Efecto moderador de la creatividad en el rendimiento en memoria cotidiana en personas mayores / Moderating effect of creativity on everyday memory performance in the elderly

Antecedentes: la sociedad envejece a pasos agigantados y propone un reto importante al conjunto de profesionales, ya que una de las mayores preocupaciones en el transcurso de los años es la pérdida de funciones cognitivas como la memoria. Con base en ello, es relevante conocer qué estrategias pueden ayudar a preservar la capacidad mnésica de las personas mayores sanas. Objetivo: analizar el efecto moderador del constructo creatividad en la memoria cotidiana, así como el de la edad en una muestra de personas mayores sanas. Métodos: Participaron 106 personas mayores sanas y voluntarias provenientes de diferentes ciudades de España. Se les aplicó la prueba de creatividad CREA y la de memoria cotidiana RBMT. Resultados: La creatividad modera la pérdida de memoria en las personas mayores, en tanto que, por cada unidad de análisis de creatividad, aumenta la memoria. Lo contrario ocurre con la edad, al aumentar esta, la memoria disminuye. No se ha observado que la edad y la creatividad tengan un efecto de interacción conjunta sobre la memoria, actuando las dos por separado. Implicaciones: la creatividad puede ser incrementada en los programas de ocio y de intervención en psicoestimulación en el envejecimiento, ya que promover un contexto de actividades que fomenten la creatividad puede ser muy ventajoso para prevenir problemas de memoria en adultos mayores sanos. Se necesitan más estudios que ahonden en esta relación y el tipo de actividades concretas creativas que pueden ser beneficiosas y efectivas (AU)

Background: The society ages at a rapid pace proposing an important challenge to the group of professionals, since one of the biggest concerns over the years is the loss of cognitive functions such as memory. Based on this, it is relevant to know what strategies can help to preserve the mnemonic capacity of healthy elderly people. Objective: to analyze the moderator effect of the creativity construct in the daily memory, as well as the age effect in a sample of healthy elderly people. Methods 106 healthy and voluntary elderly people from different cities of Spain participated. The CREA creative test and the RBMT daily memory test were applied. Results: Creativity moderates memory loss in older people, while for each unit of creativity analysis, memory increases. The opposite happens with age, as it increases, memory decreases. It has not been found that age and creativity have a joint interaction effect on memory, acting both separately. Implications: creativity can be increased in leisure programs and intervention in psychostimulation in aging, since promoting a context of activities that promote creativity can be very advantageous to prevent memory problems in healthy older adults. More studies are needed that deepen this relationship and the type of concrete creative activities that can be beneficial and effective (AU)

Factores predictores del delirium en pacientes octogenarios hospitalizados por fractura de cadera / Predictors of delirium in octogenarian patients hospitalized for hip fracture

Introducción: El delirium es considerado como uno de los grandes síndromes geriátricos por el impacto sobre el comportamiento de los pacientes y el desconcierto y frustración que origina en los profesionales y familiares. Objetivo: identificar y describir los factores predictores del riesgo de desarrollar delirium en pacientes octogenarios hospitalizados con fractura de cadera. Método: estudio de cohorte, prospectivo realizado con una muestra de 287 pacientes (87.2 ± 3.2 años) ortogeriátricos reclutados de la Unidad de Traumatología del Hospital Universitario de León (España). Se incluyeron factores predisponentes, precipitantes y de riesgo que incluyen variables sociodemográficas, basales, quirúrgicas, farmacológicas, comorbilidades y complicaciones. Resultados: la presencia de anemia, ASA (en categoría 3-4) deterioro cognitivo, ITU, alteraciones visuales y RAO, por este orden, pueden ser consideradas como variables predictivas del delirium en pacientes octogenarios hospitalizados con fractura de cadera. Conclusión: el tipo de factores predictivos que más impactan en el desarrollo del delirium podrían ser controlados desde el mismo momento de la hospitalización del paciente. Por consiguiente, es posible minimizar el efecto de desconcierto que ocasiona habitualmente el cuadro en pacientes, familiares y sanitarios. (AU)

Introduction: Delirium is considered one of the great geriatric syndromes due to the impact on the behavior of patients and the confusion and frustration that it causes in professionals and family members. Objective: identify and describe the predictors of the risk of developing delirium in hospitalized octogenarian patients with hip fracture. Methodology: prospective cohort study carried out with a sample of 287 ortho-geriatric patients (87.2 ± 3.2 years), recruited from the Traumatology Unit of the University Hospital of León (Spain). Predisposing, precipitating and risk factors were included, including sociodemographic, baseline, surgical, pharmacological comorbidities and complications variables. Results: the results of the study show that the presence of anemia, ASA (in category 3-4), cognitive impairment, UTI, visual disturbances and RAO, variables, in this order, can be considered as predictive variables of delirium in hospitalized octogenarian patients with fracture of hip. Conclusion: this study shows that the type of predictive factors that most impact the development of delirium could be controlled from the moment the patient is hospitalized. Therefore, it is possible to minimize the effect of confusion that usually causes this syndrome in patients, family members, and health professionals. (AU)

Good practices in the recovery of ambulation in octogenarian women with hip fractures.

