Changes in cognitive function after a 12-week POWER rehabilitation in older adults with schizophrenia and frailty.

BACKGROUND: The effectiveness of isolated resistance training (RT) on cognitive function among older adults with schizophrenia is insufficiently investigated. This study investigated the effectiveness of 12-weeks POWER rehabilitation, a novel RT regimen, on cognitive function among older patients with schizophrenia and frailty. METHODS: Thirty-two older adults with schizophrenia and frailty were enrolled and randomized to receive either a 12-week, twice weekly POWER rehabilitation, or without add-on training. Cognitive functioning was assessed using mini-mental state examination (MMSE), digit symbol substitution test, color trail task (CTT), and digit span task (DST). Physical performance was assessed by walking speed and hand grip strength. The generalized estimating equations was used to compare pre- and post-training outcome measure between groups. RESULTS: Between-group analysis revealed significant improvement in CTT1 and hand grip strength in the intervention group compared to the controls. Subgroup analyses showed CTT1 performance significantly improved after 12 weeks of POWER rehabilitation in the intervention group (time, p < .001), independent of age, educational level, global cognition, depressive symptoms, and psychotropic medication use. Increased hand grip strength was significantly associated with improved performance in MMSE, CTT1, and DST forward at study endpoint. CONCLUSION: A 12-week POWER rehabilitation for older patients with schizophrenia and frailty is safe and feasible, and may benefit physical and some domains of cognitive functioning.

[Early cognitive rehabilitation for patients with severe neurological impairment]. / Prise en charge cognitive précoce des patients cérébrolésés sévères.

Improving the state and future of patients severely impaired following brain injury is at the heart of early rehabilitation, established from the first days of hospitalization. For cognitive deficits, this management involves several challenges, related to hospital conditions and to the patients' capacities during the acute phase. A relevant intervention can be provided, as long as it involves an assessment adapted to these particularities and a rehabilitation targeting the most limiting deficits at this stage. These findings, discussed in the light of our clinical experience and current knowledge in the field, have yet to be scientifically tested since randomized clinical trials are still lacking. The integration of new technologies to facilitate the bedside work presents another prospect for the future.

Améliorer sans délai l'état et le devenir des patients sévèrement touchés par une lésion cérébrale constitue l'essence de la rééducation précoce, instaurée dès les premiers jours de l'hospitalisation. Pour les aspects cognitifs, cette prise en charge comporte plusieurs défis, liés aux conditions hospitalières et aux capacités des patients. Une intervention pertinente peut être pratiquée, sous réserve d'une évaluation adaptée à ces particularités et d'une rééducation ciblant les déficits les plus limitants à ce stade. Ces constats, discutés à la lumière de notre expérience clinique et des connaissances actuelles, doivent encore être prouvés scientifiquement car les essais cliniques randomisés manquent cruellement. L'intégration des nouvelles technologies pour faciliter le travail au chevet des patients constitue une autre perspective d'avenir.

Cognitive Training with Older Adults Using Smartphone and Web-Based Applications: A Scoping Review.

INTRODUCTION: The present scoping review focused on: i) which apps were previously studied; ii) what is the most common frequency for implementing cognitive training; and iii) what cognitive functions the interventions most focus on. METHODS: PRISMA guidelines were followed, and the search was conducted on Web of Science, PsycInfo, Cochrane, and Pubmed. From 1733 studies found, 34 were included. RESULTS: it was highlighted the necessity for forthcoming investigations to tackle the methodical restrictions and disparities in the domain. DISCUSSION: great diversity in intervention protocols was found. Incorporating evaluations of physical fitness in conjunction with cognitive evaluations can offer a more all-encompassing comprehension of the impacts of combined interventions. Furthermore, exploring the efficacy of cognitive training applications requires additional scrutiny, considering individual variances and practical outcomes in real-life settings.

Emerging From the Haze™: Pilot Feasibility Study Comparing Two Virtual Formats of a Cognitive Rehabilitation Intervention.

