Carolina Feldberg

Vulnerabilidad psicosocial del cuidador familiar. Creencias acerca del estado de salud del paciente neurológico y el sentimiento de sobrecarga

Resumen Objetivo Se intenta evaluar el papel de las creencias del cuidador familiar sobre el estado de salud del paciente neurologico y su relacion con el sentimiento de sobrecarga como factores de riesgo psicosocial para su salud psicofisica, desde el modelo de estres psicologico propuesto por Lazarus y Folkman. Sujetos y metodos Fueron entrevistados 128 cuidadores familiares (35 asistian a pacientes con traumatismo craneoencefalico, 38 a pacientes con esclerosis multiple y 55 a pacientes con demencia), seleccionados con la estrategia de muestreo estadistico no probabilistica, de tipo accidental. Se siguio el diseno descriptivo-comparativo, de corte transversal. Fueron utilizados un cuestionario de datos sociodemograficos y de creencias del cuidador, y la Escala de Sobrecarga del Cuidador de Zarit y Zarit. Resultados Cuanto mas negativas las creencias del cuidador, mayor probabilidad de que experimenten sentimientos mas intensos de sobrecarga. Los cuidadores de pacientes con esclerosis multiple creen, en mayor proporcion que los otros, en un mal estado de salud del enfermo, asociado a sentimientos de sobrecarga mas intensos, resultando ser los mas probablemente vulnerables frente al estres. Discusion El esclarecimiento del papel que cumplen los factores de riesgo psicosocial del cuidador familiar de enfermos neurologicos brindara elementos de juicio de interes para generar estrategias de intervencion psicoeducativas para ellos, paralelas a las clinicas, para el resguardo de su bienestar, y asi contar con una buena red de cuidado informal para este tipo de pacientes.

Prevalence of Geriatric Depression and Alexithymia and their association with sociodemographic characteristics in a sample of elderly persons living in Buenos Aires, Argentina

Fil: Tartaglini, Maria Florencia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Cardiologicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas; Argentina

Estimulación y rehabilitación cognitiva en un centro ambulatorio: descripción y análisis de las variables iniciales

Resumen Introduccion La rehabilitacion cognitiva es una practica prescrita cada vez con mayor asiduidad en pacientes neurologicos con trastornos en sus funciones mentales superiores. Objetivo Describir las caracteristicas principales y efectuar un analisis comparativo de los puntajes obtenidos en diferentes escalas en pacientes que iniciaron tratamiento de estimulacion/rehabilitacion cognitiva en INEBA. Materiales y metodos Bateria de pruebas que incluyeron memoria episodica verbal, memoria subjetiva, actividades de la vida diaria, calidad de vida y rasgos depresivos. Descripcion y comparacion entre diferentes grupos etiologicos. Resultados Se analizaron los datos de 73 pacientes (38 varones y 35 mujeres; edad media: 59,89 anos [SD 19,42], educacion formal: media 13 anos [SD 3,74]). Dentro de la poblacion predominaron las causas vasculares (20 casos, 27%), los traumatismos encefalocraneanos (9 casos, 12%) y el deterioro cognitivo leve de causa no vascular (8 casos, 11%). En el analisis de los resultados de la bateria administrada se observo una diferencia significativa entre la percepcion subjetiva de memoria de los pacientes vasculares, con traumatismos y con deterioro cognitivo leve en algunas de las dimensiones estudiadas, entre ellas recuerdo de libros y peliculas, conversaciones y acciones a realizar. Conclusiones Se encontraron diferencias en la percepcion subjetiva de memoria entre los grupos considerados. Resulta importante dentro de los programas de rehabilitacion cognitiva considerar junto a la evaluacion del desempeno objetivo, aspectos metacognitivos y de creencias de memoria para asi conocer las fortalezas y debilidades del paciente de manera integral. Esto permitira el empleo de estrategias compensatorias que apunten a mejorar el desempeno funcional del paciente.

MUSICAL TRAINING AS A PROXY VARIABLE OF COGNITIVE RESERVE: TRANSLATION AND VALIDATION OF THE ARGENTINEAN MUSICAL TRAINING QUESTIONNAIRE (CEMA)

