Virtual Reality and Serious Videogame-Based Instruments for Assessing Spatial Navigation in Alzheimer's Disease: A Systematic Review of Psychometric Properties.

Over the past decade, research using virtual reality and serious game-based instruments for assessing spatial navigation and spatial memory in at-risk and AD populations has risen. We systematically reviewed the literature since 2012 to identify and evaluate the methodological quality and risk of bias in the analyses of the psychometric properties of VRSG-based instruments. The search was conducted primarily in July-December 2022 and updated in November 2023 in eight major databases. The quality of instrument development and study design were analyzed in all studies. Measurement properties were defined and analyzed according to COSMIN guidelines. A total of 1078 unique records were screened, and following selection criteria, thirty-seven studies were analyzed. From these studies, 30 instruments were identified. Construct and criterion validity were the most reported measurement properties, while structural validity and internal consistency evidence were the least reported. Nineteen studies were deemed very good in construct validity, whereas 11 studies reporting diagnostic accuracy were deemed very good in quality. Limitations regarding theoretical framework and research design requirements were found in most of the studies. VRSG-based instruments are valuable additions to the current diagnostic toolkit for AD. Further research is required to establish the psychometric performance and clinical utility of VRSG-based instruments, particularly the instrument development, content validity, and diagnostic accuracy for preclinical AD screening scenarios. This review provides a straightforward synthesis of the state of the art of VRSG-based instruments and suggests future directions for research.

Factors influencing living space utilization among older Afro-Colombian adults.

OBJECTIVES: Investigate the factors influencing life space utilization in older Afro-descendant adults residing in Tumaco, Colombia - a marginalized region of the country. DESIGN: This cross-sectional study included 388 Afro-descendant older adults. The study assessed living space using the Life Space Assessment (LSA) scale and collected demographic data. Cognitive levels were measured with the Mini-Mental State Examination (MMSE), and depressive symptoms were assessed using the Yesavage scale. Socio-emotional indicators were determined with the Medical Outcomes Study (MOS). The research employed linear and logistic regression models for data analysis. RESULTS: On average, participants scored 27.0 on the LSA scale. A lack of perceived income resulted in a 10.44-point decrease on the LSA scale. For each unit increase in the MOS-Instrumental Dimension score, the LSA score increased by 0.52 points (95% CI 0.17-0.87). As for cognitive performance (MMSE scale), each one-point increase resulted in a 0.69 decrease in the LSA score (95% CI -1.25 to -0.12). CONCLUSION: Socioeconomic disadvantages limit living space utilization, particularly in the Afro-descendant population. Yet, social support can enhance living space use despite environmental and economic constraints.

Subjective Cognitive and Communicative Complaints and Health-Related Quality of Life in Parkinson's Disease with and without Mild Cognitive Impairment.

INTRODUCTION: Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients' subjective cognitive and communicative difficulties has not been explored. OBJECTIVE: We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints. METHODS: We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted. RESULTS: PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores. CONCLUSIONS: HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.

Factors associated with the intensity of anxiety and depression symptoms in health workers of two centres of reference for COVID 19 patient care in Antioquia, Colombia - A latent class analysis.

OBJECTIVE: To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes. METHODS: Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression. RESULTS: 486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91-0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99-8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27-7.56), and anxiety (OR = 5.5; 95%CI, 2.36-12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95-0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60-7.25), living with someone at risk of death from COVID-19 (OR = 1.86; 95%CI, 1.19-2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01-2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11-3.59). CONCLUSIONS: Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.

Comparison of the neurocognitive profile of the children of parents with bipolar disorder and controls: A transnational cross-sectional study.

INTRODUCTION: Studies that have compared the cognitive alterations of the children of parents with bipolar disorder (CPBD) versus the children of control parents (CCP), present heterogeneous results due to the studies' methodological differences, the age of the population studied, and the lack of standardisation of the measures used for the different neurocognitive domains. The objective was to compare the neurocognitive profile of CPBD versus CCP to observe if there are differences that could be proposed as possible endophenotypes of BD. RESULTS: A total of 107 individuals (51 CPBD, and 56 CCP) with ages between 6 and 16 (mean, 12.2±2.80) years of age were evaluated. Seventy-four point five percent of the CPBD group had some disorder compared to 67.9% of the CCP group. Tests such as letter-F phonemic verbal fluency, letter-S phonemic verbal fluency, overall F-A-S phonemic verbal fluency, story recall and retrieval, and Wisconsin perseverative errors showed a difference with a small effect size, but with a high degree of uncertainty. CONCLUSIONS: The CPBD did not have differences in their neurocognitive profile in comparison with CCP. Both groups have a high prevalence of psychopathology, which is a factor that could explain the lack of differences in neurocognitive performance.

Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study.

OBJECTIVE: We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS: We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS: We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS: Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.

Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study

Objective: We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). Methods: We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. Results: We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. Conclusions: Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.

Objetivo: Nuestro objetivo es determinar la prevalencia de trastornos mentales en hermanos de casos con TDAH y cómo los factores de adversidad psicosocial se relacionan con esta psicopatología en un país de ingresos bajos-medios (Colombia). Métodos: Se evaluó a sujetos con TDAH diagnosticado según los criterios del DSM-5, uno de sus padres y uno de sus hermanos (edades, 8-19 anos). Mediante la escala de calificación del TDAH y un conjunto de otros instrumentos se evaluó la presencia de trastornos mentales y adversidad psicosocial. Resultados: Se evaluó a 74 tríos formados por el caso índice con TDAH, un hermano y uno de los padres. Se halló que un 24,3% de los hermanos participantes también cumplían los criterios de TDAH y otro 24,3%, otros trastornos psiquiátricos. El riesgo de que estos hermanos tuvieran TDAH aumentó aún más cuando uno de los padres informó antecedentes de TDAH. También, que el 28,3% de las familias se enfrentaron a altos niveles de adversidad psicosocial según sus puntuaciones en el Índice de Adversidad de Rutter. Conclusiones: Los hermanos de sujetos con TDAH mostraron un significativo riesgo de TDAH y otros trastornos mentales. Ese riesgo aumenta si uno de los padres reporta antecedentes de TDAH y también cuando se presentan 2 o más factores de adversidad psicosocial. Este estudio respalda la importancia de la detección temprana con el fin de disminuir el riesgo para otros hermanos.

Psychological Status of the Participants in Alzheimer's Prevention Initiative Autosomal Dominant Alzheimer's Disease Colombia.

BACKGROUND: The SARS-CoV2 global pandemic impacted participants in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) clinical trial, who faced three stressors: 1) fear of developing dementia; 2) concerns about missing treatment; and 3) risk of SARS-CoV2 infection. OBJECTIVE: To describe the frequency of psychological disorders among the participants of the API ADAD Colombia clinical study, treated by a holistic mental health team during the COVID-19 pandemic. The extent of use of mental health team services was explored considering different risk factors, and users and non-users of these services were compared. METHODS: Participants had free and optional access to psychology and psychiatry services, outside of the study protocol. Descriptive statistics was used to analyze the frequency of the mental health difficulties. A multivariable logistic regression model has been used to assess associations with using this program. RESULTS: 66 participants were treated by the Mental Health Team from March 1, 2020, to December 31, 2020. Before and after the start of the pandemic, the most common psychological problems were anxiety (36.4% before, 63.6% after) and depression (34.8% before, 37.9% after). 70% of users assisted by psychology and 81.6% of those assisted by psychiatry felt that the services were useful for them. Female sex, depression, and anxiety before the pandemic were positively associated with being assisted by either psychology or psychiatry, while the association with hyperlipidemia was negative. CONCLUSIONS: A holistic mental health program, carried out in the context of a study, could mitigate psychopathology during pandemics such as COVID-19.

Point of care ultrasound impact in acute heart failure hospitalization: A retrospective cohort study.

BACKGROUND: Acute decompensated heart failure (ADHF) is one of the most frequent causes of emergency department (ED) visits. Point-of-Care Ultrasound (POCUS) is a reliable, easy-to-use, and available tool for an accurate diagnosis of ADHF. We aimed to analyze the impact of introducing POCUS as an additional tool to clinical standard diagnosis in clinical times of hospitalized heart failure patients. METHODS: Retrospective cohort study comparing patients consulting to ED for heart failure acute decompensation previous to the rutinary use of POCUS versus patients who received an ultrasound-guided diagnosis at entrance. Ultrasound evaluation was additional to standard diagnosis (which included natriuretic peptides, images, etc). Cumulative incidence functions were calculated for time to treatment, time to disposition decision, and time to discharge. We used a flexible parametric model for estimate the time ratio (TR) in order to reflect the effect of POCUS. RESULTS: A total of 149 patients were included. The most frequent comorbid condition was hypertension (71.8%) followed by type 2 diabetes (36.2%). B type natriuretic peptide (BNP) was over 500 ng/ml. Most patients had Stevenson B profile (83.9%) at admission. In the cumulative incidence model (Fig. A), the TR (time ratio) for the outcome time to treatment was 1.539 (CI 95% 0.88 to 2.69). The TR for the outcome time to disposition decision was 0.665 (CI 95% 0.48 to 0.99). The TR for the outcome time to discharge (hospital length of stay) was 0.663 (CI 95% 0.49 to 0.90). CONCLUSION: In our study, the introduction of POCUS to ADHF patients decreases time to disposition decision and total length of hospital stay. Conversely, time to treatment augments. There is need for the evaluation of ultrasound as an intervention in clinical trials to confirm these findings.