OBJECTIVES: To gather feasibility and preliminary data comparing two virtual delivery methods for providing Emerging From the Haze™ (Haze) to cancer survivors compared to waitlist control (WLC). SAMPLE & SETTING: Eligible participants (N = 93) reported cancer-related cognitive impairment following chemotherapy for stage I-III solid tumors, Hodgkin lymphoma, or non-Hodgkin lymphoma. METHODS & VARIABLES: A three-arm randomized design was used to compare virtual live group presentation of Haze sessions, virtual prerecorded Haze group sessions, and WLC. Data were collected at baseline, week 10, and week 14. RESULTS: Feasibility was demonstrated. Significant cognitive function improvement at week 10 versus WLC was reported for the live group, and clinical improvement was reported for the prerecorded group. The prerecorded group reported significant improvement at week 14 versus WLC in physical activity, sleep, and health-related quality of life. IMPLICATIONS FOR NURSING: Additional pilot and feasibility evidence for cognitive rehabilitation interventions was demonstrated. Prerecorded Haze delivery shows potential for clinical effectiveness and scalability. Future multisite research is warranted.

Study protocol for a randomized controlled trial: Effect of an everyday cognition training program on cognitive function, emotional state, frailty and functioning in older adults without cognitive impairment.

BACKGROUND: Ageing entails changes in complex cognitive functions that lead to a decrease in autonomy and quality of life. Everyday cognition is the ability to solve cognitively complex problems in the everyday world, enabling instrumental activities of life. Benefits have been found in studies using everyday cognition-based assessment and intervention, as the results predict improvements in everyday performance, not just in specific cognitive functions. A study protocol is presented based on assessment and training in everyday cognition versus traditional cognitive stimulation for the improvement of functionality, emotional state, frailty and cognitive function. METHODS: A parallel randomised controlled clinical trial with two arms will be conducted. It will be carried out by the University of Salamanca (Spain) in eleven centres and associations for the elderly of the City Council of Salamanca. People aged 60 years or older without cognitive impairment will be recruited. Participants will be randomly distributed into two groups: the experimental group will undergo a training programme in everyday cognition and the control group a programme of traditional cognitive stimulation, completing 25 sessions over 7 months. All participants will be assessed at the beginning and at the end of the intervention, where socio-demographic data and the following scales will be collected: The Medical Outcomes Study (MOS), Questionnaire ARMS-e, Everyday Cognition Test (PECC), Scale Yesavage, Test Montreal Cognitive Assessment (MoCA), The Functional Independence Measure (FIM), Fragility Index and Lawton y Brody Scale. DISCUSSION: The present study aims to improve conventional clinical practice on cognitive function training by proposing a specific assessment and intervention of everyday cognition based on the importance of actual cognitive functioning during the resolution of complex tasks of daily life, giving priority to the improvement of autonomy. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT05688163. Registered on: January 18, 2023.

Dyadic Art Appreciation and Self-Expression Program (NCGG-ART) for People with Dementia or Mild Cognitive Impairment and Their Family Caregivers: A Feasibility Study.

BACKGROUND: Non-pharmacological interventions effective for depressive mood and bilateral relationships among persons with cognitive impairment (PwCI) and their family caregivers (FCGs) have not been established. OBJECTIVE: To examine the feasibility of a newly developed group-based art appreciation and self-expression program (NCGG-ART) for dyads of PwCI and their FCGs. METHODS: This pilot randomized control trial included 34 dyads of PwCI diagnosed with mild to moderate Alzheimer's disease or mild cognitive impairment, and their FCGs, from an outpatient rehabilitation service (Holistic Physio-Cognitive Rehabilitation [HPCR]). Participants were randomly divided equally into the HPCR (control group) or NCGG-ART and HPCR (intervention group) groups. Both included 1-hour weekly, 6-week programs. The primary outcome was depressive symptoms among FCGs assessed using the Patient Health Questionnaire-9 (PHQ-9). Feasibility outcomes included participant satisfaction and motivation. FCGs were interviewed about their experiences and feelings regarding the program, which were analyzed using content analysis. RESULTS: Thirty-two dyads (intervention group:16; control group:16) completed the study period. High participation rates, satisfaction, and motivation were demonstrated throughout the intervention. Scores in the PHQ-9 among FCGs did not show positive effects: mean changes in the score were 1.3 for the intervention group and -0.8 for the control group (Cohen d:0.56). However, the qualitative analysis revealed favorable experiences and feelings of the FCGs, such as positive emotions, social interactions, and person-centered attitudes to and positive relationships with PwCI. CONCLUSIONS: This program demonstrated high feasibility with FCGs' favorable responses to emotions and relationships with PwCI, ensuring future investigations with a confirmatory study design.

