Jesús González-Moreno

Background: Transcranial direct current stimulation (tDCS) and cognitive training are non-pharmacological interventions for cognitive impairment in Alzheimer's disease (AD), but evidence on combined protocols in mild dementia remains limited. Objective: To evaluate home-delivered active tDCS combined with cognitive training and active tDCS alone versus sham tDCS in mild dementia due to AD, and explore whether the combined intervention showed changes across a broader range of cognitive outcomes. Methods: Forty participants with mild dementia due to AD and evidence of amyloid-β pathology were randomized to tDCS combined with cognitive training (n = 14), active tDCS alone (n = 14), or sham tDCS (n = 12). The 10-day intervention was delivered at participants’ homes by trained study personnel. Cognitive outcomes were assessed at baseline, post-intervention, and 1-month follow-up using linear mixed-effects models. Results: Significant Group × Time interactions were observed for the primary cognitive outcome, Mini-Mental State Examination (MMSE), and for all secondary cognitive outcomes except Backward Digit Span. Both active conditions showed greater change from baseline than sham tDCS in MMSE, Memory Alteration Test, verbal learning, total verbal recall, and delayed recall. The combined condition also showed greater change than sham tDCS in initial immediate recall and Forward Digit Span. No significant differences were observed between the two active conditions. Conclusions: Active tDCS, with or without cognitive training, was associated with more favorable short-term cognitive change than sham stimulation. The combined condition differed from sham across more outcomes, but not from active tDCS alone; therefore, this exploratory pattern does not establish a broader benefit of the combined intervention.

Older adults exposed to prolonged sociopolitical violence often experience chronic stress that may undermine adaptive coping processes. Instrumental reminiscence, which focuses on recalling past experiences of successfully managing adversity, has been proposed as a strategy potentially associated with greater coping flexibility in later life. This study examined whether participation in an instrumental reminiscence programme was associated with changes in coping strategies among older adults registered as victims of armed conflict in Catatumbo, Colombia. A quasi‐experimental controlled design with repeated measures (pre‐intervention, post‐intervention, 2‐month follow‐up) was conducted with 64 community‐dwelling adults aged 60 years and older (intervention n = 37; control n = 27). The intervention consisted of 8 weekly 90‐min instrumental reminiscence sessions, while the comparison group received psychoeducational sessions. Coping strategies were assessed using the Coping with Stress Questionnaire. Linear mixed‐effects models were used to examine Group × Time interactions. Significant interactions were observed for problem‐solving focus, positive reappraisal, social support seeking, overt emotional expression, negative self‐focus, and avoidance (all p < 0.001). Compared with controls, the intervention group was characterised by higher post‐intervention scores on problem‐solving focus, positive reappraisal, social support seeking, and avoidance, and lower scores on overt emotional expression and negative self‐focus; these differences were maintained at follow‐up. No significant effects were found for religious coping. Participation in the instrumental reminiscence programme was associated with changes in multiple self‐reported coping strategies among older adults exposed to chronic conflict‐related stress.

Non-pharmacological interventions such as transcranial direct current stimulation (tDCS) and cognitive training (CT) may benefit cognition in older adults

Simple reminiscence has been used as a non-pharmacological strategy to improve emotional well-being and adaptation in older adults, particularly those with mild cognitive impairment due to Alzheimer's disease. This study examined the effects of a simple reminiscence-based intervention on different reminiscence functions in this population. 113 participants were randomly assigned to an experimental (n = 61) or control group (n = 52). The experimental group received 16 reminiscence sessions over eight weeks. Assessments occurred pre-, post-intervention, and at follow-up. The eight subscales of the Reminiscence Functions Scale served as the study's primary outcome variables. Intervention effects were analyzed using 2 × 3 mixed ANOVAs (group × time). The results showed significant improvements in adaptive reminiscence functions, including identity, problem-solving, and preparation for death, as well as in the prosocial functions of conversation and teaching/informing in the experimental group compared to the control group. These findings suggest that simple reminiscence can be an effective strategy for preserving and enhancing adaptive reminiscence functions in older adults with mild cognitive impairment due to Alzheimer's disease. Clinical Implications: This intervention can be integrated into routine care for individuals with cognitive impairment, helping maintain emotional-cognitive functioning and improve quality of life.

