Tradução e adaptação transcultural da versão brasileira do Inventário de Ansiedade Geriátrica (GAI) = Translation and cross-cultural adaptation of the Brazilian version of the Geriatric Anxiety Inventory (GAI)

Introduction: There has been a growing interest in the cross-cultural adaptation of instruments for assessment of anxiety, but studies involving anxiety specifically in the geriatric population is still unusual. Thus, there is a lack of instruments designed to comply with this population. Translation and cultural adaptation is the first step to providing comparisons between different cultural contexts. Objective: Elaborate the semantic equivalence of the Geriatric Anxiety Inventory to Brazilian Portuguese. Method: The cross-cultural adaptation process consisted in four steps: two translations, two back- translations, both made by independent translators, the development of a synthetic version, and a pretest applied in a population sample. Results: For each item of the instrument, we present the results of four steps. Throughout the process, any problems found could be solved by ensuring the quality of the instrument and its appropriateness to the population to which it is intended. Discussion: The use of four-step method proved effective and safe in the process of semantic equivalence

Comparison of neuropsychological functioning in Alzheimer's disease and frontotemporal dementia

Compared the archival neuropsychological data of 15 frontotemporal dementia (FTD) patients (mean age 63.9 yrs), 16 Alzheimer's disease (AD) patients (mean age 70.3 yrs), and 16 controls were compared. Controls outperformed both patient groups on measures of verbal and nonverbal memory, executive ability, and constructional skill, with AD patients showing more widespread memory decline. Patient groups differed only in nonverbal memory, with FTD patients performing significantly better than AD patients. Patient groups also differed in pattern of performance across executive and memory domains. Specifically, AD patients exhibited significantly greater impairment on memory than executive tasks, whereas the opposite pattern characterized the FTD group. Findings suggest that examination of relative rankings of scores across cognitive domains, in addition to interpretation of individual neuropsychological scores, may be useful in differential diagnosis of FTD vs AD

Homebound Elderly People Psychotherapeutic Intervention (HEPPI): study protocol for a randomized controlled trial

OBJECTIVE: To present the study protocol for the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention aimed at homebound older adults with mild cognitive impairment and depression and/or anxiety symptoms. METHODS: A two-arm, open-label, parallel-group randomized controlled trial will be conducted to compare the effects of HEPPI with treatment as usual. Homebound older adults will be recruited from the community through contact with their health care networks in mainland Portugal. All participants will complete baseline, post-intervention, and 3-month follow-up assessments. Primary outcomes will be changes in episodic memory and depression and anxiety symptoms. Secondary outcomes will include changes in general cognition, attentional control, subjective memory complaints, quality of life, functional status, and loneliness. RELEVANCE: The availability of evidence-based home-delivered non-pharmacological interventions meeting the cognitive and emotional needs of the homebound older population could improve their access to mental health care resources and increase their mental health and quality of life.</p

Tradução e adaptação transcultural da versão brasileira do Inventário de Ansiedade Geriátrica (GAI)

INTRODUÇÃO: É crescente a produção científica brasileira referente à adaptação de instrumentos utilizados internacionalmente para avaliação de ansiedade, porém a realização de estudos envolvendo ansiedade, especificamente na população geriátrica, ainda é menos frequente. Com isso, existe carência de instrumentos de medida criados com finalidade de atender essa população. A tradução e a adaptação transcultural são o primeiro passo para disponibilização de uma medida para investigação em diferentes contextos culturais, permitindo, desse modo, estudos comparativos. OBJETIVO: Elaborar a equivalência semântica da Geriatric Anxiety Inventory para o português brasileiro. MÉTODO: O processo foi realizado em quatro etapas: duas traduções; duas retrotraduções, ambas realizadas por tradutores cegos entre si e ao instrumento original; elaboração de uma versão sintética e pré-teste realizado com uma amostra da população-alvo. RESULTADOS: Para cada item do instrumento, apresentam-se os resultados das quatro etapas. Ao longo do processo, eventuais problemas detectados puderam ser resolvidos, garantindo a qualidade do instrumento e sua adequação à população à qual se destina. CONCLUSÃO: A utilização do método em quatro etapas demonstrou ser eficaz e segura para o processo de equivalência semântica

Listening to preferred music with people with severe dementia who wander: A feasibility study

Using a modified protocol found to be effective in reducing agitation in people with dementia, we trialled the feasibility of using listening to preferred music with people with severe dementia who wander in residential aged care. Ten residents listened to their selection of preferred music for 20 minutes daily for 3 weeks under two conditions: immediately before unique peak activity periods or at randomly selected times. Of the 150 scheduled interventions, 92 were commenced and 60% of these were tolerated for the full 20 minutes. Sessions did not proceed when the participant refused (n=37), was asleep (n=12) or was not available (n=9). The intervention stopped prematurely when headphones were removed (n=20) or the participant walked away from the speaker (n=12). Despite the relatively high number of interventions that did not proceed, those who participated were observed to express more positive (58%) or neutral (32%) mood, with negative mood only recorded during 10% of the observation time. In addition, while not statistically significant, participants were observed to walk and enter the private space of others less frequently during the intervention period.These findings were consistent with staff and family member’s views. Further investigations are needed to explore the high refusal rates as well as generalisation of effects beyond the intervention tim

A single-blind, parallel-group randomised trial of a Technology-assisted and remotely delivered Cognitive Behavioural Therapy intervention (Tech-CBT) versus usual care to reduce anxiety in people with mild cognitive impairment and dementia: study protocol for a randomised trial

Abstract Background Anxiety is commonly experienced by people living with mild cognitive impairment (MCI) and dementia. Whilst there is strong evidence for late-life anxiety treatment using cognitive behavioural therapy (CBT) and delivery via telehealth, there is little evidence for the remote delivery of psychological treatment for anxiety in people living with MCI and dementia. This paper reports the protocol for the Tech-CBT study which aims to investigate the efficacy, cost-effectiveness, usability and acceptability of a technology-assisted and remotely delivered CBT intervention to enhance delivery of anxiety treatment for people living with MCI and dementia of any aetiology. Methods A hybrid II single-blind, parallel-group randomised trial of a Tech-CBT intervention (n = 35) versus usual care (n = 35), with in-built mixed methods process and economic evaluations to inform future scale-up and implementation into clinical practice. The intervention (i) consists of six weekly sessions delivered by postgraduate psychology trainees via telehealth video-conferencing, (ii) incorporates voice assistant app technology for home-based practice, and (iii) utilises a purpose-built digital platform, My Anxiety Care. The primary outcome is change in anxiety as measured by the Rating Anxiety in Dementia scale. Secondary outcomes include change in quality of life and depression, and outcomes for carers. The process evaluation will be guided by evaluation frameworks. Qualitative interviews will be conducted with a purposive sample of participants (n = 10) and carers (n = 10), to evaluate acceptability and feasibility, as well as factors influencing participation and adherence. Interviews will also be conducted with therapists (n = 18) and wider stakeholders (n = 18), to explore contextual factors and barriers/facilitators to future implementation and scalability. A cost-utility analysis will be undertaken to determine the cost-effectiveness of Tech-CBT compared to usual care. Discussion This is the first trial to evaluate a novel technology-assisted CBT intervention to reduce anxiety in people living with MCI and dementia. Other potential benefits include improved quality of life for people with cognitive impairment and their care partners, improved access to psychological treatment regardless of geographical location, and upskilling of the psychological workforce in anxiety treatment for people living with MCI and dementia. Trial registration This trial has been prospectively registered with ClinicalTrials.gov: NCT05528302 [September 2, 2022]