Efficacy of computerized cognitive training and mindfulness for improving cognition and mood in older adults: better together than separately.

BACKGROUND: The risk of cognitive decline in older adults makes it necessary to design training programs for the improvement of cognition. AIMS: To determine the efficacy of applying a combined program of computerized cognitive training (CCT) and mindfulness for improving cognition and mood and quality of life in people aged 60 years and older, compared with using both interventions separately. METHODS: Adults, older than 95 years were assigned to groups that subsequently received one of the three interventions (CCT, mindfulness, and combined). Cognitive, emotional, and quality of life assessment instruments were administered pre- and post-intervention. The standardized individual change was determined, and one-factor ANOVAs and ANCOVAs were conducted to test between-group differences. RESULTS: After controlling for confounding factors, greater significant improvements were obtained in the combined group compared with the CCT and mindfulness groups in selective attention (median effect size) and abstract reasoning (large effect size). No significant differences were found in the rest of cognitive variables, mood or quality of life. CONCLUSION: The findings indicate that, with the same investment of time, combining CCT and mindfulness effectively improves selective attention and abstract reasoning, in older adults. This combination of strategies might have implications for the improvement of cognitive impairment in older adults.

Resilience, Stress, and Cortisol Predict Cognitive Performance in Older Adults.

OBJECTIVE: to determine the relationship between stress, resilience, and cognitive performance in older people without dementia. METHOD: multiple linear regressions were performed using measures of cognitive performance as dependent variables, and measures of stress and resilience as predictors in a sample of 63 Spanish elderly people. RESULTS: participants reported low levels of stress during their lifetime. In addition to socio-demographic variables, greater stress was related to better delayed recall and worse letter-number sequencing and block design. Higher capillary cortisol was associated with lower flexibility on the Stroop task. Regarding protective factors, we found that greater psychological resilience was related to higher scores on the Addenbrooke's Cognitive Examination-III, letter-number sequencing, and verbal fluency. CONCLUSION: in older people with low stress, apart from age, gender, and education, psychological resilience is a significant predictor of global cognitive status, working memory, and fluency. Likewise, stress is related to verbal memory functioning, working memory, and visuoconstructive abilities. Capillary cortisol level predicts cognitive flexibility. These findings may help to identify risk and protective factors for cognitive decline in older people. Training-based programs to reduce stress and increase psychological resilience may play an important role in preventing cognitive decline.

Fatores de evasão no ensino superior: uma revisão de literatura / Dropout factors in higher education: a literature review

A evasão no Ensino Superior constitui preocupação internacional com impacto nas Instituições de Ensino Superior, em geral, e nos percursos de carreira individuais, em específico. Para prevenir esse fenômeno e apoiar tanto instituições como estudantes na sua tomada de decisão, urge identificar fatores de evasão no ensino superior. Apresenta-se revisão de artigos publicados em revistas científicas internacionais entre janeiro 2014 e dezembro 2018, com base no Modelo Longitudinal de Evasão Institucional. A pesquisa foi realizada em quatro bases de dados, com combinações das palavras-chave dropout, departure, academic adjustment, college adjustment, academic integration, social integration e higher education. Foram lidos integralmente 24 artigos que satisfaziam critérios de inclusão. Procedeu-se à descrição dos artigos e o conteúdo foi sistematizado em meta-síntese. Identificaram-se fatores relativos a atributos prévios à entrada no ensino superior; objetivos e compromissos prévios e posteriores a essa entrada; experiências institucionais; integração acadêmica e social. Identificaram-se ainda medidas de sinalização de evasão. Discutem-se implicações para a investigação, para serviços e políticas das Instituições de Ensino Superior.

La evasión en lo Enseñanza Universitaria constituye preocupación internacional con impacto en las Instituciones de Enseñanza Universitaria, en general, y en los recorridos de carrera individuales, en específico. Para prevenir ese fenómeno y apoyar tanto instituciones, como estudiantes en su toma de decisión, es urgente identificar factores de evasión en la enseñanza universitaria. Se presenta revisión de artículos publicados en revistas científicas internacionales entre enero 2014 y diciembre 2018, con base en el Modelo Longitudinal de Evasión Institucional. La investigación se realizó en cuatro bases de datos, con combinaciones de las palabras clave dropout, departure, academic adjustment, college adjustment, academic integration, social integration y higher education. Se leyeron integralmente 24 artículos que satisfacían criterios de inclusión. Se procedió a la descripción de los artículos y se sistematizó los contenidos en meta-síntesis. Se identificaron factores relativos a atributos previos al ingreso en la enseñanza universitaria; objetivos y compromisos previos y posteriores a esa entrada; experiencias institucionales; integración académica y social. Se identificaron, aún medidas de señalización de evasión. Se discuten implicaciones para la investigación, para servicios y políticas de las Instituciones de Enseñanza Universitaria.

