Programa de estimulación cognitiva e inteligencia emocional para mayores (PECI-PM): beneficios en la memoria cotidiana / Cognitive stimulation and emotional intelligence program for seniors (PECI-PM): benefits in daily memory

Fundamento y objetivo: una de las quejas más frecuentes entre la población anciana son los fallos en la memoria cotidiana. El objetivo del presente trabajo es analizar los efectos de un programa de estimulación cognitiva e inteligencia emocional para mayores sobre la memoria cotidiana. Material y método: en un grupo de 28 sujetos, mayores de 55 años, se aplicó el Cuestionario de fallos en la memoria cotidiana (MFE), antes y después de participar en el programa de entrenamiento. Resultados: tras 20 sesiones, se constató una mejora (puntuaciones medias más bajas en fallos de memoria) en cada uno de los factores (recuerdo de actividades, reconocimiento y monitorización de la comunicación), así como en la puntuación global del MFE. Conclusiones: en general, los resultados en quejas subjetivas de memoria son positivos con respecto a las puntuaciones obtenidas antes de las sesiones. No obstante, se espera que con la implementación del resto de sesiones, estas mejoras resulten significativas. Para la segunda fase de implementación del programa, se han incorporado nuevos contenidos y actividades, para seguir trabajando en línea con estos resultados (AU)

Principles and purpose: One of the most frequent complaints by the older population is failure of their day-to-day memory. The purpose of this study is to analyze the effects of a program for Cognitive Stimulation and Emotional Intelligence for Seniors on day-to-day memory. Materials and method: A group of 28 subjects over 55 years of age were given the Questionnaire on Failure of Day-to-Day Memory, before and after participating in the training program. Results: After 20 sessions, an improvement was shown (lower mean scores in memory failure) in each of the factors (memory of activities, recognition and monitoring of communication), as well as in the overall MFE score. Conclusions: In general, the results in subjective memory complaints are positive with respect to the scores before sessions. However, these improvements are expected to become significant with the implementation of the rest of the sessions. New content and activities have been included in the second stage of program implementation to continue working along the line of these results (AU)

Clinical correlates of retrograde amnesia in mild traumatic brain injury.

PRIMARY OBJECTIVE: The purpose of this study was to examine the clinical significance of retrograde amnesia (RA) in patients with acute mild traumatic brain injuries (MTBI). METHODS AND PROCEDURES: An emergency department sample of patients (n = 75), aged 18-60 years, with no pre-morbid medical or psychiatric conditions, who met the WHO criteria for MTBI were enrolled in this prospective, descriptive, follow-up study. This study examined the presence and duration of RA in relation to socio-demographics, MTBI severity markers including neuroimaging (CT, MRI) and clinical outcomes (Rivermead post-concussion symptoms questionnaire, post-concussion syndrome (PCS) diagnosis and return to work (RTW) status) at 2 weeks, 1 month and 6 months post-injury. MAIN OUTCOMES AND RESULTS: GCS scores and duration of post-traumatic amnesia (PTA) were related to RA. Those with GCS scores of 14 vs. 15 were more likely to have RA (χ(2)(1) = 13.70, p < 0.0001) and a longer duration (Mann-Whitney U = 56.0, p < 0.0001, d = 1.15) of RA. The duration of RA and PTA correlated positively (Spearman ρ(75) = 0.42, p < 0.0001) and those with RA had longer durations of PTA (Mann-Whitney U = 228.5, p = 0.001, d = 1.21). During the follow-up, the presence and duration of RA were not significantly associated with PCS diagnosis or time to RTW. CONCLUSIONS: In this study, the presence and duration of RA was not associated with outcome.

Sensitivity of the RBANS to acute traumatic brain injury and length of post-traumatic amnesia.

OBJECTIVE: Although the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been shown to be a useful tool in evaluating the cognitive status of patients with dementia, stroke, schizophrenia and post-acute traumatic brain injury (TBI), no studies have examined its utility in an acute TBI setting. The current study investigates the RBANS' sensitivity to acute TBI, hypothesizing that the presence and severity of injury is predictive of worse RBANS performance. METHOD: Neuropsychological testing was conducted an average of 6.1 days after emergence from post-traumatic amnesia (PTA). RBANS results were evaluated based on a normative basis, pre-injury estimates, and brain injury severity. RESULTS: In this sample of acute TBI patients (n = 51), the mean index scores on the RBANS ranged from 1.59-2.36 SD below the mean of the standardization sample. Each WRAT-4 Reading sub-test score was above the corresponding RBANS Total Scale Index score (t(31) = 10.32, p < 0.001). Regression analyses revealed that Delayed Memory (ß = - 0.365, p < 0.007) and Total Score (ß = -0.297, p < 0.023) indices were significantly predicted by PTA length after controlling for age and education. CONCLUSIONS: The RBANS appears to be a useful tool in assessing the presence and severity of acute TBI.

Retrograde memory in cerebrovascular disease and Alzheimer's disease.