Effect of hyperbaric oxygen therapy combined with repetitive transcranial magnetic stimulation on vascular cognitive impairment: a randomised controlled trial protocol.

INTRODUCTION: Vascular cognitive impairment (VCI) has an increasing prevalence worldwide, accounting for at least 20%-40% of all diagnoses of dementia. The decline in cognitive function seriously impairs patients' activities of daily living and social participation and reduces their quality of life. However, there is still a lack of advanced, definitive rehabilitation programmes for VCI. Hyperbaric oxygen therapy (HBOT) and repetitive transcranial magnetic stimulation (rTMS) are recognised treatments for improving cognitive impairment. The former can restore oxygen supply in the brain by increasing oxygen partial pressure in brain tissue, while the latter can enhance neuronal excitability and promote synaptic plasticity. However, no studies have explored the effect of HBO combined with rTMS on VCI. METHODS AND ANALYSIS: This study is designed as a single-centre, assessor-blind, randomised controlled clinical trial with four parallel arms. A total of 72 participants will be recruited and randomly assigned to the control group, HBOT group, rTMS group and HBOT combined with rTMS group at a ratio of 1:1:1:1. All enrolled participants will receive conventional treatment. The entire intervention period is 4 weeks, with a 3-week follow-up. Outcomes will be measured at baseline (T0), after a 4-week intervention (T1) and after an additional 3-week follow-up period (T2). The primary endpoint is the Montreal Cognitive Assessment score. The secondary endpoints are Mini-Mental State Examination score, Modified Barthel Index score, latency and amplitude of P300, cerebral cortical oxygenated haemoglobin (HbO2) and deoxygenated haemoglobin (HbR) concentrations as measured by task-state functional near-infrared spectroscopy. ETHICS AND DISSEMINATION: Ethics approval was obtained from the West China Hospital Clinical Trials and Biomedical Ethics Committee of Sichuan University (ethics reference: 2022 (1972)). The findings will be published in peer-reviewed journals and disseminated through scientific conferences and seminars. TRIAL REGISTRATION NUMBER: ChiCTR2300068242.

The integration of technology into a home-based visuo-cognitive training intervention for people with Parkinson's: Is the future digital?

BACKGROUND: Mobile applications and technology (e.g., stroboscopic glasses) are increasingly being used to deliver combined visual and cognitive (termed visuo-cognitive) training that replaces standard pen and paper-based interventions. These 'technological visuo-cognitive training' (TVT) interventions could help address the complex problems associated with visuo-cognitive dysfunction in people with long term neurological conditions such as Parkinson's disease. As data emerges to support the effectiveness of these technologies, patient perspectives offer an insight into how novel TVT is received by people living with long term neurological conditions. OBJECTIVE: To explore experiences of people with Parkinson's in using technology as part of a home-based visuo-cognitive training programme compared to traditional approaches to rehabilitation. METHODS: Eight people with Parkinson's who took part in a pilot randomised cross-over trial, investigating the efficacy and feasibility of TVT compared to standard care, were interviewed to explore their experiences of each arm of the training they received. Integration of Normalisation Process Theory (NPT) into the analysis enabled examination of the potential to embed novel TVT into a home-based rehabilitation intervention for people with Parkinson's disease. RESULTS: Three key themes emerged from the thematic analysis as factors influencing the implementation potential of TVT for people with Parkinson's disease: perceived value of technology, perceived ease of use and support mechanisms. Further examination of the data through the lens of NPT revealed that the implantation and embedding of novel technology was dependent on positive user experience, individual disease manifestation and engagement with a professional. CONCLUSIONS: Our findings provide insights into the challenges of engaging with technology-based interventions while living with a progressive and fluctuating disease. When implementing technology-based interventions for people with Parkinson's, we recommend that patients and clinicians collaborate to determine whether the technology fits the capacity, preference, and treatment needs of the individual patient.

