Comparación de los libros de historia de vida digitales y convencionales sobre el estado de ánimo, la comunicación, la cognición y la calidad de vida en personas con demencia en residencias: un estudio piloto / Comparison of digital and conventional life story books on mood, communication, cognition and quality of life in people with dementia in nursing homes: A pilot study

Introducción: La atención centrada en la persona (ACP) incluye la historia de vida, una forma de terapia de reminiscencia que puede ser útil en el tratamiento de la demencia. Comparamos la eficacia de usar un libro de historia de vida (LHV) digital o convencional sobre los síntomas depresivos, la comunicación, la cognición y la calidad de vida. Material y métodos: Treinta y una personas con demencia que viven en 2 centros residenciales que siguen un modelo ACP fueron aleatorizadas para recibir terapia de reminiscencia basada en el LHV digital NeuralActions (n=16) o un LHV convencional (n=15). Ambos grupos realizaron 2 sesiones semanales de 45 minutos durante 5 semanas y fueron evaluadas inmediatamente antes y después de la intervención. Los síntomas depresivos se evaluaron con la escala de Cornell (CSDD); la comunicación con la escala de Holden (HCS), la cognición con el Mini Mental State Examination (MMSE) y la calidad de vida con la escala de calidad de vida para el Alzheimer (QoL-AD). Los resultados se analizaron mediante ANOVA de medidas repetidas con el programa jamovi 2.3. Resultados: Ambos LHV mejoraron las capacidades de comunicación (η2=0,115; p <0,001), sin diferencias entre grupos. No se encontraron efectos sobre la calidad de vida, la cognición, o el estado de ánimo. Conclusiones: En centros que siguen un modelo ACP, los LVH digitales o convencionales pueden ser útiles en el tratamiento de personas con demencia facilitando la comunicación. Su papel sobre la calidad de vida, cognición o estado de ánimo es incierto. (AU)

Introduction: Person-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life. Material and methods: Thirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n=16) or a conventional LSB (n=15). Both groups performed 2 weekly sessions of 45min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program. Results: Both LSB improved communication skills (η2=0.115; p<0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found. Conclusions: In PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain. (AU)

[Comparison of digital and conventional life story books on mood, communication, cognition and quality of life in people with dementia in nursing homes: A pilot study]. / Comparación de los libros de historia de vida digitales y convencionales sobre el estado de ánimo, la comunicación, la cognición y la calidad de vida en personas con demencia en residencias: un estudio piloto.

INTRODUCTION: Person-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life. MATERIAL AND METHODS: Thirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n=16) or a conventional LSB (n=15). Both groups performed 2 weekly sessions of 45min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program. RESULTS: Both LSB improved communication skills (η2=0.115; p<0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found. CONCLUSIONS: In PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain.

Programa de reminiscencia apoyado en inteligencia artificial y basado en el patrimonio cultural inmaterial dirigido a personas mayores: un estudio piloto / Reminiscence program supported by artificial intelligence and based on intangible cultural heritage aimed at the elderly: A pilot study

Introducción: Las aplicaciones tecnológicas son una forma innovadora de brindar la terapia de reminiscencia (TR) y deben satisfacer las necesidades de las personas usuarias. El patrimonio cultural inmaterial (PCI) como tópico para dicha terapia no ha sido todavía explorado. Evaluamos la disponibilidad de una nueva aplicación apoyada en inteligencia artificial (IA) para la TR basada en el PCI dirigida a personas mayores. Material y métodos: Estudio observacional prospectivo realizado con personas de 65 años o más, sin deterioro cognitivo y con deterioro cognitivo leve y moderado que acudían a seis centros de mayores en España y Portugal. Las personas participantes testaron el primer prototipo del programa individualizado LONG-REMI en cuatro sesiones semanales consecutivas. La usabilidad y la satisfacción de la experiencia fueron evaluadas mediante la Escala visual analógica (EVA) al finalizar la intervención. Las emociones se evaluaron mediante la escala de afecto positivo y afecto negativo (PANAS) antes y al finalizar la intervención. Resultados: Se analizaron datos de 56 personas, la usabilidad y la satisfacción fueron altamente percibidas, con puntuaciones de 7,75±1,88 y 8,38±1,57, respectivamente. La subescala de subafecto positivo PANAS mostró cambios significativos (28,86±8,88 antes de la intervención vs. 36,70±9,43 post intervención, Z = -4,18, p = 0,000). No hubo cambios significativos en la subescala de afecto negativo PANAS. Conclusiones: El primer prototipo de la aplicación tecnológica LONG-REMI puede ser usado en personas mayores sin y con deterioro cognitivo. Este puede ser un instrumento potencial para futuras terapias cognitivas con actividades estimulantes y beneficio en las emociones. (AU)