Síndrome de caídas y factores asociados en personas mayores indígenas de nariño, colombia

Objetivo: Determinar los factores asociados al síndrome de caída en un grupo de personas mayores indígenas. Material y Método: Estudio descriptivo transversal, realizado con 518 indígenas mayores de 60 años, que estimó la prevalencia del síndrome de caída durante el año 2019. Los instrumentos utilizados fueron entrevista demográfica y antecedentes médicos, Evaluación Mini Nutricional (MNA por su sigla en inglés) para evaluar estado nutricional, Mini Examen del Estado Mental (MMSE por su sigla en inglés) y The Rowland Universal Dementia Assessment Scale (RUDAS) para determinar nivel cognitivo; la sintomatología depresiva se evaluó con la Escala de Depresión Geriátrica de Yesavage; el nivel funcional se valoró con la escala de Actividades Instrumentales de la Vida Diaria IADL. Se utilizaron modelos de regresión logística multivariable para examinar la asociación entre las variables sociodemográficas y la presencia de morbilidades. Se construyeron perfiles de riesgo entre individuos para estimar la probabilidad de caer a través del análisis de clases latentes. Resultados: 35,9% de los participantes presentó al menos una caída. Hombres (OR 0,55 IC del 95%: 0,38-0,80), personas con hipertensión arterial (OR 3,4 IC del 95%: 1,4-8,2), enfermedad coronaria (OR 2,5 IC del 95%: 1,3 -5,0), artritis o artrosis (OR 1,5 IC del 95%: 1,0-2,0), personas con quejas de memoria (OR 1,6 95% CI 1,1-2,5) y dependencia funcional (OR 1,6 95% CI 1,1-2,2), mostraron una asociación con este síndrome. El perfil de riesgo mostró que los sujetos con mayor número de comorbilidades tenían mayor probabilidad de caídas (0,163). Conclusiones: La prevalencia del síndrome de caídas es similar a la reportada en estudios previos. Comorbilidades propias de la vejez mostraron relación con un mayor riesgo de caídas. Se observa una relación directamente proporcional entre la cantidad de comorbilidades y mayor riesgo de caídas.

Objective: To determine the factors associated with the fall syndrome in a group of indigenous older adults. Materials and Methods: Cross-sectional descriptive study carried out with 518 indigenous people over 60 years of age that estimated the prevalence of the fall syndrome during the year 2019. Research instruments included demographic interview and medical history, Mini Nutritional Assessment (MNA) to assess nutritional status, Mini-Mental State Examination (MMSE) and RUDAS to determine cognitive performance; depressive symptomatology was assessed with the Geriatric Depression Scale by Yesavage; functional level was assessed using Instrumental Activities of Daily Living scale (IADL). Multivariate logistic regression models were used to examine the association between sociodemographic variables and the presence of morbidities. Between-individual risk profiles were set up to estimate the probability of falling, using latent class analysis. Results: 35.9% of participants had at least suffered one fall. Men (OR 0.55 95% CI 0.38-0.80), people with high blood pressure (OR 3.4 95% CI 1.4-8.2), coronary heart disease (OR 2.5 95% CI 1.3 -5.0), arthritis or osteoarthritis (OR 1.5 95% CI 1.0-2.0), people with memory complaints (OR 1.6 95% CI 1.1-2.5) and functional dependency (OR 1.5 95% CI 1.0-2.2), showed an association with this syndrome. The risk profile showed that subjects with a greater number of comorbidities were more likely to suffer a fall (0.163). Conclusions: The prevalence of the falls syndrome is similar to that reported in previous studies. Comorbidities associated with old age showed a relationship with a higher risk of falls. A directly proportional relationship was observed between the number of comorbidities and the increased risk of falls.

