Personalized Computerized Training for Cognitive Dysfunction after COVID-19: A Before-and-After Feasibility Pilot Study.

The current pilot study was set to evaluate the feasibility and potential benefit of a personalized computerized cognitive training (CCT) intervention to improve cognitive function among people living with post-acute sequelae of COVID-19 (PASC). Seventy three adults who self-reported cognitive dysfunction more than 3 months after a diagnosis of COVID-19 took part in an 8-week training study. Participants' general cognitive function was assessed before they completed as many cognitive daily training sessions as they wished during an 8-week period, using a personalized CCT application at home. At the end of this period, participants repeated the general cognitive function assessment. The differences between the scores at 8 weeks and baseline in five cognitive domains (attention, memory, coordination, perception, reasoning), complemented with analyses of the changes based on the participants' age, training time, self-reported health level at baseline and time since the initial COVID-19 infection. Participants had significant cognitive dysfunction and self-reported negative health levels at baseline. Most of the participants obtained higher scores after CCT in each of the domains as compared with baseline. The magnitude of this score increase was high across domains. It is concluded that a self-administered CCT based on gamified cognitive tasks could be an effective way to ameliorate cognitive dysfunction in persons with PASC. The ClinicalTrials.gov identifier is NCT05571852.

Paciente anciano y medicación crónica inapropiada en la comunidad ¿somos conscientes de ello? / Inappropriate prescription in the community elderly, are we aware of?

Objetivos. Analizar la prescripción según criterios de idoneidad de STOPP (Screening Tool of Older Person's Prescriptions) y de Beer's y los factores asociados en personas de 85 años. Pacientes y métodos. Estudio transversal de prescripción inadecuada a los 85 años. Se registraron: variables sociodemográficas, factores de riesgo cardiovascular, enfermedades crónicas, polifarmacia (4 o más) y valoración geriátrica. La prescripción inadecuada (PI) se valoró según prescripción total y cardiovascular. Resultados. La media de fármacos en el total de 78 sujetos fue 6,1 (3,3). El 34,6% de pacientes tenían un fármaco de PI; el 19,2% tenían dos; el 15,4% tenían tres o más, y en total, el 69,2% de pacientes presentaban algún fármaco de PI; el 37,2% tenía uno o más fármacos de PI cardiovascular. Los grupos terapéuticos responsables del total de PI fueron benzodiazepinas (BZP) 23,1%, diuréticos del asa 17,9%, inhibidores de recaptación de la serotonina (ISRR) 16,7% y los antiinflamatorios no esteroideos (AINE) representaron un 10,3% del total de criterios. El análisis bivariado halló asociación de número de fármacos y polifarmacia (p=0,030 en ambos) con PI total; no se halló significación en PI cardiovascular. El análisis multivariante mostró asociación de polifarmacia (OR: 1,22; IC 95% 1,02-1,47; p=0,031) para la PI total y de dislipemia (OR: 0,30; IC 95% 0,10-0,87; p=0,026) y de HTA (OR: 0,15; IC 95% 0,03-0,78; p=0,024) para la PI cardiovascular. Conclusiones. Más de la mitad de los pacientes de 85 años recibió una prescripción inapropiada. Dislipemia e HTA se asociaron a prescripción inapropiada cardiovascular y los grupos más frecuentes fueron BZP, diuréticos, ISRR y AINE(AU)

Objectives. To analyse the prescription according to the STOPP (Screening Tool of Older Person's Prescriptions) and Beer's suitability criteria, and associated factors in patients over 85 years-old. Patients and methods. Cross-sectional study of inappropriate prescribing to over 85 year-olds. The data recorded were: sociodemographic variables, cardiovascular risk factors, chronic illnesses, multiple medication (or polypharmacy) (4 or more) and geriatric assessment. The inappropriate prescription (IP) was evaluated according to total and cardiovascular prescription. Results. The mean number of drugs in the total of 78 subjects was 6.1 (3.3). Of the total number, 34.6% patients had 1 IP drug; 19.2% had 2; 15.4% had 3 or more, and in total 69.2% of patients had at least one IP drug, and 37.2% had 1 or more IP cardiovascular drugs. The therapeutic groups involved in the overall IP were benzodiazepines (BZP) 23.1%, loop diuretics 17.9%, selective serotonin reuptake inhibitors (SSRIs) 16.7%, and non-steroidal anti-inflammatory drugs (NSAIDs) made up 10.3% of the total criteria. The bivariate analyse found a relationship between the number of drugs and multiple medication (P=.030 in both) and total IP, with no significance found in cardiovascular IP. The multivariate analysis showed an association between multiple medication (OR: 1.22; 95% CI: 1.02-1.47; P=.031) and total IP, and dyslipaemia (OR: 0.30; 95% CI: 0.10-0.87; P=.026) and AHT (OR: 0.15; 95% CI: 0.03-0.78; P=.024) for cardiovascular IP. Conclusions. More than half the over 85 year-old patients received an inappropriate prescription. Dyslipaemia and AHT are associated with an inappropriate cardiovascular prescription, and the most frequent drug groups were, BZP, diuretics, SSRIs, and NSAIDs(AU)

[Inappropriate prescription in the community elderly, are we aware of?]. / Paciente anciano y medicación crónica inapropiada en la comunidad ¿somos conscientes de ello?

OBJECTIVES: To analyse the prescription according to the STOPP (Screening Tool of Older Person's Prescriptions) and Beer's suitability criteria, and associated factors in patients over 85 years-old. PATIENTS AND METHODS: Cross-sectional study of inappropriate prescribing to over 85 year-olds. The data recorded were: sociodemographic variables, cardiovascular risk factors, chronic illnesses, multiple medication (or polypharmacy) (4 or more) and geriatric assessment. The inappropriate prescription (IP) was evaluated according to total and cardiovascular prescription. RESULTS: The mean number of drugs in the total of 78 subjects was 6.1 (3.3). Of the total number, 34.6% patients had 1 IP drug; 19.2% had 2; 15.4% had 3 or more, and in total 69.2% of patients had at least one IP drug, and 37.2% had 1 or more IP cardiovascular drugs. The therapeutic groups involved in the overall IP were benzodiazepines (BZP) 23.1%, loop diuretics 17.9%, selective serotonin reuptake inhibitors (SSRIs) 16.7%, and non-steroidal anti-inflammatory drugs (NSAIDs) made up 10.3% of the total criteria. The bivariate analyse found a relationship between the number of drugs and multiple medication (P=.030 in both) and total IP, with no significance found in cardiovascular IP. The multivariate analysis showed an association between multiple medication (OR: 1.22; 95% CI: 1.02-1.47; P=.031) and total IP, and dyslipaemia (OR: 0.30; 95% CI: 0.10-0.87; P=.026) and AHT (OR: 0.15; 95% CI: 0.03-0.78; P=.024) for cardiovascular IP. CONCLUSIONS: More than half the over 85 year-old patients received an inappropriate prescription. Dyslipaemia and AHT are associated with an inappropriate cardiovascular prescription, and the most frequent drug groups were, BZP, diuretics, SSRIs, and NSAIDs.