OBJECTIVE: Determine good recovery practices for ambulation of octogenarian women after hospital discharge after being operated on for hip fracture. METHODS: Prospective study during the second half of 2019, with 192 women (85.95 ± 5.1 years) with hip fracture. A medical history, fracture types, complications, surgical treatment, and assessment of the level of ambulation were recorded before and after six months of hospital discharge. RESULTS: 100 patients lived in the family home and 92 in an institutional center, 68.2% provided pertrochanteric fracture and a total of 3.7 comorbidities, all of them received spinal anesthesia and were admitted an average of 11.4 days. After six months, the patients showed a significant loss of functional independence with respect to the situation prior to the fracture, both for the ability to wander and for activities of daily living. It is noteworthy that the worst prognosis in the recovery of ambulation has to do with intermediate levels of ambulation and that the functional level of departure influences to a lesser extent than the place where they perform the recovery. CONCLUSIONS: Age is a factor that influences the recovery of hip fracture, but there are other influential factors since patients who remain in the family home have a better functional prognosis than those who recover in institutionalized centers, after six months of hospital discharge.

Predictors of Delirium in Octogenarian Patients Hospitalized for a Hip Fracture.

INTRODUCTION: Since delirium is a major complication that can arise after a patient with a hip fracture has been hospitalized, it is considered to be one of the most common geriatric conditions. Therefore, its prevention and early detection are essential for reducing both the length of the patient's stay in the hospital and complications during the hospitalization process. OBJECTIVE: To identify and analyze the predictors for developing delirium in octogenarians who were admitted to hospital for a hip fracture. METHODOLOGY: A prospective study conducted with a sample of 287 patients aged 80 years and older (mean age 87.2 ± 3.2 years; 215 women, 72 men), recruited from the Trauma Unit of the University Hospital of León (Spain). Further, 71.1% of the patients lived in a family member's home, while the other 28.9% lived in a nursing home. After observing each patient's interactions with their doctor in a clinical setting, the data for this study were obtained by reviewing the selected patients' charts. The variables analyzed were sociodemographic information (age, sex, and place of residence), medical information (type of hip break and surgical intervention), cognitive impairment (MMSE score), functional level (Barthel Index score), and clinical information (pharmacological, comorbidities, complications, and the diagnosis and assessment of the severity of delirium in a patient). The univariate and multivariate logistic regression analysis showed a significant relationship between acute confusional state and the following variables: anemia, American Society of Anesthesiologists (ASA) III and IV patients, state of cognitive frailty and functional level, a urinary tract infection, changes in the visual field, renal arterial occlusion, and the type and dosage of drugs administered (this variable was identified in the multivariate model). The inverse relationship between anemia and acute confusional state is surprising. CONCLUSION: This research shows that clinical observation of acute confusional state is necessary but not sufficient for addressing this condition early and adequately in older adults who have been hospitalized for a hip fracture.

Good practices in the recovery of ambulation in octogenarian women with hip fractures

SUMMARY OBJECTIVE: Determine good recovery practices for ambulation of octogenarian women after hospital discharge after being operated on for hip fracture. METHODS: Prospective study during the second half of 2019, with 192 women (85.95 ± 5.1 years) with hip fracture. A medical history, fracture types, complications, surgical treatment, and assessment of the level of ambulation were recorded before and after six months of hospital discharge. RESULTS: 100 patients lived in the family home and 92 in an institutional center, 68.2% provided pertrochanteric fracture and a total of 3.7 comorbidities, all of them received spinal anesthesia and were admitted an average of 11.4 days. After six months, the patients showed a significant loss of functional independence with respect to the situation prior to the fracture, both for the ability to wander and for activities of daily living. It is noteworthy that the worst prognosis in the recovery of ambulation has to do with intermediate levels of ambulation and that the functional level of departure influences to a lesser extent than the place where they perform the recovery. CONCLUSIONS: Age is a factor that influences the recovery of hip fracture, but there are other influential factors since patients who remain in the family home have a better functional prognosis than those who recover in institutionalized centers, after six months of hospital discharge.