Effects of cognitive interventions with video games on cognition in healthy elderly people: a systematic review.

BACKGROUND: Currently, studies using video games as an intervention to improve cognitive functions in the elderly are on the rise. OBJECTIVE: To investigate and evaluate the effects of cognitive interventions using video games on cognition in healthy elderly people published in the last ten years. METHODS: A systematic review involving a qualitative analysis carried out between July and September 2021on the SciELO, LILACS and MEDLINE databases.. RESULTS: A total of 262 articles were identified in the initial search. After exclusion of duplicates, analysis of titles/abstracts and of the full text, a final total of 9 studies were included in the review. The objectives of the studies included investigating the effects on cognition of cognitive training (CT) programs using video games compared to programs using entertainment games or to low-intensity CT games. Despite the growing number of studies, many of them were focused on cognitive rehabilitation in elderly people with some degree of cognitive impairment, and few involved training among healthy elderly people. CONCLUSION: According to the studies analyzed, the interventions involving CT with video games promoted significant improvements in processing speed and working memory, but no improvements in executive functions.

ANTECEDENTES: Atualmente, estão em alta estudos que utilizam video games para melhorar as funções cognitivas em idosos. OBJETIVO: Investigar e avaliar os efeitos de intervenções cognitivas com video games na cognição de idosos saudáveis publicadas nos últimos dez anos. MéTODOS: Estudo de revisão sistemática com análise qualitativa realizado entre julho e setembro de 2021, das bases de dados SciELO, LILACS e MEDLINE. RESULTADOS: Foram identificados 262 estudos na busca inicial. Após a exclusão de estudos duplicados, análise dos títulos e resumos, e análise integral dos estudos, nove estudos foram incluídos na revisão. Os objetivos de alguns estudos incluíam investigar os efeitos na cognição de programas de treino cognitivo (TC) com video games comparados aos de programas com jogos de entretenimento ou com jogos com baixa intensidade de TC. Apesar do crescente número de estudos, muitos centravam-se na reabilitação cognitiva em idosos com algum comprometimento cognitivo e poucos realizaram o treino em idosos saudáveis. CONCLUSãO: Pelos estudos analisados, as intervenções de TC com video games apresentaram melhorias significativas na velocidade de processamento (VP) e na memória operacional (MO); por outro lado, não foram observadas melhorias nas funções executivas.

Recensión: eficacia de un programa de entrenamiento de ajedrez para mejorar la cognición, el estado de ánimo y la calidad de vida en adultos mayores: un estudio piloto / Critical review: effectiveness of a chess-training program for improving cognition, mood, and quality of life in older adults: a pilot study

El estudio citado nos proporciona un acercamiento al uso del ajedrez para reducir el riesgo de desarrollar deterioro cognitivo y/o demencia. Se lleva a cabo un estudio piloto controlado, no aleatorizado, con evaluaciones antes y después de un programa de entrenamiento de ajedrez con 22 adultos mayores institucionalizados y semiinstitucionalizados. Se valoran los efectos de esta intervención sobre el estado cognitivo, estado de ánimo y calidad de vida. Se obtienen mejoras significativas en el estado cognitivo y en la percepción de la calidad de vida de los/as participantes.(AU)

This study presents an approach to the use of chess to reduce the risk of developing cognitive impairment and/or dementia. A pilot controlled, non-randomised study was conducted with evaluations before and after a chess training programme with 22 older adults who were institutionalised and semi-institutionalised. The study aimed to assess the effects of this intervention on participants' cognitive status, mood, and quality of life. Significant improvements are obtained in the cognitive state and in the perception of the quality of life of the participants.(AU)

[Virtual reality technology as a promising direction in neurorehabilitation]. / Tekhnologiya virtual'noi real'nosti kak perspektivnoe napravlenie v neiroreabilitatsii.

