Marcadores cognitivos, funcionales y factores de riesgo cardiovascular en la detección del deterioro y declive cognitivos

[ES] Objetivo. Determinar la existencia de marcadores cognitivos, funcionales y factores de riesgo cardiovascular asociados a la detección del deterioro y declive cognitivos en una muestra poblacional urbana de personas mayores de 65 años. Metodología. Estudio prospectivo descriptivo observacional. La muestra basal estaba formada por un total de 313 personas mayores de 65 años, 263 de ellos sin deterioro cognitivo (edad media=75,24, DE=6,69) y 50 con deterioro cognitivo leve (edad media=81,36, DE=8,62). Tras el seguimiento de 2009-2013, la muestra de la evaluación final estaba formada por 109 participantes sin deterioro cognitivo (edad media=77,90, DE=6,84), 13 con deterioro cognitivo leve (edad media=82,62, DE=7,89) y 5 con demencia (edad media=83,60, DE=5,94). Todos los participantes completaron en ambas evaluaciones una batería de test de rastreo cognitivo (Mini-Mental State Examination (MMSE) y Test de los 7 Minutos (7MS)), escalas de funcionalidad (Índice de Barthel e Índice de Lawton y Brody), datos clínicos y sociodemográficos. Resultados. Tras el seguimiento de 2009 a 2013, observamos que los mayores de 65 años del municipio de Salamanca presentan un estado cognitivo general estable y sin afectación cognitiva, una capacidad funcional con una leve dependencia para las actividades básicas de la vida diaria y normal para las instrumentales, y una mayor prevalencia de hipertensión arterial y sedentarismo. Los rendimientos cognitivos y funcionales de los participantes sin deterioro cognitivo y con deterioro cognitivo leve se mantienen estables, aunque estos últimos con leve alteración en el estado cognitivo y funcional, y ambos con mayor prevalencia de hipertensión arterial y sedentarismo. Los participantes con demencia en la evaluación final muestran unos rendimientos cognitivos alterados, dependencia funcional moderada y una mayor prevalencia de hipertensión arterial y sedentarismo. Buenos rendimientos en la evaluación basal en los componentes de orientación espacial y atención y cálculo del MMSE, en el Test del Reloj y Fluidez categorial del 7MS, en la realización de movimientos autónomos en el traslado del sillón a la cama y en las tareas relacionadas con el lavado de ropa son marcadores protectores de deterioro cognitivo. El análisis de clusters muestra tres patrones de agrupación de estado cognitivo en base a los rendimientos en los componentes del MMSE: sin alteración cognitiva, alteración cognitiva leve y alteración cognitiva moderada. Bajas puntuaciones en el Test del Reloj y dependencia en la capacidad para realizar tareas relacionadas con el aseo personal son marcadores de riesgo declive cognitivo. Ningún factor de riesgo cardiovascular se comporta como marcador de riesgo de deterioro o declive cognitivos. La aplicación conjunta de test de rastreo cognitivo, funcional y factores de riesgo cardiovascular mediante el Análisis de Correspondencias Canónico predice los rendimientos en los componentes del MMSE en participantes con declive cognitivo. Conclusiones. Diversos componentes del MMSE, pruebas del 7MS e ítems de las escalas de valoración de la capacidad funcional de las actividades de la vida diaria ayudan determinar el riesgo de deterioro y declive cognitivos. La aplicación de estas pruebas junto con la determinación de la presencia de factores de riesgo cardiovascular permite predecir los rendimientos cognitivos en el declive cognitivo. La valoración por componentes del MMSE aportaría más información sobre la situación de las diferentes funciones cognitivas y podría ayudar a detectar precozmente el deterioro y declive cognitivos

Intelligent Dolls and robots for the treatment of elderly people with dementia

Doll and robot are effective and beneficial non-pharmacological therapies applied in different clinical settings. Doll therapy (DT), principally based in Bowlby's attachment theory, uses an empathy or lifelike baby doll to conduct caring behaviors of it. Robot therapies (RT) use care robots with a friendly attitude and appearance that create emotions and movements that lead to different verbal, motor and emotional reactions. Both DT and RT are person-centred therapies that aim to improve wellbeing of people that suffer from different neurological, psychological and mental health disorders, such as Alzheimer's Disease, autism spectrum disorder, stress or depression, by providing a realistic experience. In this paper, the characteristics of both therapies, their benefits and the possibilities of innovation in the therapeutic field are presented

Desarrollo de un protocolo para la detección del deterioro cognitivo leve y su aplicación en la docencia de la asignatura de Neuropsicología general del Grado en Psicología

Memoria ID-199. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2018-2019

Aplicación del aprendizaje basado en problemas en las asignaturas de psicología fisiológica y neuropsicología general del Grado en Psicología

Memoria ID-218. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2019-2020

Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial

Introduction The intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women. Methods and analysis Here we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019. Ethics and dissemination This study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain (‘CREC of Health Area of Salamanca’), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials. gov provided by the US National Library of Medicine, number NCT03492983. The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.Gerencia Regional de Castilla y León (GRS 1583/B/1

Aplicación del aprendizaje basado en problemas en las asignaturas de psicología fisiológica y neuropsicología general del Grado en Psicología

Memoria ID-218. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2019-2020

Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study)

Background The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. Methods This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient’s daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. Discussion Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults.This study was supported in part by grants funded by the Instituto de Salud Carlos III, Institute of Biomedical Research of Salamanca (IBSAL)-IBY17/00003, and the Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP)-RD16/0007

Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits : qualitative study in seven Spanish regions

Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having implemented some change to promote their health. The most powerful motivators to change lifestyles are having a disease, fear of becoming ill and taking care of oneself to maintain health. Health-care users believe that the main difficulties are associated with the physical, social, working and family environment, as well as lack of determination and motivation. They also highlight the need for more information. In relation to the assets and deficits of the neighbourhood, each group identifies those closer to their role. Generally, participants showed a holistic and positive concept of health and a more traditional, individual approach to health promotion. We consider therefore crucial to depart from the model of health services that focuses on the individual and the disease toward a socio-ecological health model that substantially increases the participation of health-care users and emphasizes health promotion, wellbeing and community participation