Introduction: Technological applications are an innovative way of providing reminiscence therapy and must meet the users’ needs. Intangible cultural heritage as a basis for such therapy has not been explored yet. We evaluated the applicability of a new technological application supported by artificial intelligence for reminiscence therapy based on intangible cultural heritage aimed at older people. Material and methods: A prospective observational study was carried out with people aged 65 or over, without cognitive impairment and with mild and moderate cognitive impairment who attended six centers for older people in Spain and Portugal. Participants tested the first prototype of the individualized LONG-REMI program in four consecutive weekly sessions. The usability and satisfaction of the experience were evaluated using the VAS scale at the end of the intervention. Emotions were evaluated using the PANAS scale before and at the end of the intervention. Results: Data from 56 participants were analysed. For all participants, usability and satisfaction were highly perceived, with scores of 7.75±1.88 and 8.38±1.57, respectively. The positive affect subscale PANAS showed significant changes (28.86±8.88 before the intervention versus 36.70±9.43 post intervention, Z = −4.18, P = 0.000). There were no significant changes in the PANAS negative affect subscale. Conclusions: The first prototype of the LONG-REMI technological application can be used by older people both with and without cognitive impairment. This has the potential to be an instrument for future cognitive therapies with stimulating activities and benefits for emotions. (AU)

[Reminiscence program supported by artificial intelligence and based on intangible cultural heritage aimed at the elderly: A pilot study]. / Programa de reminiscencia apoyado en inteligencia artificial y basado en el patrimonio cultural inmaterial dirigido a personas mayores: un estudio piloto.

INTRODUCTION: Technological applications are an innovative way of providing reminiscence therapy and must meet the users' needs. Intangible cultural heritage as a basis for such therapy has not been explored yet. We evaluated the applicability of a new technological application supported by artificial intelligence for reminiscence therapy based on intangible cultural heritage aimed at older people. MATERIAL AND METHODS: A prospective observational study was carried out with people aged 65 or over, without cognitive impairment and with mild and moderate cognitive impairment who attended six centers for older people in Spain and Portugal. Participants tested the first prototype of the individualized LONG-REMI program in four consecutive weekly sessions. The usability and satisfaction of the experience were evaluated using the VAS scale at the end of the intervention. Emotions were evaluated using the PANAS scale before and at the end of the intervention. RESULTS: Data from 56 participants were analysed. For all participants, usability and satisfaction were highly perceived, with scores of 7.75±1.88 and 8.38±1.57, respectively. The positive affect subscale PANAS showed significant changes (28.86±8.88 before the intervention versus 36.70±9.43 post intervention, Z = -4.18, P = 0.000). There were no significant changes in the PANAS negative affect subscale. CONCLUSIONS: The first prototype of the LONG-REMI technological application can be used by older people both with and without cognitive impairment. This has the potential to be an instrument for future cognitive therapies with stimulating activities and benefits for emotions.

Subjective psychological impacts during COVID-19 lockdown on older people, risk profiles and coping strategies: Results of an online survey in Spain.

