Validation and measurement invariance of the Scale of Positive and Negative Experience (SPANE) in a spanish general sample

Well-being has been measured based on different perspectives in positive psychology. However, it is necessary to measure affects and emotions correctly and to explore the independence of positive and negative affect. This cross-sectional study adapts and validates the Scale of Positive and Negative Experience (SPANE) with a non-probabilistic sample of 821 Spanish adults. A confirmatory factor analysis confirmed two related factors with two correlated errors. The average variance extracted was 0.502 for negative affect (SPANE-N) and 0.588 for positive affect (SPANE-P). The composite reliability was 0.791 for SPANE-N and 0.858 for SPANE-P. Measurement invariance analysis showed evidence of scalar invariance. Item-total corrected polyserial correlations showed values between 0.47 and 0.76. The path analysis used to test temporal stability, and the structural equation models used to test convergent and concurrent validity with other well-being measures, showed good fit. All path coefficients were statistically significant and over 0.480. For the validity models, the magnitude of the correlations was large and in the expected direction. The Spanish version of the SPANE show good psychometric properties. Future studies of emotional well-being in Spain can benefit from the use of this scale, and new studies must test cross-cultural invarianc

The Longitudinal Association Between a Discrepancy Measure of Anosognosia in Patients with Dementia, Caregiver Burden and Depression

Anosognòsia; Cuidadors; Estudis longitudinalsAnosognosia; Cuidadores; Estudios longitudinalesAnosognosia; Caregivers; Longitudinal studiesBackground: According to cross-sectional studies, there is an association between anosognosia in people with dementia and caregiver’s burden and depression. Anosognosia in patients may be a cause of caregiver burden and depression. However, variability in caregiver anosognosia ratings may exist as caregivers with burden and depression may have a more pessimistic view of the patients’ health. Objective: To assess the variability of caregiver anosognosia ratings of patients with dementia using a widely used anosognosia scale and its longitudinal relationship with caregiver burden and depression. Methods: A convenience cohort of 221 consecutive dementia outpatient and caregiver dyads was followed up at 12 and 24 months. The main instruments used were the Anosognosia Questionnaire-Dementia (AQ-D), Caregiver Burden Interview, and Geriatric Depression Scale. Linear mixed models were used including time as a factor in every model. Multivariate analyses controlled for caregiver’s socio-demographic and possible confounding factors. Results: Attrition at 12 and 24 months was 24.9% and 42.5% respectively. Patients at baseline were on average 77.8 years of age, 63.3% were women, and 63.3% had < 5 years of education. In the bivariate analyses, caregiver burden, depression, and gender were associated with caregiver ratings of total, cognitive, and personality AQ-D of the patient at different time points. Multivariate analyses revealed burden as the caregiver variable most consistently associated with total, cognitive, and personality caregiver AQ-D ratings of the patient. Conclusion: Some caregiver characteristics, especially burden, are associated with caregiver ratings of AQ-D with regard to the patientPSI 2010-1901

Promoting Alzheimer's Risk-Reduction through Community-Based Lifestyle Education and Exercise in Rural America: A Pilot Intervention

Introduction. Rural Americans (RA) have poorer vascular health and physical activity levels than their urban counterparts; all are dementia risk factors. Dementia risk reduction among rural individuals requires a tailored approach. The purpose of this project was to examine preliminary efficacy of a community-based physical exercise and/or dementia risk factor-reduction curriculum among rural adults 50 and older. Methods. Seventy-five rural dwelling adults 50 and older were randomized to one of three groups: 1) 10 weeks of Alzheimer’s disease risk-reduction education (ED), 2) risk-reduction education and supervised exercise (EDEX) or 3) control group (CON). Outcomes included baseline to 10-week follow-up difference in dementia knowledge (primary outcome) and physical activity, muscular endurance, healthy lifestyle engagement, and anthropometrics (secondary outcomes). Results. Sixty-nine adults successfully completed the 10-week study. Dementia knowledge increased in a Treatment Arm-dependent manner (χ2 = 6.95 (2), p = 0.03), being ED and EDEX superior to CON. Engagement in healthy lifestyle behaviors did not change statistically. However, participation specifically in physical activity increased over time (χ2 = 11.47 (2), p = 0.003) with EDEX reporting the greatest increases. No significant change in average daily steps was observed for any group. Conclusion. The results suggested dementia risk-reduction education, both with and without structured exercise, leads to improvements in dementia knowledge. When coupled with regular, supervised exercise, this education intervention also helped participants increase engagement in physical activity over 10 weeks. Tailored interventions that combine Alzheimer’s disease education and regular, supervised exercise may help reduce dementia risk in rural communities

The longitudinal association between a discrepancy measure of anosognosia in patients with dementia, caregiver burden and depression