RESUMO OBJETIVO: Determinar boas práticas para a recuperação da ambulação de octogenárias posterior à alta hospitalar após cirurgia por fratura da pelve. METODOLOGIA: Um estudo prospectivo realizado no segundo semestre de 2019 com 192 mulheres (85,95 ± 5,1 anos) com fratura da pelve. O histórico médico, tipo de fratura, complicações, tratamento cirúrgico, e avaliação do nível de ambulação foram registrados antes da alta hospitalar e após seis meses. RESULTADOS: De todas as pacientes, 100 viviam com a família e 92 em alguma instituição, 68.2% tinham fratura peritrocantérica e uma média de 3,7 comorbidades; todas receberam anastesia espinhal e ficaram internadas por 11,4 dias em média. Após seis meses, as pacientes apresentaram uma perda significativa da independência funcional em relação à situação anterior à fratura, tanto em relação à capacidade de ambulação e atividades cotidianas. É importante ressaltar que o prognóstico negativo em relação à recuperação da ambulação está relacionado a níveis intermediários de ambulação e que o nível funcional de saída tem menor influência do que o local onde a recuperação é feita. CONCLUSÃO: A idade é um fator que influencia a recuperação de fraturas da pelve. Porém, há outros fatores com influência, já que as pacientes que ficam com familiares têm um prognostico funcional melhor do que aquelas que se recuperam em instituições, após seis meses da alta hospitalar.

Características funcionales de mujeres octogenarias con fractura de cadera después del alta hospitalaria / Functional characteristics of octogenarian women with hip fracture after hospital discharge

OBJETIVO: Identificar las principales características clínicas, funcionales y cognitivas de las mujeres octogenarias hospitalizadas con diagnóstico de fractura de cadera en el Hospital Universitario de León (España). Además, determinar la influencia del domicilio, al que se trasladan los pacientes al recibir el alta hospitalaria en la recuperación de la deambulación. MÉTODO: Estudio piloto prospectivo descriptivo transversal que analiza las características fisiológicas de mujeres mayores hospitalizadas con diagnóstico de fractura de cadera en el Hospital de León. RESULTADOS: Se incluyeron 96 mujeres con una edad media de 85,95 ± 5,1 años. El número total de comorbilidades presentadas por las pacientes fue de 3,7. El tipo de fractura más frecuente fue la pertrocantérica. Todos los pacientes empeoraron respecto a la capacidad de deambulación basal, encontrando las mayores diferencias en los que fueron institucionalizados frente a los que permanecieron en su residencia habitual. CONCLUSIONES: El domicilio al que se trasladan los pacientes al recibir el alta hospitalaria es un factor determinante para la recuperación de la movilidad e independencia de los mismos. En este sentido, es importante señalar que la práctica habitual de institucionalización de las personas mayores después de una fractura de cadera se asocia con una peor recuperación

OBJECTIVE: To identify the main clinical, functional and cognitive characteristics of hospitalized octogenarian women diagnosed with hip fracture at the University Hospital of León (Spain). In addition, to determine the influence home, to which patients are transferred upon discharge from the recovery from wandering. METHOD: Prospective descriptive pilot study cross-sectional analysis of the physiological characteristics of hospitalized older women with a diagnosis of hip fracture at the Hospital de León. RESULTS: It included 96 women with an average age of 85.95 ± 5.1 years. The total number of comorbidities presented by patients was 3.7. The most common type of fracture frequent was the pertrochanteric. All patients worsened with respect to the capacity of basal wandering, finding the greatest differences in those who were institutionalized as opposed to those who remained at their usual residence. CONCLUSIONS: The address to which patients are transferred when they are discharged from hospital is a determining factor in the recovery of mobility and independence of themselves. In this regard, it is important to note that the usual practice of institutionalisation of older people after a hip fracture is associated with a worse recovery

Uso de la comunicación prosocial en profesionales sanitarios y sociales con personas mayores. Estudio piloto / Using the prosocial communication in health and social mediators with elderly. A pilot study