Objetivo: Determinar os fatores associados à síndrome de queda em um grupo de idosos indígenas. Material e Métodos: Estudo descritivo transversal, realizado com 518 indígenas com mais de 60 anos de idade, que estimou a prevalência da síndrome de quedas durante o ano de 2019. Os instrumentos utilizados incluíram entrevista demográfica e histórico médico, Mini Avaliação Nutricional (MNA sigla em inglês) para avaliar o estado nutricional, Mini Exame do Estado Mental (MMSE sigla em inglês) e RUDAS para determinar o nível cognitivo; a sintomatologia depressiva foi avaliada com a escala de Depressão Geriátrica de Yesavage; o nível funcional foi avaliado com a escala Atividades Instrumentais de Vida Diária (AIVD). Modelos de regressão logística multivariada foram usados para examinar a associação entre variáveis sociodemográficas e a presença de morbidades. Perfis de risco entre indivíduos foram construídos para estimar a probabilidade de queda, por meio de análise de classe latente. Resultados: 35,9% dos participantes sofreram pelo menos uma queda. Homens (OR 0,55 IC 95% 0,38-0,80), pessoas com hipertensão arterial (OR 3,4 IC 95% 1,4-8,2), doença coronariana (OR 2,5 IC 95% 1,3-5,0), artrite ou osteoartrite (OR 1,5 IC 95% 1,0-2,0), pessoas com queixas de memória (OR 1,6 IC 95% 1,1-2,5) e dependência funcional (OR 1,5 IC 95% 1,0-2,2) apresentaram associação com essa síndrome. O perfil de risco mostrou que indivíduos com um número maior de comorbidades tinham maior probabilidade de cair (0,163). Conclusões: A prevalência da síndrome de quedas é semelhante à descrita em estudos anteriores. As comorbidades características da idade avançada mostraram uma relação com o aumento do risco de quedas. Observa-se uma relação diretamente proporcional entre o número de comorbidades e o aumento do risco de quedas.

Normative values for handgrip strength in Colombian children and adolescents from 6 to 17 years of age: estimation using quantile regression

Abstract Objective: The objective of this study is twofold: i) to estimate the normative values for handgrip strength and relative handgrip strength, specific to sex and age, for Colombian children and adolescents from 6 to 17 years of age using quantile regression models and ii) to compare the normative values for handgrip strength and relative handgrip strength in Colombian children and adolescents with those in children and adolescents in different countries. Method: This was a cross-sectional analysis of a sample of 2647 youngsters. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). The relative handgrip strength was estimated according to weight in kilograms. The normative values were estimated to handgrip strength and relative handgrip strength through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90, and P95 developed independently for each sex. All analyses were adjusted for the expansion factor. Results: The values for handgrip strength were considerably higher in males than in females in all age ranges. Additionally, as age increased for both sexes, the values for handgrip strength increased. The percentiles by sex and age for relative handgrip strength show for males a proportional increase according to age; for females, this did not occur. Conclusions: When making comparisons with international studies, variability is observed in the methodologies used to evaluate handgrip strength and estimation methods, which could influence the discrepancies between the different reports.

Factors Associated with Happiness in Rural Older Adults: An Exploratory Study.

Introduction: Aging is a phenomenon that has increased worldwide as a result of a higher life expectancy, evidencing situations typical of this stage, which can impact the happiness of individuals, who deserve attention and approach from mental health and public health. Objective: to explore the association between sociodemographic characteristics, medical history and symptoms, emotional state, social support, cognitive performance, and functional dependence, in relation to happiness in older adults in a rural area of Túquerres, Nariño. Method: cross-sectional study of association. Results: There were 252 records in total, corresponding to the data of rural older adults. A multivariate linear regression was performed, finding an association with happiness in the variables of age (ßa = .41; CI95% .09 - .73), socioeconomic level (ßa = -.22; CI95% -.58 - .13), education level (ßa = .41; CI95% .68 - 1.49), occupation (ßa = .59; CI95% -.48 - 1.67), having chronic disease (ßa = .42; CI95% .12 - .73), breathing difficulties (ßa = -.25; CI95% -.51 - .02), joint pain (ßa = .55; CI95% .26 - .83), depression symptoms (ßa = -.21; CI95% -.48 - .06]) or anxiety (ßa = .40; CI95% .72 - .07), and social support (ßa = -.27; CI95% -.52 - -.02). Discussion: this population has unfavorable socioeconomic and health conditions that impact their perception of happiness. Conclusion: happiness is a multicausal phenomenon that in older adults is part of the result of the interaction of variables and historical decisions at a political, economic, and social level.

