Occupational complexity of paid work and housework, and its impact on the cognitive performance in community dwelling older adults, preliminary results.

Work and activity could be an important source of cognitive enrichment. Activities that are more challenging concerning the cognitive functions that are put into practice are associated with lower risk of cognitive decline in old age. Objective: The present study aimed to assess the impact of occupational complexity and household tasks in three cognitive domains (verbal episodic memory, language, and executive functions) in older adults residing within the community. Methods: A trail analysis was executed, using the structural equations procedure in 120 participants assessed with main lifetime occupational activity and household tasks questionnaire, as well as a neuropsychological assessment battery for memory, language, and executive functions. Results: The regression weights analysis indicated that complexity in household chores showed moderate effects on executive functions (ß=0.19; p=0.027) and that occupational complexity of paid work showed effects on memory (ß=0.26; p=0.008), language (ß=0.38; p<0.001), and executive functions (ß=0.55; p<0.001). Conclusion: Paid work promotes cognitive reserve, contrary to household activities which seem to have a moderate impact on cognition. Differences in activity complexity not only impact people´s economic and social status and possibilities but can also determine different courses of aging and cognitive risk.

Trabalho e atividade podem ser importantes fontes de enriquecimento cognitivo. Atividades que são mais desafiadoras quanto às funções cognitivas postas em prática se associam a menor risco de declínio cognitivo em idade avançada. Objetivo: O objetivo do presente estudo é avaliar o impacto da complexidade ocupacional e das tarefas domésticas em três domínio cognitivos (memória episódica verbal, linguagem e funções executivas) em idosos residentes na comunidade. Métodos: Foi realizada uma análise de trilha com o uso de procedimento de equações estruturais em 120 participantes, avaliados por meio de: questionário das principais atividades ocupacionais e tarefas domésticas da vida, bem como bateria de avaliação neuropsicológica para memória, linguagem e funções executivas. Resultados: A análise dos pesos de regressou mostrou que a complexidade nas tarefas domésticas apresenta efeitos moderados nas funções executivas (ß=0,19; p=0,027) e que a complexidade ocupacional do trabalho remunerado teve efeitos sobre a memória (ß=0,26; p=0,008), linguagem (ß=0,38; p<0,001) e funções executivas (ß=0,55; p<0,001). Conclusão: O trabalho remunerado promove a reserva cognitiva, em contraste com as atividades domésticas, que parecem ter impacto moderado na cognição. As diferenças na complexidade das atividades não apenas impactam o status econômico e social e as possibilidades das pessoas, mas também podem determinar diferentes cursos de envelhecimento e risco cognitivo.

Occupational complexity of paid work and housework, and its impact on the cognitive performance in community dwelling older adults, preliminary results / Complexidade ocupacional do trabalho remunerado e o trabalho doméstico e seu impacto no desempenho cognitivo de idosos residentes na comunidade, resultados preliminares

ABSTRACT Work and activity could be an important source of cognitive enrichment. Activities that are more challenging concerning the cognitive functions that are put into practice are associated with lower risk of cognitive decline in old age. Objective: The present study aimed to assess the impact of occupational complexity and household tasks in three cognitive domains (verbal episodic memory, language, and executive functions) in older adults residing within the community. Methods: A trail analysis was executed, using the structural equations procedure in 120 participants assessed with main lifetime occupational activity and household tasks questionnaire, as well as a neuropsychological assessment battery for memory, language, and executive functions. Results: The regression weights analysis indicated that complexity in household chores showed moderate effects on executive functions (β=0.19; p=0.027) and that occupational complexity of paid work showed effects on memory (β=0.26; p=0.008), language (β=0.38; p<0.001), and executive functions (β=0.55; p<0.001). Conclusion: Paid work promotes cognitive reserve, contrary to household activities which seem to have a moderate impact on cognition. Differences in activity complexity not only impact people´s economic and social status and possibilities but can also determine different courses of aging and cognitive risk.