Nervous system damage affects more than a billion people worldwide and is one of the leading causes of cognitive impairment. An urgent issue in modern medicine is the neurorehabilitation of this particular group of patients. The purpose of this article is to search for new approaches to achieve more effective recovery of cognitive functions, precisely by using virtual reality technology as a promising direction in neurorehabilitation. It has been shown that neurobiological effects of virtual reality have a positive effect on the plasticity of neurons, improve cognitive functions and positively affect the psychoemotional state. A case of the positive impact of being in the virtual environment «Outer Space¼ in a female patient with cognitive impairment and chronic pain is presented.

Motor, cognitive, and combined rehabilitation approaches on MS patients' cognitive impairment.

BACKGROUND: At the moment, the possible options for the management of cognitive dysfunctions in patients with MS (pMS) are pharmacological interventions, cognitive rehabilitation (CR), and physical exercise. However, worldwide, multimodal programs are infrequently applied in pMS and CR is not easily accessible through the National Health System as MR. OBJECTIVE: The aim of the study is to explore if the combination of motor and cognitive rehabilitation may favor better outcomes on cognitive efficiency compared to separate trainings. METHODS: Forty-eight pMS were submitted to detailed neuropsychological and motor assessments, before (T0) and after (T1) having performed one of three rehabilitation conditions (two cognitive trainings/week-Reha1; one cognitive and one motor training/week-Reha2; two motor trainings/week-Reha3, for 12 weeks); they were randomly assigned to one condition or another. The CR was focused on memory functioning and performed with the Rehacom program. RESULTS: No significant differences in age, sex, education, and disease course were found between the three groups (sig. > .05). Reha1 patients increased only their cognitive performance, and Reha3 only increased their motor performance, while Reha2 increased both cognitive and motor performances. This benefit was also confirmed by the cognitive efficiency expressed by the Cognitive Impairment Index. CONCLUSIONS: These data confirm that to include cognitive training within rehabilitation programs may induce important benefits in pMS. Furthermore, pMS seem to benefit from a combined approach (cognitive and motor) more than from CR and motor rehabilitation separately (ClinicalTrial.gov ID: NCT05462678; 14 July 2022, retrospectively registered).

Enhancing cognitive rehabilitation in multiple sclerosis with a disease-specific tool.

PURPOSE: Computerised rehabilitation programs can be used to address cognitive deficits typically caused by multiple sclerosis (MS). However, there are still doubts on their effectiveness, due to mixed results obtained in clinical trials. The objective of this paper is to improve cognitive rehabilitation (CR) practices in MS, by presenting and assessing a MS-specific cognitive rehabilitation software. METHODS: We conducted a detailed analysis of how CR is carried out in practice in MS rehabilitation centres. From the analysis, we elicited a reference CR process, and identified the essential features a software supporting the process should have. We designed and implemented MS-rehab, a novel MS-specific computerised rehabilitation system having the identified features. We experimented MS-rehab in a pilot study involving eight MS patients. To highlight the improvement with respect to the state of the art, we compared MS-rehab with available professional tools selected using well defined criteria. RESULTS: This paper has three main contributions: (1) the identification of a set of essential features a computerised tool for CR in MS should provide; (2) MS-rehab, a novel CR system designed for MS therapists and patients, which embodies innovative MS specific features; (3) the assessment of MS-rehab efficacy in a pilot study with MS patients. CONCLUSIONS: The availability of a MS-specific CR system like MS-rehab fosters the design of more rigorous clinical studies on the effectiveness of computerised rehabilitation in MS. MS-rehab demonstrated its potential and innovativeness as a tool for cognitive rehabilitation in MS.IMPLICATIONS FOR REHABILITATIONComputerized tools for cognitive rehabilitation (CR) in multiple sclerosis (MS) can be improved by a set of MS-specific features.The availability of advanced home-based cognitive rehabilitation mechanisms is fundamental for supporting standardized cognitive rehabilitation protocols in MS.A MS-specific CR system has given promising results in a pilot study involving MS patients.Hardly do state-of-the-art professional tools include all the required MS specific features.

