Cardiovascular risk in subjects over 55 years of age and cognitive performance after five years. NEDICES2-RISK study. Study protocol.

BACKGROUND: Cognitive impairment and dementia have a high prevalence among the elderly and cause significant socio-economic impact. Any progress in their prevention can benefit millions of people. Current data indicate that cardiovascular risk (CVR) factors increase the risk of developing cognitive impairment and dementia. Using models to calculate CVR specific for the Spanish population can be useful for estimating the risk of cognitive deterioration since research on this topic is limited and predicting this risk is mainly based on outcomes in the Anglo-Saxon population. The aim of this study is to assess the relationship between CVR in the Spanish population, as calculated using the FRESCO (Función de Riesgo Española de acontecimientos Coronarios y Otros) and REGICOR (Registre Gironí del Cor) CVR tables, and the change in cognitive performance at a 5-year follow-up. METHODS: Design: Observational, analytic, prospective cohort study, with a 5-year follow-up. Ambit: Population. Population: Subjects 55 to 74 years of age, included in the NEDICES2 (2014-2017) cohort, who did not present dementia and had undergone the neuropsychological evaluation (N = 962). Variables: Exposure factors (CVR factors and estimated risk according to the CVR predictors by REGICOR and FRESCO), dependent variables (change in the score of the brief neuropsychological test in the study NEDICES2 five years after the first evaluation), and clinical and socio-demographic variables. Statistical analysis: Analysis of data quality. Descriptive analysis: socio-demographic and clinical variables of subjects. Bivariate analysis: relationship between basal CVR and change in neuropsychological tests. Multivariate analysis: relationship between basal CVR and change in neuropsychological tests adjusted by co-variables. Analysis and comparison of the reliable change in independent samples. DISCUSSION: The Spanish population can benefit from determining if individuals with high CVR, which is commonly detected in usual clinical practice, will present decreased cognitive performance compared to subjects with lower CVR. This study can affect how to address CVR factors and the design of effective prevention strategies for cognitive deterioration. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03925844.

¿Sufren deterioro cognitivo los ancianos sin enfermedades cerebrales? Datos de la cohorte NEDICES / Do the elderly people without brain diseases suffer cognitive impairment? Data from the NEDICES cohort

Objetivo: evaluar el cambio cognitivo durante 3 años en los participantes del estudio NEDICES (acrónimo de Neurological Disorders in Central Spain) sin enfermedades neurológicas. Población y métodos: la cohorte NEDICES es un estudio poblacional censal que incluye a 5278 personas mayores (con una edad igual o mayor de 65 años). Para este estudio se seleccionaron participantes sin enfermedades neurológicas y que habían realizado el Mini-Mental State Examination-37 (MMSE-37) en dos cortes (1994-1995 y 1997-1998). El cambio cognitivo se calculó mediante las diferencias (DIF) en la puntuación obtenida en el MMSE-37 en ambos cortes. Según la variable DIF, la muestra se estratificó en tres grupos: con declive cognitivo (pérdida de más de 3 puntos), sin cambio cognitivo (DIF no superior a 3 puntos en valor absoluto), y mejora cognitiva (ganancia de más de 3 puntos). Se estableció una comparación de variables relevantes (médicas y psicosociales) entre los tres grupos mediante análisis de varianza y la prueba de la chi-cuadrado. Resultados: cumplieron los criterios de inclusión 2039 participantes, con una edad media de 72,2 años (desviación estándar [DE] = 5,7). La variable DIF se distribuyó normalmente y conllevó un decremento mínimo (media [M] = -0,8 puntos; DE = 3,6). El grupo de declive cognitivo estuvo integrado por 433 sujetos (22 %), el grupo sin cambio por 1311 (64 %) y el de mejora por 275 (13 %). No se encontraron diferencias significativas entre los grupos en comorbilidad ni salud subjetiva; el grupo con declive cognitivo tenía más edad, menor nivel de estudios, hacía menos ejercicio, sufría un leve declive en las actividades instrumentales, y probablemente esté integrado mayoritariamente por casos de deterioro cognitivo leve (MCI, del inglés mild cognitive impairment). Conclusión: el declive cognitivo en los participantes seleccionados fue poco relevante; el grupo con deterioro cognitivo debe estar integrado mayoritariamente por casos de MCI incidentes (AU)

Objective: To assess the cognitive change along three years of the NEDICES (Neurological disorders in Central Spain) participants. Population and methods: The NEDICES cohort is a census population-based study integrated by 5278 elderly (65 years and older). For this study, participants with MMSE-37 and without neurological illnesses in two waves (1994-5 y 1997-8) were selected. The cognitive change of individuals was calculated by the differences (DIF) on MMSE37 scores in both waves. According to the DIF, the sample was stratified in three groups: cognitive decline group (loss > three points in MSSE-37), group without cognitive change (change no higher than three points in absolute value) and cognitive improvement group (gain > three points). The three groups were compared in relevant medical and psychosocial variables by means of analysis of variance and chi-square test. Results: 2039 (mean age = 72.21; SD = 5.72) participants met the criteria for inclusion in the study. The variable DIF showed a normal distribution and had a minimal decrement (mean = -0.8; SD = 3.63). The cognitive decline group was integrated by 433 (22 %) subjects, the group without cognitive change by 1331 (64 %), and the group of cognitive improvement by 275 (13 %). No significant differences among groups were found in comorbidities or subjective health. The cognitive decline group was more aged, less educated, performed less physical exercise, suffered slight worsening in instrumental activities and probably was highly integrated by cases of mild cognitive impairment (MCI). Conclusion: The selected participants had an insignificant cognitive decline; the cognitive decline group probably is mainly integrated by MCI cases (AU)

Deterioro de la memoria no verbal en la demencia tipo Alzheimer: ¿olvido o adquisición? / Non-verbal memory impairment in Alzheimer-type dementia: Forgetting or acquisition?

