Clustering analysis identifies two subgroups of women with fibromyalgia with different psychological, cognitive, health-related, and physical features but similar widespread pressure pain sensitivity.

OBJECTIVE: Given that identification of groups of patients can help to better understand risk factors related to each group and to improve personalized therapeutic strategies, this study aimed to identify subgroups (clusters) of women with fibromyalgia syndrome (FMS) according to pain, pain-related disability, neurophysiological, cognitive, health, psychological, or physical features. METHODS: Demographic, pain, sensory, pain-related disability, psychological, health, cognitive, and physical variables were collected in 113 women with FMS. Widespread pressure pain thresholds were also assessed. K-means clustering was used to identify groups of women without any previous assumption. RESULTS: Two clusters exhibiting similar widespread sensitivity to pressure pain (pressure pain thresholds) but differing in the remaining variables were identified. Overall, women in one cluster exhibited higher pain intensity and pain-related disability; more sensitization-associated and neuropathic pain symptoms; higher kinesiophobia, hypervigilance, and catastrophism levels; worse sleep quality; higher anxiety/depressive levels; lower health-related function; and worse physical function than women in the other cluster. CONCLUSIONS: Cluster analysis identified one group of women with FMS exhibiting worse sensory, psychological, cognitive, and health-related features. Widespread sensitivity to pressure pain seems to be a common feature of FMS. The present results suggest that this group of women with FMS might need to be treated differently.

Bayesian Linear Regressions Applied to Fibromyalgia Syndrome for Understanding the Complexity of This Disorder.

A better understanding of the connection between factors associated with pain sensitivity and related disability in people with fibromyalgia syndrome may assist therapists in optimizing therapeutic programs. The current study applied mathematical modeling to analyze relationships between pain-related, psychological, psychophysical, health-related, and cognitive variables with sensitization symptom and related disability by using Bayesian Linear Regressions (BLR) in women with fibromyalgia syndrome (FMS). The novelty of the present work was to transfer a mathematical background to a complex pain condition with widespread symptoms. Demographic, clinical, psychological, psychophysical, health-related, cognitive, sensory-related, and related-disability variables were collected in 126 women with FMS. The first BLR model revealed that age, pain intensity at rest (mean-worst pain), years with pain (history of pain), and anxiety levels have significant correlations with the presence of sensitization-associated symptoms. The second BLR showed that lower health-related quality of life and higher pain intensity at rest (mean-worst pain) and pain intensity with daily activities were significantly correlated with related disability. These results support an application of mathematical modeling for identifying different interactions between a sensory (i.e., Central Sensitization Score) and a functional (i.e., Fibromyalgia Impact Questionnaire) aspect in women with FMS.

Sex Hormones and Healthy Psychological Aging in Women.

Besides their key role in reproduction, estrogens have effects in several organs in the body, as confirmed by the identification of estrogen receptors (ER) in multiple tissues. Experimental evidence has shown that estrogens have significant impacts on the central nervous system (CNS), and a key question is to what extent the fall in estrogen levels in the blood that occurs with increasing age, particularly around and following the menopause, has an impact on the cognitive function and psychological health of women, specifically regarding mood. This review will consider direct effects of menopausal changes in estrogens on the brain, including cognitive function and mood. Secondary pathways whereby health factors affected by changes in estrogens may interact with CNS functions, such as cardiovascular factors, will be reviewed as well insofar as they also have an impact on cognitive function. Finally, because decline in estrogens may induce changes in the CNS, there is interest in clarifying whether hormone therapy may offer a beneficial balance and the impact of hormone therapy on cognition will also be considered.

Phonemic and semantic verbal fluency tasks: normative data for elderly Brazilians / Fluência verbal fonêmica e semntica: dados normativos de idosos Brasileiros

This study aims to investigate the influence of sociodemographic characteristics on the performance of older people on two tasks of verbal fluency and provide normative data for a Brazilian population of healthy elderly individuals with different educational levels. The initial sample included 521 individuals aged from 60 years, participating in the Program Family Health Strategy. Participants who had scores suggestive of cognitive decline on the Mini-Mental State Examination, depressive symptoms in Geriatric Depression Scale and self-reported neurological or psychiatric disorders were excluded. The final sample consisted of 218 participants in phonemic verbal fluency task (letters F, A and S) and 265 participants for semantic verbal fluency task (animals). The performance in both tests was associated with age and education, but not with sex. Still, the education variable was shown to have a greater impact on scores in phonemic and semantic tests than age in both forms of evocation. The results of this study suggest the importance of providing normative data for elderly Brazilians appropriate to age and education on verbal fluency tasks. (AU)