This study explores the psychological impacts of lockdown among older people during the coronavirus disease 2019 pandemic in Spain, and identifies risk profiles and adaptative behaviors. A cross-sectional online survey was disseminated by social networks through snowball sampling (April-June 2020). The survey included ad-hoc questions about psychological impacts on subjective cognitive functioning, emotional distress, and loneliness. Open end-questions were coded according to Lazarus and Folkman's coping strategies framework. Of the 2010 respondents, 76% experienced impact in at least one cognitive function (11% reporting severe effects), 78% frequent sadness and 13% frequent loneliness. Age 80+, women and low education increased the risk of loneliness and severe impact in memory and processing speed. Living alone was an additional risk factor for loneliness and sadness. Lockdown is associated with cognitive impacts, emotional distress, and loneliness being risk profiles related to inequality axes. Coping strategies should inform aging policies to prevent psychological impacts during the lockdown.

LONG-REMI: An AI-Based Technological Application to Promote Healthy Mental Longevity Grounded in Reminiscence Therapy.

Reminiscence therapy (RT) consists of thinking about one's own experiences through the presentation of memory-facilitating stimuli, and it has as its fundamental axis the activation of emotions. An innovative way of offering RT involves the use of technology-assisted applications, which must also satisfy the needs of the user. This study aimed to develop an AI-based computer application that recreates RT in a personalized way, meeting the characteristics of RT guided by a therapist or a caregiver. The material guiding RT focuses on intangible cultural heritage. The application incorporates facial expression analysis and reinforcement learning techniques, with the aim of identifying the user's emotions and, with them, guiding the computer system that emulates RT dynamically and in real time. A pilot study was carried out at five senior centers in Barcelona and Portugal. The results obtained are very positive, showing high user satisfaction. Moreover, the results indicate that the high frequency of positive emotions increased in the participants at the end of the intervention, while the low frequencies of negative emotions were maintained at the end of the intervention.

Developing Evidence for Football (Soccer) Reminiscence Interventions Within Long-term Care: A Co-operative Approach Applied in Scotland and Spain.

Loneliness is a common experience within long-term care and, to promote well-being and quality of life among people with dementia, it is important to draw upon a repertoire of strategies that provide social stimulation, companionship, and enjoyment. This paper describes and reflects on a program of co-operative social participatory research that sought to introduce football-focused (ie, soccer-based) reminiscence based in 4 community settings within Spain and Scotland. Findings are reported and inform an original conceptual model that supports the introduction of sustainable approaches to the development of football-focused reminiscence with and for people with dementia.

Ensayo clínico aleatorizado de una estrategia de prevención de caídas en ancianos institucionalizados basada en el Mini Falls Assessment Instrument

Introducción. El Mini Falls Assessment Instrument (MFAI) identifica factores de riesgo de caídas de un individuo y los vincula a intervenciones específicas. El objetivo de este estudio fue evaluar la eficacia del MFAI como base de una estrategia de prevención de caídas en ancianos institucionalizados. Material y métodos. Ensayo aleatorizado por conglomerados (identificador NCT00888953). Se aleatorizaron 16 residencias a aplicar el MFAI (intervención) o una versión modificada no vinculada a acciones (control). La variable principal fue la ocurrencia de caídas durante el seguimiento (12 meses). Otras variables evaluadas: número total de caídas, función física, calidad de vida, estado funcional y efectos adversos. Resultados. Se analizaron datos de 330 participantes (197 intervención, 137 control). Ambos grupos presentaron un número similar de factores de riesgo: 7 en el grupo intervención (rango 1-12) y 8 en el grupo control (1-13). En el grupo intervención cayeron más personas (49% vs 38%), y el número de caídas (315 vs 109) y la tasa por 100 personas-año fueron mayores (192,5 vs 179,8) que en el grupo control. En el análisis multivariable no hay diferencias significativas en el riesgo de caída (odds ratio = 1,45; intervalo de confianza [IC] del 95%: 0,67 a 3,14; p = 0,350), aunque la tasa de incidencia es significativamente mayor en el grupo intervención (razón de tasas de incidencia = 2,23; IC 95%: 1,43 a 3,48; p < 0,001). Conclusiones. Los resultados del MFAI como estrategia para la prevención de caídas no son concluyentes. Se necesitan estudios adicionales que proporcionen evidencia de calidad (AU)

