Cognitive performance of people with traumatic spinal cord injury: a cross-sectional study comparing people with subacute and chronic injuries.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To assess the impact of spinal cord injury (SCI) on cognitive function in individuals with subacute and chronic SCI. SETTING: National Hospital for SCI patients (Spain). METHODS: The present investigation was designed to determine the nature, pattern, and extent of cognitive deficits in a group of participants with subacute (n = 32) and chronic (n = 34) SCI, using a comprehensive battery of reliable and validated neuropsychological assessments to study a broad range of cognitive functions. Twenty-seven able-bodied subjects matched to the groups with SCI for age and educational level formed the control group. RESULTS: The neuropsychological assessment showed alterations in the domain of attention, processing speed, memory and learning, executive functions, and in recognition in participants with SCI. The prevalence of cognitive dysfunction in the chronic stage was also confirmed at the individual level. The comparison of the neuropsychological assessment between the groups with subacute and chronic SCI showed a worsening of cognitive functions in those with chronic SCI compared to the group with subacute SCI. CONCLUSIONS: In participants with SCI, cognitive dysfunctions are present in the subacute stage and worsen over time. From a clinical point of view, we confirmed the presence of cognitive dysfunction that may interfere with the first stage of rehabilitation which is the most intense and important. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual's quality of life and possible integration to society.

Measuring elderly people's quality of life through the Beck Hopelessness Scale: a study with a Spanish sample.

OBJECTIVES: Hopelessness is a key element of suicidal intent. It can instill a pessimistic outlook on the future, leading an individual to believe that suicide is the only answer to their problems. Hopelessness operates as a modulating variable between depression and suicidal behavior. The aim of this study was to confirm the factor structure of the Beck Hopelessness Scale (BHS) in a non-clinical sample. METHOD: Three hundred and sixty-two Spanish individuals, aged over 60, free of cognitive impairment and depressive symptoms, completed the BHS scale. Participants were tested using confirmatory factor analysis (CFA), using one-, two- and three-factor models. RESULTS: The one- and two-factor models presented adequate fit indices. Specifically, the indices of the two-factor models were better than those of the one-factor model. The two-factor model, without items 4, 9 and 14, provided the best fit, given that the indices obtained in the CFA and their internal consistency were better than those of the other models. CONCLUSION: The validation of the BHS for a population of Spanish older adults provides a reliable and valid measure of hopelessness and could be useful in clinical practice and research as an effective tool for the early detection of suicidal behaviors.

Reminiscence functions scale: factorial structure and its relation with mental health in a sample of Spanish older adults.

BACKGROUND: The reminiscence functions scale (RFS) is a 43-item self-report instrument designed to assess the use of reminiscence for different functions. This study aims, on one hand, to analyze the factorial structure and the psychometric properties of the RFS and, on the other, to examine the relationship between the functions of reminiscence and mental health. METHODS: RFS scale and measures of depressive symptomology, despair, and life satisfaction were administered to a sample of persons over the age of sixty (n = 364). RESULTS: After eliminating three conflictive items from the original scale, the confirmatory factor analysis results present a factorial structure comprising eight traditional factors and adequate reliability scores (from 0.73 to 0.87). Using structural equation modeling, we find that these reminiscence factors are organized in three second-order factors (self-positive, self-negative, and prosocial). Results show that the self-positive factor relates negatively and the self-negative factor relates positively with symptoms of mental health problems. CONCLUSIONS: These results, on one hand, confirm that the RFS scale is a useful instrument to assess reminiscence functions in a sample of Spanish older adults and, on the other, that the three-factor model of reminiscence is a better predictor of mental health than the alternative four-factor model.

Factor structure and psychometric properties of the center for epidemiologic studies depression scale (CES-D) in older populations with and without cognitive impairment.

The CES-D is widely used for the assessment of depressive symptoms in the adult population. However, few studies have been performed to assess the utility of this scale in an older population with cognitive impairment. The factor structure of the Spanish version of the CES-D was examined in an observational, cross sectional study in 623 older adults (M = 72.74 years; SD = 7.7). The validity of the scale was determined in two samples of older adults, one comprising 162 participants with cognitive impairment (M = 76.73 years; SD = 8.1) and one with 58 participants without cognitive impairment (M = 74.64 years; SD = 9.0). The results confirm previous results of a four factor structure. With regard to the validity of the scale, in the group with cognitive impairment the area under the ROC curve is 0.84 (95% CI: 0.77-0.89) and the cut-off point for possible depression is 13, while in the group without cognitive impairment the area is 0.90 (95% CI: 0.79-0.96) and the optimal cut-off point is 28. These results show that the Spanish version of the CES-D is a valid instrument for the identification of depression in older adults with and without cognitive impairment.

Terapia sobre revisión de vida basada en la recuperación de recuerdos autobiográficos específicos en ancianos que presentan síntomas depresivos / Life review therapy based on retrieval of specific autobiographical memories in elderly individuals with depression

Introducción: el objetivo de este estudio fue examinar la eficacia de un modelo de revisión de vida, basado en el entrenamiento para la recuperación de los recuerdos autobiográficos específicos positivos, como tratamiento en ancianos deprimidos. Material y método: se asignó aleatoriamente a 2 grupos --tratamiento y control-- a 43 personas mayores con una edad comprendida entre los 65 y los 93 años, con sintomatología depresiva y sin demencia. Los resultados indican diferencias significativas entre los grupos experimental y control después de 4 semanas de práctica en la recuperación de recuerdos autobiográficos. Resultados: en el postest, los sujetos que recibieron tratamiento mostraron menos síntomas depresivos y un mayor número de acontecimientos específicos recordados. Las conclusiones sugieren que la práctica en memoria autobiográfica, basada en el recuerdo de acontecimientos específicos, puede utilizarse en terapias sobre revisión de vida con efectividad y podría ser una herramienta útil en la psicoterapia con los ancianos depresivos

Introduction: the aim of this study was to examine the efficacy of a new model of life review based on retrieval of specific positive autobiographical memories to treat depressed older adults. Material and method: forty-three adults aged 65-93 years with clinically significant depressive symptomatology and no dementia were randomly assigned to the treatment or control groups. The results indicated significant differences between the experimental and control groups after 4 weeks of practising autobiographical retrieval. Results: in the post-test, individuals in the treatment group showed fewer depressive symptoms and retrieval of a greater number of specific events. The findings suggest that practice in autobiographical memory, based on retrieval of specific events, may be among the components of life review that account for its effectiveness and could be a useful tool in psychotherapy in older adults with depression