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

Sex-Differences in Health-Related Characteristics of Senior Center Users: The VERISAÚDE Study

[Abstract] Background: We explored sex-related differences in sociodemographic, medical, psychological, and functional conditions in older adults attending to senior citizens’ centers. Materials and Methods: An exploratory study was conducted as part of the VERISAÚDE project, a cross-sectional population-based study of individuals aged ≥65 years enrolled in senior community centers located in Galicia, Northwest of Spain (n = 749). A comprehensive gerontological evaluation was used to assess the social, medical, psychological, and functional characteristics of the sample. Results: Women presented a higher prevalence of frailty (p = 0.017), a higher risk of malnutrition (p = 0.029), more medication consumption (p = 0.002), and polypharmacy (p = 0.008), higher depressive scores (p = 0.007), and lower cognitive scores (p = 0.045) than men, who showed a higher prevalence of hearing impairment (p = 0.034), toxic habits (all ps = 0.0001), and comorbidity (p = 0.002), and better quality of life (p = 0.030), and social resources (p = 0.002). Participants considered that attending and being involved in senior centers has a positive influence on their health and promotes successful aging. Discussion: Important differences were found between women and men in health variables, suggesting that sex exerts a powerful influence on health status in older age. These differences should be identified and taking into account when designing interventions to promote active aging and to improve the quality of life of older adults. Taking a sex perspective during the evaluation process could lead to a higher number of older people being effectively treated in clinical practice.Xunta de Galicia; ED431C 2017/49Xunta de Galicia; ED431F 2017/09Xunta de Galicia; IN607C 2016/08Xunta de Galicia; EM 2012/100-VERISAÚDE ProjectThis work was supported by the Xunta de Galicia (ED431C 2017/49, ED431F 2017/09, FrailNet network IN607C 2016/08, and EM 2012/100-VERISAÚDE Project: Effectiveness of the Comprehensive Gerontological Assessment and longitudinal follow-up in the healthy aging promotion). LL-L 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 Fun

Changes in frailty status in a community-dwelling cohort of older adults: the VERISAÚDE study

[Abstract] Objectives: Greater understanding of changes in the degree of frailty is important for clarifying the natural history of frailty and may help clinical decision-making regarding preventive interventions. The objectives of this study were to explore natural frailty transition rates at 1-year follow-up and to identify the main determinants of such transitions. Study design: Prospective longitudinal study covering a representative sample of community-dwelling older adults aged ≥65 years (n = 749) at baseline, and transition information at 1-year follow-up (n = 537). Mean outcome measures: The assessment of frailty status was based on phenotypic criteria (unintentional weight loss, weakness, exhaustion, slow walking speed, low physical activity). Frailty transitions (progressed, regressed, no change, or death) and associated factors were assessed. Results: Most participants remained unchanged from their baseline status (57.1% non-frail, 83.4% pre-frail, 66.7% frail). Regarding frailty transitions, 42.9% of non-frail older adults at baseline had progressed to a pre-frail status by the 1-year follow-up, and 7.9% of pre-frail older adults had become frail. Importantly, 33.3% of frail older adults regressed to a pre-frail status and 8.7% of pre-frail adults had regressed to a non-frail status. Non-frail females tended to progress to pre-frailty significantly more than males (p = 0.006), and mortality was higher among participants classified as frail at baseline (10.7%). Logistic regression showed that the main determinants of worsening frailty were hearing impairment (OR 3.180; 95% CI 1.078–9.384), congestive heart failure (OR 10.864; 95% CI 1.379–85.614), and polypharmacy (OR 2.572, 95% CI 1.096–6.037). Conclusion: Our results confirm the dynamic of frailty and the bidirectional nature of frailty transitions, and indicate the need for preventing and treating these conditions in later life in order to minimize the burden of frailty.Xunta de Galicia; EM 2012/100Xunta de Galicia; ED431C 2017/49Xunta de Galicia; IN607C, 2016/0