RESUMO Trabalho e atividade podem ser importantes fontes de enriquecimento cognitivo. Atividades que são mais desafiadoras quanto às funções cognitivas postas em prática se associam a menor risco de declínio cognitivo em idade avançada. Objetivo: O objetivo do presente estudo é avaliar o impacto da complexidade ocupacional e das tarefas domésticas em três domínio cognitivos (memória episódica verbal, linguagem e funções executivas) em idosos residentes na comunidade. Métodos: Foi realizada uma análise de trilha com o uso de procedimento de equações estruturais em 120 participantes, avaliados por meio de: questionário das principais atividades ocupacionais e tarefas domésticas da vida, bem como bateria de avaliação neuropsicológica para memória, linguagem e funções executivas. Resultados: A análise dos pesos de regressou mostrou que a complexidade nas tarefas domésticas apresenta efeitos moderados nas funções executivas (β=0,19; p=0,027) e que a complexidade ocupacional do trabalho remunerado teve efeitos sobre a memória (β=0,26; p=0,008), linguagem (β=0,38; p<0,001) e funções executivas (β=0,55; p<0,001). Conclusão: O trabalho remunerado promove a reserva cognitiva, em contraste com as atividades domésticas, que parecem ter impacto moderado na cognição. As diferenças na complexidade das atividades não apenas impactam o status econômico e social e as possibilidades das pessoas, mas também podem determinar diferentes cursos de envelhecimento e risco cognitivo.

Estimation of cognitive reserve and its impact on cognitive performance in older adults.

OBJECTIVES: Cognitive reserve provides evidence in the search for answers regarding the role that lifestyle has in the protection of cognition in old age. Through a structural equations model, different things were analyzed: the relative weight of education, occupational complexity, free time activities and the intelligence quotient in cognitive reserve; and its impact on three cognitive domains: memory, language and executive functions. DESIGN: A trail analysis was executed, using structural equations procedure. PARTICIPANTS: 167 older participants (mean = 76.74 years, standard deviation = 6.8 years). MEASUREMENTS: Participants were assessed with: Sociodemographic Questionnaire, Occupational Activity Agency Questionnaire, Social Participation Questionnaire and Neuropsychological Evaluation Battery for: memory, language and executive functions. RESULTS: The cognitive reserve factor is well represented by the measures included, with values ​​between .43 and .86, and shows a direct effect on language (ß = .52, p < .001), executive functions (ß = .77, p <.001), and memory (ß = .36, p = .003). CONCLUSIONS: In conclusion, lifestyle factors, such as education, occupational complexity, leisure time activities and intelligence quotient have an impact on the conformation of cognitive reserve and performance in some psychological processes.

Cuestionario de Depresión Geriátrica de Yesavage abreviado (GDS-VE): Análisis de su estructura interna en adultos mayores residentes en Buenos Aires, Argentina

Resumen: La depresión es uno de los trastornos del estado de ánimo más frecuentes e incapacitantes en la población de adultos mayores. Para medirla, una de las escalas más utilizadas es el Cuestionario de Depresión Geriátrica de Yesavage, en su versión abreviada (GDS-VE). Pese a su reconocimiento y frecuente utilización, aún no se ha realizado un análisis de estas características en población argentina. Actualmente, con motivo de la pandemia por COVID-19 y el contexto de aislamiento, la American Psychological Association recomienda adaptar las prácticas presenciales a la modalidad virtual. Dada esta necesidad, el presente trabajo tiene por objetivo analizar la estructura interna del GDS-VE para las modalidades de administración de lápiz y papel e Internet, examinando la equivalencia métrica entre ambas. Se realizó un análisis factorial confirmatorio y se estimó la consistencia interna para las dos modalidades. También se examinó la invarianza factorial entre ambas formas de administración. Participaron 696 adultos mayores que respondieron al cuestionario mediante dos modalidades de administración (50% lápiz y papel y 50% Internet). Como resultado, se verificó un adecuado ajuste del modelo a los datos empíricos para las dos versiones (lápiz y papel e Internet), como también una adecuada invarianza métrica entre ellas. Estos hallazgos aportan evidencias de validez y confiabilidad acerca de la estructura interna del GDS-VE, en población argentina.

Abstract: Depression represents one of the most frequent and disabling mood disorders in the elderly population. To measure it, one of the most used scales is the Geriatric Depression Questionnaire, developed by Yesavage, in its abbreviated version (GDS-VE). Despite its ample acknowledgment and frequent use, an analysis of these characteristics has not yet been carried outon the Argentine population. Currently, because of the COVID-19 pandemic and the isolation context, the American Psychological Association recommends adapting face-to-face to virtual practices. Given this need, the present work aims to analyze the internal structure of the GDS-VE, for pencil-paper and Internet modalities examining the metric equivalence between both of them. A confirmatory factor analysis was carried out and the internal consistency was estimated for both modalities. Factor invariance between both forms of administration was also examined. A total of 696 older adults participated and responded to the questionnaire, using two modes of administration (50% pencil-paper and 50% Internet). As a result, an adequate adjustment of the model to the empirical data was verified for both versions (pencil-paper and Internet), as well as an adequate metric invariance between them. These findings provide evidence of validity and reliability of the GDS-VE instrument, on the Argentine population.

