Papel de la reserva cognitiva en la recuperación cognitiva de pacientes que han sufrido una adicción grave a sustancias / The role of the cognitive reserve in the cognitive recovery of patients who have suffered a severe addiction to substances

Introducción: La reserva cognitiva resulta ser una variable de pronóstico en la recuperación cognitiva tras un daño cerebral. Pocos estudios han abordado su papel en el estado cognitivo tras un período sostenido de adicción a sustancias. Objetivo: Analizar el papel modulador de la reserva cognitiva sobre la relación entre el tiempo de abstinencia y el estado cognitivo de los pacientes con adicción grave a sustancias. Pacientes y métodos: Se valora a un total de 26 pacientes en recuperación tras una adicción grave a sustancias con un protocolo de evaluación neuropsicológica y cuestionarios de reserva cognitiva. Se emplea el análisis factorial exploratorio para conformar las variables y el análisis de regresión lineal para ver las relaciones predictivas. Resultados: Se obtienen tres factores de funcionamiento cognitivo: integridad de procesamiento, control inhibitorio y memoria verbal, así como un factor global de reserva. En los modelos de regresión, sólo se encuentran relaciones predictivas en un modelo de relación directa entre la abstinencia y la memoria verbal, y en un modelo de relación independiente entre la reserva cognitiva y el tiempo de abstinencia con la memoria verbal, pero no en la relación de modulación, ni en otras relaciones en el resto de los factores. Conclusión: Se debate el papel de la reserva cognitiva como mediadora en el estado cognitivo en los pacientes en período de abstinencia tras una adicción grave a sustancias: muestra una relación con la memoria, pero no una modulación del papel del tiempo de abstinencia sobre ese estado cognitivo

Introduction: Cognitive reserve has been shown to be a prognostic variable in cognitive recovery after brain damage. Few studies have addressed its role in the cognitive status after a sustained period of substance addiction. Aim: To analyse the modulating role of cognitive reserve in the relation between withdrawal time and the cognitive status of patients with severe substance addiction. Patients and methods: A total of 26 patients recovering from severe substance addiction were assessed using a neuropsychological assessment protocol and cognitive reserve questionnaires. Exploratory factor analysis is used to define the variables and linear regression analysis is employed to view the predictive relations. Results: Three cognitive functioning factors are obtained: processing integrity, inhibitory control and verbal memory, as well as an overall reserve factor. In the regression models, predictive relations are found only in a model of a direct relation between withdrawal and verbal memory, and in a model of an independent relation between cognitive reserve and withdrawal time and verbal memory, but not in the modulation relationship or in other relations in the rest of the factors. Conclusion: The article discusses the role of the cognitive reserve as a mediator in the cognitive status of patients in a period of withdrawal after a serious addiction to substances. A relationship with memory is shown, but no modulation of the role of withdrawal time on that cognitive status is detected

Construcción y validación de una escala de autoeficacia para la actividad física / Construction and validation of a self-efficacy scale for physical activity

Fundamento: La estimación con pruebas estandarizadas de la creencia en la capacidad personal para practicar con regularidad actividad física (autoeficacia para la actividad física) nos permite establecer predicciones sobre la práctica real de esta conducta. El objetivo del trabajo es validar una escala que determine los niveles de autoeficacia de los usuarios adultos de los servicios de salud de atención primaria para realizar actividad física regular. Métodos: Fases: 1) Construcción de la escala y revisión por expertos, 2) Estudio piloto, 3) Determinación de su fiabilidad y validez. La muestra estuvo compuesta por 388 personas de 18 a 65 años usuarias de Centros de Salud de la provincia de Sevilla seleccionadas mediante muestreo por conglomerados (centros de salud) y cuotas (tamaño del municipio, edad y sexo). La validez concurrente fue hallada con el Cuestionario Internacional de Actividad Física (IPAQ) y la discriminante con el Inventario de Depresión de Beck (BDI). Resultados: Validez de contenido y fiabilidad:  de Cronbach>0,9 en todos los factores y Beta = 0,96. El análisis factorial mostró tres factores que explicaron el 52,569% de la varianza. La escala fue sensible a los niveles de actividad medidos con el IPAQ F (1)= 4.131; p <0,05 y correlacionó negativamente con el BDI (r=-0,127; p <0,05). Conclusiones: Las propiedades psicométricas de la escala son adecuadas para medir la autoeficacia de las personas adultas usuarias de los servicios de salud para practicar actividad física(AU)

Background: The estimation by standardized tests on belief in personal capacity to practice regular physical activity (self-efficacy for physical activity) allows us to make predictions about the actual practice of this behavior. We do not have measuring instruments suitable for this purpose, therefore, we propose to construct and validate a scale to determine levels of self-efficacy of adult users of the Primary Health Care Services for regular physical activity. Methods: Phases: 1) Develop and review the scale by expert judges. 2) A pilot study. 3) Determination of reliability and validity of the test. The sample was 388 adult users (18-65 years) of health centres from the province of Seville selected by cluster sampling (health centres) and quotas (town size, age and sex). Concurrent validity was found by the International Physical Activity Questionnaire (IPAQ) and discriminant validity by Beck Depression Inventory (BDI). Results: The results reported adequate content validity and high reliability (Cronbach Alpha > 0,9 in all factors and Beta = 0,96). Exploratory factor analysis showed three factors explaining 52,569% of the variance. The scale was sensitive to activity levels assessed by the IPAQ (F (1)= 4.131; p <0.05) and negatively correlated with BDI (r = -0,127; p <0,05). Conclusions: The psychometric properties of the scale are appropriate for measuring the efficacy of adult users of Health Services to practice regular physical activity(AU)

[Attentional neural networks impairment in healthy aging]. / Afectación de las redes neurales atencionales durante el envejecimiento saludable.