Loneliness as a risk factor for cancer-related cognitive impairment: a secondary data analysis from the Haze study.

PURPOSE: The purpose of this study was to investigate the association between loneliness and cancer-related cognitive impairment (CRCI) in a cohort of breast cancer survivors. METHODS: Female breast cancer survivors (stage I-III) reporting cognitive impairments 2 months to 5 years after chemotherapy (n = 61) participated in a prospective, nonblinded, waitlist-controlled pilot study. The intervention was a tailored cognitive rehabilitation program. Data were collected pre-/post-intervention. Loneliness was measured using the UCLA Loneliness Scale. Perceived cognitive function was measured using two subscales of the FACT-Cog and two PROMIS - Applied Cognition short forms. Spearman correlation coefficients were calculated to determine the relationship between loneliness and perceived cognitive function (PCF). RESULTS: Participants' loneliness severity was correlated with diminished PCF across all cognitive measures (Spearman r= -0.63 FACT-Cog Perceived Cognitive Impairment, p < 0.0001; r= -0.6 FACT-Cog Perceived Cognitive Abilities, p < 0.0001; r= -0.49 PROMIS Cognitive Ability, p = 0.0002; r = 0.50 PROMIS General Concerns, p = 0.0002). Loneliness scores significantly decreased following participation in the cognitive rehabilitation program in intervention participants as compared to wait-list controls [-5.0 ± 7.24, 95% CI (-8.06, -1.94), p = 0.0025]. CONCLUSIONS: Perceived loneliness was significantly and consistently correlated with PCF. The intervention may have served a dual purpose in both addressing cognitive deficits and loneliness. Additional research dedicated to understanding the association between loneliness and cognitive function, as well as screening for and addressing loneliness in clinical oncology settings, may be warranted. IMPLICATIONS FOR REHABILITATIONScreening for and addressing loneliness in oncology rehabilitation settings is warranted.Rehabilitation professionals are well-positioned to screen for and address loneliness during clinic visits as part of routine cancer rehabilitation care.Group settings may be appropriate for addressing cancer-related cognitive impairment in rehabilitation, as these groups may serve the dual purpose of addressing cognitive impairment and loneliness simultaneously.

Power of combined modern technology: Multitouch-multiuser tabletops and virtual reality platforms (PowerVR) in social communication skills training for children with neurological disorders: A pilot study.

New technologies such as multitouch-multiuser tabletops (MMT) and virtual reality (VR) provide modern neurorehabilitation options. The aim was to describe the structure of acquired social communication deficits in children with neurological disorders (ND) and implement a new PowerVR method- combined MMT/VR interfaces, into social neurorehabilitation. The study was designed based on the Structured Social Rehabilitation Model. Sixty children with ND aged 8-13 years participated: 28 with epilepsy, 10 with traumatic brain injury (TBI), 3 with tic disorders, 3 with stroke, 16 with other ND. A total of 16 patients (M = 10.5 years, SD = 1.8) completed trainings with pre- and post-intervention assessments. Forty-four patients participated in base-level assessment (M = 10.2 years, SD = 1.6). Two age-matched patients practiced in pairs on MMT and individually in VR. The most impaired components in patients were theory of mind (ToM) skills. A total of 64% of children presented behavioral problems related to executive dysfunctions. Patients lacked conflict resolution (median 38% out of 100%) and empathy skills (25%). After trainings, communication and cooperation, pragmatics, social attention, conflict resolution, and empathy skills improved. Patients' general verbal ToM and understanding false beliefs (p < .005) increased. Children's ability to start conversations improved; they experienced less bullying. Findings suggest that the combined technology-based intervention PowerVR offers increased power for multicomponent training of socio-emotional skills.