Temporomandibular juxtaarticular chondroma : case report

Chondromas are benign tumours composed of mature hyaline cartilage. We present here the first case in the English language medical literature of juxtaarticular chondroma of the temporomandibular joint in the parotid region. Within the rarity of cartilage disorders of the temporo-mandibular joint (TMJ), this particular condition is a diagnostic curiosity. The patient, a 54 year old woman, presented a right preauricular tumour of 3.5 cm. which had been developing for 4 years. It was not painful but there was a recent symptomology of TMJ dysfunction, with pain and clicks. The diagnostic possibilities of a parotid pleomorphic adenoma and of a cartilage tumour of the TMJ suggested a difficult preoperative differential diagnosis, which influenced our approach regarding therapy. The tumour was excised, preserving the parotid gland. This enabled us to confirm the histological diagnosis of chondroma, composed solely of chondroide tissue. We have described the clinical characteristics of our case, and carried out a review of the relevant literature, emphasising the differential diagnoses

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

Análisis desde "El nuevo espíritu del capitalismo" de L. Boltanski y E. Chiapello sobre la vigencia de M. Weber, M. Horkheimer y T.W. Adorno.

Es un trabajo de filosofía social que trata de analizar la vigencia de autores clásicos en la sociedad contemporánea. Para ello, se utiliza la descripción de la sociedad actual que se expone en el libro "El nuevo espíritu del capitalismo" de Luc Boltanski y Ève Chiapello, y también las estructuras, categorías y conceptos que estos autores emplean. Desde ahí, el trabajo consiste en comprobar si las teorías de Max Weber, por un lado; y de Max Horkheimer y Theodor W. Adorno en "Dialéctica de la Ilustración" siguen siendo útiles y vigentes para analizar la sociedad contemporánea o no. Y también si sus demandas han sido satisfechas por el capitalismo o no.La elección de estos autores se debe a su situación como representantes de lo que Boltanski y Chiapello denominan "crítica artista". Algo específico del actual capitalismo sería haber asimilado y asumido como propias, de ahí que resulte interesante utilizar esos autores. Las conclusiones del trabajo son que, si bien algunas de las demandas que Weber, Horkheimer y Adorno reclaman siguen siendo valiosas (pues la solución a ellas del capitalismo es sólo aparente), la forma de reclamarlas, es decir, los análisis que dan lugar a esas demandas, no habría resistido el paso del tiempo. Por ello, estos autores resultan inútiles para hablar de la sociedad actual.<br /

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

Efficacy of a computerized cognitive training application on cognition and depressive symptomatology in a group of healthy older adults: a randomized controlled trial

[Abstract] Objective. The purpose of this study was to evaluate the efficacy of a multimedia and interactive cognitive program on cognition and depressive symptomatology in healthy older adults. Methods. Adults aged ≥65 years were randomly assigned to two groups: the experimental group in which the participants received a computerized cognitive training application; and the control group in which the participants received no intervention during the protocol. Performance on the mini-mental state examination (MMSE) and the short-form of the geriatric depression scale (GDS-SF) were analysed using a three-way repeated-measure analysis of variance. Results. To determine cognition after the training, the cognitive program was used and the results were assessed using the MMSE, indicating that the significant time effects within the groups reflected the score for cognitive assessment that was significantly better after the intervention in the experimental group. No significant differences were observed with regard to the depressive symptomatology or between the groups according to sex or educational level on the two dimensions previously established (cognition and depressive symptomatology). Conclusion. The development of technological applications for intervention in older adults is increasing. Based on the established objective, we can conclude that the computerized intervention may constitute a good alternative to enhance the cognitive status in older people

Nutritional determinants of frailty in older adults: a systematic review

[Abstract] Background. Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults. Methods. PubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles. Results. Of the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty. Conclusions. This systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty syndrome in older adults. However, more longitudinal studies on this topic are required to further understand the potential role of nutrition in the prevention, postponement, or even reversion of frailty syndrome.Xunta de Galicia; IN607C, 2016/0

The impact of hearing loss on language performance in older adults with different stages of cognitive function

[Abstract] Purpose. The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. Materials and methods. Participants were distributed into two groups according to Reisberg’s Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1–3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. Results. Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=−0.298; P<0.003) was observed in the predementia group (r=−0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. Conclusion. In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly