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Czaja SJ, Kallestrup P, Harvey PD. The Efficacy of a Home-Based Functional Skills Training Program for Older Adults With and Without a Cognitive Impairment. Innov Aging 2024; 8:igae065. [PMID: 39081781 PMCID: PMC11287767 DOI: 10.1093/geroni/igae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Indexed: 08/02/2024] Open
Abstract
Background and Objectives The performance of everyday technology-based tasks, such as online banking or shopping, can be challenging for older adults, especially those with a cognitive impairment. Technology-based tasks are cognitively demanding and require learning new skills. This study explored the efficacy of a technology-based functional skills assessment and training program (FUNSAT) among aging adults with and without mild cognitive impairment (MCI) in home settings. Research Design and Methods One hundred and eighty-four racially/ethnically diverse male and female adults aged 65+ participated in the study. The sample included 75 noncognitively impaired (NC) older adults and 109 older adults with MCI. The FUNSAT program includes medication and money management, transportation, and shopping tasks. The MCI participants were randomized to the FUNSAT training or FUNSAT training combined with computer-based cognitive training (FUNSAT/CCT). The nonimpaired adults received the FUNSAT training only. Using alternative forms of the assessment component of the FUNSAT program, assessments occurred at baseline, post-training, and 1- and 3-month post-training. This paper reports the post-training results. Results The findings indicated that the performance of both the nonimpaired and MCI participants improved significantly for all 6 tasks post-training. Specifically, training resulted in improvements in task completion time and task errors. Participants also reported greater confidence when performing the tasks in the real world. Discussion and Implications Nonimpaired aging adults and those with MCI can learn to perform technology-based everyday tasks. Further, home-based technology training protocols are feasible for aging adults with and without a cognitive impairment. Clinical Trial Registration NCT0467944 1.
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Affiliation(s)
- Sara J Czaja
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | | | - Philip D Harvey
- Department of Psychiatry and Behavioral Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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Mimenza-Alvarado AJ, Ambrosio-Palma A, Aguilar-Navarro SG. Cognitive function in Mexican older adults 6-months after recovering from SARS-CoV-2 infection. Rev Esp Geriatr Gerontol 2024; 59:101479. [PMID: 38691898 DOI: 10.1016/j.regg.2024.101479] [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: 10/29/2022] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND SARS-CoV-2 infection has been associated with multiple short- and long-term complications including depression, and cognitive impairment (CI). However, older adults with CI after COVID-19 have not been fully documented. OBJECTIVE To evaluate cognitive function in Mexican adults post-recovery from SARS-CoV-2 infection. METHODS In this prospective observational cohort study, we assess cognitive function (CF) by the Montreal Cognitive Assessment (MOCA) test with a cut-off less than 26 points, and functional status via telemedicine. Eligible patients with a history of moderate-severe COVID-19 aged ≥60 years, cognitively healthy (evaluated by Everyday Cognition Scale) and required admission to an intensive care unit (ICU) were included. Patients with history of dementia, stroke, and delirium during the cognitive evaluation were excluded. The association between CI and COVID-19 was assessed with a Cox regression model. RESULTS From the 634 patients admitted to the ICU, 415 survived, afterward 308 were excluded and 107 were analyzed. Mean age was 70 years, 58% were female, and 53% had severe COVID. The mean MoCA score was 21±5 points, CI was present in 61 patients (57%). Infection severity (RR 1.87; 95% CI: 1.11-3.15, p<0.05), lower education (RR 0.92; 95% CI: 0.87-0.97, p<0.01), and activity daily living disability (RR 1.87; 95% CI: 1.07-3.26, p<0.05) were the main factors associated with CI (unadjusted model by age and sex). The delayed recall, orientation, and language (83.2, 77.6 and 72.9% respectively) domains were the most affected in patients with CI. CONCLUSIONS Fifty-seven percent of patients analyzed developed CI six months post-ICU discharge due to SARS-CoV-2, and COVID severity was the main factor associated to its outcome.
