ABSTRACT
The challenge of postcovid syndrome (PCS) is of great interest due to its wide distribution and variety of clinical signs. The main neurological signs of PCS are discussed. Data on the presumptive mechanisms forming PCS are presented. The potential for using the drug Mexidol to treat patients with PCS is addressed.
ABSTRACT
Background. Currently, there are two main areas ofstudy ofthe impactofa new coronavirus infection on mental processes: the first is in connection with the regime of self-isolation and restrictions in a pandemic;the second – with the impact ofthe pathological process itselfandthe post-covidsyndrome on the centralnervous system. The results of the studies indicate the relationship of this infection with local lesions ofthe brain andthe corresponding disturbances in the functioning ofmental processes. The aim of the research. To systematize and analyze the results of studies onthemainroutesofpenetrationoftheSARS-CoV-2virusintothecentralnervoussystem, cognitiveandemotionaldisordersin peoplewhohaverecoveredfromCOVID-19, and to discuss the areas of psychological rehabilitation for this group of patients. Materialsandmethods. InformationsearchwascarriedoutusingInternetresources (PubMed, WebofScience, Scopus, bmj.com, eLibrary.ru, frontiersin.org, sciencedirect. com, ncbi.nlm.nih.gov), literature sources were analyzed for the period from May of 2020 to November of 2021 for the following keywords: COVID-19, SARS-CoV-2, cognitive functions, cognitions, cognitive impairments, emotional dysfunction, affective dysfunction. Results. According to the analysis ofthe literature, mostresearchers identify the neurogenic pathway of SARS-CoV-2 penetration into the CNS, as well as penetration through the bloodstream or through cerebral lymphatic drainage, which are a possible cause ofmentaldisorders ofa neurologicalnature. Correction ofthese violations involves the creation of a comprehensive system of rehabilitation with the inclusion of psychotherapeutic methods. Conclusions. Despite the lackofa single picture describing the specifics ofcognitive and affective symptoms in COVID-19, in the most general terms, there is a certain consensus. So, quite often, post-COVIDcognitive symptoms are characterizedby impairedmemory andattention, andpost-COVIDaffective symptoms are characterized by increasedlevels ofanxiety, depression, andfatigue. Theissues ofdiagnosis andcorrection of disorders in post-COVID syndrome and the admissibility of the existence of this diagnosis are still relevant. © 2022 Arkheologiia Evraziiskikh Stepei. All rights reserved.
ABSTRACT
The increasing availability of online video content, partially fueled by the Covid-19 pandemic and the growing presence of social media, adds to the importance of providing audio descriptions as a media alternative to video content for blind and visually impaired persons. To address concerns as to what can be sufficiently described, we developed a concept providing audio descriptions in three levels of detail. We included an additional feature for providing optional explanations to terms and abbreviations, helping users without specific knowledge or persons with neurodiversity in comprehending complex video content. We implemented these features in a prototype based on the open-source Able Player, using an XML-based data structure to store information for all layers of audio descriptions. A qualitative user test focused on the benefits of multi-layered audio descriptions and optional explanatory content. Findings suggest that the choice on several levels of detail is received positively by users. They also appreciated the concept of optional explanations and came up with further use cases for such a practice. Participants preferred a higher level of detail for a high-paced action video and a lower level for informative content. © 2022, Springer Nature Switzerland AG.
ABSTRACT
BACKGROUND: Serious games have been found to have enhancing and preventative effects on cognitive abilities in healthy older adults. Yet, there are few results on the effects in older seniors with age-related low cognitive impairments. Their special needs were considered when designing and using innovate technology in the area of prevention, which is especially relevant owing to the continuously aging population. OBJECTIVE: The objective of this study was to evaluate the impact of a serious game on the cognitive abilities of seniors in order to potentially implement innovative resource-oriented technological interventions that can help to meet future challenges. METHODS: In this controlled trial, we tested the serious game MemoreBox, which features modules specifically designed for seniors in nursing homes. Over a period of 1 year, we tested the cognitive abilities of 1000 seniors at 4 time points using the Mini-Mental Status Test. Only half of the participating seniors engaged with the serious game. RESULTS: The study included an intervention group (n=56) and a control group (did not play; n=55). Based on the in-game data collection, a second intervention group (n=38) was identified within the original intervention group, which exactly followed the planned protocol. There were no noteworthy differences between the demographic and main variables of the overall sample. The large reduction in the sample size was due to the effects of the COVID-19 pandemic (drop-out rate: 88.9%). The CI was set at 5%. Mixed analysis of variance (ANOVA) between the cognitive abilities of the intervention and control groups did not show a statistically significant difference between time and group (F2.710,295.379=1.942; P=.13; partial η²=0.018). We noted approximately the same findings for mixed ANOVA between the cognitive abilities of the second intervention and control groups (F3,273=2.574; P=.054; partial η²=0.028). However, we did observe clear tendencies and a statistically significant difference between the 2 groups after 9 months of the intervention (t88.1=-2.394; P=.02). CONCLUSIONS: The results of this study show similarities with the current research situation. Moreover, the data indicate that the intervention can have an effect on the cognitive abilities of seniors, provided that they regularly play the serious game of MemoreBox. The small sample size means that the tendency toward improvement cannot be proven as statistically significant. However, the tendency shown warrants further research. Establishing an effective prevention tool as part of standard care in nursing homes by means of an easy-to-use serious game would be a considerable contribution to the weakened health care system in Germany as it would offer a means of activating senior citizens in partially and fully inpatient care facilities. TRIAL REGISTRATION: German Clinical Trials Register DRKS00016633; https://tinyurl.com/2e4765nj.