Dropping out of Higher Education is an international concern with an impact on Higher Education Institutions, in general, and on individual career paths, in particular. In order to prevent this phenomenon and support both institutions and students in their decision-making, it is urgent to identify evasion factors in higher education. A review made in published articles in international scientific journals between January 2014 and December 2018 is presented, based on the Longitudinal Institutional Evasion Model. The search was carried out in four databases, with combinations of the keywords dropout, departure, academic adjustment, college adjustment, academic integration, social integration, and higher education. Twenty-four articles that met the inclusion criteria were fully read. The articles were described and the content was systematized in meta-synthesis. Factors related to attributes prior to entering higher education were identified; objectives and commitments prior and subsequent to this entry; institutional experiences; academic and social integration. Evasion signaling measures were also identified. Implications for research, services and policies of Higher Education Institutions are discussed.

Diferencias entre hombres y mujeres en los procesos de toma de decisiones en pacientes con trastornos relacionados con sustancias / Differences between men and women in decision-making processes in patients with substance-related disorders

Resumen Los trastornos relacionados con sustancias (TRS) pueden cursar con alteraciones neuropsicológicas que afectan las actividades de la vida diaria de una persona. El objetivo principal de este trabajo es estudiar el proceso de la toma de decisiones en pacientes con TRS y analizar si hay diferencias entre hombres y mujeres. Se administró una versión computarizada de la Iowa Gambling Task (IGT) a una muestra total de 101 pacientes con TRS que solicitaron tratamiento ambulatorio, 81 hombres (80,2%) y 20 mujeres (19,8%). Los resultados muestran una alteración en la toma de decisiones. Asimismo, se observó un peor rendimiento en el grupo de los hombres en la toma de decisiones en comparación con el grupo de las mujeres. Estos datos comprueban la importancia de tener en cuenta el sexo a la hora del diagnóstico e intervención en personas con TRS. Se precisan estudios futuros que profundicen en estas diferencias.

Abstract Substance-related disorders (TRS) can cause neuropsychological alterations that affect the activities of a person's daily life. The main objective of this work is to study the process of decision making in patients with TRS and to analyze if there are differences between men and women. A computerized version of the Iowa Gambling Task (IGT) was administered to a total sample of 101 patients with TRS who requested outpatient treatment, 81 men (80.2%) and 20 women (19.8%). The results obtained show an alteration in the decision making. Likewise, a worse performance was observed in the group of men in decision making compared to the group of women. These data point to the importance of taking into account sex at the time of diagnosis and intervention in people with SDB. Future studies are needed to delve into these differences.

Effects of aging on memory strategies: a validation of the Portuguese version of the Test of Memory Strategies.

OBJECTIVE: Previous literature has shown that executive functions (EF) are related to performance in memory tasks. The fact that there are no psychometric tests that evaluate these two constructs simultaneously led a group of researchers to develop the Test of Memory Strategies (TSM). Given the potential importance of this instrument for neuropsychological evaluation, in this study, we aimed to evaluate the psychometric properties of the TMS in Portuguese sample. We also examined the effect of aging by exploring profiles of performance on the TMS, comparing young and elderly healthy subjects. METHOD: Total of 135 healthy participants were submitted to a neuropsychological assessment and were divided into four age groups: a group of young adults (25-35 years) and three groups of older individuals (aged 60-69 years, 70-79 years, and 80 or more years). RESULTS: Findings supported the reliability of the TMS scores, based on analyses of internal consistency. As expected, factor analysis of the TMS scores revealed that the test yielded two factors, one capturing EF and the other memory. Correlations with classic neuropsychological tests supported convergent and discriminant validity of the TMS scores. The elderly groups presented more difficulties in creating and mobilizing memory strategies when compared with a younger group, after controlling for the influence of education, although both groups presented increases in performance throughout the five TMS subscales. CONCLUSIONS: The findings suggest that the TMS is an adequate measure to assess memory and EF, simultaneously, presenting adequate psychometric properties for a Portuguese sample.

