El neuroticismo y la extraversión de los cuidadores de personas con demencia como factores moduladores de la sobrecarga asistencial

[Resumen] Introducción Los cuidadores de personas con demencia tienen más altos niveles de sobrecarga en comparación con otros cuidadores, centrándose la mayoría de los estudios en factores inmediatos, como los déficits cognitivos, factores psicológicos y conductuales; sin considerar la personalidad. Objetivos - Estudiar la influencia de la personalidad en relación a la sobrecarga - Analizar los efectos del cuidado sobre la afectividad - Examinar la relación entre la personalidad y la morbilidad psíquica Método Estudio transversal con 33 cuidadores que presentaban sobrecarga intensa. Se evalúa su personalidad, afectividad y salud percibida. Resultados El neuroticismo estaba significativamente correlacionado con la sobrecarga (r = 0,60, p< 0,01), la depresión (r = 0,68, p< 0,01) y la ansiedad estado (r = 0,46, p < 0,01) y rasgo (r = 0,67, p< 0,01). La extraversión lo estaba con el neuroticismo (r = -0,42, p< 0,01) y la sobrecarga (r=-0,46, p< 0,01). La depresión correlacionaba con la ansiedad estado (r = 0,63, p < 0,01) y rasgo (r = 0,66, p < 0,01). Conclusiones La personalidad del cuidador ejerce una importante influencia sobre la percepción de la carga, por lo que es necesario tenerla en cuenta en los modelos teóricos y empíricos del proceso del cuidado.[Resumo] Introdución Os coidadores de persoas con demencia teñen máis altos niveis de sobrecarga en comparación con outros coidadores, centrándose a maioría dos estudos nos factores inmediatos, como os déficits cognitivos, factores psicolóxicos e condutuais; sen considerar a personalidade. Obxectivos: - Estudar a influencia da personalidade en relación á sobrecarga - Analizar os efectos do coidado sobre a afectividade - Examinar a relación entre a personalidade e a morbilidade psíquica Método Estudo transversal con 33 coidadores que presentaban sobrecarga intensa. Avalíase a súa personalidade, afectividade e saúde percibida. Resultados O neuroticismo estaba significativamente correlacionado coa sobrecarga (r = 0,60, p< 0,01), a depresión (r = 0,68, p< 0,01) e a ansiedade estado (r = 0,46, p < 0,01) e rasgo (r = 0,67, p< 0,01). A extraversión estábao co neuroticismo (r = -0,42, p< 0,01) e a sobrecarga (r=-0,46, p< 0,01). A depresión correlacionaba coa ansiedade estado (r = 0,63, p < 0,01) e rasgo (r = 0,66, p < 0,01). Conclusións A personalidade do coidador exerce unha importante influencia sobre a percepción da carga, polo que é necesario tela en conta nos modelos teóricos e empíricos do proceso de coidado.[Abstract] Background Dementia caregiver´s have higher levels of burden compared to other caregivers, being most of the studies focused on the immediate factors, such as the cognitive deficits, behavioural and psychological factors; without considering caregiver´s personality. Objectives: - To study personality influence related to perceived burden - To analyze the caring effects on affectivity - To examine the correlation between the personality and psychic morbidity Methods A cross-sectional study was conducted with 33 caregivers who had intense burden levels. Their personality, affectivity and self-rated health were evaluated. Results Neuroticism was significantly correlated with burden (r = 0.6, p < 0.01), depression (r = 0.68, p < 0.01) and both anxiety measures, state (r = 0.46, p < 0.01) and trait (r = 0.67, p < 0.01). Extraversion was significantly correlated with neuroticism (r = -0.42, p < 0.01) and burden (r = -0.46, p < 0.01). Depression was significantly correlated with state (r = 0.63, p < 0.01) and trait anxiety (r = 0.66, p < 0.01). Conclusions: Caregiver's personality exerts an important influence on the perception of burden, so it's necessary to have this in mind in the theoretical and empirical models regarding the caregiving proces

The influence of neuroticism and extraversion on the perceived burden of dementia caregivers: an exploratory study

[Abstract] Most studies reflect dementia caregivers usually sustain higher levels of burden compared to other caregivers. However, they do not consider variability within the caregiver, such as personality traits. The purpose of this study was to examine the influence of extraversion and neuroticism on dementia caregiver burden. A cross-sectional descriptive study was conducted with 33 caregivers looking after demented-patients. All caregivers had intense burden levels, and their personality, depression, anxiety and self-rated health were evaluated. Personality variables had important effects on the caregiver burden and consequences on their mental health. Neuroticism was significantly correlated with burden (r = 0.6, p < 0.01), depression (r = 0.68, p < 0.01) and both anxiety measures, state (r = 0.46, p < 0.01) and trait (r = 0.67, p < 0.01). Extraversion was significantly correlated with neuroticism (r = 0.42, p < 0.01) and burden (r = 0.46, p < 0.01). Finally, depression was significantly correlated with state (r = 0.63, p < 0.01) and trait anxiety (r = 0.66, p < 0.01). These results indicate the importance of considering the caregiver personality in the theoretical and empirical models of the caring process. It is necessary to adequately assess the caregiver personality, as those presenting high levels of neuroticism and low levels of extraversion are more vulnerable to experience negative caring effects