Resumo: A depressão representa uma das condições mais frequentes e incapacitantes na população idosa. Para mensurá-la, uma das escalas mais utilizadas é o Yesavage Geriatric Depression Questionnaire, em sua versão abreviada (GDS-VE). Apesar de seu reconhecimento e uso frequente, uma análise dessas características ainda não foi realizadana população argentina. Atualmente, devido à pandemia COVID-19 e ao contexto de isolamento, a American Psychological Association recomenda adaptar as práticas presenciais para o modo virtual. Diante dessa necessidade, o presente trabalho tem como objetivo analisar a estrutura interna do GDS-VE para as modalidades lápis e papel e administração de Internet, examinando a equivalência métrica entre ambas. Foi realizada uma análise fatorial confirmatória e estimada a consistência interna para ambas as modalidades. A invariância fatorial entre as duas formas de administração também foi examinada. Participaram 696 idosos, que responderam ao questionário em duas modalidades de aplicação (50% papel-lápis e 50% Internet). Como resultado, verificou-se um adequado ajuste do modelo aos dados empíricos para as duas versões (lápis-papel e Internet), bem como uma adequada invariância métrica entre elas. Esses achados fornecem evidências de validade e confiabilidade do instrumento GDS-VE na população argentina.

Prevalence of Geriatric Depression and Alexithymia and their association with sociodemographic characteristics in a sample of elderly persons living in Buenos Aires, Argentina / Prevalencia de Depresión Geriátrica y Alexitimia. Su asociación con características sociodemográficas, en una muestra de adultos mayores residentes en Buenos Aires, Argentina

Abstract Objective: to evaluate the prevalence of Geriatric Depression and Alexithymia and their association with sociodemographic characteristics in independent elderly persons without known depression. Method: a cross-sectional study was conducted, based on a non-probabilistic, intentional type sampling strategy. A total of 176 independent men and women aged over 60 years residing in the city of Buenos Aires, Argentina, were evaluated through individual interviews using the following instruments: a sociodemographic (ad hoc) questionnaire, an adapted version of the questionnaire of the Yesavage Geriatric Depression Scale (V-15) and the Latin American Alexithymia LAC TAS-20 Scale. The Chi-squared and Student's t-tests were used and the Odds Ratio was calculated, with a probability of error less than or equal to 0.05. Results: The mean age was 73 years (+7.1 years) and 72.7% of the participants were women. The prevalence of Geriatric Depression was 35.8%, while that of Alexithymia was 50.6%. The presence of Geriatric Depression was significantly associated with the female gender and with individuals who did not work. High Alexithymia values were observed among those with primary education and a low occupational level. Conclusion: The evaluation of Geriatric Depression and Alexithymia in clinical care is recommended, and the social determinants of the health of the elderly should also be considered in the diagnosis and treatment of these conditions. AU

Resumen Objetivo: Evaluar la prevalencia de Depresión Geriátrica y Alexitimia y su asociación con las características sociodemográficas de los adultos mayores autoválidos sin depresión conocida. Método: Estudio de corte transversal. La estrategia de muestreo seleccionada fue la no probabilística, de tipo intencional. Se seleccionaron 176 adultos mayores de 60 años, de diferente género y autoválidos, residentes en la Ciudad Autónoma de Buenos Aires, Argentina, los cuales fueron evaluados a través de una entrevista individual con los siguientes instrumentos: Cuestionario de datos sociodemográficos (ad hoc), adaptación del Cuestionario de Depresión Geriátrica de Yesavage (V-15) y la Escala Latinoamericana de Alexitimia LAC TAS-20. Se utilizaron las pruebas de χ2 (Ji cuadrado), t de Student y se calcularon los Odds Ratio, fijándose una probabilidad de error menor o igual a 0,05. Resultados: La edad media fue 73 años (+7,1 años) y el 72,7% son mujeres. La prevalencia de Depresión Geriátrica fue de 35,8%, y de Alexitimia del 50,6%. La presencia de Depresión Geriátrica se asoció significativamente con el género femenino y con los que no trabajaban. Altos valores de Alexitimia se observaron entre quienes tenían estudios primarios y un bajo nivel ocupacional. Conclusión: Se recomienda la evaluación de Depresión Geriátrica y Alexitimia en la atención clínica, considerando además, para su diagnóstico y tratamiento a los determinantes sociales de la salud de los adultos mayores.AU

