Caregiver training: Evidence of its effectiveness for cognitive and functional improvement in older adults.

AIMS AND OBJECTIVES: The objectives of this study were to assess the benefits of a caregiver training programme on the cognitive and functional status of older adults, and to compare the effects of this programme according to type of caregiver (professional vs. family caregiver). BACKGROUND: Due to demographic changes that have resulted in an aging population, the role of caregiver of an older adult has become very important in recent years. DESIGN AND METHODS: The sample was composed of 160 older adults: (a) 100 received care from caregivers who had taken the three-month training programme (treatment group), of which 60 were professional caregivers and 40 were family caregivers, and (b) 60 received care from caregivers who had not taken the programme (control group). In order to evaluate programme effects on cognitive and functional status, we used both direct measures answered by the older adults (MMSE, CAPE and EuroQol) and caregiver reports (Barthel and RMPBC). We used a quasi-experimental, pre-post design. We followed SQUIRE 2.0 guidelines for reporting. RESULTS: The results showed that older adults who were cared for by caregivers that had participated in the training programme showed gains in quality of life and cognitive ability and maintenance of functional ability. Within the treatment group, although everyone significantly improved their scores, the older adults cared for by family caregivers improved in more of the cognitive sub-items than did their peers in the professional caregiver group. CONCLUSIONS: The data obtained show that a caregiver training programme based on cognitive stimulation produces cognitive, functional and health-related quality-of-life benefits in older adults. Furthermore, the caregivers reported increased satisfaction with their work. RELEVANCE TO CLINICAL PRACTICE: The improvements obtained in the older adults and in caregivers show the relevance of this type of intervention when working in the clinical field of caregiving.

[Caregiver training in a cognitive stimulation program: Differential effects according to the type of caregiver]. / Formación de cuidadores en un programa de estimulación cognitiva: efectos diferenciales según el tipo de cuidador.

BACKGROUND AND OBJECTIVES: The ageing population and the increasing dependency associated with it, makes the caregiver a highly relevant figure nowadays. The present study analyzes the socio-demographic differences between family and professional caregivers and their satisfaction and implication in a training program for caregivers. METHODS: The sample consisted of 59 caregivers of older people (37 were family caregivers and 22 professional caregivers) which received and implemented a caregivers training program in their daily care functions. These caregivers were trained in communication skills and cognitive stimulation strategies so they could use them in their daily care activities with the older adults under their care during a period of 3 months. All the participants were assessed with a socio-demographic questionnaire, 2 questionnaires to analyze their satisfaction with their work and the training received and one questionnaire to analyze their ability to detect and react to memory and behavior problems in the older adults they attended. RESULTS: The results showed socio-demographic differences, improvements in satisfaction in family caregivers and a greater commitment in their daily work after the treatment in both groups although these effects could be due to different reasons. CONCLUSIONS: The research shows the benefits of carrying out training programs for caregivers as they significantly increase the quality and satisfaction with caregiving. The study also displays the need to adjust such programs taking into account that the socio-demographic characteristics and training needs are different depending on whether de caregiver is a family member or a professional.

Formación de cuidadores en un programa de estimulación cognitiva: efectos diferenciales según el tipo de cuidador / Caregiver training in a cognitive stimulation program: Differential effects according to the type of caregiver

Antecedentes y objetivo: El envejecimiento y el incremento de la dependencia asociado al mismo hacen del cuidador una figura de gran relevancia en la actualidad. El presente estudio analiza las diferencias sociodemográficas entre cuidadores familiares y profesionales así como el grado de satisfacción e implicación de ambos grupos en un programa de formación de cuidadores.Métodos: La muestra constó de 59 cuidadores de personas mayores (37 cuidadores familiares y 22 profesionales) que recibieron e implementaron un programa de formación de cuidadores en sus funciones de cuidados diarias. Estos cuidadores fueron formados en estrategias de comunicación y estimulación cognitiva para que las implementaran con las personas mayores que cuidaban durante un periodo de 3 meses. Todos los participantes fueron evaluados con un cuestionario sociodemográfico, con 2 instrumentos para analizar su satisfacción con el cuidado y con la formación recibida y con un cuestionario en el que se analizaba la capacidad que tenían para detectar y reaccionar ante problemas de memoria y de conducta de las personas mayores a las que atendían.Resultados: Los resultados mostraron diferencias sociodemográficas entre ambos grupos de cuidadores, mejoras tras el tratamiento en la satisfacción laboral de los cuidadores familiares y una mayor implicación en su trabajo diario en ambos grupos de cuidadores aunque dichos efectos puedan ser debidos a diferentes motivos.Conclusiones: La investigación realizada muestra las ventajas de llevar a cabo programas de formación de cuidadores ya que logran incrementar la calidad y la satisfacción con el cuidado. También se muestra la necesidad de adaptar dichos programas ya que las características sociodemográficas y las necesidades formativas son diferentes en función de si el cuidador es un familiar o un profesional. (AU)