INTRODUCTION: Diverse evidences have shown that the process of natural aging causes a decline in different cognitive functions, including among them the attentional process. AIM: To determine how the healthy aging affects to the different attentional networks. SUBJECTS AND METHODS: Two groups: young subjects (32.5 ± 9.7 years) and an elderly group (62.7 ± 4.7 years). As instrument to evaluate the attention process the ANT (Attention Network Test) was used. RESULTS: Highly significant differences were observed for all conditions involved in the ANT (no cue, center cue, spatial cue, congruent and incongruent) between both groups (p < 0.001). As for the analysis of network effects, no one showed differences between the two groups. Considering the block variable, the post hoc analysis showed that the orienting network for the young subjects exhibited a normal benefit in the first block while the elderly group don't show that benefit caused by the deficiency using spatial cues. Moreover, the alerting network showed a bigger effect in the first block regarding the second one in the older adults and the opposed effect for the executive and orienting network was observed. CONCLUSIONS: The obtained data show that a decrease exists in the speed processing in the elderly group. In the orienting network seems that the older adults require a bigger training period to use the spatial cues, although later on, they can benefit from the same cues almost at the same level that the young subjects.

Afectación de las redes neurales atencionales durante el envejecimiento saludable / Attentional neural networks impairment in healthy aging

Introducción. Existen diversas evidencias de que el proceso de envejecimiento natural ocasiona un declive en las diferentes funciones cognitivas, incluyendo la atención. Sujetos y métodos. Dos grupos de estudio: jóvenes (32,5 ± 9,7 años) y adultos mayores saludables (62,7 ± 4,7 años). Como instrumento para evaluar la atención utilizamos el test de redes atencionales –Attention Network Test (ANT)–. Resultados. En el ANT, en lo que respecta al tiempo de reacción ante las diferentes condiciones que se dan (sin clave, clave central, clave espacial, congruencia e incongruencia), encontramos diferencias significativas en todas ellas entre ambos grupos (p < 0,001). En cuanto al análisis de redes, éstas no mostraron diferencias entre ambas muestras. Si comparamos el efecto por bloques del ANT, el análisis post hoc mostró que la red de orientación para los sujetos jóvenes presenta un beneficio por el uso de las claves espaciales en el primer bloque, mientras que para los sexagenarios no. Además, la red de alerta mostró un mayor efecto en el primer bloque respecto del segundo en los adultos mayores y el efecto opuesto para la red ejecutiva y de orientación. Conclusiones. Los datos obtenidos muestran que existe una disminución en la velocidad de procesamiento en las personas mayores. En el caso particular de la red de orientación parece que los mayores requieren un intervalo temporal mayor para emplear las claves espaciales, aunque posteriormente tras cierto entrenamiento pueden beneficiarse de éstas casi al mismo nivel que los sujetos jóvenes (AU)

Introduction. Diverse evidences have shown that the process of natural aging causes a decline in different cognitive functions, including among them the attentional process. Aim. To determine how the healthy aging affects to the different attentional networks. Subjects and methods. Two groups: young subjects (32.5 ± 9.7 years) and an elderly group (62.7 ± 4.7 years). As instrument to evaluate the attention process the ANT (Attention Network Test) was used. Results. Highly significant differences were observed for all conditions involved in the ANT (no cue, center cue, spatial cue, congruent and incongruent) between both groups (p < 0.001). As for the analysis of network effects, no one showed differences between the two groups. Considering the block variable, the post hoc analysis showed that the orienting network for the young subjects exhibited a normal benefit in the first block while the elderly group don’t show that benefit caused by the deficiency using spatial cues. Moreover, the alerting network showed a bigger effect in the first block regarding the second one in the older adults and the opposed effect for the executive and orienting network was observed. Conclusions. The obtained data show that a decrease exists in the speed processing in the elderly group. In the orienting network seems that the older adults require a bigger training period to use the spatial cues, although later on, they can benefit from the same cues almost at the same level that the young subjects (AU)

[Construction and validation of a self-efficacy scale for physical activity]. / Construcción y validación de una escala de autoeficacia para la actividad física.

BACKGROUND: The estimation by standardized tests on belief in personal capacity to practice regular physical activity (self-efficacy for physical activity) allows us to make predictions about the actual practice of this behavior. We do not have measuring instruments suitable for this purpose, therefore, we propose to construct and validate a scale to determine levels of self-efficacy of adult users of the Primary Health Care Services for regular physical activity. METHODS: Phases: 1) Develop and review the scale by expert judges. 2) A pilot study. 3) Determination of reliability and validity of the test. The sample was 388 adult users (18-65 years) of health centres from the province of Seville selected by cluster sampling (health centres) and quotas (town size, age and sex). Concurrent validity was found by the International Physical Activity Questionnaire (IPAQ) and discriminant validity by Beck Depression Inventory (BDI). RESULTS: The results reported adequate content validity and high reliability (Cronbach Alpha > 0,9 in all factors and ß = 0,96). Exploratory factor analysis showed three factors explaining 52,569% of the variance. The scale was sensitive to activity levels assessed by the IPAQ (F (1)= 4.131; p <0.05) and negatively correlated with BDI (r = -0,127; p <0,05). CONCLUSIONS: The psychometric properties of the scale are appropriate for measuring the efficacy of adult users of Health Services to practice regular physical activity.