Introduction. The Mini Falls Assessment Instrument (MFAI) identifies risk factors for falls in an individual and links them to specific interventions. This study evaluates the effectiveness of MFAI as the basis for a falls prevention strategy in institutionalized elderly. Material and methods. A cluster randomized clinical trial (identifier NCT00888953) was conducted in 16 nursing homes randomized to apply MFAI (intervention) or a modified version not linked to actions (control). The primary endpoint was the occurrence of falls during follow-up (12 months). Secondary variables were total number of falls, physical function, quality of life, functional status, and adverse effects. Results. Data from 330 participants (197 intervention, 137 control) were analyzed. Both groups had a similar number of risk factors: 7 in the intervention group (range 1-12) and 8 (1-13) in the control group. In the intervention group there were more fallers (49% vs. 38%), and higher number of falls (315 vs. 109), and fall rate per 100 person-years (192.5 vs. 179.8) than the control group. In the multivariate analysis, there were no significant differences in fall risk (odds ratio = 1.45; 95% confidence interval [CI]: .67 to 3.14; P = .350), but the incidence rate is significantly higher in the intervention group (Incidence rate ratio = 2.23; 95% CI: 1.43 to 3.48; P < .001). Conclusions. The results on the efficacy of the MFAI as a fall prevention strategy are inconclusive. Additional studies are needed in order to provide good quality evidence (AU)

[Randomized clinical trial of a fall-prevention strategy for institutionalized elderly based on the Mini Falls Assessment Instrument]. / Ensayo clínico aleatorizado de una estrategia de prevención de caídas en ancianos institucionalizados basada en el Mini Falls Assessment Instrument.

INTRODUCTION: The Mini Falls Assessment Instrument (MFAI) identifies risk factors for falls in an individual and links them to specific interventions. This study evaluates the effectiveness of MFAI as the basis for a falls prevention strategy in institutionalized elderly. MATERIAL AND METHODS: A cluster randomized clinical trial (identifier NCT00888953) was conducted in 16 nursing homes randomized to apply MFAI (intervention) or a modified version not linked to actions (control). The primary endpoint was the occurrence of falls during follow-up (12 months). Secondary variables were total number of falls, physical function, quality of life, functional status, and adverse effects. RESULTS: Data from 330 participants (197 intervention, 137 control) were analyzed. Both groups had a similar number of risk factors: 7 in the intervention group (range 1-12) and 8 (1-13) in the control group. In the intervention group there were more fallers (49% vs. 38%), and higher number of falls (315 vs. 109), and fall rate per 100 person-years (192.5 vs. 179.8) than the control group. In the multivariate analysis, there were no significant differences in fall risk (odds ratio=1.45; 95% confidence interval [CI]: .67 to 3.14; P=.350), but the incidence rate is significantly higher in the intervention group (Incidence rate ratio=2.23; 95% CI: 1.43 to 3.48; P<.001). CONCLUSIONS: The results on the efficacy of the MFAI as a fall prevention strategy are inconclusive. Additional studies are needed in order to provide good quality evidence.

Efficacy of memory training in healthy community-dwelling older people: study protocol for a randomized controlled trial.