Non-invasive diagnostic and prognostic evaluation of liver cirrhosis and portal hypertension

Cirrhosis is the final stage of most of chronic liver diseases, and is almost invariably complicated by portal hypertension, which is the most important cause of morbidity and mortality in these patients. This review will focus on the non-invasive methods currently used in clinical practice for diagnosing liver cirrhosis and portal hypertension. The first-line techniques include physical examination, laboratory parameters, transient elastography and Doppler-US. More sophisticated imaging methods which are less commonly employed are CT scan and MRI, and new technologies which are currently under evaluation are MR elastography and acoustic radiation force imaging (ARFI). Even if none of them can replace the invasive measurement of hepatic venous pressure gradient and the endoscopic screening of gastroesophageal varices, they notably facilitate the clinical management of patients with cirrhosis and portal hypertension, and provide valuable prognostic information

Prevalence of cognitive impariment: effects of level of education, age, sex, and associated factors

[Abstract] Aims: To examine the prevalence of cognitive impairment in a Spanish elderly population and to analyse its association with some social and medical factors. Methods: We randomly selected a representative sample (n = 600) of people over 65 from Narón Council (A Coruña). Socio-demographic and biomedical data were collected and cognitive status was assessed using the Mini-Mental State Examination (MMSE). Results: We determined variations in the prevalence from 35.2%, when age or level of education distribution was not applied, to 22.2% when they were applied. Women showed a higher probability of cognitive impairment than men. Negative correlation was observed between the age of the subject and the MMSE secore (Spearman correlation p = -0.45, p < 0.001), with the possibility of developing cognitive impairment increasing each year. For our sample, cognitive impairment was associated with an increase of morbidity and mortality in the elderly population. This association was found with the presence of dementia. heart failure. anaemia, stroke and auditory deficits. Conclusions: Knowledge of the real prevalence rates, together with the establishment of adequate preventive and intervention measures, can be factors that may diminish the socio-sanitary impact of cognitive impairment

Risk factors of high burden caregivers of dementia patients institutionalized at day-care centres

[Abstract] We examined which variables are associated with day care centres utilization among caregivers of dementia patients. A cross-sectional analysis of sociodemographic variables, relationship with caring and psychological aspects was conducted in 58 informal caregivers with intense burden. 58.6 % used day care assistance and 41.4 % did not. The results showed the importance of the commitment between the caregiver and their family and friends. The use of day care services is independent of the age, gender, educational level, marital status, occupation and relationship with the patient. However, in the multivariate analysis the provision of help by families and friends predicted the use of day care assistance. The bivariate analysis showed a significant relationship between depressive symptoms and self-rated health with day care attendance. Screening the help provision from families and friends in caregivers of dementia patients with intense burden would be relevant to design interventions which delay their institutionalization and reduce costs

Los fármacos más consumidos en personas mayores con estado nutricional deteriorado

ResumenXunta de Galicia; ED431C2017/49Xunta de Galicia; IN607C 2016/0

Effects of multisensory stimulation on a sample of institutionalized elderly people with dementia diagnosis: a controlled longitudinal trial

[Abstract] Long-term effects of multisensory stimulation were assessed using a ‘‘Snoezelen’’ room on older residents with dementia. Thirty patients were randomly assigned to 3 groups: multisensory stimulation environment (MSSE) group, individualized activities (activity) group, and control group. The MSSE and activity groups participated in two 30-minute weekly individualized intervention sessions over 16 weeks. Pre-, mid-, posttrial, and 8-week follow-up behavior, mood, cognitive, and functional impairment in basic activities of daily living were registered. Items included in the physically nonaggressive behavior factor improved significantly in post- versus pretrial in the MSSE group compared to the activity group, with no significant differences between MSSE and control groups. The MSSE and activity groups demonstrated behavior improvements and higher scores on the Cohen-Mansfield agitation inventory, verbal agitated behavior factor, and Neuropsychiatric Inventory–Nursing Home, with no significant differences between groups. The MSSE could have long-term positive effects on such neuropsychiatric symptoms in older people with dementia

Accesibility and usability of computer-based cognitive stimulation: Telecognitio®

