[Cognition in medical residents with and without anxiety in a specialist training hospital]. / Cognición en médicos residentes con y sin ansiedad en un hospital formador de especialistas.

Background: The resident doctor plays an important role in people's health care. Objective: To compare the cognition of medical residents with/without anxiety in a specialist training hospital. Material and methods: Comparative, prospective, cross-sectional study. Medical residents of any grade and specialty were included, who signed informed consent. Those with a diagnosis of cognitive impairment were excluded, and who did not complete the tests were eliminated. AMAS-A test was applied to assess anxiety and NEUROPSI: Attention and memory test for cognitive characteristics. Mann-Whitney's U and Spearman's rho were used, p≤0.05 was considered significant. Results: 155 residents were evaluated, 55.5% men, mean age 32.4 years. Internal Medicine was the predominant specialty (25.2%). AMAS-A identified 94.19% residents with anxiety. NEUROPSI reported Attention and memory domain (38.7%) in normal classification, Memory (34.2%) in high normal, and Attention and executive functions (32.3%) in severe alteration as predominant assessments. Only Memory showed a significant difference between residents with and without anxiety (p=0.015). Attention and executive functions-Physiological anxiety (r=-0.21, p=0.009) and Attention and memory-Social concern (r=-0.268, p=0.001) correlations were significant. Conclusions: The percentage of anxiety and cognitive alterations in residents physicians is high. Anxiety decisively affects memory capacity in these medical doctors.

Introducción: el médico residente desempeña un papel importante en la atención a la salud de los pacientes. Objetivo: comparar la cognición de médicos residentes con y sin ansiedad en un hospital formador de especialistas. Material y métodos: estudio comparativo, prospectivo, transversal, en médicos residentes de cualquier grado y especialidad, que firmaron consentimiento informado. Se excluyeron aquellos con diagnóstico de alteración cognitiva y se eliminaron los que no completaron las pruebas realizadas. Se aplicaron AMAS-A para evaluar ansiedad y NEUROPSI: Atención y memoria para características cognitivas. Se utilizaron U de Mann-Whitney, y rho de Spearman. Se consideró significativa una p ≤ 0.05. Resultados: se evaluaron 155 residentes, 55.5% hombres, edad media 32.4 años. Medicina Interna fue la especialidad predominante (25.2%). Se identificó ansiedad en el 94.19% de los residentes. Predominaron los dominios Atención y memoria en clasificación normal (38.7%), Memoria en normal-alto (34.2%) y Atención y funciones ejecutivas en alteración severa (32.3%). Memoria mostró diferencia significativa entre residentes con y sin ansiedad (p = 0.015). Las correlaciones de Atención y funciones ejecutivas-Ansiedad fisiológica (r = -0.21, p = 0.009) y Atención y memoria-Preocupación social (r = -0.268, p = 0.001) resultaron significativas. Conclusiones: el porcentaje de ansiedad y alteraciones cognitivas en residentes es alto. La ansiedad afecta decisivamente la capacidad de memoria en estos médicos.

Utility of a Spanish version of Three Words-Three Shapes Test to detect memory impairment in primary progressive aphasia.

INTRODUCTION: Three Words-Three Shapes (3W3S) is a bedside test that assesses verbal and non-verbal memory and has proven useful in staging memory decline in amnestic disorders and primary progressive aphasia. Given its simple structure, the 3W3S can be easily adapted to other languages maintaining the original shapes and only modifying the words. We aim to validate a Spanish version of the 3W3S test and establish whether memory loss patterns present in amnesic disorders associated with Alzheimer's etiology and PPA were correctly characterized. METHOD: The translation and adaptation of the 3W3S were performed according to standardized guidelines and applied to a cohort of patients with Dementia of Alzheimer's type (DAT = 20), mild cognitive impairment (aMCI= 20), primary progressive aphasia (PPA = 20), and healthy controls (HC = 20). RESULTS: In verbal memory performance, PPA patients' score was lower than that of MCI and HC and similar to DAT's in the effortless encoding (p < 0.001), delayed recall (p < 0.001), and recognition (p < 0.012). For non-verbal performance, PPA patients performed better than DAT and similar to HC and MCI subjects (p < 0.001). CONCLUSIONS: Results show good applicability of 3W3S to determine memory function in PPA patients, independently from language ability. Visual and verbal components of memory are dissociated in PPA.

Worse associative memory recall in healthy older adults compared to young ones, a face-name study in Spain and Mexico.

INTRODUCTION: The Face Name Associative Memory Exam (FNAME) is sensitive to associative memory changes early in the Alzheimer's disease spectrum, but little is known about how healthy aging affects FNAME performance. We aimed to assess aging effects on an extended version of the test, which captures further associative memory abilities beyond the recall and recognition domains measured in the original version. METHOD: We adapted FNAME versions in Spain and Mexico, adding new subtests (Spontaneous Name Recall, Face-Name Matching). We compared the performance of 21 young adults (YA) and 27 older adults (OA) in Spain, and 34 YA and 36 OA in Mexico. Recall was analyzed using a mixed-model ANOVA including subtest scores as dependent variables, age group as a fixed-factor independent variable, and recall subtest as a three-level repeated-measure independent variable. The rest of the associative memory domains were analyzed through t-tests comparing the performance of YA and OA. RESULTS: In Spain, we found significant effects for age group and recall subtest, with large effect sizes. The recognition subtests (Face Recognition, Name Recognition) displayed ceiling effects in both groups. The new subtests displayed medium-to-large effect sizes when comparing age groups. In Mexico, these results were replicated, additionally controlling for education. In both studies, recall performance improved after repeated exposures and it was sustained after 30 minutes in YA and OA. CONCLUSIONS: We document, in two different countries, a clear aging pattern on the extended FNAME: regardless of education, OA remember fewer stimuli than YA through recall subtests. The new subtests provide evidence on associative memory changes in aging beyond recall.