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Salazar-Frías D, Rodríguez-Bailón M, Ricchetti G, Navarro-Egido A, Funes MJ. The Cognitive Awareness Scale for Basic and Instrumental activities of daily living to measure self-awareness after acquired brain injury: Preliminary evidence of its validity. Clin Neuropsychol 2024; 38:1133-1155. [PMID: 37941388 DOI: 10.1080/13854046.2023.2278822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/29/2023] [Indexed: 11/10/2023]
Abstract
Objective: There is a crucial need for reliable tools to measure impaired self-awareness (ISA) in patients with acquired brain injury (ABI) across cognitive-functional domains. The aim of this study was to assess the psychometric properties of the Cog-Awareness ADL Scale, which is a novel self-proxy discrepancy method for measuring ISA in both basic and instrumental activities of daily living. Methods: This multicenter study included 54 patients (no-low ISA n = 33; severe ISA, n = 21) from four outpatient rehabilitation units in Málaga-Granada, Spain, and 51 healthy controls. The participants and proxy raters completed the Cog-Awareness ADL Scale and the Patient Competency Rating Scale (PCRS). Agreement between both scales was assessed using Spearman's correlations and the Bland-Altman plot. Group comparisons were made on measures of SA, cognitive abilities and demographic variables. Sensitivity and specificity were analysed by ROC curve analysis. Results: Convergent validity was supported by strong correlations with the PCRS and its subscales (rho's ranging from 0.51 to 0.80, p < 0.01 for all). The Bland-Altman plot confirmed measurement agreement (only 3.70% of the scores were outside the 95% limits). External validity was demonstrated by effectively discriminating between healthy controls and ABI patients with no-low and severe ISA on each discrepancy index while controlling for cognitive/demographic variables. The Cog-Awareness ADL Scale showed optimal diagnostic accuracy (AUC = 0.95, sensitivity = 0.90, specificity = 0.90). Conclusions: The Cog-Awareness ADL Scale proved to be a feasible, valid, and clinical tool to assess ISA across different cognitive-functional domains, in Spanish ABI-patients.
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Affiliation(s)
- Daniel Salazar-Frías
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - María Rodríguez-Bailón
- Physiotherapy (Occupational Therapy) Department, Health Science School, University of Málaga, Málaga, Spain
| | - Giorgia Ricchetti
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Alba Navarro-Egido
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - María Jesús Funes
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
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Pinto JO, Pontes D, Dores AR, Peixoto B, Barbosa F. Activities of Daily Living Inventory (ADLI): Proposal of a new instrument and preliminary data. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-18. [PMID: 38913789 DOI: 10.1080/23279095.2024.2367741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
The evaluation of Activities of Daily Living (ADL) has become a critical issue in neuropsychology, but existing instruments for evaluating ADL have some limitations. This work aims to propose a new instrument to evaluate ADL, the ADL Inventory (ADLI), for which we present preliminary data. The ADLI was developed based on a comprehensive model of the stages of test development and following a combined framework of the World Health Organization's International Classification of Functioning, Disability, and Health and the American Occupational Therapy Association models. Besides sociodemographic information, ADLI includes 144 items, organized into four sections: (a) basic ADL; (b) IADL; (c) advanced ADL; and (d) factors influencing functionality. The main characteristics of ADLI are: having self- and informant-report forms; including items focused on different sensory and neurocognitive functions; individualizing the progression along items considering the person's functionality; considering the impact of several factors on functionality; and using a large response scale. Preliminary data of predictive and convergent validity for ADLI are presented. The preliminary study comprised 15 older adults. The Addenbrooke's Cognitive Examination - III, the Barthel Index, and the Instrumental Activities of Daily Living (IADL) Scale were applied to determine the predictive and convergent validity of ADLI.
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Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Department of Social, Behavioral Sciences of University Institute of Health Sciences- CESPU, Gandra, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
- Lusófona University, Porto, Portugal
| | - Diogo Pontes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Bruno Peixoto
- Department of Social, Behavioral Sciences of University Institute of Health Sciences- CESPU, Gandra, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, Porto, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Raimo S, Maggi G, Ilardi CR, Cavallo ND, Torchia V, Pilgrom MA, Cropano M, Roldán-Tapia MD, Santangelo G. The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis. Neurol Sci 2024; 45:2427-2443. [PMID: 38347298 DOI: 10.1007/s10072-024-07366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/25/2024] [Indexed: 05/12/2024]
Abstract
Literature suggests that dementia and, more generally, cognitive impairment affect the capacity to carry out activities of daily living (ADL) in aging. However, it is important to decipher the weight of specific cognitive domains and neurodegenerative profiles mainly related to ADL difficulties. A meta-analysis was conducted to investigate the nature and strength of the association between cognitive functioning and ADL in healthy older adults, mild cognitive impairment (MCI), and dementia. A comprehensive search of the PubMed, PsycINFO (PROQUEST), and Scopus databases for cross-sectional or longitudinal studies up until December 2022. Our meta-analytic results revealed that: overall, instrumental ADL (IADL) showed a significant association with executive functioning, in particular, abstraction ability/concept formation, set-shifting, and processing speed/complex attention/working memory, regardless of type of participants (i.e., healthy older adults, MCI, and dementia); whereas ADL (both basic ADL, BADL, and IADL) significantly correlated with global cognitive functioning and long-term verbal memory, with a moderator effect of clinical condition (e.g., increasing ES based on the level of cognitive impairment). Moreover, visuospatial and language abilities significantly correlated with ADL, mainly when performance-based tasks were used for ADL assessment. These findings emphasize the importance of neuropsychological assessment in aging to early identify people most at risk of functional decline and shed light on the need to consider specific cognitive abilities in rehabilitation programs.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy.
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
| | - Gianpaolo Maggi
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
| | - Ciro Rosario Ilardi
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
| | | | - Valentina Torchia
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | | | - Maria Cropano
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
| | | | - Gabriella Santangelo
- Department of Psychology, 'Luigi Vanvitelli' University of Campania, Caserta, Italy
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Lebely C, Lepron E, Villepinte C, Scannella S, De Boissezon X. Assessment of executive function impairments in adults with acquired brain injury across single-case experimental design: A scoping review of primary outcomes. Neuropsychol Rehabil 2024:1-35. [PMID: 38739463 DOI: 10.1080/09602011.2024.2345410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/12/2024] [Indexed: 05/16/2024]
Abstract
The use of single-case experimental design (SCED) to evaluate cognitive remediation is growing. SCEDs require rigorous methodology and appropriate choice of primary outcomes. To review primary outcomes that assess executive function impairments in patients with acquired brain injury (ABI). A scoping review was conducted using the Arksey and O'Malley framework and the PRISMA extension for scoping review (PRISMA-ScR). Five databases were searched resulting in the inclusion of twenty-one studies. Primary outcomes were extracted and classified according to the type of measure, ecological setting and sources of possible bias. A wide variety of primary outcomes were identified; the majority of which evaluated behavioural performance during a real-life activity or in a real-life simulated setting. The most frequent bias observed across outcomes was the coaching effect. The findings of this scoping review highlight the importance of selecting appropriate outcomes for repeated measures in SCED studies. Direct observation of the target behaviour is a potential gold standard for assessing the effectiveness of a cognitive intervention.
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Affiliation(s)
- C Lebely
- Physical Medicine and Rehabilitation Department, University of Toulouse Hospital, Toulouse, France
- ToNIC, NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - E Lepron
- ISAE-SUPAERO, University of Toulouse, Toulouse, France
| | - C Villepinte
- ToNIC, NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
- Physiological Explorations Department, University of Toulouse Hospital, Toulouse, France
| | - S Scannella
- ISAE-SUPAERO, University of Toulouse, Toulouse, France
| | - X De Boissezon
- Physical Medicine and Rehabilitation Department, University of Toulouse Hospital, Toulouse, France
- ToNIC, NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
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Faria AL, Almeida Y, Branco D, Câmara J, Cameirão M, Ferreira L, Moreira A, Paulino T, Rodrigues P, Spinola M, Vilar M, Bermúdez i Badia S, Simões M, Fermé E. NeuroAIreh@b: an artificial intelligence-based methodology for personalized and adaptive neurorehabilitation. Front Neurol 2024; 14:1258323. [PMID: 38322797 PMCID: PMC10846403 DOI: 10.3389/fneur.2023.1258323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024] Open
Abstract
Cognitive impairments are a prevalent consequence of acquired brain injury, dementia, and age-related cognitive decline, hampering individuals' daily functioning and independence, with significant societal and economic implications. While neurorehabilitation represents a promising avenue for addressing these deficits, traditional rehabilitation approaches face notable limitations. First, they lack adaptability, offering one-size-fits-all solutions that may not effectively meet each patient's unique needs. Furthermore, the resource-intensive nature of these interventions, often confined to clinical settings, poses barriers to widespread, cost-effective, and sustained implementation, resulting in suboptimal outcomes in terms of intervention adaptability, intensity, and duration. In response to these challenges, this paper introduces NeuroAIreh@b, an innovative cognitive profiling and training methodology that uses an AI-driven framework to optimize neurorehabilitation prescription. NeuroAIreh@b effectively bridges the gap between neuropsychological assessment and computational modeling, thereby affording highly personalized and adaptive neurorehabilitation sessions. This approach also leverages virtual reality-based simulations of daily living activities to enhance ecological validity and efficacy. The feasibility of NeuroAIreh@b has already been demonstrated through a clinical study with stroke patients employing a tablet-based intervention. The NeuroAIreh@b methodology holds the potential for efficacy studies in large randomized controlled trials in the future.
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Affiliation(s)
- Ana Lúcia Faria
- Department of Psychology, Faculty of Arts and Humanities, University of Madeira, Funchal, Portugal
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
| | - Yuri Almeida
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Diogo Branco
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Joana Câmara
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Mónica Cameirão
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Luis Ferreira
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - André Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Teresa Paulino
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Pedro Rodrigues
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Mónica Spinola
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
| | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Sergi Bermúdez i Badia
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Mario Simões
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Eduardo Fermé
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
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Buele J, Varela-Aldás JL, Palacios-Navarro G. Virtual reality applications based on instrumental activities of daily living (iADLs) for cognitive intervention in older adults: a systematic review. J Neuroeng Rehabil 2023; 20:168. [PMID: 38110970 PMCID: PMC10729470 DOI: 10.1186/s12984-023-01292-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND In recent years, the use of virtual reality (VR) as a complementary intervention in treating cognitive impairment has significantly increased. VR applications based on instrumental activities of daily living (iADL-VR) could offer a promising approach with greater ecological validity for intervention in groups with cognitive impairments. However, the effectiveness of this approach is still debated. OBJECTIVE This systematic review aims to synthesize the effects of iADL-VR interventions to rehabilitate, train, or stimulate cognitive functions in healthy adults and people with mild cognitive impairment (MCI) and different types of dementia. METHODS A systematic search was performed in the Scopus, PubMed, IEEE Xplore, Web of Science, and APA PsycNet databases until September 2022 and repeated in April 2023. The selected studies met the search terms, were peer-reviewed, included an iADL-VR intervention, and were written in English. Descriptive, qualitative studies, reviews, cognitive assessment, non-intervention studies, those unrelated to VR or iADL, those focused on motor aspects, and non-degenerative disorders were excluded. The PEDro scale was used to assess the methodological quality of the controlled studies. To present and synthesize the results, we organized the extracted data into three tables, including PEDro scores, participant characteristics, and study characteristics. RESULTS Nineteen studies that met the inclusion and exclusion criteria were included. The total sample reached 590 participants, mostly women (72.67%). Approximately 30% were diagnosed with Alzheimer's disease or dementia, and 20% had mild cognitive impairment. Variables such as authors and year of publication, study design, type of intervention and VR applied, duration of the intervention, main findings, and conclusions were extracted. Regarding demographic characteristics, the sample size, age, sex, years of education, neurological diagnosis, dropouts, and the city and country where the intervention took place were recorded. Almost all studies showed improvements in some or all the outcomes after the intervention, generally greater in the iADL-VR group than in the control group. CONCLUSION iADL-VR interventions could be beneficial in improving the performance of cognitive functions in older adults and people with MCI and different types of dementia. The ecological component of these tasks makes them very suitable for transferring what has been learned to the real world. However, such transfer needs to be confirmed by further studies with larger and more homogeneous samples and longer follow-up periods. This review had no primary funding source and was registered with PROSPERO under registration ID: 375166.
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Affiliation(s)
- Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción, Universidad Indoamérica, Ambato, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, Teruel, Spain
| | - José Luis Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación (CICHE), Universidad Indoamérica, Ambato, Ecuador
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Fernández MP, Labra JA, Menor J, Alegre E. Analysis of Convergent Validity of Performance-Based Activities of Daily Living Assessed by PA-IADL Test in Relation to Traditional (Standard) Cognitive Assessment to Identify Older Adults with Mild Cognitive Impairment. Behav Sci (Basel) 2023; 13:975. [PMID: 38131831 PMCID: PMC10740513 DOI: 10.3390/bs13120975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/11/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Difficulty in performing instrumental activities of daily living (IADLs) is currently considered an important indicator of cognitive impairment in the elderly. A non-experimental case-control investigation was conducted to assess the convergent validity of the PA-IADL with traditional (standard) cognitive assessment tests in its ability to identify adults with mild cognitive impairment. The analysis of the data was carried out by means of various multivariate statistical tests, and the sequence in its execution led to the conclusion that 8 of the 12 Tasks that make up the PA-IADL allow for the identification of people with mild cognitive impairment (MCI) to the same extent as traditional cognitive assessment tests and regardless of age. Age was found to be a moderating variable in the performance of the eight tasks; however, the results allow us to hypothesize that people with MCI experience a significant decline when it happens but thereafter, the deterioration that occurs does so at the same rate as the deterioration experienced by healthy people. They also allow us to hypothesize that the difference in the cognitive skills required by the eight functional tasks, and therefore also in the cognitive skills required by the traditional (standard) tests of a person with MCI compared to a person of the same age without MCI (Healthy), is approximately 10 years. These hypotheses have remarkable relevance and should be tested via longitudinal research. In the meantime, the results highlight the importance of the IADL assessment for the diagnosis of MCI as a complement to the standard cognitive assessment.
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Affiliation(s)
- María Paula Fernández
- Department of Psychology, Oviedo University, Plaza de Feijoo, 33003 Oviedo, Spain; (M.P.F.); (J.M.)
| | - José Antonio Labra
- Department of Psychology, Oviedo University, Plaza de Feijoo, 33003 Oviedo, Spain; (M.P.F.); (J.M.)
| | - Julio Menor
- Department of Psychology, Oviedo University, Plaza de Feijoo, 33003 Oviedo, Spain; (M.P.F.); (J.M.)
| | - Eva Alegre
- Department of Well-Being and Health, Town Hall of Villaquilambre, 24193 Villaquilambre, Spain;
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Mayes WP, Jansari A, Leonard HC. Exploring Executive Functioning of Adults With Probable Developmental Coordination Disorder Using the Jansari Assessment of Executive Functions. Dev Neuropsychol 2023; 48:315-334. [PMID: 37830357 DOI: 10.1080/87565641.2023.2264424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023]
Abstract
Many individuals with Developmental Coordination Disorder (DCD) demonstrate executive functioning difficulties on standardized assessments, yet these difficulties have not been investigated using ecologically-valid measures. 26 adults with probable DCD (pDCD), and 26 typically developing (TD) adults completed selected background measures and the Jansari assessment of Executive Functions (JEF©). JEF© is an ecologically-valid measure that provides measures of Planning, Prioritization, Selective-Thinking, Creative-Thinking, Adaptive-Thinking, and Action-, Event- and Time-Based Prospective Memory. pDCD participants were impaired relative to TD participants, with difficulties in Planning, Action-, and Event-Based Prospective Memory. These findings are consistent with self-reported difficulty and provide avenues for research investigating intervention.
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Affiliation(s)
| | - Ashok Jansari
- Department of Psychology, Goldsmiths, University of London, London, UK
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Faria AL, Latorre J, Silva Cameirão M, Bermúdez i Badia S, Llorens R. Ecologically valid virtual reality-based technologies for assessment and rehabilitation of acquired brain injury: a systematic review. Front Psychol 2023; 14:1233346. [PMID: 37711328 PMCID: PMC10497882 DOI: 10.3389/fpsyg.2023.1233346] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/03/2023] [Indexed: 09/16/2023] Open
Abstract
Purpose A systematic review was conducted to examine the state of the literature regarding using ecologically valid virtual environments and related technologies to assess and rehabilitate people with Acquired Brain Injury (ABI). Materials and methods A literature search was performed following the PRISMA guidelines using PubMed, Web of Science, ACM and IEEE databases. The focus was on assessment and intervention studies using ecologically valid virtual environments (VE). All studies were included if they involved individuals with ABI and simulated environments of the real world or Activities of Daily Living (ADL). Results Seventy out of 363 studies were included in this review and grouped and analyzed according to the nature of its simulation, prefacing a total of 12 kitchens, 11 supermarkets, 10 shopping malls, 16 streets, 11 cities, and 10 other everyday life scenarios. These VE were mostly presented on computer screens, HMD's and laptops and patients interacted with them primarily via mouse, keyboard, and joystick. Twenty-five out of 70 studies had a non-experimental design. Conclusion Evidence about the clinical impact of ecologically valid VE is still modest, and further research with more extensive samples is needed. It is important to standardize neuropsychological and motor outcome measures to strengthen conclusions between studies. Systematic review registration identifier CRD42022301560, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=301560.
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Affiliation(s)
- Ana Lúcia Faria
- Faculdade de Artes e Humanidades, Universidade da Madeira, Funchal, Portugal
- NOVA Laboratory for Computer Science and Informatics, Lisbon, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
| | - Jorge Latorre
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
| | - Mónica Silva Cameirão
- NOVA Laboratory for Computer Science and Informatics, Lisbon, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Sergi Bermúdez i Badia
- NOVA Laboratory for Computer Science and Informatics, Lisbon, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
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Alberts JL, Shuaib U, Fernandez H, Walter BL, Schindler D, Miller Koop M, Rosenfeldt AB. The Parkinson's disease waiting room of the future: measurements, not magazines. Front Neurol 2023; 14:1212113. [PMID: 37670776 PMCID: PMC10475536 DOI: 10.3389/fneur.2023.1212113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/08/2023] [Indexed: 09/07/2023] Open
Abstract
Utilizing technology to precisely quantify Parkinson's disease motor symptoms has evolved over the past 50 years from single point in time assessments using traditional biomechanical approaches to continuous monitoring of performance with wearables. Despite advances in the precision, usability, availability and affordability of technology, the "gold standard" for assessing Parkinson's motor symptoms continues to be a subjective clinical assessment as none of these technologies have been fully integrated into routine clinical care of Parkinson's disease patients. To facilitate the integration of technology into routine clinical care, the Develop with Clinical Intent (DCI) model was created. The DCI model takes a unique approach to the development and integration of technology into clinical practice by focusing on the clinical problem to be solved by technology rather than focusing on the technology and then contemplating how it could be integrated into clinical care. The DCI model was successfully used to develop the Parkinson's disease Waiting Room of the Future (WROTF) within the Center for Neurological Restoration at the Cleveland Clinic. Within the WROTF, Parkinson's disease patients complete the self-directed PD-Optimize application on an iPad. The PD-Optimize platform contains cognitive and motor assessments to quantify PD symptoms that are difficult and time-consuming to evaluate clinically. PD-Optimize is completed by the patient prior to their medical appointment and the results are immediately integrated into the electronic health record for discussion with the movement disorder neurologist. Insights from the clinical use of PD-Optimize has spurred the development of a virtual reality technology to evaluate instrumental activities of daily living in PD patients. This new technology will undergo rigorous assessment and validation as dictated by the DCI model. The DCI model is intended to serve as a health enablement roadmap to formalize and accelerate the process of bringing the advantages of cutting-edge technology to those who could benefit the most: the patient.