Los profesionales sociales y de la salud están desbordados ante la creciente demanda de servicios, lo que requiere crear fórmulas dirigidas a una implicación más activa de los usuarios en su propia salud. Objetivo: diseñar un cuestionario de prosociabilidad y aplicarlo a profesionales del ámbito social y sanitario en vivo. Metodología: Cuatro observadores valoraron la prosociabilidad de 20 profesionales que interaccionaban con mayores en situación de consulta y/o actividades de ocio. La herramienta de evaluación fue un Cuestionario de buenas prácticas de comunicación prosocial, elaborado por nuestro equipo. Nueve factores relacionados con la competencia prosocial fueron observados mediante 22 ítems de conductas y actitudes. Resultados: los centros y profesionales de la salud emplean más la prosociabilidad, posiblemente ya que atienden de forma personalizada, mientras que centros y profesionales sociales atienden grupalmente. Conclusiones: Se precisan más investigaciones sobre cómo incorporar conductas prosociales en atención grupal. Además, se necesita más entrenamiento de competencias prosociales para disminuir el estilo de rol de experto, dominante entre los profesionales del estudio

Social and sanitary professionals are overwhelmed by the growing demand of services. This fact calls for the creation of terapeutical formulas promoting the active implication of users with their own health. Objective: Observe the level of prosocial communication among social and health professionals while interacting with seniors in either medical consultation or leisure supervision. Metodology: 4 observers have assessed the prosociability of 20 social and sanitary professionals. The evaluation tool was the Test of Best Practices for Prosocial Communication, designed and developed by our own research team. It includes 9 factors related to prosocial competence and 22 items related to specific behaviours and attitudes. Results: The sanitary centers and professionals exhibit higher prosocial scores. While sanitary centers take care of users on a personal basis, social centers handle users on a groupal basis. Conclusions: More research is required on strategies to incorporate prosocial conducts under groupal attention. The study manifests that more training is needed on prosocial competence in order to aminorate the expert role, which is dominant among professionals in this study

Relación entre los índices de funcionalidad cardíaca y cognitiva en personas mayores institucionalizadas / Relation between cardiac and cognitive functionality indexes in old institutionalized persons

Los datos más recientes sugieren que la disfunción cardíaca, cuantificada por el gasto cardíaco, está relacionada con el funcionamiento cognitivo. Objetivo: determinar si el funcionamiento cardíaco actúa como predictor de la función cognitiva en personas institucionalizadas con índice cardíaco normal. Método: estudio observacional con una muestra de 30 sujetos mayores de 80 años, con historial médico clínico sin cardiopatías. Resultados: el análisis de regresión múltiple confirma que las variables cardíacas de riesgo cardiovascular e insuficiencia cardíaca son predictoras del nivel de funcionamiento cognitivo y acumulan un 95,1% de la varianza. Sin embargo, destaca la notable falta de correspondencia entre las medidas clínicas cardíacas y cognitivas con la medida biológica de índice cardíaco. Conclusión: aunque los datos observacionales no pueden establecer causalidad, nuestros resultados muestran que la función cardíaca con índice cardíaco normal se asocia con deterior cognitivo

Most recent data suggest that cardiac disfunction as quantified by cardiac output is related to cognitive performance. Objective: determine if cardiac functionality acts as predictor of cognitive function in old institutionalized persons with normal cardiac index. Method: Observational design with a sample of 30 subjects over 80 years old with medical history without cardiopathies. Results: Multiple regression analysis confirms the hypothesis with respect to the effect of cardiovascular risk and cardiac insufficiency variables, which together account for 95.1% of variance. However, there is a remarkable lack of correspondence between clinical cardiac-cognitive measures and the biological measure of cardiac index. Conclusions: Even if empirical data do not stablish a causal link, our results show that cardiac function with a normal cardiac index is associated with cognitive impairment

[Psychometric properties of the satisfaction with life scale in active elderly women]. / Propiedades psicométricas de la escala de satisfacción con la vida en mujeres mayores activas.

OBJECTIVE: The present study analyzes the psychometric properties of the Spanish version of the Satisfaction with Life Scale. METHODS: The sample of 310 active elderly women with primary school education and living in their own homes. The scale's reliability was examined with Cronbach's alpha and the exploratory factor analysis. RESULTS: The reliability show a value of 0.75. Principal components analysis showed a single factor solution accounting for 51.32% of the variance. Item 5 "The conditions of my life are excellent" explained the highest percentage of variance in the data. CONCLUSION: These analyses showed acceptable internal consistency.