Introducción: El envejecimiento es un fenómeno que ha aumentado a nivel mundial como consecuencia de una mayor esperanza de vida, evidenciando situaciones propias de esta etapa, que pueden impactar en la felicidad de los individuos, quienes merecen la atención y el abordaje desde la salud mental y la salud pública. Objetivo: explorar la asociación entre las características sociodemográficas, los antecedentes y síntomas médicos, el estado emocional, el apoyo social, el desempeño cognitivo y la dependencia funcional, con la felicidad en los adultos mayores de una zona rural de Túquerres, Nariño. Método: estudio transversal de asociación, con análisis de datos secundarios. Resultados: Se contó con 252 registros en total, correspondientes a los datos de los adultos mayores rurales. Se realizó una regresión lineal multivariable, encontrando asociación con la felicidad de las variables nivel socioeconómico (ßa = -.22; C95% -.58 - .13), nivel de escolaridad (ßa = .41; IC95% -.68 - 1.49), ocupación (ßa = .59; IC95% -.48 - 1.67), contar con enfermedad crónica (ßa = .42; IC95% .12 - .73), dificultades para respirar (ßa = -.25; IC95% -.51 - .02), presentar dolor en las coyunturas (ßa = .55; IC95% .26 - .83), presentar síntomas de depresión (ßa = -.21; IC95% -.48 - .06]) o de ansiedad (ßa = .40; IC95% .72 - .07) y apoyo social (ßa = -.27; IC95% -.52 - -.02). Discusión: esta población cuenta con condiciones socioeconómicas y de salud desfavorables que impactan en su percepción de felicidad. Conclusión: La felicidad es un fenómeno multicausal que en los adultos mayores hace parte del resultado de la interacción de variables y decisiones históricas, a nivel político, económico y social.

Correlation between cognitive performance and structural neuroanatomy in patients with type I bipolar affective disorder treated with and without lithium.

INTRODUCTION: Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS: Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS: Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD = .67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ = -0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS: The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.

Validity and reliability of the SBI (Spanish Burnout Inventory) in medical surgical specialists / Validez y contabilidad del CESQT en médicos especialistas quirúrgicos

Abstract Introduction: Burnout Syndrome is the term used to describe the psychological response to patient care-related chronic work stress. Studies have found that the prevalence of practitioner burnout in Colombia ranges between 17.6% and 45%. Given the importance of this phenomenon in our setting, we decided to carry out a validation and reliability study of the Spanish Burnout Inventory (SBI). Objective: To assess the validity and reliability of the SBI in medical surgical specialists working in fourteen health care facilities in Antioquia (Colombia) in 2018. Methods: The study was conducted in 14 healthcare institutions among 8 surgical specialties. The tool consists of 20 items collected by means of face-to-face interviews under the supervision of a psychologist, and maintaining confidentiality. The psychometric assessment included content validity (CV), construct validity using confirmatory factor analysis (CFA) and reliability using Cronbach's Alpha. Results: The study sample consisted of 234 participants. CV of the tool was 0.82. The CFA showed acceptable model fit, with the results of goodness-of-fit being X2=384.578 (p<0.00i; df: 165), RMSEA = 0.075 [90% CI: 0.066 - 0.085], CFI = 0.953, TLI = 0.946 and WRMR=1.074. The SBI Cronbach's alpha was 0.79. Conclusions: The SBI showed acceptable CV levels for all the items and domains. The SBI is a valid tool with adequate reliability for use in medical surgical specialists of healthcare institutions in Antioquia-Colombia.

Resumen Introducción: El síndrome de Quemarse por el Trabajo es la respuesta psicológica al estrés laboral crónico relacionado con la atención de pacientes. La prevalencia del síndrome en médicos colombianos varía entre el 17 % y el 45 %, usando cuestionarios no validados. Objetivo: Evaluar la validez y fiabilidad del Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT), en médicos especialistas quirúrgicos que laboraban en instituciones de salud de Antioquia, Colombia en 2018. Métodos: El estudio se realizó en 14 instituciones hospitalarias con 8 especialidades quirúrgicas, el instrumento consta de 20 ítems cuya recolección se hizo presencial, supervisado por una psicóloga, manteniendo la confidencialidad; la evaluación psicométrica incluyó validez de contenido (VC), validez de constructo mediante análisis factorial confirmatorio (AFC) y fiabilidad con alfa de Cronbach. Resultados: Se encuestaron 234 especialistas. La VC del instrumento fue de 0,82. Los índices de bondad de ajuste en el AFC fueron: X2=384,578 (p < 0,001; gl: 165), RMSEA = 0,075 [IC 90 %: 0,066-0,085], CFI = 0,953, TLI = 0,946 y WRMR = 1,074. El alfa de Cronbach fue 0,79. Conclusiones: El CESQT tiene niveles aceptables de VC para los ítems y sus dimensiones. El CESQT es un instrumento válido con adecuada fiabilidad para ser utilizado en médicos especialistas quirúrgicos de instituciones de salud de Antioquia, Colombia.