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Affiliation(s)
- Jay L. Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, United States
- Cleveland Clinic, Neurological Institute, Center for Neurological Restoration, Cleveland, OH, United States
| | - Umar Shuaib
- Cleveland Clinic, Neurological Institute, Center for Neurological Restoration, Cleveland, OH, United States
| | - Hubert Fernandez
- Cleveland Clinic, Neurological Institute, Center for Neurological Restoration, Cleveland, OH, United States
| | - Benjamin L. Walter
- Cleveland Clinic, Neurological Institute, Center for Neurological Restoration, Cleveland, OH, United States
| | - David Schindler
- Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, United States
| | - Mandy Miller Koop
- Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, United States
| | - Anson B. Rosenfeldt
- Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, United States
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11
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Libon DJ, Emrani S, Matusz EF, Wasserman V, Perweiler E, Ginsberg TB, Powell L, Bezdicek O, Swenson R, Schmitter-Edgecombe M. Instrumental activities of daily living and mild cognitive impairment. J Clin Exp Neuropsychol 2023; 45:473-481. [PMID: 37624105 DOI: 10.1080/13803395.2023.2249626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Functional impairments are a necessary requirement for the diagnosis of a dementia along with observed cognitive impairment. Comparatively, functional abilities are often relatively intact in those with mild cognitive impairment (MCI). OBJECTIVE The current research examined the associations between memory clinic participants classified as cognitively intact, amnestic MCI, and mixed/dysexecutive MCI, using Jak-Bondi criteria, and Instrumental Activities of Daily Living - Compensation Scale (IADL-C) abilities, an informant-based questionnaire that quantifies functional abilities. The associations between functional abilities as assessed with the IADL-C and performance on neuropsychological tests were also investigated. METHODS IADLC scores were obtained along with a comprehensive neuropsychological protocol on memory clinic participants (n = 100) classified as cognitively normal (CN), amnestic MCI (aMCI), or a combined mixed/dysexecutive (mixed/dys) MCI. Regression analyses were employed to determine how the IADLC related to neuropsychological test performance. RESULTS On the IADLC, greater functional impairment was commonly observed in the mixed/dys MCI group compared to CN participants. Furthermore, the mixed/dys MCI group had lower scores on activities such as Money and Self-Management, Travel and Event Memory subscales compared to the CN group. Linear regression analyses found greater functional impairment in relation to lower scores on executive and episodic memory tests. CONCLUSIONS Greater functional impairment as assessed with the IADL-C appears to be disproportionately associated with dysexecutive difficulty, and to a lesser degree, episodic memory.
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Affiliation(s)
- David J Libon
- Department of Geriatrics and Gerontology, New Jersey Institute for Successful Aging, Rowan University-School of Osteopathic Medicine, Stratford, USA
- Department of Psychology, Rowan University, Glassboro, USA
| | - Sheina Emrani
- Department of Psychiatry, Brown University, Providence, USA
| | - Emily F Matusz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, USA
| | - Victor Wasserman
- Department of Geriatrics and Gerontology, New Jersey Institute for Successful Aging, Rowan University-School of Osteopathic Medicine, Stratford, USA
| | | | | | - Leonard Powell
- Department of Psychology, Rowan University, Glassboro, USA
| | - Ondrej Bezdicek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Rodney Swenson
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA
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12
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Salazar-Frías D, Funes MJ, Merchán-Baeza JA, Ricchetti G, Torralba-Muñoz JM, Rodríguez-Bailón M. Translation, cross-cultural adaptation and validation of the 10-item Weekly Calendar Planning Activity in Spanish-speaking ABI patients: a multicenter study. Front Psychol 2023; 14:1018055. [PMID: 37384192 PMCID: PMC10293833 DOI: 10.3389/fpsyg.2023.1018055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/15/2023] [Indexed: 06/30/2023] Open
Abstract
We present the process of translation, adaptation, and validation in the Spanish context of the 10-item version of the Weekly Calendar Planning Activity (WCPA-10), a performance-based measure of cognitive instrumental activities of daily living (C-IADL). The study consisted of two phases: I) translation/cultural adaptation of the WCPA, conducted by professional bilingual translators, a panel of experts, and a pilot study, and II) validation in a sample of 42 acquired brain injury patients (ABI) and 42 healthy participants (HC). WCPA primary outcomes showed expected convergent/discriminant validity patterns with socio-demographical and clinical variables and cognitive processes identifying those WCPA outcomes that best predicted executive and memory deficits measured with a battery of traditional neuropsychological tests. In addition, performance on the WCPA was a significant predictor of everyday functioning over variables such as socio-demographics or global cognition when measured with traditional tests. External validity was established by the WCPA's ability to identify everyday cognitive deficits in ABI patients compared to HC, even in those with subtle cognitive impairment based on neuropsychological tests. The Spanish WCPA-10 seems an appropriate and sensitive assessment tool to identify cognitive-functional impairment in ABI-patients, even those with subtle cognitive impairment. The results also highlight the relevance of this kind of test, as they indicate a better prediction of patients' real-world functioning than traditional neuropsychological tests.
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Affiliation(s)
- Daniel Salazar-Frías
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - María Jesús Funes
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Jose Antonio Merchán-Baeza
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
| | - Giorgia Ricchetti
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Jose Maria Torralba-Muñoz
- Asociación Granadina de Familias por la Rehabilitación del Daño Cerebral Adquirido, AGREDACE, Granada, Spain
| | - María Rodríguez-Bailón
- Department of Physiotherapy (Occupational Therapy), Health Science School, University of Málaga, Málaga, Spain
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13
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Estrada-Barranco C, Martinez-Javaloyes MDLÁ, Rodriguez-Costa I, Sanz-Esteban I, Bermejo-Franco A, Aranda-Ruiperez A, Gallegos-Martínez MDLÁ. Effectiveness of a Program Based on Action-Observation Training (AOT) on Motor, Functional and Cognitive Aspects in Patients with Cognitive Impairment: A Non-Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11071030. [PMID: 37046957 PMCID: PMC10093786 DOI: 10.3390/healthcare11071030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Cognitive impairment is frequent in elderly subjects. It is associated with motor impairment, a limitation in quality of life and frequently, institutionalization. The aim of this work is to test the efficacy of a therapeutic group program based on action-observation learning. METHODS a non-randomized controlled trial study was conducted. We included 40 patients with cognitive impairment from a nursing home who were categorized into mild and moderate cognitive impairment and divided separately into a control and experimental group. Experimental group performed a 4-week group work, in which each patient with mild cognitive impairment was paired with a patient with moderate cognitive impairment. Thus, patients with mild cognitive impairment observed a series of functional exercises performed by their peers and replicated them. Simultaneously, the patients with moderate cognitive impairment replicated the movement after observing it performed by a patient with mild cognitive impairment. The control group continued to receive their usual care at the center. The upper limb function, cognitive level and function in basic activities of human daily life were measured before and after the intervention and compared with the control group. RESULTS statistically significant differences were found in the functionality of basic activities of daily living, in the functionality of the upper limb and in the cognitive level in all patients in the experimental group regardless of the initial cognitive level. No statistically significant differences were found in the control group. CONCLUSIONS the implementation of a group, peer-based, action-observation learning therapeutic program is effective in improving the basic activities of human daily life, cognitive level and upper limb functionality in patients with mild and moderate dementia.