ABSTRACT
OBJECTIVES: This study aims to examine the feasibility of an intergenerational remote intervention program designed to promote the wellbeing and social connection of vulnerable older adults, mainly people with aphasia and dementia during the COVID-19 pandemic in the south of Brazil. Undergraduate students were guided to lead weekly sessions of clowning, storytelling, dancing, and cooking-related activities for 3 months (from November/2020 to February/2021). METHOD: The mixed-method design of the study addresses the implementation and feasibility of the program. Data analysis considered both quantitative-number of individuals who accepted the invitation to participate, voluntary dropouts, attendance-and qualitative data-participative observation and thematic analysis of evaluative conversations. An inclusive group of 34 older adults with stroke-induced cognitive impairments, dementia and individuals without any neurological conditions enrolled in the program based on social and racial equity principles. Feasibility and acceptability were addressed in terms of recruitment, implementation, remote evaluation, delivery of remote intervention, adherence, and attendance. Activities and participants' perceptions are described. RESULTS: The initial period of the program achieved 83.7% of adherence and sustainability for additional 3 months. Preliminary results suggest feasibility and acceptability, considering formal and informal support in digital inclusion. Participatory observations describe that the structure of sessions and activities were well received. The analysis of participants' perceptions detects the thematic saliency of feelings of social connection and a sense of having learned with the group. CONCLUSIONS: Preliminary results of this study demonstrate the feasibility and acceptability of the program, pointing to its potential mental health benefits.
ABSTRACT
To prospectively describe 1-year outcomes, with a focus on functional outcome, cognitive outcome, and the burden of anxiety, depression, and post-traumatic stress disorder, in coronavirus disease 2019 patients managed with extracorporeal membrane oxygenation. DESIGN: Prospective case series. SETTING: Tertiary extracorporeal membrane oxygenation center in the United States. PATIENTS: Adult coronavirus disease 2019 acute respiratory distress syndrome patients managed with extracorporeal membrane oxygenation March 1, 2020, to July 31, 2020. INTERVENTIONS: Baseline variables, treatment measures, and short-term outcomes were obtained from the medical record. Survivors were interviewed by telephone, a year following the index intensive care admission. Functional outcome was assessed using the modified Rankin Scale and the World Health Organization Disability Assessment Scale 2.0. Cognitive status was assessed with the 5-minute Montreal Cognitive Assessment. The Hospital Anxiety and Depression Scale was used to screen for anxiety and depression. Screening for post-traumatic stress disorder was performed with the Posttraumatic Stress Disorder Checklist 5 instrument. MEASUREMENTS AND MAIN RESULTS: Twenty-three patients were managed with extracorporeal membrane oxygenation, 14 (61%) survived to hospital discharge. Thirteen (57%) were alive at 1 year. One patient was dependent on mechanical ventilation, another intermittently required supplemental oxygen at 1 year. The median modified Rankin Scale score was 2 (interquartile range, 1-2), median World Health Organization Disability Assessment Scale 2.0 impairment score was 21% (interquartile range, 6-42%). Six of 12 previously employed individuals (50%) had returned to work, and 10 of 12 (83%) were entirely independent in activities of daily living. The median Montreal Cognitive Assessment score was 14 (interquartile range, 13-14). Of 10 patients assessed with Hospital Anxiety and Depression Scale, 4 (40%) screened positive for depression and 6 (60%) for anxiety. Four of 10 (40%) screened positive for post-traumatic stress disorder. CONCLUSIONS: Functional impairment was common a year following the use of extracorporeal membrane oxygenation in coronavirus disease 2019, although the majority achieved independence in daily living and about half returned to work. Long-term anxiety, depression, and post-traumatic stress disorder were common, but cognitive impairment was not.
ABSTRACT
Intensive care unit survivors experience prolonged physical impairments, cognitive impairments, and mental health problems, commonly referred to as post-intensive care syndrome (PICS). Previous studies reported the prevalence, assessment, and prevention of PICS, including the ABCDEF bundle approach. Although the management of PICS has been advanced, the outbreak of coronavirus disease 2019 (COVID-19) posed an additional challenge to PICS. The prevalence of PICS after COVID-19 extensively varied with 28-87% of cases pertaining to physical impairments, 20-57% pertaining to cognitive impairments, and 6-60% pertaining to mental health problems after 1-6 months after discharge. Each component of the ABCDEF bundle is not sufficiently provided from 16% to 52% owing to the highly transmissible nature of the virus. However, new data are emerging about analgesia, sedation, delirium care, nursing care, early mobilization, nutrition, and family support. In this review, we summarize the recent data on PICS and its new challenge in PICS after COVID-19 infection.
ABSTRACT
Social-distancing guidelines from the COVID-19 pandemic have potential to compound morbidity in persons with dementia (PwD) and increase caregiver burden. This qualitative study utilized semi-structured interviews between August-November 2020 to explore the impact of COVID-19 on PwD and caregivers. Conventional qualitative content analysis was used. Inter-coder reliability was confirmed using the kappa coefficient. Twenty-five interviews were completed with four themes emerging: disruption of socialization, fear and risk mitigation, coping strategies, and caregiver burden. Participants described how lack of socialization and confinement led to feelings of loneliness, depression, and worsening memory problems. Caregivers reported increased burden and heightened feelings of responsibility for their loved one. Increased isolation imposed by the pandemic has a detrimental impact on PwD. Further work is needed to develop interventions to support PwD and other cognitive impairments and caregivers during the pandemic and when in-person socialization is not possible.