Phonological fluency norms for Spanish middle-aged and older adults provided by the SCAND initiative (P, M, & R).

OBJECTIVE: Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores. METHOD: A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05). RESULTS: Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures. CONCLUSIONS: The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.

Functional Connectivity Hypersynchronization in Relatives of Alzheimer's Disease Patients: An Early E/I Balance Dysfunction?

Alzheimer's disease (AD) studies on animal models, and humans showed a tendency of the brain tissue to become hyperexcitable and hypersynchronized, causing neurodegeneration. However, we know little about either the onset of this phenomenon or its early effects on functional brain networks. We studied functional connectivity (FC) on 127 participants (92 middle-age relatives of AD patients and 35 age-matched nonrelatives) using magnetoencephalography. FC was estimated in the alpha band in areas known both for early amyloid accumulation and disrupted FC in MCI converters to AD. We found a frontoparietal network (anterior cingulate cortex, dorsal frontal, and precuneus) where relatives of AD patients showed hypersynchronization in high alpha (not modulated by APOE-ε4 genotype) in comparison to age-matched nonrelatives. These results represent the first evidence of neurophysiological events causing early network disruption in humans, opening a new perspective for intervention on the excitation/inhibition unbalance.

Programa de rehabilitación de las capacidades atencionales en pacientes con demencia tipo Alzheimer y enfermedades cerebrovasculares / Program for the rehabilitation of attentional processes in patients with Alzheimer's disease and stroke

En los últimos años, el incremento de la esperanza de vida y el aumento del número de personas que padecen algún tipo de demencia o enfermedad cerebrovascular han hecho patente la necesidad de desarrollar métodos de intervención neuropsicológica. El objetivo principal de esta investigación es la búsqueda de un método de rehabilitación de las capacidades atencionales que se muestre efectivo en pacientes con enfermedad de Alzheimer en estadios iniciales así como en personas que hayan sufrido un accidente cerebrovascular. Para ello se ha diseñado un programa de rehabilitación neuropsicológica que ha sido aplicado a dos muestras: una formada por veintidós personas diagnosticadas de demencia tipo Alzheimer y otra constituida por diez sujetos que habían sufrido un accidente cerebrovascular en los últimos seis meses (AU)

[Training program in strategies to improve memory]. / Programa de entrenamiento en estrategias para mejorar la memoria.

INTRODUCTION: The Training Program in Strategies to Improve Memory arises like answer to the high percentage of complaints that older people express on their loss of memory. The main aim of this program is to intervene in those failures, trying to improve the quality of life of this population sector, more and more numerous. DEVELOPMENT: The specific objectives of this Program are: to inform on what it is, how it works and how it is possible to improve the memory; to learn a wide range of useful strategies to obtain it; and to modify attitudes and beliefs on the memory of older people. The phases of the Program are: 1. Pre training evaluation: a battery of test, that have relation with the tasks and strategies that they are going to handle in the training sessions, is administered. 2. Training program: it consists of nine sessions of 90 minutes of duration each one, with a frequency of two sessions per week. In the sessions they deal with attention, concentration, memory, perception, language, etc., through the learning of the following strategies: association, categorization, visualization, repetition, etc. Each session has its own objectives, tasks and strategies to learn. There are 10 or 12 people in each group. 3. Posttraining evaluation: it is applied when finalizing the nine sessions of training. The same wide range of tests than in the first evaluation is administered (different forms or versions). 4. Final evaluation: it is made to the six months of the application of the training program. It tries to measure if the subjects keep on using the learnt strategies. 5. Monitoring sessions: during the six months mentioned, two monitoring sessions are carried out to fix the strategies to learnt. 6. Evaluation of the program: an evaluation of human and material resources employed and activities is made, just like the satisfaction with the program. At the present time, this program has been applied to 34 older than sixty people, and the results obtained demonstrate the existence of a clear improvement after the training, which is maintained six months after. But in addition to the mentioned improvement, the data show a reduction in the levels of anxiety and depression.

[Forensic neuropsychology in the aging and the dementias]. / Aspectos de la Neuropsicología Forense en el envejecimiento y en las demencias.

INTRODUCTION. Forensic Neuropsychology establishes an expert valuation of the brain-injured patient (or supposed), or of the law offender people (or supposed) requiring law protection due to their illness. This discipline has a fundamental role in the study of cerebral organic syndromes, particularly in the dementias. DEVELOPMENT. The demential syndrome is common to a group of diseases as degenerative or cardiovascular disorders, brain tumors, syphilis, alcoholism or toxic factors, etc. When speaking of dementia we refer to a syndrome characterized by a progressive and global deterioration of the cognitive functions (memory, language, attention, space-temporal orientation, praxis, thinking, etc.) with preservation of the level of conscience (DSM-IV). This symptomatology affects the personality of the individual as reasonable being , as well as to his behavior and social adaptation. The decrease or loss of the intellectual and volitives abilities of the affected person of a demential syndrome, if it is permanent, also implies a change in its legal situation, since its legal capacity is altered. Therefore, it will be necessary to adopt protective measures for his person and his patrimony. Even if it is necessary, to promote a process of disability, whose sentence will be emitted by a judge, who will indicate: the degree of the mentioned disability, the trusteeship regime and who is designated as a legal tutor.