Risco de quedas e seus fatores associados na pessoa idosa hospitalizada / Risk of falls and its associated factors in hospitalized older adults

Resumo Objetivo analisar o risco de queda e sua associação com as variáveis demográficas, clínicas, estado cognitivo, risco de sarcopenia e fragilidade da pessoa idosa hospitalizada em uma clínica médica de um hospital universitário. Método Estudo quantitativo, observacional, transversal e analítico realizado com 60 pessoas idosas hospitalizadas na clínica médica de um hospital universitário da cidade de São Paulo - SP, Brasil, com o uso dos seguintes questionários: perfil demográfico, dados clínicos, Mini Exame do Estado Mental, Escala de Morse, Escala SARC-F e Índice de Fragilidade Tilburg. Foram realizadas análises descritivas e teste de normalidade de Kolmogorov-Smirnov. Para as variáveis quantitativas foi utilizado o teste de correlação de Spearman e para categóricas, o teste U Mann-Whitney. Para identificar a associação, foi utilizada a regressão linear múltipla e adotado um nível de significância de 5%. Resultados Predomínio do sexo feminino, entre 60-79 anos e sem companheiro (a). Ademais, 80% apresentavam comprometimento cognitivo, 88,3% foram categorizados como frágeis, 60% apresentavam risco para sarcopenia e 75% possuíam alto risco de queda durante a hospitalização. Verificou-se associação do comprometimento cognitivo, ser frágil e ter risco de sarcopenia com o risco de queda na pessoa idosa hospitalizada. Conclusão o elevado risco de quedas em idosos hospitalizados está diretamente relacionado com a presença de deficit cognitivo, síndrome da fragilidade e o risco para sarcopenia, afirmando que esses fatores merecem atenção dos gestores e profissionais de enfermagem.

Abstract Objective To analyze the risk of falls and its association with demographic and clinical variables, cognitive status, risk of sarcopenia and frailty among older adults hospitalized in a medical clinic of a university hospital. Method A quantitative, observational, cross-sectional analytical study of 60 older adults hospitalized in the medical clinic of a university hospital in São Paulo city, São Paulo state, Brazil, was carried out. Questionnaires collecting demographic profile and clinical data, the Mini-Mental State Examination, Morse Scale, SARC-F Scale and Tilburg Frailty Indicator were applied. Descriptive analyses and the Kolmogorov-Smirnov normality test were performed. Spearman's correlation test was used for quantitative variables and the Mann-Whitney U-test for categorical variables. Multiple linear regression was used to identify the associations and a significance level of 5% was adopted. Results The study sample comprised predominantly individuals that were female, aged 60-79 years and without a partner. Overall, 80% had cognitive impairment, 88.3% were diagnosed as frail, 60% were at risk for sarcopenia, and 75% had a high risk of falls during hospitalization. Cognitive impairment, frailty and sarcopenia risk were associated with risk of falls in the hospitalized older adults. Conclusion High risk of falls in the hospitalized older adults was directly associated with the presence of cognitive impairment, frailty syndrome and sarcopenia risk, confirming that these factors warrant attention from managers and nursing professionals.

Cognitive impairment predicts engagement in inpatient stroke rehabilitation.

Patient engagement during inpatient rehabilitation is an important component of rehabilitation therapy, as lower levels of engagement are associated with poorer outcomes. Cognitive deficits may impact patient engagement during inpatient stroke rehabilitation. Here, we assess whether patient performance on the cognitive tasks of the 30-min National Institute of Neurologic Disorders and Stroke - Canadian Stroke Network (NINDS-CSN) screening battery predicts engagement in inpatient stroke rehabilitation. Prospective data from 110 participants completing inpatient stroke rehabilitation at an academic medical center were utilized for the present analyses. Cognitive functioning was assessed at inpatient stroke rehabilitation admission using the NINDS-CSN cognitive battery. Patient engagement was evaluated at discharge from an inpatient rehabilitation unit using the Hopkins Rehabilitation Engagement Rating Scale. The results demonstrate that the NINDS-CSN cognitive battery, specifically subtests measuring executive functioning, attention and processing speed, predicts patient engagement in inpatient stroke rehabilitation. Cognitively impaired patients undergoing rehabilitation may benefit from modifications and interventions to increase engagement and improve functional outcomes.