Correlación entre el desempeño cognitivo y la neuroanatomía estructural en pacientes con trastorno afectivo bipolar tipo I tratados con y sin litio / Correlation Between Cognitive Performance and Structural Neuroanatomy in Patients with Type I Bipolar Affective Disorder Treated with and Without Lithium

RESUMEN Introducción: El tratamiento del trastorno afectivo bipolar (TAB) con litio se ha relacionado con menos deterioro cognitivo y menores cambios en la anatomía estructural cerebral comparado con otros tratamientos. Sin embargo, los estudios son heterogéneos y son pocos los que evalúan si estos efectos están relacionados. El objetivo de este estudio es evaluar y relacionar el desempeno cognitivo y la neuroanatomía estructural en pacientes tratados con y sin litio. Métodos: Estudio de corte trasversal que incluyó a 48 sujetos con TAB I: 22 tratados con litio y 26 sin litio. Se evaluó el desempeno en las pruebas neuropsicológicas Wechsler III (WAIS III), TMTAyB (Trial Making Test), prueba de aprendizaje verbal de California (TAVEC), prueba de Figura compleja de Rey y prueba de clasificación de tarjetas de Wisconsin. Se evaluaron estructuras cerebrales obtenidas por resonancia magnétiva (RM) cerebral. Se calculó la diferencia de medias estandarizada (DME) entre ambos grupos, con ajuste por variables de confusión mediante puntuación de propensión, y se empleó el coeficiente de correlación de Spearman (p) para evaluar la relación existente entre el desempeno cognitivo y las regiones neuroanatómicas. Resultados: Respecto al grupo sin litio, el grupo con litio tuvo menos errores perseverativos en el Wisconsin (DME = -0,69) y mayores áreas corticales derecha e izquierda (DME = 0,85 y DME = 0,92); mayor superficie en el cíngulo anterior izquierdo (DME = 1,32), la corteza orbi-tofrontal medial derecha (DME = 1,17), el giro frontal superior derecho (DME = 0,82), los giros precentrales derecho e izquierdo (DME = 1,33 y DME = 0,98); mayor volumen de la amígdala derecha (DME = 0,57), el hipocampo derecho (DME = 0,66), el putamen derecho (DME = 0,87) y el tálamo derecho (DME = 0,67). En el grupo con litio, se encontró una correlación con dichos errores y el espesor del giro precentral izquierdo (p = -0,78), el volumen del tálamo derecho (p = -0,44) y la amígdala derecha (p = 0,6). Conclusiones: El grupo con litio tuvo mejor flexibilidad cognitiva y mayor dimensión en algunas regiones corticales frontales y subcorticales. Además, hubo correlación moderada a alta entre el desempeno en esta función ejecutiva y el espesor del giro precentral derecho, y los volúmenes del tálamo y la amígdala derecha. Estos hallazgos podrían indicar un efecto neuroprotector del litio

ABSTRACT Introduction: Lithium treatment of bipolar disorder (BD) has been associated with less impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. Methods: Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propen-sity score, and the Spearman correlation coefficient (p) was used to assess the relationship between cognitive performance and neuroanatomical regions. Results: Compared to the group without lithium, the group with lithium had fewer perse-verative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amyg-dala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD=.67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (p = -0.78), the volume of the right thalamus (p =-0.44), and the right amygdala (p = 0.6). Conclusions: Thelithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.

Normative values for handgrip strength in Colombian children and adolescents from 6 to 17 years of age: estimation using quantile regression.

OBJECTIVE: The objective of this study is twofold: i) to estimate the normative values for handgrip strength and relative handgrip strength, specific to sex and age, for Colombian children and adolescents from 6 to 17 years of age using quantile regression models and ii) to compare the normative values for handgrip strength and relative handgrip strength in Colombian children and adolescents with those in children and adolescents in different countries. METHOD: This was a cross-sectional analysis of a sample of 2647 youngsters. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). The relative handgrip strength was estimated according to weight in kilograms. The normative values were estimated to handgrip strength and relative handgrip strength through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90, and P95 developed independently for each sex. All analyses were adjusted for the expansion factor. RESULTS: The values for handgrip strength were considerably higher in males than in females in all age ranges. Additionally, as age increased for both sexes, the values for handgrip strength increased. The percentiles by sex and age for relative handgrip strength show for males a proportional increase according to age; for females, this did not occur. CONCLUSIONS: When making comparisons with international studies, variability is observed in the methodologies used to evaluate handgrip strength and estimation methods, which could influence the discrepancies between the different reports.