Retrograde memory is frequently tested in the mental status examination of patients with stroke or degenerative dementia. The goal of this experiment was to compare gradients of retrograde memory in patients without neurologic disease (n = 26), patients with cerebrovascular disease (n = 43), and patients with probable Alzheimer's disease (n = 27). Patients were asked to recall and then name photographs of the 6 most recent US presidents. The free recall of patients with both cerebrovascular disease and probable Alzheimer's disease formed an exaggeration of the normal forgetting curve seen in control patients, in that the most recent presidents were most likely to be remembered. For photo naming, control patients showed essentially no forgetting, whereas patients with cerebrovascular disease or Alzheimer's disease had substantial memory loss with no temporal gradient. Alzheimer's disease caused significantly worse retrograde memory loss than did cerebrovascular disease, despite the two groups' equivalence in global intellectual functioning. Consistent with the focal or multifocal nature of cerebrovascular disease, stepwise multiple regression of retrograde memory on neuropsychological testing indicated that producing names by free recall was predicted by aphasic deficits, and that photo naming was predicted by visuoperceptual deficits. In Alzheimer's disease, free recall was predicted primarily by deficits in verbal new learning, consistent with amnesia, whereas photo naming was predicted by loss of general knowledge, consistent with dementia. The results are consistent with the idea that free recall of names from the past is a form of episodic memory, whereas naming of famous faces from the past is a form of semantic memory.

Early stage assessment and course of acute stress disorder after mild traumatic brain injury.

Although it has been established that acute stress disorder (ASD) and posttraumatic stress disorder occur after mild traumatic brain injury (MTBI) the qualitative differences in symptom presentation between injury survivors with and without a MTBI have not been explored in depth. This study aimed to compare the ASD and posttraumatic stress disorder symptom presentation of injury survivors with and without MTBI. One thousand one hundred sixteen participants between the ages of 17 to 65 years (mean age: 38.97 years, SD: 14.23) were assessed in the acute hospital after a traumatic injury. Four hundred seventy-five individuals met the criteria for MTBI. Results showed a trend toward higher levels of ASD in the MTBI group compared with the non-MTBI group. Those with a MTBI and ASD had longer hospital admissions and higher levels of distress associated with their symptoms. Although many of the ASD symptoms that the MTBI group scored significantly higher were also part of a postconcussive syndrome, higher levels of avoidance symptoms may suggest that this group is at risk for longer term poor psychological adjustment. Mild TBI patients may represent a injury group at risk for poor psychological adjustment after traumatic injury.

Effects of temporal lobe epilepsy on retrograde memory.

PURPOSE: In a previous investigation (Lah et al., 2004), we found deficits in retrograde memory in patients who had undergone temporal lobectomy (TL). In this study, we set out to determine whether such deficits are present before surgery in patients with temporal lobe epilepsy (TLE). METHODS: Memory for public and autobiographic facts and events was assessed in patients with focal left-sided (n=15) or right-sided (n=14) TLE and healthy control subjects (n=15). The impact of epilepsy and underlying cognitive deficits on retrograde memory also was examined. RESULTS: Patients with left TLE demonstrated retrograde memory deficits across domains. Patients with right TLE showed defective recall only in the autobiographic domain. Young age at onset (younger than 14 years) was associated with greater difficulties in recall of famous events, and patients receiving polytherapy had significantly reduced recall of autobiographic events compared with those receiving monotherapy. In most cases, deficient memory for the past was associated with impairments in other cognitive skills, especially language abilities. CONCLUSIONS: In unoperated-on patients with TLE, we found deficits in retrograde memory that were similar to those seen after TL, with the pattern of deficits being influenced by side of lesion, anticonvulsant medication, and word-finding deficits. Unlike patients tested after right TL, patients with right TLE did not have difficulty recalling details of famous events, which raises the possibility that right TL results in a decline in this aspect of retrograde memory.

[Primary loss of consciousness and amnesia in subarachnoid hemorrhage--a quantitative study]. / Primäre Bewusstlosigkeit und Amnesie bei Subarachnoidalblutung--eine quantifizierende Untersuchung.

Subarachnoid hemorrhages (SAH) being sudden events affecting the brain in a rather wide-spread fashion are apt to induce loss of consciousness (LOC) and amnesia. The aim of the present study was to collect data on their frequency and extent. To this end we examined 48 patients at a mean of one year post-onset. Two thirds of them reported anterograde and an additional 17% retrograde amnesia; in 40% LOC (median 6 minutes) was observed. The durations were extremely skewed towards shorter times with a median of 2.7 days for anterograde and 1.3 days for retrograde amnesia who--with a single exception--were markedly shorter than anterograde amnesia. Summing up, a significant proportion of all SAH suffered LOC and amnesia occurred in the majority of cases. SAH therefore are events which with respect to LOC and amnesia bear some resemblance with closed head injuries. Exact observation and history taking may disclose important data on their severity and possible sequelae.

Predictors of retrograde amnesia following ECT.

OBJECTIVE: Substantial progress has been made in identifying how the treatment parameters used in ECT impact on cognitive side effects. However, there is limited information regarding individual differences in vulnerability to these side effects. The authors examined patients' pretreatment global cognitive status and postictal orientation recovery time as potential predictors of the magnitude of retrograde amnesia for autobiographical memories after ECT. METHOD: Seventy-one inpatients with major depressive disorder were randomly assigned to four ECT conditions that varied in electrode placement (right unilateral versus bilateral) and stimulus dosage (low versus high intensity). Orientation recovery time was assessed at virtually every session during the course of ECT. Global cognitive status was assessed with the modified Mini-Mental State examination before treatment, during the week after termination of treatment, and 2 months after treatment ended. Retrograde amnesia was assessed at these same time points with the Autobiographical Memory Interview. RESULTS: Pre-ECT global cognitive status and the duration of postictal disorientation were strong predictors of the magnitude of retrograde amnesia in the week after the course of ECT and at 2-month follow-up. In general, these relationships were maintained regardless of technical parameters in the administration of the ECT. CONCLUSIONS: Patients who manifest global cognitive impairment before treatment and patients who experience prolonged disorientation in the acute postictal period may be the most vulnerable to persistent retrograde amnesia for autobiographical information.