lower cognitive performance. This stresses the relevance to understand the prevalence and characteristics of PA and SB in the context of dementia. The aim of this study was to examine PA and SB characteristics of ambulatory and community dwelling patients with dementia compared to cognitively healthy age-, sexand weightmatched controls. Methods: A cross-sectional study design was used. Community dwelling patients with dementia were included (N1⁄445, age1⁄479.665.9 years, MMSE1⁄422.863.2). Controls were age-, sexand weight-matched to the dementia patients (N1⁄449, age1⁄480.067.7 years, MMSE1⁄429.061.2). Participants wore a wrist accelerometer for seven days. Data was conferred from counts per epoch to counts per minute (CPM). Cut-off points of 145 CPM, 145-274 CPM, 274-597 CPM and>597 CPMwere used for sitting, very light, light-to-moderate and moderate-to-vigorous PA, respectively. To account for individual differences in waking time, our primary analysis was based on activity levels expressed as a percentage of total (awake) measuring time.Results:Relative sitting time and the duration of average sitting bout was significantly higher in dementia patients compared to controls (median and interquartile range: 57% (49-68) vs 55% (47 – 59) and 18.3 (16.4–21.1) minutes vs 16.6 (15.3–18.4) minutes, P1⁄40.042 and 0.008 respectively). In addition, dementia patients spent a lower percentage of their waking time in light-to-moderate and moderate-to-vigorous intensity PA (20% (15–23) vs 22% (18–25) and 5% (2–10) vs 10% (5–13), P1⁄40.017 and 0.001 respectively). Whilst older controls show significantly less PA and more SB compared to their younger peers, no such changes were present when comparing dementia patients aged 80 years and aged<80 years. Conclusions:In the current study we revealed that dementia patients are more sedentary and perform less PA compared to cognitively healthy controls, as measured by accelerometry. This may have clinically important consequences, given the observation of previous prospective studies that this type of behavior independently predicts all-cause mortality and morbidity.

THE ROLE OF LEISURE ACTIVITIES THROUGHOUT ADULT Life Span: A COMPARATIVE STUDY BETWEEN MCI PATIENTS AND HEALTHY OLDER ADULTS

1 16 8.20 1.40 19 7.40 1.21 0.60 [-0.08, 1.28] 1.73 0.084 12.3 29.2 4 113 14.30 2.80 108 13.50 2.90 0.28 [0.01, 0.54] 2.07 0.039 81.5 51.3 5 11 14.30 2.80 10 10.80 2.30 1.30 [0.34, 2.27] 2.66 0.008 6.2 19.5 Fixed effect model 0.38 [0.14, 0.62] 3.14 0.002 100.0 Random effects model 0.57 [-0.60, 1.75] 2.10 0.170 100.0 Prediction Interval [-4.99, 6.14] Poster Presentations: Tuesday, July 24, 2018 P1360

PREVALENCE OF GERIATRIC DEPRESSION AND ALEXITHYMIA IN WIFE CAREGIVERS OF PATIENTS WITH DEMENTIA

(observed in the patient) were found between caregivers of DLB and PDD. Self-reported burden profiles were similar across all caregivers. Conclusions:These findings support the hypothesis that there are differences in the experience of caregiving for those with DLB and other dementia types. These findings also support the hypothesis that a greater frequency in behavior problems exhibited by the patient can lead to greater reports of grief in the caregiver. While there were no differences found in the experience of caregiver burden between diseases, the lack of differences may be due to the failure of current measures to capture the unique facets of DLB. The creation of new measures is needed to investigate other potential differences in the caregiving experience for patients with DLB.

OCCUPATIONAL SELF-DIRECTION AND ITS ROLE AS A BUFFERING FACTOR OF COGNITIVE PERFORMANCE IN OLD AGE: PRELIMINARY RESULTS

the particular fMRI experiment. Results: Following 4 months of intensive individual training, we found improvement in tests of memory and executive functions in both physical training groups. In the fMRI experiments,we found reliable responses to story condition in regions that are related to higher order processing of information (temporo-parietal junction, marginal, supramarginal gyri, frontal areas). Moreover, hippocampal activation inmemory encoding task increased followingaerobic intervention. In addition, increasedBDNFwascorrelated with improved cognition, with no association with the type of exercise. Conclusions: The physical training results in functional and structural changes. Our findings demonstrated that cognitive performance can be affected by exercise of both types. The insights gained from the study may have important scientific value and clinical implications for individuals who are at the early stages of AD.

FAMILY CAREGIVERS OF PATIENTS WITH DEMENTIA: AN ANALYSIS OF THE FEELING OF BURDEN ACCORDING TO THEIR VULNERABILITY AND PSYCHOSOCIAL RESOURCES