Background and objectives: The ageing population and the increasing dependency associated with it, makes the caregiver a highly relevant figure nowadays. The present study analyzes the socio-demographic differences between family and professional caregivers and their satisfaction and implication in a training program for caregivers.Methods: The sample consisted of 59 caregivers of older people (37 were family caregivers and 22 professional caregivers) which received and implemented a caregivers training program in their daily care functions. These caregivers were trained in communication skills and cognitive stimulation strategies so they could use them in their daily care activities with the older adults under their care during a period of 3 months. All the participants were assessed with a socio-demographic questionnaire, 2 questionnaires to analyze their satisfaction with their work and the training received and one questionnaire to analyze their ability to detect and react to memory and behavior problems in the older adults they attended.Results: The results showed socio-demographic differences, improvements in satisfaction in family caregivers and a greater commitment in their daily work after the treatment in both groups although these effects could be due to different reasons.Conclusions: The research shows the benefits of carrying out training programs for caregivers as they significantly increase the quality and satisfaction with caregiving. The study also displays the need to adjust such programs taking into account that the socio-demographic characteristics and training needs are different depending on whether de caregiver is a family member or a professional. (AU)

Relationship between hospitalization and functional and cognitive impairment in hospitalized older adults patients.

OBJECTIVES: To study changes in the cognitive status and dependency of patients aged over 65 years during hospitalization for bone fracture and how these changes relate to the total number of days of admission and absolute rest during hospitalization. Along with cognitive decline, musculoskeletal disorders are considered key factors in this patient population. As well as requiring hospital admission and/or surgical treatment, fractures increase the risk factors that contribute to disability and dependency in older adults. METHOD: A longitudinal case-series study with repeated follow-up assessments was conducted. The sample consisted of 259 older adults. The following tests were administered: Barthel index, Lawton-Brody's scale, Phototest, and informant questionnaire on cognitive decline in the elderly. RESULTS: The main variable which fosters functional dependency, cognitive decline, and functional loss and diminishes functional gain (both in the hospital and at home) is the number of days of bed rest during hospitalization. CONCLUSIONS: The present study reveals that the greater impact on levels of functional dependency and cognitive decline comes from the patient's days of bed rest in hospital, rather than the total days of hospitalization. These findings could be taken into consideration when discussing post-discharge functional recovery.

Trayectorias de envejecimiento de una muestra de personas mayores: un estudio longitudinal / Trajectories of aging in a sample of elderly people: a longitudinal study

Introducción. En el presente estudio se analizan variables psicológicas asociadas a la evolución cognitiva y al nivel de funcionamiento cognitivo de una muestra de personas mayores. Material y métodos. Si bien este trabajo se enmarca en una investigación más amplia en la que inicialmente se evaluaron 141 personas, en este estudio se analiza únicamente el funcionamiento cognitivo y la evolución cognitiva de las 64 personas mayores de las que se ha realizado un seguimiento a los 4 años de la evaluación inicial con una edad media de 83,84 años (rango de edad entre 65 y 99 años). En la evaluación inicial los participantes fueron evaluados con una batería psicológica que incluía el MEC, una prueba de fluidez verbal semántica, una tarea de atención sostenida, una tarea de memoria de trabajo, un cuestionario de calidad de vida, un baremo de dependencia y la prueba AVLT en su versión de potencial de aprendizaje. En el seguimiento fueron evaluados con la prueba MEC, la prueba de fluidez verbal semántica FVS y la prueba de memoria verbal AVLT-PA. Resultados. Los resultados muestran trayectorias relativamente estables de envejecimiento y que las variables que mejor predicen la evolución cognitiva de las personas mayores son la memoria de trabajo y la puntuación de postest del AVLT-PA. Conclusiones. A pesar del tiempo transcurrido entre ambas evaluaciones y la edad de los participantes, las personas mayores se han mantenido relativamente estables en su funcionamiento cognitivo, lo cual contradice la idea de que especialmente a partir de los 80 años se produce un declive generalizado del funcionamiento cognitivo en la vejez (AU)