¿Los hijos de pacientes con trastorno bipolar tienen una peor percepción de la calidad de sueño? / Do Children of Patients with Bipolar Disorder have a Worse Perception of Sleep Quality?

RESUMEN Introducción: los Hijos de Padres con Trastorno Bipolar (HPTB) constituyen una población de riesgo ya que pueden heredar el Trastorno Bipolar (TB) como también manifestaciones clínicas tempranas como seria las alteraciones en el sueño. Objetivo: comparar la presencia de trastornos psiquiátricos y las alteraciones en el sueño de los HPTB con los Hijos de Padres Control (HPC). Métodos: Se realizó un estudio analítico de corte transversal, que comparó HPTB versus HPC. Se entrevistaron con instrumentos validados para determinar la existencia de síntomas y trastornos psiquiátricos. Utilizamos las escalas: "Cuestionario de evaluación de sueño" y "Encuesta sobre hábitos de sueño en escolares" para determinarlas características del sueño y factores asociados con el mismo. Adicionalmente se obtuvo el registro de sueño (7-21 días) por medio de un reloj de actígrafia. Resultados: Se reunió una muestra con 42 sujetos (18 HPTB y 24 HPC). Se encontraron diferencias en la presentación de los trastornos psiquiátricos. El grupo de HPTB presento mayor frecuencia del trastorno depresivo mayor (TDM; p = 0,04) y el trastorno disruptivo de la regulación emocional (TDRE, p = 0,04). En el grupo de HPC por su parte se presentó una mayor frecuencia de Trastorno por Déficit de Atención e Hiperactividad (TDAH; p = 0,65) y de Trastorno de Ansiedad por Separación (TAS; p = 0,46). También se encontraron diferencias a nivel del sueño en las medidas subjetivas. En comparación con el HPC, el grupo de HPTB presento una peor percepción de la calidad de sueño (p = 0,02), una mayor presencia de pesadillas (p = 0,01), un menor tiempo total de sueño y una mayor latencia de sueño. Sin embargo, no se encontraron diferencias entre los dos grupos en las mediciones de actigrafías. Conclusiones: el grupo de HPTB presenta mayor frecuencia de trastornos del estado de ánimo, y a su vez una mayor presencia de alteraciones del sueño en las medidas subjetivas. Es posible que exista una asociación entre los síntomas afectivos, las alteraciones en el sueño y el consumo de café. No se encontraron diferencias en el perfil de sueño por actígrafía. © 2020 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados. Children

ABSTRACT Introduction: The offspring of bipolar parents (BO) is a high-risk population for inheriting the bipolar disorder (BD) and other early clinical manifestations, such as sleep disturbances. Objective: To compare the presence of psychiatric disorders and sleep disturbances of BO versus offspring of control parents (OCP). Methods: A cross-sectional analytical study was conducted that compared BO versus OCP. The participants were assessed using valid tools to determine the presence of psychiatric symptoms or disorders. The "Sleep Evaluation Questionnaire" and "School Sleep Habits Survey" were used to determine sleep characteristics and associated factors. Sleep records (7-21 days) were also obtained by using an actigraphy watch. Results: A sample of 42 participants (18 BO and 24 OCP) was recruited. Differences were found in the presentation of the psychiatric disorder. The BO group showed a higher frequency of major depression disorder (MDD; P = .04) and Disruptive Mood Dysregulation Disorder (DMDD; P = .04). The OCP group showed a higher frequency of Attention Deficit and Hyperactivity Disorder (ADHD; P = .65), and Separation Anxiety Disorder (SAD; P = .46). Differences were also found in sleep by using subjective measurements. Compared to the OCP group, BO had a worse perception of quality of sleep (P = .02), a higher frequency of nightmares (P = .01), a shorter total sleep time, and a higher sleep latency. Nevertheless, no differences were found between groups in the actigraphy measurements. Conclusions: The BO group had a higher frequency of Mood Disorders, and at the same time a higher number of sleep disturbances in the subjective measurements. It is possible that there is an association between mood symptoms, sleep disturbances, and coffee intake. No differences were found in the sleep profile by using actigraphy. © 2020 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.