Effect of computerized cognitive rehabilitation in comparison between young and old age after traumatic brain injury.

INTRODUCTION: Cognitive dysfunction reduces patients' quality of life and social participation with traumatic brain injury (TBI). Computerized cognitive rehabilitation is increasingly being used for cognitive therapy in TBI patients. The purpose of this study was to investigate the influence of age on the effect of computerized cognitive rehabilitation in cognitive dysfunction after TBI. MATERIAL AND METHODS: A total of 34 patients with cognitive dysfunction after TBI were enrolled. Participants performed 30 sessions of computerized cognitive rehabilitation (Comcog) for 6 weeks. A cognitive evaluation was performed before and after treatment with Mini-Mental State Examination (MMSE) and Computerized Neurophyschologic Test (CNT). RESULTS: There were no cognitive tests that differed between the young group and the old group at baseline. However, after computerized cognitive rehabilitation, the young group showed significant improvement compared to the old group in verbal memory, visual memory, attention, and visuo-motor coordination tests. The young group showed improvement in MMSE, verbal and visual memory, and visuo-motor coordination tests after computerized cognitive rehabilitation. In contrast, the old group showed significant improvement only in MMSE and visual learning test, one of the visual memory tests. CONCLUSION: Our findings demonstrate that age may be an important factor related to the effect of computer cognitive rehabilitation on cognitive dysfunction after TBI. Methodologically more ordered studies with larger sample sizes are needed in the future.

Estudio piloto sobre el efecto de la telerehabilitación en la calidad de vida de personas mayores con deterioro cognitivo / Pilot study on the effect of telerehabilitation in quality of life among elderly people with cognitive impairment

Introducción: Los procesos de atención a personas mayores han presentado cambios debido al confinamiento sanitario causado por el COVID-19, por esta razón la telerehabilitación se impulsa como una estrategia para continuar los procesos de rehabilitación cognitiva a personas mayores. Objetivo: evaluar la percepción de la calidad de vida de personas mayores con deterioro cognitivo que se encuentran en telerehabilitación, comparado con la calidad de vida de personas mayores con deterioro cognitivo sin telerehabilitación. Método: se realizó un estudio descriptivo para identificar los cambios en la calidad de vida de personas mayores con procesos de telerehabilitación. Se emplearon los instrumentos Quality of Life in Alzheimer's Disease y la escala GENCAT. Resultados: el estudio descriptivo mostró cambios favorables en la calidad de vida de las personas mayores que estuvieron en el proceso de telerehabilitación, mientras que el grupo control presentó cambios negativos. Conclusiones: este estudio permite evidenciar los cambios en la calidad de vida de personas mayores con deterioro cognitivo que participa en un proceso de telerehabilitación durante el confinamiento sanitario. Estos cambios favorables se presentaron en las dimensiones de bienestar emocional, bienestar material, inclusión social y derechos.

Introduction: the processes of care for elderly have presented changes, due to the sanitary confinement caused by COVID-19 pandemic. For this reason, telerehabilitation is promoted as a strategy to continue the processes of cognitive rehabilitation for the elderly. Aim: To evaluate quality of life perceptions among older people with cognitive impairment, who received telerehabilitation, compared with quality of life of older people with cognitive impairment without Telerehabilitation. Method: a descriptive study to identify changes in quality of life of older people receiving tele-rehabilitation processes. Assessment instruments used were: Quality of Life in Alzheimer's Disease and the GENCAT scale. Results: this descriptive study showed favorable changes in quality of life of the elderly who were in the telerehabilitation process, while the control group presented negative changes. Conclusions: this study offers evidence on the changes in the quality of life for elderly people with cognitive impairment who participate in a telerehabilitation process during sanitary confinement. These favorable changes occurred in the dimensions of emotional well-being, material well-being, social inclusion and rights.