Introduction. The present study analyzes variables associated with different trajectories of aging, and the level of cognitive functioning in a sample of older adults. Material and methods. Although this work is part of a broader investigation where initially 141 people were assessed, this paper only discusses the cognitive functioning and cognitive development of 64 older people who have been followed up four years after the initial assessment, with a mean age of 83.84 years (age range 65 to 99 years). In the initial assessment all the participants were assessed with a psychological battery that included the MEC, the verbal fluency task FVS, a sustained attention task, a working memory test, a Quality of Life Questionnaire, a scale of dependency, and the AVLT-Learning Potential test. In the follow up assessment, participants have been assessed with the MEC, the verbal fluency task FVS, and the verbal memory test AVLT-PA. Results. the results show relatively stable trajectories of aging and that the variables that better predict cognitive evolution of the elderly are working memory and post-test score in the AVLT-LP. Conclusions. Despite the time lapse between the two assessments and the age of the participants, older adults have remained relatively stable in their cognitive functioning, which in part contradicts the idea that - especially after 80 years - a general decline of cognitive functioning occurs in old age (AU)

Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study.

Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme.

[Trajectories of aging in a sample of elderly people: a longitudinal study]. / Trayectorias de envejecimiento de una muestra de personas mayores: un estudio longitudinal.

INTRODUCTION: The present study analyzes variables associated with different trajectories of aging, and the level of cognitive functioning in a sample of older adults. MATERIAL AND METHODS: Although this work is part of a broader investigation where initially 141 people were assessed, this paper only discusses the cognitive functioning and cognitive development of 64 older people who have been followed up four years after the initial assessment, with a mean age of 83.84 years (age range 65 to 99 years). In the initial assessment all the participants were assessed with a psychological battery that included the MEC, the verbal fluency task FVS, a sustained attention task, a working memory test, a Quality of Life Questionnaire, a scale of dependency, and the AVLT-Learning Potential test. In the follow up assessment, participants have been assessed with the MEC, the verbal fluency task FVS, and the verbal memory test AVLT-PA. RESULTS: the results show relatively stable trajectories of aging and that the variables that better predict cognitive evolution of the elderly are working memory and post-test score in the AVLT-LP. CONCLUSIONS: Despite the time lapse between the two assessments and the age of the participants, older adults have remained relatively stable in their cognitive functioning, which in part contradicts the idea that--especially after 80 years--a general decline of cognitive functioning occurs in old age.

Predicción del deterioro cognitivo en ancianos mediante el análisis del rendimiento en fluidez verbal y en atención sostenida / Prediction of cognitive impairment in the elderly by analysing their performance in verbal fluency and in sustained attention

Introducción. El deterioro cognitivo en el anciano se relaciona con diferentes variables biopsicosociales. Objetivo. Identificar qué variables cognitivas son relevantes a la hora de diferenciar ancianos sanos de ancianos con deterioro cognitivo, con el fin de proponer una evaluación de cribado breve no influida por el nivel educativo para la detección del deterioro cognitivo en la vejez. Sujetos y métodos. Se evaluaron 264 ancianos, de 65-96 años, en funcionamiento cognitivo general, atención sostenida, plasticidad cognitiva o potencial de aprendizaje, memoria de trabajo y fluidez verbal. Se establecieron dos grupos diferenciados, ancianos sanos y ancianos con deterioro cognitivo, a partir del corte de 24 puntos en el miniexamen cognitivo. Resultados. El análisis discriminante mostró que el mejor indicador del deterioro cognitivo fue el rendimiento en fluidez verbal semántica (FVS), seguido de la atención sostenida y el potencial de aprendizaje. Las tareas de FVS y atención sostenida mostraron unas áreas bajo las curvas ROC de 0,811 y 0,777, respectivamente. Para la FVS, un punto de corte de 10 palabras tuvo una sensibilidad para la discriminación de los ancianos sin deterioro del 74% y una especificidad del 80%, mientras que la atención sostenida mostró una sensibilidad del 68,4% y una especificidad del 68,6%. Conclusiones. El rendimiento en FVS y en atención sostenida parece ser un factor de protección frente al deterioro cognitivo en la vejez, con lo que podría utilizarse como prueba de cribado para la detección de ancianos con deterioro (AU)

Introduction. Cognitive decline is related to different kind of biopsychosocial variables in the elderly. Aim. To identify which cognitive variables are important to differentiate between healthy elderly people and elderly people with cognitive impairment in order to propose a brief screening assessment for cognitive impairment in which education is not relevant. Subjects and methods. 264 subjects were divided into two groups taking into account the cutoff point 23/24 in the MEC, and all of them were assessed in cognitive functioning, sustained attention, cognitive plasticity, working memory, and verbal fluency. Results. Discriminant analysis showed that the cognitive variables which best explain cognitive impairment were verbal fluency, sustained attention and cognitive plasticity. The area under the ROC curve for the verbal fluency task was 0.811 and for the sustained attention task was 0.777. A cutoff point with 10 words in the verbal fluency task showed a sensitivity of 74% and a specificity of 80% for healthy elderly people, while a cutoff point with 33 correct answers in the sustained attention task showed a sensitivity of 68.4% and a specificity of 68.6% for the same group. Conclusions. These findings suggest that a high performance on verbal fluency and sustained attention protect against cognitive impairment in the elderly so that verbal fluency and sustained attention tasks are good tests for cognitive impairment screening purposes (AU)

[Prediction of cognitive impairment in the elderly by analysing their performance in verbal fluency and in sustained attention]. / Prediccion del deterioro cognitivo en ancianos mediante el analisis del rendimiento en fluidez verbal y en atencion sostenida.