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Affiliation(s)
- Alberto Jose Mimenza-Alvarado
- Deparment of Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Abdias Ambrosio-Palma
- Deparment of Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Sara Gloria Aguilar-Navarro
- Deparment of Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico.
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Pinto JO, Pontes D, Peixoto B, Dores AR, Barbosa F. Ecological validity of neuropsychological interventions: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-20. [PMID: 38588721 DOI: 10.1080/23279095.2024.2328694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND The concept of ecological validity (EV) in neuropsychological interventions (NI) has been consistently advocated, but there is a lack of reviews focused on how EV is operationalized in NI programmes. This review aims to address this gap by exploring the outcome measures more commonly used for assessing EV and to understand the main characteristics of programmes with good EV. METHOD A literature search was conducted to identify studies that examined the EV of NI programmes, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Collaboration Guidelines. RESULTS A total of twenty-seven studies were included in this review. Among these, only three studies explicitly described the procedures used to assess EV. Additionally, almost half of the studies assumed that interventions had good EV based on the characteristics of the programmes. The inconsistent assessment of EV of NI programmes prevented the identification of specific characteristics of programmes demonstrating good EV. CONCLUSION This systematic review reveals a significant gap in the literature concerning the operationalization of EV within the field of NI. Further research is required to establish a consistent definition of EV in the context of NI and to develop criteria for its effective operationalization.
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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
| | - Diogo Pontes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University 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, Gandra, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences, (1H-TOXRUN, IUCS-CESPU), Gandra, 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
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Sáez-Gutiérrez S, Fernández-Rodríguez EJ, Sánchez-Gómez C, García-Martín A, Barbero-Iglesias FJ, Sánchez Aguadero N. Study protocol for a randomized controlled trial: Effect of an everyday cognition training program on cognitive function, emotional state, frailty and functioning in older adults without cognitive impairment. PLoS One 2024; 19:e0300898. [PMID: 38551981 PMCID: PMC10980185 DOI: 10.1371/journal.pone.0300898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/28/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Ageing entails changes in complex cognitive functions that lead to a decrease in autonomy and quality of life. Everyday cognition is the ability to solve cognitively complex problems in the everyday world, enabling instrumental activities of life. Benefits have been found in studies using everyday cognition-based assessment and intervention, as the results predict improvements in everyday performance, not just in specific cognitive functions. A study protocol is presented based on assessment and training in everyday cognition versus traditional cognitive stimulation for the improvement of functionality, emotional state, frailty and cognitive function. METHODS A parallel randomised controlled clinical trial with two arms will be conducted. It will be carried out by the University of Salamanca (Spain) in eleven centres and associations for the elderly of the City Council of Salamanca. People aged 60 years or older without cognitive impairment will be recruited. Participants will be randomly distributed into two groups: the experimental group will undergo a training programme in everyday cognition and the control group a programme of traditional cognitive stimulation, completing 25 sessions over 7 months. All participants will be assessed at the beginning and at the end of the intervention, where socio-demographic data and the following scales will be collected: The Medical Outcomes Study (MOS), Questionnaire ARMS-e, Everyday Cognition Test (PECC), Scale Yesavage, Test Montreal Cognitive Assessment (MoCA), The Functional Independence Measure (FIM), Fragility Index and Lawton y Brody Scale. DISCUSSION The present study aims to improve conventional clinical practice on cognitive function training by proposing a specific assessment and intervention of everyday cognition based on the importance of actual cognitive functioning during the resolution of complex tasks of daily life, giving priority to the improvement of autonomy. TRIAL REGISTRATION ClinicalTrials.gov; ID: NCT05688163. Registered on: January 18, 2023.