Actitudes y significados acerca de la jubilación: un estudio comparativo de acuerdo al género en adultos mayores / Attitudes and meanings regarding retirement: a comparative study according to gender in older adults

El objetivo del estudio es evaluar si las expectativas sociales de ®rol¼ diferencial de género influyen en la adaptación de los adultos mayores a la jubilación, a través de los significados y actitudes hacia el retiro laboral. Se empleó un diseño ex post facto, de carácter retrospectivo simple. Participaron 300 adultos mayores autoválidos de clase media, 150 varones y 150 mujeres, residentes en la Ciudad Autónoma de Buenos Aires y conurbano bonaerense (República Argentina). Se administró un cuestionario de datos sociodemográfico y perfil jubilatorio, la Escala de Actitudes hacia la jubilación y la adaptación argentina del Cuestionario de Significados acerca de la jubilación. Los resultados denotan que las mujeres, en comparación con los varones, presentan actitudes más favorables hacia la jubilación y la significan más como un ®Descanso¼, ®Comienzo¼ o ®Continuidad¼. Esta diferencia podría deberse al impacto diferencial que generaría la pérdida del ®rol¼ laboral de acuerdo al género...

The objective of the study is to assess whether the social expectations of ®role¼ û differential of gender û influence in the adaptation of older adults to retirement, through meanings and attitudes toward retirement. An ex post facto design of simple retrospective character was used. It was attended by 300 self-governing middle class older adults; 150 men and 150 women residing in the Autonomous City, Buenos Aires, and influence areas (Argentina). We administered a questionnaire of sociodemographic data and retirement profile, a Scale of Attitudes toward retirement, and the argentine adaptation of the Meaning about retirement Questionnaire. The results show that women in comparison with men have more favorable attitudes toward retirement and they denote it more as ®Rest¼, ®Beginning¼ or ®Continuity¼. This difference could be due to the differential impact that would result in the loss of the labor ®role¼ according to gender...

Geriatric depression and its relation with cognitive impairment and dementia.

Different subtypes of depressive syndromes exist in late life; many of them have cognitive impairment and sometimes it is difficult to differentiate them from dementia. This research aimed to investigate subtypes of geriatric depression associated with cognitive impairment, searched for differential variables and tried to propose a study model. A hundred and eighteen depressive patients and forty normal subjects matched by age and educational level were evaluated with an extensive neuropsychological battery, scales to evaluate neuropsychiatric symptoms and daily life activities (DLA). Depressive patients were classified in groups by SCAN 2.1: Major Depression Disorder (MDD) (n: 31), Dysthymia Disorder (DD) (n: 31), Subsyndromal Depression Disorder (SSD) (n: 29), Depression due to Dementia (n: 27) (DdD). Neuropsychological significant differences (p<0.05) were observed between depressive groups, demonstrating distinctive cognitive profiles. Moreover, significant differences (p<0.05) were found in DLA between DdD vs all groups and MDD vs controls and vs SSD. Age of onset varied in the different subtypes of depression. Beck Depression Inventory (BDI) and Mini Mental State Examination (MMSE) were significant variables that helped to differentiate depressive groups. Significant correlations between BDI and Neuropsychological tests were found in MDD and DD groups. Depressive symptoms and its relation with neuropsychological variables, MMSE, cognitive profiles, DLA and age of onset of depression should be taken into consideration for the study of subtypes of geriatric depression.

Adaptación y evidencias de validez del Cuestionario de Significados acerca de la jubilación en adultos mayores argentinos / Adaptation and validity evidence of the Questionnaire of Meanings about retirement in argentinian older adults

Se presentan las adaptaciones lingüística y psicométrica para el Cuestionario de Significados acerca de la jubilación (Pastor et al., 2003), realizadas sobre una muestra de 250 adultos mayores autoválidos, de nivel socioeconómico medio, residentes en C.A.B.A. y zonas de influencia. La adaptación lingüística del instrumento original, de origen español, fue evaluada de forma por 5 jueces expertos, realizándose luego un estudio piloto a partir del cual se confeccionó una versión preliminar del Cuestionario adaptado. Esto permitió obtener evidencias de validez aparente y de contenido. Se efectuó a continuación el cálculo de análisis psicométricos para 1) la evaluación de la homogeneidad de los elementos, 2) el análisis de evidencias de validez de constructo, mediante la realización de un Estudio Factorial Exploratorio, y 3) el estudio de su consistencia interna. Se obtuvo un instrumento abreviado constituido por 17 reactivos, agrupados en cuatro dimensiones: “Pérdida”, “Comienzo”, “Descanso” y “Continuidad”, que evalúan los diferentes significados que los sujetos otorgan a la jubilación. El estudio resulta relevante por el impacto que poseen las formas de vivenciar la jubilación en la adaptación de los adultos mayores frente a este suceso vital y a los cambios que éste acarrea.