Background: According to cross-sectional studies, there is an association between anosognosia in people with dementia and caregiver's burden and depression. Anosognosia in patients may be a cause of caregiver burden and depression. However, variability in caregiver anosognosia ratings may exist as caregivers with burden and depression may have a more pessimistic view of the patients' health. Objective: to assess the variability of caregiver anosognosia ratings of patients with dementia using a widely used anosognosia scale and its longitudinal relationship with caregiver burden and depression. Methods: A convenience cohort of 221 consecutive dementia outpatient and caregiver dyads was followed up at 12 and 24 months. The main instruments used were the Anosognosia Questionnaire-Dementia (AQ-D), Caregiver Burden Interview, and Geriatric Depression Scale. Linear mixed models were used including time as a factor in every model. Multivariate analyses controlled for caregiver's socio-demographic and possible confounding factors. Results: Attrition at 12 and 24 months was 24.9% and 42.5% respectively. Patients at baseline were on average 77.8 years of age, 63.3% were women, and 63.3% had <5 years of education. In the bivariate analyses, caregiver burden, depression, and gender were associated with caregiver ratings of total, cognitive, and personality AQ-D of the patient at different time points. Multivariate analyses revealed burden as the caregiver variable most consistently associated with total, cognitive, and personality caregiver AQ-D ratings of the patient. Conclusion: Some caregiver characteristics, especially burden, are associated with caregiver ratings of AQ-D with regard to the patient

Patient Polypharmacy use Following a Multi-Disciplinary Dementia Care Program in a Memory Clinic: A Retrospective Cohort Study

Introduction. Dementia increases the risk of polypharmacy. Timely detection and optimal care can optimize the prognosis for patients with dementia, which may in turn reduce polypharmacy. We aimed to compare the change in polypharmacy use among memory clinic patients living with dementia who participate in a dementia care program, vs those who did not. We hypothesized that patients in the dementia care program would reduce their use of polypharmacy compared to those who were not in the program. Methods. We retrospectively analyzed EMR data from a university memory clinic. The final analytic sample consisted of 381 patients: 107 in the program and 274 matched patients not in the program. We used logistic regression of outcomes (five or more concurrent medications) at follow-up, controlled for the same outcome at baseline to assess the change in polypharmacy, and stratified outcomes by prescription and over-the-counter. Results. The two groups did not differ in the use of five or more total and prescription medications at follow-up controlling for the use of 5 or more of the respective medications at baseline and covariates. Being in the program was associated with a threefold lower odds of using 5 or more over-the-counter medications at follow-up (OR=0.30; p&lt;0.001) after controlling for using 5 or more over-the-counter medications at baseline and covariates. Conclusions. Dementia care might reduce polypharmacy of over-the-counter medications, potentially reducing risky medication-medication interactions. More research is needed to infer causality and understand how to reduce prescription medication polypharmacy

Health and ageing : Active ageing in older adults and health related quality of life in people with dementia

The continuing growth of older age groups worldwide needs an increased understanding of the ageing phenomena. For this reason, the present thesis is aimed at two very important outcomes in the elderly, active ageing (AA) in older adults and health-related quality of life (HRQL) in people with dementia. To do this, I have participated in different studies and used different research methodologies. In the first publication of this thesis, I study the distribution and associations with sociodemographic variables of different definitions of AA in a large adult population sample in Spain, Poland and Finland. The next publication reviews the previous literature on HRQL instruments for dementia in order to understand such complex concept and compare the different instruments in terms of for example data collection method or purpose of assessment. In the last publication, I explore the distribution of HRQL in the very old population in Cambridge by creating a new instrument using an already existing conceptual framework. Note: data from Courage Project (http://www.courageineurope.eu/) used for the thesis.El continuo envejecimiento de la población mundial hace que sea necesario entender mejor este fenómeno. Por esta razón, la presente tesis doctoral tiene como objetivo estudiar dos variables muy importantes en la gente mayor, envejecimiento activo (AA) en la gente mayor y calidad de vida relacionada con la salud (HRQL) en gente con demencia. Para ello, he participado en diferentes estudios y he utilizado diferentes metodologías de investigación. En la primera publicación de esta tesis, estudio la distribución y asociación de diferentes definiciones de AA con variables sociodemográficas en una amplia muestra poblacional de España, Polonia y Finlandia. En la siguiente publicación llevo a cabo una revisión de la literatura sobre instrumentos para medir HRQL en demencia con tal de entender este complejo concepto y comparar los diferentes instrumentos en cuanto al método de recogida de información o al motivo de evaluación, por ejemplo. En la ultima publicación, exploro la distribución de HRQL en la población de gente muy mayor de Cambridge, creando un nuevo instrumento utilizando un marco conceptual ya existente. Nota: se usan los datos del Proyecto Courage (http://www.courageineurope.eu/)

Health-related quality-of-life instruments for Alzheimer's disease and mixed dementia

BACKGROUND: Over the last 20 years, a number of instruments developed for the assessment of health-related quality of life (HRQL) in dementia have been introduced. The aim of this review is to synthesize evidence from published reviews on HRQL measures in dementia and any new literature in order to identify dementia specific HRQL instruments, the domains they measure, and their operationalization. METHODS: An electronic search of PsycINFO and PubMed was conducted, from inception to December 2011 using a combination of key words that included quality of life and dementia. RESULTS: Fifteen dementia-specific HRQL instruments were identified. Instruments varied depending on their country of development/validation, dementia severity, data collection method, operationalization of HRQL in dementia, psychometric properties, and the scoring. The most common domains assessed include mood, self-esteem, social interaction, and enjoyment of activities. CONCLUSIONS: A number of HRQL instruments for dementia are available. The suitability of the scales for different contexts is discussed. Many studies do not specifically set out to measure dementia-specific HRQL but do include related items. Determining how best to operationalize the many HRQL domains will be helpful for mapping measures of HRQL in such studies maximizing the value of existing resources.This work was supported by the Instituto de Salud Carlos III with a predoctoral grant (PFIS