Este estudo buscou investigar a influência de características sociodemográficas no desempenho de idosos em duas tarefas de fluência verbal, além de fornecer dados normativos de referência nessas tarefas, conforme níveis de educação, para a população brasileira de idosos saudáveis​​. A amostra inicial incluiu 521 idosos com idade a partir 60 anos, participantes do Programa Estratégia Saúde na Família. Foram excluídos os participantes que tinham pontuações sugestivas de declínio cognitivo no Mini Exame do Estado Mental, de sintomas depressivos na Escala de Depressão Geriátrica e com autorrelato de doenças neurológicas ou de distúrbios psiquiátricos. A amostra final foi composta por 218 participantes que responderam à tarefa de fluência verbal fonêmica (letras F, A e S) e 265 que responderam à tarefa semântica (animais). O desempenho em ambas as tarefas foi associado à idade e aos anos de ensino formal, mas não ao sexo. Ainda, a variável escolaridade mostrou ter um impacto maior no desempenho de fluência verbal do que a idade em ambas as modalidades de evocação. Os resultados desse estudo sugerem a importância de oferecer dados normativos de idosos brasileiros, adequados à idade e à escolaridade, em tarefas de fluência verbal. (AU)

Efecto moderador de la institucionalización en las actividades de la vida diaria y bienestar en el envejecimiento / Moderator effect of living in nursing homes on well-being and activities of daily life in the elderly

OBJETIVO: El envejecimiento con éxito es un concepto multidimensional que se puede evaluar a partir de componentes objetivos y subjetivos como el funcionamiento físico, psicológico y social. El objetivo de este trabajo es comparar el funcionamiento en variables relacionadas con el envejecimiento exitoso en ancianos institucionalizados y no institucionalizados. MÉTODO: Se realizó un diseño de dos grupos independientes, institucionalizados (N=242) y no institucionalizados (N=607), todos de más de 65 años, evaluándose sus actividades de la vida diaria (AVD) y el bienestar psicológico. RESULTADOS: El Índice de Barthel mostró diferencias significativas, siendo inferior la media de los institucionalizados que la de los no institucionalizados. En relación al bienestar, el MANOVA mostró diferencias entre grupos para todas las escalas. En los posteriores ANOVA's la variable crecimiento personal mostró las mayores diferencias y porcentaje de varianza explicada. Se obtuvieron correlaciones significativas de la edad con el Índice de Barthel, y con las siguientes escalas de bienestar psicológico de Ryff: autoaceptación, relaciones positivas con otros, dominio del ambiente y propósito en la vida. CONCLUSIONES: Los institucionalizados muestran puntuaciones significativamente inferiores en AVD y en bienestar psicológico, actuando como variable moderadora, que puede empeorar su situación. La edad afecta de forma más clara al bienestar de los institucionalizados, reafirmándose la necesidad de generar estrategias que mejoren la adaptación de las personas.

OBJECTIVES: Successful aging is a multidimensional concept that can be evaluated from objective and subjective components, such as physical, psychological and social functioning. This study aimed to compare the performance on variables related to successful aging in elderly institutionalized and non-institutionalized. METHODS: We conducted a design of two independent groups, institutionalized (N = 242) and non-institutionalized (N = 607), all aged over 65 years, evaluating their activities of daily living (ADL) and psychological well being. RESULTS: The Barthel index showed significant differences, being the mean of the institutionalized group lower than the mean of the non- institutionalized group. Regarding well-being, MANOVA showed differences between groups for all the scales. In subsequent ANOVA's, the variable personal growth showed the greatest differences and the percentage of explained variance. There were significant correlations between age and the Barthel Index, and the following scales Ryff's psychological well-being: self-acceptance, positive relations with others, environmental mastery and purpose in life. CONCLUSIONS: The institutionalized group has significantly lower scores in ADL and psychological well-being, and therefore living in nursing homes acts as a moderating variable that can worsen the situation. Additionally, age clearly affects the well-being of the institutionalized group, strengthening the need for generating strategies that improve the adaptation of the elderly.

Análisis de las redes sociales en la vejez a través de la entrevista Manheim / Analyses of the social networks for the elderly through the Manheim interview

OBJETIVO: Reconocer quiénes son las figuras suministradoras de apoyo, psicológico e instrumental, en la vejez, así como precisar si existen diferencias en función de la edad y el sexo. MATERIAL Y MÉTODOS: Se utilizó la entrevista Manheim de apoyo social y se recogieron las opiniones de 101 personas mayores (>65 años) de la provincia de Valencia (España), entre enero y mayo de 2006. RESULTADOS: Se han encontrado diferencias estadísticamente significativas en el apoyo psicológico y el instrumental y tanto en relación con la edad como con el sexo del entrevistado. CONCLUSIONES: Respecto del género, los datos muestran que los hombres reciben más apoyo de sus parejas, mientras que las mujeres tienden a priorizar a los hijos como suministradores de apoyo. Acerca de la edad, las parejas son más importantes en la primera de las franjas de edad consideradas (65-75 años) y a medida que la edad aumenta los hijos las reemplazan.

OBJECTIVE: To analyse who are the people giving psychological and instrumental support to the elderly, as well as potential differences among these caregivers according to age and/or sex of the elderly. MATERIAL AND METHODS: Manheim interview for social support was used to gather the opinions of 101 elder people (>65 years) living in Valencia (Spain), from January to May, 2006. RESULTS: Statistically significant differences were found on both psychological and instrumental support depending on age and sex of the interviewed elderly. CONCLUSIONS: With respect to sex differences old men seek for support mainly from their partners, while son and daughters are the main source of support for old women. With respect to age, there are changes in the figures giving support as age increases. Partners are the main figure to give support within the 65-75 years, but its importance decreases with age, while sons and daughters became more important as age of the elderly increases.