The paper describes the linguistic and psychometric adaptations of the Questionnaire of Meanings about Retirement (Pastor et al., 2003) made from a sample of 250 non-dependent middle class senior adults, living in the city of Buenos Aires and its zones of influence. The linguistic adaptation of the Spanish original instrument was evaluated by 5 expert judges, building a preliminary version of the adapted Questionnaire after the performance of a pilot study. This allowed to obtain face and content validity evidence. Later, various psychometric analyses were carried out for 1) the evaluation of element homogeneity, 2) construct validity evidence by the conduction of an Exploratory Factorial Study, and 3) the study of internal consistency. An abbreviated instrument was obtained, consisting of 17 reactives, grouped in four dimensions: “Loss”, “Start”, “Rest” and “Continuity”, that assess the meanings that individuals give to retirement. The relevance of the study lies in the impact that the ways of experiencing retirement have on the adaptation of senior adults to this life event and the involved changes.

Estrés, mecanismos de afrontamiento y participación social en ancianos institucionalizados y no institucionalizados: un estudio en la Cuidad Autónoma de Buenos Aires, República Argentina / Stress, coping mechanisms and social participation in institutionalized and non-institutionalized elderly: a study in the City of Buenos Aires, Argentina

Objetivo: Evaluar si los adultos mayores que viven en sus hogares y los que habitan en residencias geriátricas presentan respuestas diferentes en sus perfiles sociodemográficos, fuentes de estrés, afrontamiento e integración social.Método: El diseño utilizado fue el descriptivo-comparativo, de corte transversal. 300 ancianos autoválidos, de diferente género, de nivel socioeconómico medio y residentes en un gran centro urbano, conformaron la muestra del estudio. 150 habitaban en sus hogares y 150 en un geriátrico. Un cuestionario de datos básicos, el Cuestionario de Estilos de Afrontamiento de Folkman y Lazarus y el Inventario de Actividades de Stefani, fueron administrados como entrevista individual.Resultados: Se hallaron diferencias significativas entre ambos grupos en el estado civil y razones de exclusión del mercado de trabajo, en los estresores y afrontamientos, y en la participación social.Discusión La importancia de la percepción del control personal para la satisfacción vital del anciano, propuesto por Shultz, y su probable diferencia de acuerdo a habitar en un geriátrico con normas fijas o en el hogar con rutina generadas por la historia personal, justificarían, en parte, los hallazgos: aflicciones por vivir en un nuevo ámbito, afrontamiento menos activo y baja interacción social fuera de sus límites vs. aflicciones por problemas de salud, afrontamiento más activo y participación en diversos tipos de actividades en la comunidad.

Factores de riesgo psicosocial en cuidadores familiares de pacientes con demencia / Psychosocial risk factors in family caregivers of patients with dementia

Objetivo: Describir los factores de riesgo psicosocial en cuidadores familiares de pacientes con demencias. Método: Diseño descriptivo-correlacional de corte transversal. Instrumentos: Cuestionario de datos sociodemográficos y psicosociales, Cuestionario de Estilos y Estrategias de Afrontamiento, Inventario de Recursos Sociales y Escala de Sobrecarga. Los instrumentos fueron administrados a 200 cuidadores residentes en C.A.B.A. y Gran Bs. As., Argentina. Resultados: La percepción negativa del cuidador del estado de salud del paciente, el mayor número de días dedicados al cuidado, la utilización inadecuada de los estilos y estrategias de afrontamiento, la insatisfacción con el apoyo percibido de la red social, la existencia de un vínculo desfavorable con el familiar asistido, y la actitud negativa de este último hacia el tratamiento, se presentan como factores de riesgo psicosocial de los cuidadores familiares entrevistados. Discusión: Los cuidadores son calificados como pacientes ocultos. Para referirse al conjunto de patologías que los afecta se utiliza el concepto de síndrome del cuidador. Por lo tanto se recomienda realizar la evaluación psicosocial del cuidador, considerando los factores de riesgo señalados, con el propósito de evaluar si el cuidador está en condiciones de asistir al paciente, sin que se vea afectado su bienestar ni el del enfermo.