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Affiliation(s)
- Cecilia Estrada-Barranco
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Isabel Rodriguez-Costa
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28805 Madrid, Spain
| | - Ismael Sanz-Esteban
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Alberto Bermejo-Franco
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
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14
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Ribas MZ, Paticcié GF, Noleto FM, Ramanzini LG, Veras ADO, Dall'Oglio R, Filho LBDA, Martins da Silva JG, Lima MPP, Teixeira BE, Nunes de Sousa G, Alves AFC, Vieira Lima LMF, Sallem CC, Garcia TFM, Ponte de Oliveira IM, Rocha RSDC, Jucá MDS, Barroso ST, Claudino Dos Santos JC. Impact of dysexecutive syndrome in quality of life in Alzheimer disease: What we know now and where we are headed. Ageing Res Rev 2023; 86:101866. [PMID: 36709886 DOI: 10.1016/j.arr.2023.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023]
Abstract
Alzheimer's disease (AD) is a common form of dementia that leads to multiple repercussions in the patient's life. This condition's clinical characteristics include loss of memory, temporal and spatial disorientation, language or executive dysfunction, and subsequent decline of social function. Dysexecutive syndrome (DS), the second most frequent neuropsychological dysfunction in AD, affects multiple brain areas and causes cognitive, behavioral, and emotional difficulties. We aimed to analyze the association between DS and AD and elucidate possible lack of evidence that may urge further research on this theme. Especially when dealing with such a disabling disease, where new findings can directly imply a better prognosis.
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Affiliation(s)
| | | | - Felipe Micelli Noleto
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | | | - Arthur de Oliveira Veras
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Renato Dall'Oglio
- Faculdade Evangélica Mackenzie do Paraná (FEMPAR), Curitiba, PR, Brazil
| | | | | | | | | | | | | | | | - Camilla Costa Sallem
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Tulia Fernanda Meira Garcia
- Escola Multicampi de Ciências Médicas do RN, Universidade Federal do Rio Grande do Norte (EMCM-UFRN), Caicó, RN, Brazil
| | | | | | - Mikaio de Sousa Jucá
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Sarah Távora Barroso
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Júlio César Claudino Dos Santos
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil; Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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15
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Martínez-Pernía D, Olavarría L, Fernández-Manjón B, Cabello V, Henríquez F, Robert P, Alvarado L, Barría S, Antivilo A, Velasquez J, Cerda M, Farías G, Torralva T, Ibáñez A, Parra MA, Gilbert S, Slachevsky A. The limitations and challenges in the assessment of executive dysfunction associated with real-world functioning: The opportunity of serious games. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-17. [PMID: 36827177 PMCID: PMC11177293 DOI: 10.1080/23279095.2023.2174438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.
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Affiliation(s)
- David Martínez-Pernía
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Loreto Olavarría
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Victoria Cabello
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Henríquez
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Philippe Robert
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d'Azur, Nice, France
| | - Luís Alvarado
- Departamento de Psiquiatría y Salud Mental Norte, Universidad de Chile, Santiago, Chile
| | - Silvia Barría
- Departamento de Ciencias Neurologicas Oriente, Facultad de Medicina, Universidad de Chile, and Servicio de Neurología, Hospital del Salvador, Santiago, Chile
| | - Andrés Antivilo
- Departamento de Ciencias Neurologicas Oriente, Facultad de Medicina, Universidad de Chile, and Servicio de Neurología, Hospital del Salvador, Santiago, Chile
| | - Juan Velasquez
- Facultad de Ciencias Físicas y Matemáticas, Web Intelligence Center, Universidad de Chile, Santiago, Chile
- Department of Industrial Engineering, Faculty of Physical and Mathematical Sciences, Instituto Sistemas Complejos de Ingeniería (ISCI), University of Chile, Santiago, Chile
| | - Mauricio Cerda
- Integrative Biology Program, Institute of Biomedical Sciences, and Center for Medical Informatics and Telemedicine, Faculty of Medicine, and Biomedical Neuroscience Institute, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gonzalo Farías
- Department of Neurology North, Faculty of Medicine, University of Chile, Santiago, Chile
- Center for advanced clinical research (CICA), Hospital Clínico Universidad de Chile, Chile
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), Instituto de Neurología Cognitiva Foundation, Favaloro University, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Trinity College Dublin (TCD), Dublin, Ireland
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Sam Gilbert
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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16
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Sánchez Castillo S, Smith L, Díaz Suárez A, López Sánchez GF. Limitations in Activities of Daily Living among Older Adults with COPD, Asthma, or Asthma-COPD Overlap Residing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3467. [PMID: 36834162 PMCID: PMC9959111 DOI: 10.3390/ijerph20043467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Activities of daily living (ADL) may be limited by the presence of chronic diseases, and limitations in ADL contribute to an increased risk of falling. In people with asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO), ADL may be affected owing to poor asthma control and COPD ventilatory limitations. The aim of this study was to establish the differing prevalence of limitations in ADL among older Spanish adults with chronic respiratory diseases (COPD, asthma, and ACO). Data from the Spanish National Health Survey were analyzed. The sample was composed of 944 older adults aged ≥65 years and with a positive diagnosis of COPD (n = 502), asthma (n = 241), or ACO (n = 201). Five basic activities of daily living (BADL) and seven instrumental activities of daily living (IADL) were studied. Frequency and percentages were used to describe sample characteristics and limitations of ADL. Significant differences were analyzed using chi-square tests. Results revealed a significant higher number of older adults with COPD (34.8%) and asthma (32.5%) without limitations in doing hard housework in comparison to ACO (17.8%). Regarding meal preparation, a higher percentage of asthmatics without difficulties (77.7%) and a lower percentage with many difficulties (2.6%) were observed in comparison to ACO (64.8%-10.2%). No differences were found in BADL, with approximately 80-90% without limitations. It seems that limitations in IADL vary according to the type of chronic pulmonary diseases, but further research is needed to clarify why differences were found only for preparing meals and hard housework. These findings should be considered in the design of interventions to promote ADL in older adults with respiratory disease.
