Efectos de la terapia no farmacológica en el envejecimiento normal y el deterioro cognitivo: consideraciones sobre los objetivos terapéuticos / Effects of non-pharmacological therapy on normal ageing and on cognitive decline: reflections on treatment objectives

Introducción: Las terapias no farmacológicas (TNF) en el envejecimiento y las demencias representan un conjunto de intervenciones orientadas a estimular el rendimiento de los procesos cognitivos, mejorar la afectividad, potenciar la independencia en la vida cotidiana y, en última instancia, incrementar la calidad de vida de los pacientes. Métodos: Se aplicó una batería de pruebas que valoraban 4 dominios principales (estado mental eneral, afectividad, calidad de vida y actividades de la vida diaria) a una muestra de 317 adultos con más de 64 a˜nos (240 con envejecimiento normal y 77 con deterioro cognitivo). Posteriormente, fueron asignados a grupos de TNF en función de sus capacidades o a otras actividades no específicas. Se valoró el beneficio tras 9 meses de TNF con la misma batería de pruebas. Resultados: Los resultados evidencian una mejora del estado mental general en el envejecimiento sano y ausencia de progresión en el envejecimiento patológico. En los 2 grupos, la afectividad (ansiedad y depresión) y la calidad de vida autopercibida se vio beneficiada por la TNF. No obstante, no parecen mejorar otros aspectos habitualmente incluidos entre los objetivos terapéuticos, como la independencia en las actividades de la vida diaria. Conclusiones: Este trabajo evidencia los resultados positivos que se obtienen por la aplicación de un programa de TNF en el envejecimiento. Es importante destacar que los individuos con deterioro cognitivo se benefician más del mismo, si bien su aplicación generalizada parece resultar un óptimo programa preventivo primario en estos aspectos cognitivos y emocionales (AU)

Introduction: Non-pharmacological therapies for normal ageing and dementia are a set of treatment programmes intended to improve the performance of cognitive processes, improve emotional well-being, promote independence in daily life activities, and ultimately increase patients’ quality of life. Methods: We applied a battery of tests assessing four major domains (general mental state, emotional well-being, quality of life, and daily life activities) to a sample of 317 adults older than 64 (240 with normal ageing and 77 with cognitive impairment). They were then assigned either to non-pharmacological therapy groups according to their abilities or to other non-specific activities. Progress was assessed 9 months later using the same test battery. Results: The results show a general improvement in mental state in the group with normal ageing and absence of disease progression in the group with pathological ageing. In both groups, emotional well-being (anxiety and depression) and self-identified quality of life both benefited from non-pharmacological therapy. However, other aspects commonly included among the therapeutic targets did not seem to improve, including independence in daily life activities. Conclusions: This study provides evidence that non-pharmacological therapy in ageing patients can produce positive results. It must be stressed that benefits are greater in individuals with cognitive impairment, although generalising use of this therapy could prove to be an excellent primary programme for preventing cognitive and emotional disorders (AU)

Effects of non-pharmacological therapy on normal ageing and on cognitive decline: reflections on treatment objectives.

INTRODUCTION: Non-pharmacological therapies for normal ageing and dementia are a set of treatment programmes intended to improve the performance of cognitive processes, improve emotional well-being, promote independence in daily life activities, and ultimately increase patients' quality of life. METHODS: We applied a battery of tests assessing four major domains (general mental state, emotional well-being, quality of life, and daily life activities) to a sample of 317 adults older than 64 (240 with normal ageing and 77 with cognitive impairment). They were then assigned either to non-pharmacological therapy groups according to their abilities or to other non-specific activities. Progress was assessed 9 months later using the same test battery. RESULTS: The results show a general improvement in mental state in the group with normal ageing and absence of disease progression in the group with pathological ageing. In both groups, emotional well-being (anxiety and depression) and self-identified quality of life both benefited from non-pharmacological therapy. However, other aspects commonly included among the therapeutic targets did not seem to improve, including independence in daily life activities. CONCLUSIONS: This study provides evidence that non-pharmacological therapy in ageing patients can produce positive results. It must be stressed that benefits are greater in individuals with cognitive impairment, although generalising use of this therapy could prove to be an excellent primary programme for preventing cognitive and emotional disorders.

Sensory and consumer perception of the addition of grape seed extracts in cookies.

The aim of this study was to understand sensory and instrumental similarities and differences among an array of cookies made with bulk and microencapsulated grape seed extract (GSE) and then to determine how these differences impact consumer acceptance. Total of 4 types of cookies (control, enriched with bulk GSE, and enriched with 2 different microencapsulated GSE) were evaluated by instrumental analyses, a sensory trained panel using the quantitative descriptive analysis (QDA®) methodology, and a consumer acceptance test that included a usage and attitude survey. The addition of GSE resulted in darker brown cookies; microencapsulation partially masked the color that the GSE conferred to the cookies. The cookies with the microencapsulated GSE showed a significant higher antioxidant activity, microencapsulation may have reduced the GSE heat degradation. The QDA(®) trained panelists found the enriched cookies to be more astringent and with aromas and flavors similar to whole grains flours. Consumers rated the control cookie and 1 GSE encapsulated cookie at parity; they were equally well liked (P > 0.05). When provided with information, nearly 60% of consumers stated that they were willing to purchase cookies enriched with antioxidants. This high positive percentage may increase if consumers received more education on the health benefits of antioxidant consumption.

The spectrum of metanephric adenofibroma and related lesions: clinicopathologic study of 25 cases from the National Wilms Tumor Study Group Pathology Center.

The authors report nine new metanephric adenofibroma (MAFs; previously termed nephrogenic adenofibroma) and 16 related tumors from the files of the National Wilms Tumor Study Group Pathology Center (NWTSGPC). All tumors contained a variable amount of a bland spindle cell stroma, which is essentially identical to the recently described metanephric stromal tumor (MST). Features that distinguish this stroma from congenital mesoblastic nephroma (CMN) include intratumoral angiodysplasia, concentric cuffing of entrapped tubules ("onion skinning"), and heterologous differentiation. The epithelial components of these lesions spanned a wide range of appearances. All tumors contained at least focally an inactive embryonal epithelium identical morphologically to metanephric adenoma (MA), and hence each case could be classified as containing MAF. The epithelium of nine tumors had this appearance throughout, and hence these were considered usual MAFs. The epithelium of four tumors demonstrated increased mitotic activity but was otherwise similar to MA. The epithelial component of seven tumors spanned a morphologic spectrum from inactive MA to malignant epithelial predominant Wilms tumor (WT), with gradual transitions noted in several cases. Five other tumors contained a carcinomatous component distinct from these lesions but identical morphologically to papillary renal cell carcinoma (PRCC). In one of these cases, this component had metastasized to the regional lymph nodes at the time of diagnosis. No tumor recurred during follow-up, although almost all patients received adjuvant therapy for WT regardless of their tumor's histology and NWTSGPC diagnosis. In conclusion, MAF is a biphasic tumor that spans the morphologic spectrum between benign pure stromal (MST) and pure epithelial (MA) lesions, and can merge with the morphology of WT, supporting the concept that these are all related lesions. A relationship to PRCC is also evident.