Do Children of Patients with Bipolar Disorder have a Worse Perception of Sleep Quality?

INTRODUCTION: The offspring of bipolar parents (BO) is a high-risk population for inheriting the bipolar disorder (BD) and other early clinical manifestations, such as sleep disturbances. OBJECTIVE: To compare the presence of psychiatric disorders and sleep disturbances of BO versus offspring of control parents (OCP). METHODS: A cross-sectional analytical study was conducted that compared BO versus OCP. The participants were assessed using valid tools to determine the presence of psychiatric symptoms or disorders. The "Sleep Evaluation Questionnaire" and "School Sleep Habits Survey" were used to determine sleep characteristics and associated factors. Sleep records (7-21 days) were also obtained by using an actigraphy watch. RESULTS: A sample of 42 participants (18 BO and 24 OCP) was recruited. Differences were found in the presentation of the psychiatric disorder. The BO group showed a higher frequency of major depression disorder (MDD; P = .04) and Disruptive Mood Dysregulation Disorder (DMDD; P = .04). The OCP group showed a higher frequency of Attention Deficit and Hyperactivity Disorder (ADHD; P = .65), and Separation Anxiety Disorder (SAD; P = .46). Differences were also found in sleep by using subjective measurements. Compared to the OCP group, BO had a worse perception of quality of sleep (P = .02), a higher frequency of nightmares (P = .01), a shorter total sleep time, and a higher sleep latency. Nevertheless, no differences were found between groups in the actigraphy measurements. CONCLUSIONS: The BO group had a higher frequency of Mood Disorders, and at the same time a higher number of sleep disturbances in the subjective measurements. It is possible that there is an association between mood symptoms, sleep disturbances, and coffee intake. No differences were found in the sleep profile by using actigraphy.

[Anthropometric and body composition characteristics associated with handgrip strength in children and adolescents. A scoping review]. / Características antropométricas y de composición corporal asociadas a la fuerza prensil manual en niños y adolescentes. Una Revisión Sistemática Exploratoria.

Handgrip strength is a robust indicator of the biological health of children and adolescents. Objecti ves: to identify the anthropometric characteristics and body composition related to handgrip stren gth, and to describe the main characteristics of the protocols used for its evaluation. METHODOLOGY: A scoping review was developed; the search was carried out in 1.) Medline; 2.) Web of Science; 3.) Science Direct; 4.) Scielo; and 5.) EBSCO's Sportdiscus. Original investigations were included if they have handgrip strength data, anthropometric characteristics, and body composition. RESULTS: 59 reports published between 2005 and 2020 were selected. Among them, nutritional classification was the most studied characteristic (n = 25; 42.3%), followed by body mass index (n = 23; 38.9%). In 47.5% (28 reports), the number of tests performed on each individual to estimate the handgrip strength value was not clear. The dynamometer brand Takei Scientific Instrument Co. Ltd. was the most used, with 49.2 %. The most widely used indicator was absolute handgrip (86.4%, 51 reports). CONCLUSIONS: There is a wide variety of protocols used for handgrip strength assessment with va riations in body position, arm and hand selection, number of repetitions, and intervals between measurements. A proportional pattern of values was found between absolute handgrip strength and body mass index, Σ skinfolds, however, when adjusted by mass (relative handgrip strength), the relationship is inverse.

Diagnostic accuracy of the UDS 3.0 neuropsychological battery in a cohort with Alzheimer's disease in Colombia.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disease that causes a gradual loss of cognitive functions and limits daily activities performance. Early diagnosis of AD is essential to start timely treatment. This study aimed to validate the Uniform Data Set neuropsychological battery version 3.0 (UDS 3.0) in a Colombian cohort. METHODS: This study is a cross-sectional type, consecutive, incidental, with 143 persons, divided into two groups: 48 diagnosed AD cases and 95 healthy controls, between the ages of 50 and 80+, and between 1 and 19+ years of education. RESULTS: The results indicate differences between the control group and the AD group in most battery tests. A significant correlation was found between the Montreal Cognitive Assessment (MoCA), Multilingual Naming Test (MINT), Craft Story, Benson Figure Test, P-word and F-word Phonemic Fluency Test, and their respective reference tests. Cutoff points were found based on the Youden index for each sub-test. The results indicate that all sub-tests are above the reference line of the ROC curve. CONCLUSION: The use of the UDS 3.0 in Colombia would help improving clinical diagnostic routes because of its high accuracy and high correlation with tests that measure general impairment; it has good sensitivity and specificity, and it can be a useful tool for AD.