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Affiliation(s)
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Arturo Díaz Suárez
- Faculty of Sports Sciences, University of Murcia, 30720 San Javier, Spain
| | - Guillermo Felipe López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, 30120 Murcia, Spain
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17
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McLean E, Cornwell MA, Bender HA, Sacks-Zimmerman A, Mandelbaum S, Koay JM, Raja N, Kohn A, Meli G, Spat-Lemus J. Innovations in Neuropsychology: Future Applications in Neurosurgical Patient Care. World Neurosurg 2023; 170:286-295. [PMID: 36782427 DOI: 10.1016/j.wneu.2022.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/11/2023]
Abstract
Over the last century, collaboration between clinical neuropsychologists and neurosurgeons has advanced the state of the science in both disciplines. These advances have provided the field of neuropsychology with many opportunities for innovation in the care of patients prior to, during, and following neurosurgical intervention. Beyond giving a general overview of how present-day advances in technology are being applied in the practice of neuropsychology within a neurological surgery department, this article outlines new developments that are currently unfolding. Improvements in remote platform, computer interface, "real-time" analytics, mobile devices, and immersive virtual reality have the capacity to increase the customization, precision, and accessibility of neuropsychological services. In doing so, such innovations have the potential to improve outcomes and ameliorate health care disparities.
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Affiliation(s)
- Erin McLean
- Department of Psychology, Hofstra University, Hempstead, New York, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Jun Min Koay
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Noreen Raja
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
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18
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Gonzalez C, Mimmack KJ, Amariglio RE, Becker JA, Chhatwal JP, Fitzpatrick CD, Gatchel JR, Johnson KA, Katz ZS, Kuppe MK, Locascio JJ, Udeogu OJ, Papp KV, Premnath P, Properzi MJ, Rentz DM, Schultz AP, Sperling RA, Vannini P, Wang S, Marshall GA. Associations of the Harvard Automated Phone Task and Alzheimer's Disease Pathology in Cognitively Normal Older Adults: Preliminary Findings. J Alzheimers Dis 2023; 94:217-226. [PMID: 37212093 PMCID: PMC10330453 DOI: 10.3233/jad-220885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Detecting clinically meaningful changes in instrumental activities of daily living (IADL) at the earliest stages of Alzheimer's disease (AD) is critical. OBJECTIVE The objective of this exploratory study was to examine the cross-sectional relationship between a performance-based IADL test, the Harvard Automated Phone Task (APT), and cerebral tau and amyloid burden in cognitively normal (CN) older adults. METHODS Seventy-seven CN participants underwent flortaucipir tau and Pittsburgh Compound B amyloid PET. IADL were assessed using the three Harvard APT tasks: prescription refill (APT-Script), health insurance company call (APT-PCP), and bank transaction (APT-Bank). Linear regression models were used to determine associations between each APT task and entorhinal cortex, inferior temporal, or precuneus tau with or without an interaction with amyloid. RESULTS Significant associations were found between APT-Bank task rate and interaction between amyloid and entorhinal cortex tau, and APT-PCP task and interactions between amyloid and inferior temporal and precuneus tau. No significant associations were found between the APT tasks and tau or amyloid alone. CONCLUSION Our preliminary findings suggest an association between a simulated real-life IADL test and interactions of amyloid and several regions of early tau accumulation in CN older adults. However, some analyses were underpowered due to the small number of participants with elevated amyloid, and findings should be interpreted with caution. Future studies will further explore these associations cross-sectionally and longitudinally in order to determine whether the Harvard APT can serve as a reliable IADL outcome measure for preclinical AD prevention trials and ultimately in the clinic setting.
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Affiliation(s)
- Christopher Gonzalez
- Department of Psychology, Illinois Institute of Technology,
Chicago, IL 60616, USA
| | - Kayden J. Mimmack
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Rebecca E. Amariglio
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - J. Alex Becker
- Department of Radiology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Jasmeer P. Chhatwal
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Colleen D. Fitzpatrick
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Jennifer R. Gatchel
- Department of Psychiatry, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Division of Geriatric Psychiatry, McLean Hospital, Harvard
Medical School, Belmont, MA 02478, USA
| | - Keith A. Johnson
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Department of Radiology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Zoe S. Katz
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Madeline K. Kuppe
- Cognitive Neuroimaging Laboratory, Graduate Program for
Neuroscience, Boston University, Boston, MA 02215, USA
| | - Joseph J. Locascio
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Onyinye J. Udeogu
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Pranitha Premnath
- Department of Psychology, The Graduate Center, City
University of New York, New York, NY 10016, USA
| | - Michael J. Properzi
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Aaron P. Schultz
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Patrizia Vannini
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Sharon Wang
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
| | - Gad A. Marshall
- Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA
- Center for Alzheimer Research and Treatment, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, 02115, USA
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19
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Tsang M, Gan S, Boscardin J, Wong ML, Walter LC, Smith AK. The epidemiology of preexisting geriatric and palliative conditions in older adults with poor prognosis cancers. J Am Geriatr Soc 2022; 70:3402-3412. [PMID: 36259424 PMCID: PMC9772051 DOI: 10.1111/jgs.18039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/19/2022] [Accepted: 08/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Older patients with poor prognosis cancers have complex needs that can benefit from geriatrics and palliative care principles. Because they are not routinely assessed, the prevalence of preexisting geriatric and palliative conditions in this population is unknown. METHODS We used the nationally representative Health and Retirement Study (HRS) linked with Medicare claims (1998-2016) to identify adults aged ≥65 years diagnosed with poor prognosis cancers (cancers with a median survival ≤1 year). Using the HRS interview before the first Medicare cancer claim, we used survey-weighted descriptive statistics and modified Poisson regression analysis to examine the prevalence of the following clinically significant conditions: functional impairment, difficulty with mobility, falls and injurious falls, social support, cognition, advance care planning, use of pain or sleep medications, and presence of pain or breathlessness. RESULTS Of 2105 participants (mean age 76, 53% women, 34% lung cancer, 21% gastrointestinal cancer), the median survival was 9.6 months. Approximately 65% had difficulty climbing stairs (95% CI 63%-67%), 49% had no advance directive (95% CI 45%-54%), 35% lived alone (95% CI 33%-37%), 36% fell in the last 2 years (95% CI 34%-38%), and 32% rated their memory as poor (95% CI 29%-34%). After adjusting for gender, cancer type, and HRS survey time before the first Medicare claim for a poor prognosis cancer, functional impairment and falls were highest among adults aged 85+. Adults aged 65-74 years were less likely to have an advance directive. After adjusting for age, cancer type, and HRS survey time, women had a higher rate of pain and physical impairment. In exploratory analyses, race and socioeconomic status predicted difficulty with mobility and instrumental activities of daily living, living alone, and advance directive completion. CONCLUSIONS Due to a high prevalence across multiple domains, all older adults with poor prognosis cancers should be assessed for geriatric and palliative care conditions.