Background:Mild Cognitive Impairment (MCI) is regarded as both a risk state for dementia and an intermediate state between normal aging and dementia (Gauthier et al., 2006; Luis et al., 2003; DeCarli, 2003). There is no standard treatment for MCI. Regular participation in dance preserves cognition into old age (Katenstroth, 2010) and leisure activities which include dancing likewise reduce the risk for dementia (Verghese, 2003). Dance combines physical activity, social and emotional engagement, and cognitive stimulation all thought to maintain synaptic connections and plasticity. A structured modular ballroom dance program called “indak” or rhythm was designed by a multidisciplinary team using concepts of visualization, musicality exercise, improvisation and dance recall, and increasing complexity. Indak was pilot tested and showed compliance was good. We examined whether ballroom dancing could improve cognition. Methods: This single-blinded (blind assessor) observational study was done on elderly diagnosed with MCI based on the Petersen criteria. We used Alzheimer’s Disease Assessment Scale (ADAS-Cog), Montreal Cognitive Assessment-Philippines (MoCA-P), Mini-Mental State ExamPhilippines (MMSE-P) for baseline and post-intervention assessment. The intervention consisted of one-hour dance sessions twice weekly for 12 months and conducted by professionally certified dance teachers. Paired t-testswere used to compare preand post-interventions scores, and unpaired t-test for comparing post-intervention scores between dancers and non-dancers. Results: All 207 Filipino elderly with MCI underwent baseline assessment. One hundred one vounteered to participate in the intervention. Baseline versus post-intervention scores showed the dancers’ mean change improved in ADAS-Cog, MoCA-P and MMSE-P (3.1665.99, 0.9663.33, 0.8962.39 respectively) and all were significant (p<0.01). Among controls, only theMMSE significantly improved. When the post-intervention scores were compared between dancers and controls, the difference in the MoCA-P, Logical Memory and Boston Naming were likewise significant. Conclusions: Indak is a 12-month ballroom dance program that is novel and effective yet relatively inexpensive non-pharmacological strategy to improve cognition among community-dwelling elderly Filipinos with MCI. Ballroom dance can then be studied in a randomized controlled trial, alone or as part of multidimensional intervention, to delay dementia onset or modify progression of MCI.

THE ROLE OF EDUCATION AND OCCUPATIONAL COMPLEXITY IN THE COGNITIVE PERFORMANCE OF OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT

Background: As it stands now, finding positive content and solutions to engage with individuals who experience Alzheimer’s disease and dementia is a task that requires a lot of effort, time and emotional availability, something that caregivers oftentimes can’t afford. These upworthy resources are out there, dispersed across the world wide web. Methods:My team and I are developing and curating a website that caters to the needs of caregivers like myself, who want to see an alternative to the tragedy-infused language, so that we can be empowered and motivated to support our family members and ourselves. Moreover, we offer primary care-partners, like my dad, Yuri, a wide range of arts-based techniques and activities to engage with their loved ones. Results: Arts for Dementia will be an easy to access database through which both family and institutional caregivers can discover websites, Apps, events, articles, podcasts and practical arts-based techniques for a better, happier and more positive lifestyle with dementia. We also encourage the users’ comments on the existing content and submissions of new positive, arts-based content to share with our community. Conclusions:Our goal is to provide positive and enjoyable solutions for life with dementia and ultimately create a community that ventures beyond loss, into life.

Influence of the affective valence of visual materials in recognition among healthy individuals and patients with Alzheimer's disease dementia

OBJECTIVE: To research into the influence of the affective valence of picture in visual recognition tests among healthy individuals and patients with mild Alzheimer’s Disease Dementia (ADD). BACKGROUND:Patients with Alzheimer’s disease (AD) present with impairments both at the structures associated with emotions, and in episodic memory. The involvement of the amygdala in patients with AD might imply emotional deficit in information processing. It has been reported that the impairment of patients with AD to perceive emotions might be lower than their deficit at the level of other cognitive functions, with a higher recalling of materials when the materials have emotional content. DESIGN/METHODS: Fifteen healthy individuals (age (mean±Standard Deviation) 73±8.48 years, education 13.2±3.9 years, Mini Mental State Examination (MMSE) 29.4±1.55), and 15 patients with ADD (age 75.47±7.61 years, education 10.8±4 years, MMSE 24.6±2.85), paired by age and education were included. Ten pictures with neutral valence and 10 pictures with negative valence were selected from the International Affective Picture System, paired by arousal level. Successful recognition of pictures and reaction time by picture valence were assessed by ANOVA test. RESULTS: A better performance was recorded both in terms of the number of successful recognition instances (F=1570;p=0.01) and of reaction time (F=285.40;p=0.01) in the control group compared to patients with ADD. Both groups evidenced a better recognition accuracy with negative-valence pictures than with neutral-valence pictures (F=4.66;p=0.04). CONCLUSIONS: A better performance of the control group was noted both in terms of processing rate and of recognition accuracy. In both groups, the recognition accuracy was higher with negative-valence prompts. These findings suggest that the emotional content of the information facilitates recognition. Disclosure: Dr. Irrazabal has nothing to disclose. Dr. Saux has nothing to disclose. Dr. Feldberg has nothing to disclose. Dr. Somale has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. DEMEY has nothing to disclose.