Sex differences on anxiety and depression in older adults and their relationship with cognitive impairment / Diferencias por sexo en ansiedad y depresión en personas adultas mayores y su relación con el deterioro cognitivo

Introduction Subjective memory complaints (SMCs) in elderly adults could express cognitive decline in the future. A consensus has been reached about how these SMC relate to mood variables, but further research is required to determine which socio-demographic, cognitive, functional and occupational factors will act as predictors in elderly adults. Objetivo To analyze, through a descriptive observational study, the relationship between anxiety/depression and sex, age and occupation, with cognitive/functional performance in 367 older adults with SMC, but without objective cognitive impairment in a primary healthcare center. Methods The cognitive variables were measured by applying the Spanish version of Mini-Mental State Examination (MEC-35) and Set-test for verbal fluency. To measure functional level, the Barthel index and Lawton and Brody scales were employed. Physical occupational status and mental occupational status were measured based on three levels, low, medium and high, according to the American Occupational Therapy Association. Results Low educational and occupational physical and mental levels were related to anxiety and depression. In addition, differences by sex were found on anxiety and depression related to different factors. In men, anxiety was related to higher cognitive level, and in women to higher functional performance in IADLs. On the contrary, depression in men was related to lower cognitive level and higher performance in ADLs. Conclusions It is important to maintain a sex-gender perspective on the study of anxiety and depression in elderly, taking into account social roles and the traints of the work environment, in order to avoid cognitive and functional impairment (AU)

Introducción Las quejas subjetivas de memoria (SMC) en adultos mayores podrían expresar un daño cognitivo en el futuro. Existe consenso sobre la relación de estas SMC con variables del estado de ánimo pero se necesita más investigación para determinar qué factores sociodemográficos, cognitivos, funcionales y ocupacionales serían los predictores en los adultos mayores. Objetivo Analizar la relación entre ansiedad y depresión con el sexo, edad y ocupación, así como con el desempeño cognitivo y funcional en 367 adultos mayores con SMC en un centro de atención primaria. Métodos Las variables cognitivas se midieron mediante la version Española del Mini-Mental State Examination (MEC-35) y Set-Test para la fluidez verbal. Para medir el nivel funcional se utilizaron el índice de Barthel y la escala de Lawton y Brody. El estado ocupacional físico y mental fueron medidos en base a tres niveles (bajo, medio y alto) según la American Occupational Therapy Association. Resultados Los niveles educativos y ocupacionales físicos y mentales bajos se relacionaron con ansiedad y depresión. Además, se encuentran diferencias por sexo en los factores relacionados con la ansiedad y depresión. En los hombres, la ansiedad se relacionó con un mayor nivel cognitivo y en las mujeres con mayor desempeño funcional en las actividades instrumentales de la vida diaria (AIVD). Por el contrario, la depresión en los hombres se relacionó con menor nivel cognitivo y un mayor desempeño en las actividades básicas de la vida diaria (ABVD). Conclusiones Es importante mantener la perspectiva sexo-género en el análisis de la ansiedad y depresión en personas mayores, teniendo presentes los roles sociales y características del entorno laboral, para evitar el deterioro cognitivo y funcional (AU)

Sex differences on anxiety and depression in older adults and their relationship with cognitive impairment.

INTRODUCTION: Subjective memory complaints (SMCs) in elderly adults could express cognitive decline in the future. A consensus has been reached about how these SMC relate to mood variables, but further research is required to determine which socio-demographic, cognitive, functional and occupational factors will act as predictors in elderly adults. OBJETIVE: To analyze, through a descriptive observational study, the relationship between anxiety/depression and sex, age and occupation, with cognitive/functional performance in 367 older adults with SMC, but without objective cognitive impairment in a primary healthcare center. METHODS: The cognitive variables were measured by applying the Spanish version of Mini-Mental State Examination (MEC-35) and Set-test for verbal fluency. To measure functional level, the Barthel index and Lawton and Brody scales were employed. Physical occupational status and mental occupational status were measured based on three levels, low, medium and high, according to the American Occupational Therapy Association. RESULTS: Low educational and occupational physical and mental levels were related to anxiety and depression. In addition, differences by sex were found on anxiety and depression related to different factors. In men, anxiety was related to higher cognitive level, and in women to higher functional performance in IADLs. On the contrary, depression in men was related to lower cognitive level and higher performance in ADLs. CONCLUSIONS: It is important to maintain a sex-gender perspective on the study of anxiety and depression in elderly, taking into account social roles and the traints of the work environment, in order to avoid cognitive and functional impairment.

Análisis del efecto de un programa de estimulación cognitiva en adultosmayores con cognición normal: ensayo clínico aleatorizado / Analysis of the effect of cognitive stimulation program in older adults with normal cognition: randomized clinical trial