[Resumen] Introducción: A pesar del gran avance de la tecnología en el campo de la intervención cognitiva computarizada, existen muy pocos estudios que sirvan de guía para la mejora del diseño de este tipo de herramientas dirigidas a las personas mayores. El objetivo principal de este trabajo es realizar una aproximación al grado de adaptación de dos aplicaciones de psicoestimulación utilizadas en nuestro medio. Así´ mismo, a través de la observación de los problemas de uso de estas dos aplicaciones uso en una pequeña muestra de personas mayores, se elabora una tabla de requisitos mínimos que a nuestro juicio deberían cumplir. Finalmente, se presenta Telecognitio®, una aplicación para la estimulación cognitiva de los mayores que incorpora ciertas funcionalidades de interés. Material y métodos: Se evalúa el uso de dos herramientas de intervención cognitiva sobre una muestra de sujetos mayores a través de un cuestionario elaborado al efecto. Se realiza un análisis descriptivo de los resultados obtenidos y se sugieren posibles relaciones entre los resultados y el nivel cognitivo del sujeto. Resultados: Observamos que las personas mayores, especialmente si tienen deterioro cognitivo, presentan dificultades en la comprensión de los enunciados que transmiten las instrucciones para las diferentes actividades. Así mismo, el tiempo para responder a las cuestiones planteadas parece ser insuficiente. Cuando la pantalla es táctil se producen errores, tanto de precisión como de mantenimiento de la presión, aunque el uso de este dispositivo resulte más intuitivo que el ratón convencional. Conclusiones: Las aplicaciones computarizadas de valoración y estimulación cognitiva van a constituirse en herramientas de uso generalizado entre la población de personas mayores, por lo que sería conveniente adaptarlas mejorando su accesibilidad y usabilidad.[Abstract] Introduction: Despite of the huge technological advance in the field of computer-based cognitive interventions, very few applications have been designed to be used by the elderly. The main objective of this study was to assess the adaptability of two psycho-stimulation applications used in geriatrics. A further aim was to design a table of the minimum requirements to be met through the use of these applications in a small sample of elders. In addition, Telecognitios® —an application with some interesting functionalities— is presented. Material and methods: We performed a pilot test of two cognitive intervention tools, which were evaluated by a sample of elderly people through a specifically designed questionnaire. A descriptive study of the results was performed, as well as of the possible correspondence between the subjects’ cognitive status and the results. Results: The results of this study indicate that, in general, elderly people and especially those with cognitive impairment had difficulties in understanding the instructions for the various activities, as well as little time to answer the questions. In the case of a touch screen, errors occurred, both due to accuracy and pulse time, although this device is more intuitive than the conventional mouse. Conclusions: Computer-based cognitive stimulation and evaluation applications will become widely used among the elderly. Therefore, these applications should be adapted for universal accessibility and usability

A Novel Automatic Method to Estimate Visual Acuity and Analyze the Retinal Vasculature in Retinal Vein Occlusion Using Swept Source Optical Coherence Tomography Angiography

[Abstract] The assessment of vascular biomarkers and their correlation with visual acuity is one of the most important issues in the diagnosis and follow-up of retinal vein occlusions (RVOs). The high workloads of clinical practice make it necessary to have a fast, objective, and automatic method to analyze image features and correlate them with visual function. The aim of this study is to propose a fully automatic system which is capable of estimating visual acuity (VA) in RVO eyes, based only on information obtained from macular optical coherence tomography angiography (OCTA) images. We also propose an automatic methodology to rapidly measure the foveal avascular zone (FAZ) area and the vascular density (VD) in the superficial and deep capillary plexuses in swept-source OCTA images centered on the fovea. The proposed methodology is validated using a representative sample of 133 visits of 50 RVO patients. Our methodology estimates VA with very high precision and is even more accurate when we integrate depth information, providing a high correlation index of 0.869 with the real VA, which outperforms the correlation index of 0.855 obtained when estimating VA from the data obtained by the semiautomatic existing method. In conclusion, the proposed method is the first computational system able to estimate VA in RVO, with the additional benefits of being automatic, less time-consuming, objective and more accurate. Furthermore, the proposed method is able to integrate depth information, a feature which is lacking in the existing method.Mutua Madrileña; 2017/365

Multisensory stimulation on mood, behavior, and biomedical parameters in people with dementia: is it more effective than conventional one-to-one stimulation?

[Abstract] The purpose of this study was to assess the effects of multisensory stimulation in a multisensory stimulation environment (MSSE) such as a Snoezelen room versus one-to-one activity sessions with regard to mood, behavior, and biomedical parameters (heart rate and blood oxygen saturation). The MSSE group and activity group (one-to-one activities) of patients with dementia participated in 2 weekly individualized intervention sessions over 16 weeks, where mood and behavior before, during, and after the sessions, and biomedical parameters immediately before and after, were recorded. Immediately after the sessions, patients spoke more spontaneously, related better to others, were more attentive to their environments, more active/alert, less bored/inactive, and more relaxed/content. Both groups exhibited decreases in heart rate and increases in oxygen saturation (SpO2) values from before to after the sessions. The MSSE sessions in a Snoezelen room were found to be as effective as activity sessions, highlighting the importance of the one-to-one interaction with the therapist