BACKGROUND: There is limited evidence on the efficacy and social utility of cognitive training. To address this, we have designed a randomized controlled trial to assess the effectiveness of memory training workshops for healthy older people in terms of their short- and long-term impact on cognitive function, health-related quality of life, and functionality. METHODS/DESIGN: A randomized controlled trial will be performed in health care centers in Barcelona (Spain) through comparison of a group of individuals participating in memory training workshops (experimental group) with another group with similar characteristics not participating in the workshops (control group). The intervention will consist of twelve 90-minute group sessions imparted once a week by a psychologist specialized in memory training. The groups will each comprise approximately 15 people, for a total number of 230 patients involved in the study. Each session has its own objectives, materials and activities. The content of the intervention is based on memory training from different perspectives, including cognitive and emotional aspects and social and individual skills. Data will be collected at baseline, at 3-4 months and at 6 months. To assess the efficacy of the intervention on cognitive function, health-related quality of life and functionality, a statistical analysis will be performed by fitting a repeated-measures mixed effects model for each main outcome: Self-perceived memory, measured by a Subjective Self-reported Memory Score (from 0 to 10) and by the Memory Failures in Everyday life questionnaire (MFE); Everyday memory, measured using the Rivermead Behavioural Memory Test-3 (RBMT-3) and Executive control abilities, measured in terms of visual-perceptual ability, working memory and task-switching ability with the Trail Making Test (TMT) and with the digit span scale of the Wechsler Adult Intelligence Scale III (WAIS III). DISCUSSION: The results of this study will be highly useful for social and public health policies related to older people. Given the continuous increase in the prevalence of older people, a large number of interventions targeting memory loss are funded by public resources. To ensure transparency and effective prioritization, research such as the present study is needed to provide evidence of the effectiveness and usefulness of these interventions. TRIAL REGISTRATION: Number: NCT02431182 .

Impact of Qigong on quality of life, pain and depressive symptoms in older adults admitted to an intermediate care rehabilitation unit: a randomized controlled trial.

BACKGROUND AND AIMS: Qigong has been used as a complementary therapy to improve different health-related problems. This study aims to test the effects of Qigong on quality of life, pain and depressive symptoms in older hospitalized patients. METHODS: In this randomized controlled single blind study, we randomized 58 ≥50 years adults admitted to a post-acute intermediate care rehabilitation facility, to receive a 90 min, bi-weekly, 4-week structured Qigong intervention plus usual care and rehabilitation (N = 29) or usual care and rehabilitation alone (N = 29). Outcomes included quality of life (0-100 points visual analogical scale), pain (0-10 points scale), and depressive symptoms (5-item modified Yesavage Geriatric Depression Scale). We also evaluated participants' compliance and safety. RESULTS: Of the enrolled 58 participants (mean age ± SD = 74.3 ± 8.2 years, 88 % women) we dropped-out four in the control group. No statistically significant differences in baseline characteristics were shown between groups, including age, gender, marital status, education, comorbidity and functional status, main diagnostic at admission and number of rehabilitation sessions. In an intention-to-treat analysis (repeated measures ANOVA) the intervention group experienced a significant improvement in quality of life (mean increase of 19 points vs 2.6 points for controls, p = 0.002). Pain and depressive symptoms improved in both groups. Adherence was good (79 % of participants completed the whole program). No adverse events were reported. CONCLUSIONS: According to our results, a structured Qigong intervention, together with usual care, might contribute to improve quality of life of patients admitted to a post-acute intermediate care rehabilitation unit, compared to usual care.

Changes in whole-brain functional networks and memory performance in aging.

We used resting-functional magnetic resonance imaging data from 98 healthy older adults to analyze how local and global measures of functional brain connectivity are affected by age, and whether they are related to differences in memory performance. Whole-brain networks were created individually by parcellating the brain into 90 cerebral regions and obtaining pairwise connectivity. First, we studied age-associations in interregional connectivity and their relationship with the length of the connections. Aging was associated with less connectivity in the long-range connections of fronto-parietal and fronto-occipital systems and with higher connectivity of the short-range connections within frontal, parietal, and occipital lobes. We also used the graph theory to measure functional integration and segregation. The pattern of the overall age-related correlations presented positive correlations of average minimum path length (r = 0.380, p = 0.008) and of global clustering coefficients (r = 0.454, p < 0.001), leading to less integrated and more segregated global networks. Main correlations in clustering coefficients were located in the frontal and parietal lobes. Higher clustering coefficients of some areas were related to lower performance in verbal and visual memory functions. In conclusion, we found that older participants showed lower connectivity of long-range connections together with higher functional segregation of these same connections, which appeared to indicate a more local clustering of information processing. Higher local clustering in older participants was negatively related to memory performance.