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Affiliation(s)
- Mazie Tsang
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, California, USA
| | - Siqi Gan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - John Boscardin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Melisa L. Wong
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, California, USA
| | - Louise C. Walter
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Alexander K. Smith
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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20
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Zhao G, Zhang J, Sun W, Xie C, Zhang H, Gao Y, Wen S, Ha Z, Nan F, Zhu X, Feng S, Cao X, Zhang Y, Zhu Y, Jin N, Lu H. Immunological evaluation of recombination PRRSV GP3 and GP5 DNA vaccines in vivo. Front Cell Infect Microbiol 2022; 12:1016897. [PMID: 36275018 PMCID: PMC9582230 DOI: 10.3389/fcimb.2022.1016897] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
The porcine reproductive and respiratory syndrome virus (PRRSV) is a threat to the health of pigs worldwide, but commercially available vaccines offer limited protection against PRRSV infection. It is necessary to develop a more effective DNA vaccine. The immunological effects of DNA vaccines with three adjuvants were examined in pigs (Susscrofa domestica) challenged with PRRSV. These DNA vaccines, which encoded PRRSV GP3 and GP5, were formulated with A1, A2, and A3. Serum specific and neutralizing antibodies, IL-4, IFN-γ, IL-2, IL-10, CD4+ and CD8+T-lymphocytes, health status, histopathology, and viral loads were determined. The results showed that the use of adjuvant A3 led to higher levels of neutralizing antibodies and a lower viral load in pigs compared to the other adjuvants. The neutralizing antibody titers of the pVAX-GP35+A1 and pVAX-GP35+A3 groups reached a peak of 1:19 at 35 dpi. The maximum concentration of IL-4 was 136.77 pg/mL in the pVAX-GP35+A3 group. At 35 dpi, the IFN-γ concentration in the pVAX-GP35+A1 group was 227.4 pg/mL. pVAX-GP35+A3 group shows the highest IL-2 and IL-10 expression to the peak of 597.6 pg/mL and 189.1 pg/mL, respectively. We found a formulation demonstrated beneficial immune outcomes. This study provides an alternative vaccine to protect pigs from PRRSV.
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Affiliation(s)
- Guanyu Zhao
- College of Veterinary Medicine, College of Animal Science, Jilin University, Changchun, China
| | - Jiaqi Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Wenchao Sun
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Changzhan Xie
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - He Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Yan Gao
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Shubo Wen
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Zhuo Ha
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Fulong Nan
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Xiangyu Zhu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Sheng Feng
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Xinyu Cao
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Ying Zhang
- College of Veterinary Medicine, College of Animal Science, Jilin University, Changchun, China
- *Correspondence: Ying Zhang, ; Yanzhu Zhu, ; Ningyi Jin, ; Huijun Lu,
| | - Yanzhu Zhu
- Institute of Special Animal and Plant Sciences, Chinese Academy of Agricultural Sciences, Changchun, China
- Animal Science and Technology College, Jilin Agriculture Science and Technology University, Jilin, China
- *Correspondence: Ying Zhang, ; Yanzhu Zhu, ; Ningyi Jin, ; Huijun Lu,
| | - Ningyi Jin
- College of Veterinary Medicine, College of Animal Science, Jilin University, Changchun, China
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- *Correspondence: Ying Zhang, ; Yanzhu Zhu, ; Ningyi Jin, ; Huijun Lu,
| | - Huijun Lu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- *Correspondence: Ying Zhang, ; Yanzhu Zhu, ; Ningyi Jin, ; Huijun Lu,
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21
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Patchitt J, Porffy LA, Whomersley G, Szentgyorgyi T, Brett J, Mouchlianitis E, Mehta MA, Nottage JF, Shergill SS. Alpha3/alpha2 power ratios relate to performance on a virtual reality shopping task in ageing adults. Front Aging Neurosci 2022; 14:876832. [PMID: 36212034 PMCID: PMC9540381 DOI: 10.3389/fnagi.2022.876832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background Aspects of cognitive function decline with age. This phenomenon is referred to as age-related cognitive decline (ARCD). Improving the understanding of these changes that occur as part of the ageing process can serve to enhance the detection of the more incapacitating neurodegenerative disorders such as Alzheimer’s disease (AD). In this study, we employ novel methods to assess ARCD by exploring the utility of the alpha3/alpha2 electroencephalogram (EEG) power ratio – a marker of AD, and a novel virtual reality (VR) functional cognition task – VStore, in discriminating between young and ageing healthy adults. Materials and methods Twenty young individuals aged 20–30, and 20 older adults aged 60–70 took part in the study. Participants underwent resting-state EEG and completed VStore and the Cogstate Computerised Cognitive Battery. The difference in alpha3/alpha2 power ratios between the age groups was tested using t-test. In addition, the discriminatory accuracy of VStore and Cogstate were compared using logistic regression and overlying receiver operating characteristic (ROC) curves. Youden’s J statistic was used to establish the optimal threshold for sensitivity and specificity and model performance was evaluated with the DeLong’s test. Finally, alpha3/alpha2 power ratios were correlated with VStote and Cogstate performance. Results The difference in alpha3/alpha2 power ratios between age cohorts was not statistically significant. On the other hand, VStore discriminated between age groups with high sensitivity (94%) and specificity (95%) The Cogstate Pre-clinical Alzheimer’s Battery achieved a sensitivity of 89% and specificity of 60%, and Cogstate Composite Score achieved a sensitivity of 83% and specificity of 85%. The differences between the discriminatory accuracy of VStore and Cogstate models were statistically significant. Finally, high alpha3/alpha2 power ratios correlated strongly with VStore (r = 0.73), the Cogstate Pre-clinical Alzheimer’s Battery (r = -0.67), and Cogstate Composite Score (r = -0.76). Conclusion While we did not find evidence that the alpha3/alpha2 power ratio is elevated in healthy ageing individuals compared to young individuals, we demonstrated that VStore can classify age cohorts with high accuracy, supporting its utility in the assessment of ARCD. In addition, we found preliminary evidence that elevated alpha3/alpha2 power ratio may be linked to lower cognitive performance.