Propiedades psicométricas de la escala de satisfacción con la vida en mujeres mayores activas / Psychometric properties of the satisfaction with life scale in active elderly women

Objetivo: El presente estudio analiza las propiedades psicométricas de la versión en castellano de la Escala de Satisfacción con la Vida. Método: Se utilizó una muestra de 310 mujeres mayores activas, con estudios primarios y que viviesen en su domicilio habitual. La fiabilidad de la escala se examinó con el alfa de Cronbach y con un análisis factorial exploratorio. Resultados: La fiabilidad de la escala fue de 0,75. El análisis de componentes principales mostró un único factor que explicaba el 51,32% de la variancia. El ítem 5 «Las circunstancias de mi vida son buenas» es el que explica un mayor porcentaje de variancia de los datos. Conclusión: El análisis de fiabilidad muestra una buena consistencia interna (AU)

Objective: The present study analyzes the psychometric properties of the Spanish version of the Satisfaction with Life Scale. Methods: The sample of 310 active elderly women with primary school education and living in their own homes. The scale's reliability was examined with Cronbach's alpha and the exploratory factor analysis. Results: The reliability show a value of 0.75. Principal components analysis showed a single factor solution accounting for 51.32% of the variance. Item 5 “The conditions of my life are excellent” explained the highest percentage of variance in the data. Conclusión: These analyses showed acceptable internal consistency (AU)

Efectos del tratamiento combinado de fármaco más estimulación cognitiva en la demencia moderada: seguimiento de dos años / Effects of combined pharmacologic and cognitive treatment in the progression of moderate dementia: a two-year follow-up

Objetivos: estudiar la eficacia de un tratamiento combinado (fármaco anticolinesterásico y entrenamiento cognitivo) en los procesos cognitivos de pacientes con demencia moderada después de 2 años de tratamiento. Material y métodos: cincuenta pacientes, 64,0% mujeres, edad media ± desviación estándar de 77,9 ± 6,2 años, diagnosticados de enfermedad de Alzheimer (EA) en estadio FAST ≥ 4. Asignación aleatorizada, ciega, a 4 grupos de tratamiento: grupo 1 (n = 12 individuos) recibió estimulación cognitiva; grupo 2 (n = 13), tratamiento farmacológico; grupo 3 (n = 12), tratamiento combinado (fármaco y estimulación cognitiva), y grupo 4 (n = 13), sin tratamiento. La eficacia terapéutica se evaluó, al cabo de uno y 2 años, mediante las escalas Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale (ADAS-Cog) y Functional Staging of Dementia of the Alzheimer's Type (FAST). Se realiza comparación entre los resultados obtenidos en los distintos grupos tras el seguimiento (ANOVA para medidas repetidas), nivel de significación p < 0,05. Resultados: los grupos de tratamiento mostraron cambios significativamente positivos frente al declive del grupo control para todas las escalas estudiadas al cabo de un año (p < 0,0001). El efecto deletéreo del tratamiento al cabo de 2 años es homogéneo en estos grupos, aunque en el grupo 3 (tratamiento combinado) se aprecia una tendencia al enlentecimiento de su deterioro funcional frente al resto (p no significativa). Conclusión: el tratamiento combinado (farmacológico y cognitivo) en la EA en estadio moderado produce efectos beneficiosos durante el primer año del tratamiento y mitiga el deterioro que se produce al segundo año en relación con otras formas de tratamiento

Objectives: to study the efficacy of combined treatment (anticholinesterase drugs and cognitive stimulation) in improving cognitive function in patients with moderate dementia after a 2-year follow-up. Material and methods: fifty patients (64.0% women, mean age 77.9 years [SD 6.2]) diagnosed with Alzheimer's disease (AD) in functional assessment stage (FAST) ≥ 4 were included. The patients were randomly assigned to 4 treatment groups: group 1 (n = 12) received cognitive stimulation; group 2 (n = 13) received drug therapy; group 3 (n = 12) received combined therapy (drug therapy plus cognitive stimulation), and group 4 (n = 13) received no treatment. The evaluator was blind to treatment allocation. Therapeutic efficacy was evaluated after 1 and 2 years through the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale (ADAS-Cog) and FAST. The results obtained in the distinct study groups were compared after follow-up (repeated measures ANOVA). Statistical significance was set at p < 0.05. Results: at the end of 1 year, the two treatment groups showed significant positive changes compared with cognitive decline in the control group in all the scales studied (p < 0.0001). After 2 years, deterioration was homogeneous in these groups, although group 3 (combined therapy) showed a nonsignificant tendency toward slowing of functional deterioration compared with the remaining groups. Conclusion: combined treatment (pharmacological and cognitive) in moderate-stage AD produces beneficial effects during the first year of treatment and mitigates the deterioration produced in the second year in comparison with other forms of treatment