El estudio pretende comparar el rendimiento de pacientes, diagnosticados de enfermedad de Alzheimer temprana (EA) y depresión mayor unipolar (D), con un grupo de sujetos sanos control (SC) en diferentes tareas de memoria no verbal (MNV), recuerdo de posición y reconocimiento de dibujos abstractos. Todos los participantes completaron un protocolo integral para el diagnóstico de la demencia. Los pacientes con EA (n= 27) y depresión unipolar (n= 19) fueron comparados con el grupo SC (n= 30) en un test estandarizado de aprendizaje visoespacial. Los pacientes con EA rindieron significativamente más bajo en MNV en comparación con el grupo SC y D, pero no hubo diferencias entre EA y D en el recuerdo de posición. Asimismo, el grupo de EA no mostró una tasa de olvido mayor en el recuerdo de posición o reconocimiento de dibujos en comparación con los grupos SC y D. Estos resultados son interpretados en función de los procesos neurocognitivos que explican el deterioro de la MNV en la EA y la depresión (AU)

The research aims to compare patients diagnosed with early Alzheimer’s disease (AD) and unipolar major depression (D) with a healthy control group (HS) on diverse nonverbal memory tasks (NVM), recall of position, and recognition of abstracts designs. All participants completed a global protocol for diagnosis of dementia. The patients with early AD (n= 27) and D (n= 19) were compared with the healthy subject group (n= 30) on a standardised visuospatial learning test. The AD patients scored significantly lower than HS and D on NVM tasks, but there were no significant differences between AD and D on position recall. Furthermore, the AD group did not show faster forgetting rates on position recall or design recognition in comparison to HS and D groups. These results are interpreted in terms of neurocognitive processes that explain NVM impairment in AD and depression (AU)

[Non-verbal memory impairment in Alzheimer-type dementia: Forgetting or acquisition?]. / Deterioro de la memoria no verbal en la demencia tipo Alzheimer: ¿olvido o adquisición?

Non-verbal memory impairment in Alzheimer-type dementia: Forgetting or acquisition?. The research aims to compare patients diagnosed with early Alzheimer's disease (AD) and unipolar major depression (D) with a healthy control group (HS) on diverse nonverbal memory tasks (NVM), recall of position, and recognition of abstracts designs. All participants completed a global protocol for diagnosis of dementia. The patients with early AD (n= 27) and D (n= 19) were compared with the healthy subject group (n= 30) on a standardised visuospatial learning test. The AD patients scored significantly lower than HS and D on NVM tasks, but there were no significant differences between AD and D on position recall. Furthermore, the AD group did not show faster forgetting rates on position recall or design recognition in comparison to HS and D groups. These results are interpreted in terms of neurocognitive processes that explain NVM impairment in AD and depression.

Resiliencia y el modelo Burnout-engagement en cuidadores formales de ancianos / Resilience and the burnout-engagement model in formal caregivers of the elderly

Este artículo investiga en Cuidadores Formales de Ancianos la relación entre Resiliencia y aspectos mentales negativos y positivos del bienestar psicológico (Burnout-Engagement). La muestra estaba formada por 265 cuidadores de diversas residencias geriátricas de las comunidades de Extremadura y de Castilla y León. Los instrumentos utilizados fueron: Connor-Davidson Resilience Scale, Maslach Burnout Inventory-General Survey y Utrecht Work Engagement Scale. Los hallazgos más significativos demuestran que los cuidadores con altas puntuaciones en Resiliencia, frente a los de bajas puntuaciones, obtuvieron mayores niveles de eficacia y compromiso laboral (Engagement), además exteriorizaron menor agotamiento emocional y cinismo. No se puede concluir que los cuidadores más resilientes no llegan a quemarse (Burnout), sino que logran mayores habilidades y competencias de compromiso laboral (vigor, dedicación y absorción), y en la medida que refuerzan estos atributos personales, mitigan la vulnerabilidad al Burnout

This paper investigates the relationship between resilience and positive/negative mental aspects of psychological well-being in formal caregivers for the elderly. The sample consisted of 265 caregivers who work in different residential homes in Extremadura and Castilla y León (Spain). The instruments used included the Connor-Davidson Resilience Scale, the Maslach Burnout Inventory-General Survey and the Utrecht Work Engagement Scale. The most significant findings show that caregivers with higher levels of resilience also have higher levels of professional efficacy and job engagement (vigor, dedication and absorption) and appear to be less emotionally exhausted or cynical than caregivers with lower levels of resilience. It cannot be concluded that more resilient caregivers will not get burned out, but they develop better engagement skills. As they strengthen these personal attributes, they become less vulnerable to burnout

[Resilience and the burnout-engagement model in formal caregivers of the elderly]. / Resiliencia y el modelo burnout-engagement en cuidadores formales de ancianos.

This paper investigates the relationship between resilience and positive/negative mental aspects of psychological well-being in formal caregivers for the elderly. The sample consisted of 265 caregivers who work in different residential homes in Extremadura and Castilla y León (Spain). The instruments used included the Connor-Davidson Resilience Scale , the Maslach Burnout Inventory-General Survey and the Utrecht Work Engagement Scale. The most significant findings show that caregivers with higher levels of resilience also have higher levels of professional efficacy and job engagement (vigor, dedication and absorption) and appear to be less emotionally exhausted or cynical than caregivers with lower levels of resilience. It cannot be concluded that more resilient caregivers will not get burned out, but they develop better engagement skills. As they strengthen these personal attributes, they become less vulnerable to burnout.