Effect of a multicomponent exercise program and cognitive stimulation (VIVIFRAIL-COGN) on falls in frail community older persons with high risk of falls: study protocol for a randomized multicenter control trial

Mat complBackground: Falls represent important drivers of intrinsic capacity losses, functional limitations and reduced quality of life in the growing older adult’s population, especially among those presenting with frailty. Despite exercise- and cognitive training-based interventions have shown efectiveness for reducing fall rates, evidence around their puta‑ tive cumulative efects on falls and fall-related complications (such as fractures, reduced quality of life and functional limitations) in frail individuals remains scarce. The main aim of this study is to explore the efectiveness program combining an individualized exercise program and an executive function-based cognitive training (VIVIFRAIL-COGN) compared to usual care in the prevention of falls and fall-related outcomes over a 1-year follow-up. Methods: This study is designed as a four-center randomized clinical trial with a 12-week intervention period and an additional 1-year follow-up. Three hundred twenty frail or pre-frail (≥1 criteria of the Frailty Phenotype) older adults (≥75 years) with high risk of falling (defned by fall history and gait performance) will be recruited in the Falls Units of the participating centers. They will be randomized in a 1:1 ratio to the intervention group (IG) or the control group (CG). The IG will participate in a home-based intervention combining the individualized Vivifrail multicomponent (aerobic, resistance, gait and balance and fexibility) exercise program and a personalized executive function-based cognitive training (VIVIFRAIL-COGN). The CG group will receive usual care delivered in the Falls Units, including the Otago Exercise Program. Primary outcome will be the incidence of falls (event rate/year) and will be ascertained by self-report during three visits (at baseline, and 6 and 12 weeks) and telephone-based contacts at 6, 9 and 12 months after randomization. Secondarily, efects on measures of physical and cognitive function, quality of life, nutritional, muscle quality and psychological status will be evaluated. Discussion: This trial will provide new evidence about the efectiveness of an individualized multidomain interven‑ tion by studying the efect of additive efects of cognitive training and physical exercise to prevent falls in older frail persons with high risk of falling. Compared to usual care, the combined intervention is expected to show additive efects in the reduction of the incidence of falls and associated adverse outcomes. Trial registration: NCT04911179 02/06/2021. © 2022, The Author(s).The present study is funded by a grant from the Spanish Ministry of Science and Innovation and the Instituto de Salud Carlos III (PI20/01546). Instituto de Salud Carlos III, PI20/01546, Alvaro Casas-Herrer

Valoración de las actividades de la vida diaria en personas con deterioro cognitivo, estudio psicométrico de la escala VAVDI.

Objective: a good assessment of the performance level in the activities of daily living is crucial to develop treatments adapted to the needs of every patient. The aim of this article is to present the scale of " Instrumental activities of daily living (IADLs) and Activities of Daily Living Assessment " designed by Mariel Pellegrini; to carry out a psychometric study of its reliability and validity; and to study the relationships between cognitive impairment, demographic variables and Activities of Daily Living (ADL) and instrumental activities of daily living (IADL). Methods: 80 patients beginning treatment in the cognitive impairment unit were assessed. The Mini-Mental State Examination was administered and a reliability and validity analysis of the scale was performed. Results: the two subscales or sections (ADLs and IADLs) and the global assessment met the Cronbach Alpha criterion> 0.7. The total scores of the global assessment and its two subscales differentiated the functional performance of the sample divided by age and sex groups, but not by level of cognitive functioning. Conclusion: the scale produced an adequate psychometric functioning in patients with mild cognitive impairment. Correlations have been found between the ADLs and IADLs assessment scale and the demographic variables studied, highlighting the protective factor of the roles played throughout life in keeping patients’ autonomy. This study provides an assessment tool that will allow to identify different ADLs performance levels in patients with cognitive impairment.Objetivo: la valoración del nivel desempeño en actividades de la vida diaria es de gran utilidad para desarrollar tratamientos adaptados a las necesidades de cada paciente. Los objetivos de este artículo son presentar la escala de “Valoración de las actividades de la vida diaria e instrumentales” creada por Mariel Pellegrini, realizar un estudio psicométrico de la fiabilidad y validez de dicha escala, estudiar las relaciones entre el deterioro cognitivo y las variables demográficas con las actividades de la vida diaria básicas e instrumentales. Método: se ha evaluado con ella a 80 pacientes que iniciaron tratamiento en la Unidad de Deterioro Cognitivo. Se ha administrado el Mini-Mental State Examination. Se han realizado análisis de fiabilidad y validez de la escala. Resultados: las dos subescalas o secciones (actividades de la vida diaria básicas y actividades de la vida diaria instrumentales) y el global de la valoración de actividades de la vida diaria e instrumentales cumplieron el criterio Alpha de Cronbach > 0.7. Las puntuaciones to tales de la valoración y de sus dos subescalas (actividades de la vida diaria básicas e instrumentales) diferencian el desempeño funcional entre grupos organizados por edad y sexo, pero no por nivel de funcionamiento cognitivo. Conclusión: la escala presenta un funcionamiento psicométrico adecuado en los pacientes con deterioro cognitivo leve. Se han encontrado relaciones entre la escala Valoración de las actividades de la vida diaria e instrumentales y las variables demográficas estudiadas. Destacar el factor protector de los roles desempañados a lo largo de la vida para el mantenimiento de la autonomía. Tras este estudio disponemos de una escala que va a permitir evaluar los diferentes niveles de actividades de la vida diaria en pacientes con deterioro cognitivo

Correction: Effect of a multicomponent exercise program and cognitive stimulation (VIVIFRAIL-COGN) on falls in frail community older persons with high risk of falls: study protocol for a randomized multicenter control trial

Correction: BMC Geriatrics 22, 612 (2022)After publication of this article [1], the authors reported that the statement in the Funding information section was incorrectly given as ’The present study is funded by a grant from the Spanish Ministry of Science and Innovation and the Instituto de Salud Carlos III (PI20/01546).’ and should have read ’The present study is funded by a grant from the Spanish Ministry of Science and Innovation and the Instituto de Salud Carlos III (PI20/01546), co-financed by FEDER funding’. The original article [1] has been corrected.1 págin

La Historia en la literatura española del siglo XIX

Editors literaris: José Manuel González Herrán, Marisa Sotelo Vázquez, Cristina Carbonell, Hazel Gold, Dolores Thion Soriano-Mollá, Blanca Ripoll Sintes i Jessica Cáliz MontesEste volumen recoge los frutos del VII Coloquio de la Sociedad de Literatura Española del Siglo XIX, celebrado en Barcelona entre el 22 y el 24 de octubre de 2014. El encuentro contó con una nutrida participación de especialistas procedentes de universidades españolas y de otros países europeos, norteamericanas y japonesas. Las cuarenta y siete ponencias se agrupan en seis secciones que abordan los diferentes aspectos de las relaciones entre la literatura y la historia desde el Romanticismo hasta el fin de siglo, así como la interacción de la historia con los distintos géneros literarios, especialmente la novela y el teatro, sin olvidar otras vertientes culturales como la prensa. Asimismo, se dedican sendas secciones monográficas a Benito Pérez Galdós y Emilia Pardo Bazán