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Affiliation(s)
| | - Eduardo José Fernández-Rodríguez
- Department of Nursing and Physiotherapy, Universidad de Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Celia Sánchez-Gómez
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Department of Developmental and Educational Psychology, Universidad de Salamanca, Salamanca, Spain
| | - Alberto García-Martín
- Department of Labour Law and Social Work, Universidad de Salamanca, Salamanca, Spain
| | - Fausto José Barbero-Iglesias
- Department of Nursing and Physiotherapy, Universidad de Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Natalia Sánchez Aguadero
- Department of Nursing and Physiotherapy, Universidad de Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
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Sáez-Gutiérrez S, Fernandez-Rodriguez EJ, Sanchez-Gomez C, Garcia-Martin A, Polo-Ferrero L, Barbero-Iglesias FJ. Effectiveness of Different Neurocognitive Intervention Approaches on Functionality in Healthy Older Adults: A Systematic Review. Behav Sci (Basel) 2024; 14:87. [PMID: 38392440 PMCID: PMC10886235 DOI: 10.3390/bs14020087] [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: 11/15/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/24/2024] Open
Abstract
Subtle loss of functionality in healthy older adults is considered one of the most important predictors of cognitive decline. Neurocognitive interventions are increasingly being used, from a preventive maintenance approach to functional capacity. This study evaluates the effectiveness of different neurocognitive approaches on the functionality of healthy older adults. In this systematic review (CRD42023473944), an extensive search was conducted for articles published in the last 10 years (2013-2023) in the following databases: Medline, Scopus, and Web of Science. A total of 809 trials were identified, of which 18 were considered to be eligible for inclusion in the review. The data revealed heterogeneity in sample size, measures of functional assessment, neurocognitive interventions used, number of sessions, session duration, and time. Traditional cognitive stimulation is shown to have no significant functional benefit, while other less commonly used neurocognitive interventions, such as those based on everyday cognition, are associated with more significant benefits. Moreover, it is demonstrated that although the Instrumental Activities of Daily Living scale (IADL) is the most used test in similar studies, it is not sensitive enough to detect changes in functionality in healthy elderly individuals, with other tests such as the Timed Instrumental Activities of Daily Living (TIADL) being more advantageous. Therefore, a new guideline is proposed for its use in clinical practice and research, using homogeneous study protocols and neurocognitive interventions that allow for the transfer and generalization of results in daily life.
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Affiliation(s)
- Susana Sáez-Gutiérrez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Eduardo J Fernandez-Rodriguez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Celia Sanchez-Gomez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Department of Developmental and Educational Psychology, University of Salamanca, 37007 Salamanca, Spain
| | - Alberto Garcia-Martin
- Department of Labour Law and Social Work, University of Salamanca, 37007 Salamanca, Spain
| | - Luis Polo-Ferrero
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Fausto J Barbero-Iglesias
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
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Jung ES, Choi YY, Lee KH. Effects of Integrative Cognitive Function Improvement Program on Cognitive Function, Oral Health, and Mental Health in Older People: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14339. [PMID: 36361215 PMCID: PMC9659034 DOI: 10.3390/ijerph192114339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
We aimed to investigate the effects of an integrative cognitive function improvement program that combined existing cognitive, emotional, and physical therapies on cognitive function, oral health, and mental health in elder participants. Participants were classified into one of the following groups: cognitively normal (CN; n = 18), mild cognitive impairment (MCI; n = 17), and control (n = 17). An integrative cognitive function improvement program was administered to the CN and MCI groups for six weeks. To measure cognitive function, electroencephalogram (EEG) and cerebral blood flow (CBF) were evaluated, and to measure oral health, the O'Leary index, Löe & Silness index, tongue coating, unstimulated saliva flow rate, and oral muscle strength were measured. To measure mental health status, mental health, happiness and social support were measured. The CN and MCI groups showed a significant change in EEG-based indices for awareness level and physical stress. Regarding oral health, the O'Leary and the Löe & Silness index score decreased significantly in the CN and MCI groups. Saliva flow rate increased significantly in the CN and MCI groups. In regards to mental health, the happiness score increased post-intervention in the CN and MCI groups. In conclusion, the integrative cognitive function improvement program was effective in improving cognitive function, oral health, and mental health of elder people.
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Affiliation(s)
- Eun-Seo Jung
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu 11644, Korea
| | | | - Kyeong-Hee Lee
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu 11644, Korea
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