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Affiliation(s)
- Joel Patchitt
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Trafford Centre for Medical Research, University of Sussex, Brighton, United Kingdom
| | - Lilla A. Porffy
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- *Correspondence: Lilla A. Porffy,
| | - Gabriella Whomersley
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Timea Szentgyorgyi
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jack Brett
- Faculty of Media and Communications, Bournemouth University, Poole, United Kingdom
| | - Elias Mouchlianitis
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- School of Psychology, University of East London, London, United Kingdom
| | - Mitul A. Mehta
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Judith F. Nottage
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Sukhi S. Shergill
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Kent and Medway Medical School, Canterbury, United Kingdom
- Kent and Medway National Health Service and Social Care Partnership Trust, Kent, United Kingdom
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22
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PlanTEA: Supporting Planning and Anticipation for Children with ASD Attending Medical Appointments. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In people with Autism Spectrum Disorder (ASD), skills related to anticipation and mental flexibility are often impaired, so their thinking tends to be very rigid and their behavior is based on establishing routines. For this reason, children with ASD may show disruptive behaviors when faced with disturbing but necessary activities, such as going to a doctor’s appointment. Therefore, it is very convenient and necessary for their families to prepare in advance for the visit and to explain the details of the procedure to be performed at the consultation. The use of anticipation boards in these situations allows to prepare such situations and to reduce stress for both the ASD child and their families or caregivers. In this context, the use of technology can provide great benefits for anticipating a new event, or whatever risks the control of their routines, as well as enhancing developmental skills such as communication, autonomy, social interaction, etc. This article describes a software tool, for mobile devices such as tablets, that allows the planning of the attendance of children with ASD to the necessary medical appointments throughout their childhood and adolescence, as well as communication with specialists. This app, named PlanTEA, has undergone a preliminary evaluation that has yielded very positive results. Most participants found the app useful in helping to anticipate (94.1%) and improve communication (94.2%) for people with ASD in medical contexts, considered it easy to use, with no technical support needed to use it (almost 100%), and would recommend its use (94.2%). This first evaluation has also allowed us to define the next steps to be taken to improve and enhance this tool and thus reach a wider population within the autistic disorder. As a result of the evaluation carried out and the comments received, it is proposed to extend its use to adult users and those with high-functioning autism, which supposes expanding and extending the functionalities of the current version of PlanTEA.
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23
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Usher R, Stapleton T. Assessing Older Adults’ Decision-Making Capacity for Independent Living: Practice Tensions and Complexities. J Appl Gerontol 2022; 41:1264-1273. [PMID: 35060410 PMCID: PMC9024017 DOI: 10.1177/07334648211065029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Decision-making capacity (DMC) is a salient issue due to increasing ageing populations and associated dementia-related diseases. Legislative and policy developments emphasise older adults’ rights to participate in decision-making. Fifty-two occupational therapists working with older adults from a range of practice settings in Ireland participated in focus groups to discuss their contribution to multidisciplinary assessments of older adult’s DMC for independent living. Findings indicate lack of shared understanding of DMC and conflicting philosophies of practice and highlight the need for a comprehensive and multidisciplinary approach. Findings also highlight that older people are often excluded from care-planning, and independent living options are determined by availability of community services rather than their preferences. Future research will attempt to inform practice in assessing and supporting older adults’ DMC for independent living.
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Affiliation(s)
- Ruth Usher
- Department of Occupational Therapy and Occupational Science, University College Cork, Ireland
| | - Tadhg Stapleton
- Discipline of Occupational Therapy, Trinity College Dublin, Ireland
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24
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Romero-Ayuso D, Toledano-González A, Rodríguez-Martínez MDC, Arroyo-Castillo P, Triviño-Juárez JM, González P, Ariza-Vega P, Del Pino González A, Segura-Fragoso A. Effectiveness of Virtual Reality-Based Interventions for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis. CHILDREN-BASEL 2021; 8:children8020070. [PMID: 33494272 PMCID: PMC7909839 DOI: 10.3390/children8020070] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = −1.38; p = 0.009), correct hits (SMD = −1.50; p = 0.004), and perceptual sensitivity (SMD = −1.07; p = 0.01); and moderate for commissions (SMD = −0.62; p = 0.002) and reaction time (SMD = −0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses.
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Affiliation(s)
- Dulce Romero-Ayuso
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (P.A.-C.); (P.A.-V.)
- Correspondence:
| | - Abel Toledano-González
- Faculty of Health Sciences, University of Castilla-La Mancha, Talavera la de Reina, 45600 Toledo, Spain; (A.T.-G.); (A.S.-F.)
| | | | - Palma Arroyo-Castillo
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (P.A.-C.); (P.A.-V.)
| | | | - Pascual González
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, 02071 Albacete, Spain;
| | - Patrocinio Ariza-Vega
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (P.A.-C.); (P.A.-V.)
| | - Antonio Del Pino González
- Department of Educational Orientation, IES Máximo Laguna, Consejería de Educación, Junta de Castilla-La Mancha, Santa Cruz de Mudela, 13730 Ciudad Real, Spain;
| | - Antonio Segura-Fragoso
- Faculty of Health Sciences, University of Castilla-La Mancha, Talavera la de Reina, 45600 Toledo, Spain; (A.T.-G.); (A.S.-F.)
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25
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Camp N, Lewis M, Hunter K, Johnston J, Zecca M, Di Nuovo A, Magistro D. Technology Used to Recognize Activities of Daily Living in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E163. [PMID: 33379319 PMCID: PMC7795436 DOI: 10.3390/ijerph18010163] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 02/03/2023]
Abstract
The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.
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Affiliation(s)
- Nicola Camp
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.C.); (K.H.); (J.J.)
| | - Martin Lewis
- Department of Sport and Exercise Science, University of Derby, Derby DE22 1GB, UK;
| | - Kirsty Hunter
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.C.); (K.H.); (J.J.)
| | - Julie Johnston
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.C.); (K.H.); (J.J.)
| | - Massimiliano Zecca
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough LE11 3TU, UK;
| | | | - Daniele Magistro
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.C.); (K.H.); (J.J.)
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26
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Romero-Ayuso D, Toledano-González A, Segura-Fragoso A, Triviño-Juárez JM, Rodríguez-Martínez MC. Assessment of Sensory Processing and Executive Functions at the School: Development, Reliability, and Validity of EPYFEI-Escolar. Front Pediatr 2020; 8:275. [PMID: 32548086 PMCID: PMC7272669 DOI: 10.3389/fped.2020.00275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/30/2020] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to determine the psychometric properties of the Assessment of Sensory Processing and Executive Functions at the School (EPYFEI-Escolar), a questionnaire designed to assess the sensory processing and executive functions as underlying processes for school participation. The total sample consisted of 536 children aged between 3 and 11 years old who lived in Spain. A total of 103 teachers completed the questionnaire. An exploratory factor analysis was conducted, which showed five main factors: (1) initiation, organization, execution, and supervision of the action; (2) inhibitory control; (3) sensory processing; (4) emotional self-regulation and play; and (5) self-competence. Some of these factors were similar to those found in the EPYFEI for parents in the home context. The reliability of the analysis was high, both for the whole questionnaire and for the factors it is composed of. The results provide evidence of the potential usefulness of the EPYFEI-Escolar in school contexts for determining academic needs and difficulties of children; moreover, this tool can also be used to plan intervention programs in the school environment according to the needs of each child and school.
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Affiliation(s)
- Dulce Romero-Ayuso
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Abel Toledano-González
- Department of Psychology, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Antonio Segura-Fragoso
- Department of Medical Sciences, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
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