INTRODUCTION: Cognitive decline is related to different kind of biopsychosocial variables in the elderly. AIM. To identify which cognitive variables are important to differentiate between healthy elderly people and elderly people with cognitive impairment in order to propose a brief screening assessment for cognitive impairment in which education is not relevant. SUBJECTS AND METHODS: 264 subjects were divided into two groups taking into account the cutoff point 23/24 in the MEC, and all of them were assessed in cognitive functioning, sustained attention, cognitive plasticity, working memory, and verbal fluency. RESULTS: Discriminant analysis showed that the cognitive variables which best explain cognitive impairment were verbal fluency, sustained attention and cognitive plasticity. The area under the ROC curve for the verbal fluency task was 0.811 and for the sustained attention task was 0.777. A cutoff point with 10 words in the verbal fluency task showed a sensitivity of 74% and a specificity of 80% for healthy elderly people, while a cutoff point with 33 correct answers in the sustained attention task showed a sensitivity of 68.4% and a specificity of 68.6% for the same group. CONCLUSIONS: These findings suggest that a high performance on verbal fluency and sustained attention protect against cognitive impairment in the elderly so that verbal fluency and sustained attention tasks are good tests for cognitive impairment screening purposes.

Impact of admissions for bone fractures on the dependency ratio of adults over 65 years of age in Southern Spain.

Hospital admission for acute illness, as in the case of bone fractures, means for some elderly people a loss of autonomy, not always associated with the illness causing hospitalization. The factors and/or modulators contributing to this situation have not been sufficiently studied. The aim of this study was to describe the characteristics of hospitalized elderly patients diagnosed with bone fractures, after surgery is carried out, and to establish the associated variables to their cognitive and functional dependency at discharge. The outcomes show that functional deterioration significantly correlates (positively) to anxiety self-control at discharge and knowledge about the therapy at discharge and inversely (negatively), to the patient's age, polypharmacy, and length of inpatient stay until surgery. From our outcomes we conclude the need to design and apply actions leading toward a reduction of the pre-surgery inpatient stay, immediate mobilization programs as well as training and information about therapeutic procedures.

Evaluación de funciones cognitivas en la población con síndrome de Down / No disponible

Se expone la necesidad de encontrar una metodología evaluativa propia de personas con discapacidad intelectual, entre las que se encuentran las personas con síndrome de Down. Por ello, se muestran los inconvenientes de la utilización de la evaluación tradicional psicométrica en este tipo de población, proponiendo como alternativa de valoración la evaluación del potencial de aprendizaje o evaluación dinámica, muy apropiada para este tipo de personas pero muy desconocida al mismo tiempo. Se pretende, además en la primera parte dar difusión a este tipo de evaluación; en la segunda parte se muestran los resultados de una escala de evaluación desde el punto de vista de la evaluación del potencial de aprendizaje, aplicada al síndrome de Down (AU)

No disponible

Un estudio de validez del Inventario de Solución de Problemas Sociales (Social Problem-Solving Inventory-R, SPSI-R) / A study about the validity of the Social Problem-solving Inventory-R (SPSI-R)

La habilidad para solucionar problemas interpersonales es uno de los tópicos que más interés está recibiendo en los últimos años entre los psicólogos dedicados a la práctica clínica. Cada vez un mayor número de trabajos de investigación ponen de relieve las relaciones entre estas habilidades y diferentes problemas psicológicos, en este contexto nos parece interesante la comprobación de validez de un instrumento como el SPSI-R (Inventario de Solución de Problemas Sociales Revisado) de D. Zurilla, Nezu y Maydeu-Olivares (1997) diseñado para evaluarlas. Este instrumento, que responde al modelo de solución de problemas sociales de sus autores ha mostrado su validez en muestras de otros paises. Este trabajo ha tenido como objetivo la traducción al castellano de dicho inventario y la comprobación de su validez de constructo y de su validez concurrente con otros instrumentos que evalúan habilidades similares Han participado 184 estudiantes de la Universidad de Granada y se ha utilizado el mencionado inventario junto con el CPI (Inventario Psicológico de California) de H. G. Gough (1986/1992) (AU)