, and a prevalence of 3.2% (95% CI 1.7-5.9) if only frail individuals were considered. Age, educational level, profession and psychological well-being variables significantly predicted CF. Frailty and pre-frailty are high-prevalence health conditions in older adults influenced by socio-demographic, socio-educative and affective factors

Foreign language training to stimulate cognitive functions

This study presents the results of the training that is part of the doctoral thesis entitled: “Efecto de un entrenamiento lingüístico-cognitivo con lengua extranjera en la frecuencia del fenómeno de la punta de la lengua, las puntuaciones de la memoria de trabajo y en el tiempo requerido para una tarea de velocidad de procesamiento en personas adultas de 40 a 60 años” (Effect of a foreign language cognitive-linguistic training on the frequency of the tip-of-the-tongue phenomenon, working memory scores and the time required for a processing speed task in adults aged 40 to 60 years) under the direction of Mercedes Suárez de la Torre, and the co-direction of Francia Restrepo de Mejía, research professors at the Universidad Autónoma de Manizales, and endorsed by the Bioethics Committee of the same university. In addition, David Facal-Mayo, from the Universidad de Santiago de Compostela, A Coruña, Spain, was a permanent advisorAdult development throughout a lifetime implies a series of changes in systems, including cognitive and linguistic functioning. The aim of this article is to study the effect of foreign language training on linguistic processing, particularly the frequency of the tip-of-the-tongue (TOT) phenomenon and on other cognitive processes such as processing speed and working memory in adults aged 40 to 60 years. Sixty-six healthy Colombian teachers were enrolled in this study. They were then randomly divided into an experimental group (33 healthy adults who underwent a four-week training period) and a passive control group (33 healthy adults who did not undergo any training). All participants performed induction tasks for the TOT phenomenon, working memory and processing speed before and after the four weeks. Results showed more of an effect in the semantic access, phonological access and processing speed measures with a better performance in the experimental group than in the control group. In Colombia, this type of training is still new and little is known to date about programs to prevent cognitive impairments. The need to conduct more studies confirming or refuting these findings is discussed, thus raising awareness about the extent of this type of training to increase the linguistic and cognitive performance of adultsS

Episodix: a serious game to detect cognitive impairment in senior adults. A psychometric study

Introduction Assessment of episodic memory is traditionally used to evaluate potential cognitive impairments in senior adults. The present article discusses the capabilities of Episodix, a game to assess the aforementioned cognitive area, as a valid tool to discriminate among mild cognitive impairment (MCI), Alzheimer’s disease (AD) and healthy individuals (HC); that is, it studies the game’s psychometric validity study to assess cognitive impairment. Materials and Methods After a preliminary study, a new pilot study, statistically significant for the Galician population, was carried out from a cross-sectional sample of senior adults as target users. A total of 64 individuals (28 HC, 16 MCI, 20 AD) completed the experiment from an initial sample of 74. Participants were administered a collection of classical pen-and-paper tests and interacted with the games developed. A total of six machine learning classification techniques were applied and four relevant performance metrics were computed to assess the classification power of the tool according to participants’ cognitive status. Results According to the classification performance metrics computed, the best classification result is obtained using the Extra Trees Classifier (F1 = 0.97 and Cohen’s kappa coefficient = 0.97). Precision and recall values are also high, above 0.9 for all cognitive groups. Moreover, according to the standard interpretation of Cohen’s kappa index, classification is almost perfect (i.e., 0.81–1.00) for the complete dataset for all algorithms. Limitations Weaknesses (e.g., accessibility, sample size or speed of stimuli) detected during the preliminary study were addressed and solved. Nevertheless, additional research is needed to improve the resolution of the game for the identification of specific cognitive impairments, as well as to achieve a complete validation of the psychometric properties of the digital game. Conclusion Promising results obtained about psychometric validity of Episodix, represent a relevant step ahead towards the introduction of serious games and machine learning in regular clinical practice for detecting MCI or AD. However, more research is needed to explore the introduction of item response theory in this game and to obtain the required normative data for clinical validityThis research was supported by the University of VigoS