Fundamento:Los programas de estimulación cognitiva en adultos mayores persiguen mejorías cognitivas y emocionales. Existen escasos programas adaptados por niveles cognitivos y ocupacionales en mayores sin deterioro cognitivo. El objetivo fue analizar la efectividad de una intervención de estimulación cognitiva adaptada a dos niveles cognitivos en adultos mayores sobre la cognición y el estado de ánimo.Material y métodos:Ensayo clínico aleatorizado (CONSORT) en un centro de salud, que incluyó 201 participantes ≥ 65 años (101 intervención y 100 control) evaluados tras la intervención, a los seis meses y al año. Los instrumentos de evaluación fueron el mini-examen cognoscitivo (MEC), la escala de ansiedad abreviada de Goldberg y la escala de depresión geriátrica de Yesavage (GDS-15). La intervención se efectuó mediante un programa de estimulación cognitiva de dos niveles cognitivos según MEC (nivel alto: 32-35; nivel bajo: 28-31) con diez sesiones de 45 minutos. El análisis estadístico se realizó mediante t-Student.Resultados:La diferencia de las medias de puntuación MEC entre los grupos control e intervención fue estadísticamente significativa en las tres valoraciones; estas diferencias se observaron independientemente del sexo, edad, nivel cognitivo, y estado de ánimo. Al año se incrementó 1,48 puntos la puntuación MEC en el grupo de nivel alto y 2,03 en el de nivel bajo. Las puntuaciones MEC no variaron según ansiedad y depresión en ninguna de las valoraciones.Conclusiones:El programa de estimulación cognitiva, adaptado por niveles cognitivos, muestra beneficios cognitivos en personas mayores sin deterioro cognitivo que viven en la comunidad, independientemente del sexo, edad y nivel educativo.(AU)

Background: Cognitive stimulation programs in older adults seek cognitive and emotional improvements.The literature makes no reference to programs adapted according to cognitive and occupational levels in older adults with no cognitive impairment. The objective of this study was to analyze the effectiveness of level-adapted cognitive stimulation intervention in older adults in terms of cognition and mood. Methods: Randomized clinical trial (CONSORT) at a health center, which included 201 participants ≥65 years (101 intervention and 100 control) evaluated immediately after the intervention, then at six months and finally at one year. The assessment instruments were the cognitive mini-exam (CME), the abbreviated Goldberg anxiety scale and the Yesavage geriatric depression scale (GDS-15). The intervention was carried out through a cognitive stimulation program with two cognitive levels according to CME (high: 32-35; low: 28-31) with ten sessions of 45 minutes. Statistical analysis was performed by Student’s t-test. Results: The difference observed in the averages between control and intervention groups was statistically significant in the three assessments; these differences were observed regardless of gender, age, cognitive level, and mood. One year after the intervention, CME score reached an increase of 1.48 points in the in the high level group and 2.03 points in the low level. However, no significant differences in CME score were observed in any of the assessments for anxiety or depression. Conclusion: A cognitive stimulation program, cognitive level-adapted, has shown cognitive benefits in older adults without cognitive impairment living in the community, regardless of sex, age and educational level.(AU)

[Analysis of the effect of cognitive stimulation program in older adults with normal cognition: randomized clinical trial].

BACKGROUND: Cognitive stimulation programs in older adults seek cognitive and emotional improvements. The literature makes no reference to programs adapted according to cognitive and occupational levels in older adults with no cognitive impairment. The objective of this study was to analyze the effectiveness of level-adapted cognitive stimulation intervention in older adults in terms of cognition and mood. METHODS: Randomized clinical trial (CONSORT) at a health center, which included 201 participants =?65 years (101 intervention and 100 control) evaluated immediately after the intervention, then at six months and finally at one year. The assessment instruments were the cognitive mini-exam (CME), the abbreviated Goldberg anxiety scale and the Yesavage geriatric depression scale (GDS-15). The intervention was carried out through a cognitive stimulation program with two cognitive levels according to CME (high: 32-35; low: 28-31) with ten sessions of 45 minutes. Statistical analysis was performed by Student's t-test. RESULTS: The difference observed in the averages between control and intervention groups was statistically significant in the three assessments; these differences were observed regardless of gender, age, cognitive level, and mood. One year after the intervention, CME score reached an increase of 1.48 points in the in the high level group and 2.03 points in the low level. However, no significant differences in CME score were observed in any of the assessments for anxiety or depression. CONCLUSION: A cognitive stimulation program, cognitive level-adapted, has shown cognitive benefits in older adults without cognitive impairment living in the community, regardless of sex, age and educational level.

Efficacy of cognitive intervention programs in amnesic mild cognitive impairment: A systematic review.

BACKGROUND: Amnesic mild cognitive impairment (aMCI) is considered a prodromal stage of Alzheimer's disease. Given the absence of an effective pharmacological treatment for aMCI, increasing numbers of studies are attempting to understand how cognitive interventions could benefit aMCI patients. The aim of this systematic review was to evaluate the current evidence regarding the efficacy on cognition of cognitive intervention programs in older adults with aMCI. METHODS: We searched for randomized controlled trials and clinical trials published until March 2020 on PubMed, Web of Science, Cochrane Library, SCOPUS, and OTseeker. A total of 454 works were identified and 7 studies that met the inclusion criteria, were included in this review. PRISMA guidelines were followed and PEDro scale was included for the measurement of the quality of the selected studies. RESULTS: Cognitive interventions showed positive effects on cognition. Cognitive training programs considerably enhanced the Mini Mental State Examination scores. However, no relevant differences in global cognition were found using other assessment tools as DRS-2 or ADAS-Cog Scale. Cognitive training and cognitive rehabilitation programs seemed to improve several cognitive domains as memory, language or executive function in aMCI patients in both post-training and at follow-up analysis. CONCLUSIONS: Our findings support that cognitive interventions can be an effective option for people with aMCI. Cognitive interventions improved global cognitive function post-intervention, but also seemed to enhance some cognitive domains post-intervention and at follow-up. However, more studies are needed to analyze the potential benefits of cognitive intervention on aMCI.