Neuropsychological functioning in methadone maintenance patients with HIV / Función neuropsicológica en el tratamiento de mantenimiento con metadona en pacientes con VIH

Although highly active antiretroviral therapy (HAART) has improved survival rates of HIV patients, HIV-associated neurocognitive disorders (HAND) still exist in a highly prevalent group of persons with this disease. In this study we seek to evaluate the influence of drug use in the neuropsychological performance of seropositive drug users. We carried out an extensive neuropsychological evaluation and compared the performance of seropositive drug users (n = 90) with that of a control group of seronegative drug users (n = 48). The results reveal that methadone maintenance programmes can make the seropositive subject neuropsychologically vulnerable. Likewise, we found that giving up drugs have a protective effect in the presence of neuropsychological alterations associated with HIV. These findings lead us to suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users, noting that these alterations are multifactorial.

Aunque la terapia antirretroviral de gran actividad (TARGA) ha mejorado los índices de supervivencia de los pacientes infectados por el VIH, los trastornos neurocognitivos asociados con el VIH (TNAV) todavía existen en un grupo de personas altamente prevalente a esta enfermedad. En este estudio buscamos evaluar la influencia del consumo de drogas en el rendimiento neuropsicológico de los usuarios de drogas seropositivos. Llevamos a cabo una amplia evaluación neuropsicológica, y el rendimiento de los usuarios de drogas seropositivos (n = 90) se comparó con la de un grupo control de usuarios de drogas seronegativos (n = 48). Los resultados demuestran que los programas de tratamiento de mantenimiento con metadona pueden convertir en vulnerable a nivel neuropsicológico al individuo seropositivo. Asimismo, descubrimos que abandonar las drogas provoca un efecto protector frente a la existencia de alteraciones neuropsicológicas asociadas con el VIH. Estos resultados nos llevan a sugerir que la seropositividad no basta para explicar las alteraciones neuropsicológicas de los usuarios de drogas seropositivos, ya que estas alteraciones al parecer son multifactoriales.

Cognitive reserve during neuropsychological performance in HIV intravenous drug users.

HIV-associated neurocognitive disorders are frequently observed in people with HIV. We aimed to evaluate the influence of cognitive reserve on the neuropsychological performance of seropositive drug users. We carried out a neuropsychological assessment and compared the performance of seropositive drug users (n = 75) with that of a group of seronegative drug users (n = 48). The results showed that a low cognitive reserve makes the seropositive patients neuropsychologically vulnerable. Likewise, we found that a high cognitive reserve has a protective effect in the presence of neuropsychological impairment associated with HIV. In the seronegative group, differences in a small number of tests were found between participants with low and high cognitive reserve. Overall, these data suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users; rather, these alterations are multifactorial.

Influence of depressed mood on neuropsychologic performance in HIV-seropositive drug users.

Some studies point out that depression affects the performance of HIV patients in neuropsychological tasks, but at present this effect is not clear. The purpose of the present paper was to study whether the presence of symptoms of depression affects the neuropsychologic performance of seropositive drug users in tasks of attention/concentration, learning and memory, language, construction and visuospatial function, speed of motor performance, cognitive flexibility, manual skill and concept formation and reasoning. In order to carry out this research a sample consisting of 127 male volunteer subjects was used. These subjects were distributed in four groups: one group consisted of HIV-seropositive drug users with symptoms of depression (n = 33); the second group consisted of HIV-seropositive drug users without symptoms of depression (n = 47); the third group was formed by HIV-seronegative drug users with symptoms of depression (n = 15) and the fourth group was formed by HIV-seronegative drug users without symptoms of depression (n = 32). The results reveal the effect of symptoms of depression (evaluated by the Beck Depression Inventory) on the neuropsychologic performance of seropositive drug users. This effect, however, was not observed in the seronegative group. These findings lead us to suggest that symptoms of depression constitute a risk factor for presenting neuropsychologic disturbances in seropositive subjects, which could well be acting as a factor that foments the neuropsychological effects of HIV.