Background: Background: This study investigates the effects of cognitive interventions on executive functions and attention in patients with moderate Alzheimer's, comparing traditional and technology-based methods with a control group. Method: A randomized controlled trial was conducted with 112 participants, divided into three groups: traditional intervention, technology-based intervention, and control group. Sixteen sessions were carried out, assessed using standardized tests and applying hierarchical linear mixed models to adjust for confounding factors and random effects. Results: The interventions proved effective in improving executive functions. The model for backward digits and categorical fluency was optimized with MMSE scores, highlighting the benefits of good cognitive performance and the negative impacts of age on categorical fluency. The similarity-abstraction variable demonstrated the beneficial effects of education and cognitive performance. Conclusions: Cognitive training is a valuable tool for improving executive functions and attention in moderate Alzheimer's, indicating significant practical benefits. Future research should focus on the mechanisms of skill transfer to optimize interventions and improve the quality of life for those affected.

Introduction: Optimising the management of chronicity has been a global challenge for decades. Individuals with long-term conditions (LTCs) and their families live with them for years. Thus, it is necessary to include both of their perspectives in the management and adaptation of the interventions proposed. The psychometric properties of the living with LTCs scale from the perspective of the family caregiver are unknown. The objective of the present study is to describe the psychometric properties of the EC-PC-Fam in a Spanish-speaking population.Methods: An observational, cross-sectional study was performed with a retest of part of the sample. The fit of the model was optimised with a factorial analysis, and the psychometric properties were verified.Results: A sample of 311 caregivers was recruited. Most of them were women (68.2%) and had a mean age of 58.29±9.91 years (range: 32–84 years). The initial version did not obtain acceptable fit scores. To improve the fit, different versions were tested, refining the distribution of the items until optimisation was reached in V.10 (19 items). Cronbach’s alpha was 0.81 for the scale as a whole. The intraclass correlation coefficient was 0.77. The EC-PC-Fam scale is strongly and inversely correlated with a scale that measures the burden of the caregiver (r_s=−0.46), and moderately related to the health-related quality of life (r_s=0.373) and social support (r_s=0.38).Conclusions: The EC-PC-Fam scale from a family perspective is defined as a promising tool for promoting personalised care and for optimising the management of LTCs, and a new approach that includes family caregivers is proposed for clinical practice. The scale is an instrument with a moderate fit and optimum psychometric properties to measure living with LTCs from the perspective of a family caregiver. New validation studies are recommended to verify the fit of the proposed factorial solution.

Suicide is one of the leading causes of death worldwide, affecting numerous individuals close to the person who died by suicide, including family members, friends, and colleagues. Those affected by the suicide of someone are referred to as “suicide survivors”, and the psychological consequences they face are particularly severe. One of these consequences is grief, which is more complicated in survivors of suicide compared with those grieving deaths from other causes, mainly because of the stigma that continues to surround them. Therefore, psychotherapeutic intervention for suicide loss survivors is crucial. This study examines the efficacy of cognitive-behavioral programs for addressing grief and other related variables in suicide loss survivors. The search was conducted in databases including Psycinfo, Academic Search Premier, Medline, APA PsycArticles, E-Journals, Scopus, and PubMed. Five randomized controlled trials were selected, one of which focused exclusively on minors. The results reveal that cognitive-behavioral therapy is effective, although the methodological quality of these studies is not adequate, and the representativeness of the samples is very low. More RCTs are needed on the application of cognitive-behavioral programs to treat grief in suicide loss survivors.

Introducción. El ejercicio físico mejora la salud psicofísica de los adultos mayores. Sin embargo, existen variables sociodemográficas que favorecen o dificultan la práctica deportiva que han sido escasamente investigadas (educación, ingresos, género y estado civil), ni se ha prestado atención a estas variables en relación con los diferentes deportes practicados (gimnasia, actividades acuáticas, yoga, pilates y danza). Objetivo. Por ello, el objetivo de este estudio ha sido conocer el perfil sociodemográfico de los adultos mayores que realizan algún deporte. Procedimiento. Se utilizó la escala de calidad de vida CUBRECAVI y un cuestionario sociodemográfico en una muestra de 358 personas mayores de 60 años (M = 69,66, DT = 4,74). Resultados. Los resultados han mostrado que entre los mayores que hacen gimnasia hay más participantes que tienen menor cualificación académica (p < 0,001), bajos ingresos (p < 0,001); y mujeres (p = 0,003); y que los solteros y divorciados realizan actividades de danza en mayor proporción que otras actividades (p = 0,004). Conclusiones. En conclusión, la actividad deportiva practicada por los adultos mayores está relacionada con el nivel de educación que tienen, los ingresos que perciben, el género y su estado civil. Palabras clave: Personas mayores; envejecimiento; deporte, actividad física; diferencias socioeconómicas; educación; ingresos; género. Introduction: Physical exercise enhances the psychophysical well-being of older adults. However, sociodemographic variables that may either facilitate or impede the engagement in physical activities, such as education, income, gender, and marital status, have been insufficiently explored. Furthermore, limited attention has been given to these variables concerning specific physical activities, including gymnastics, aquatic activities, yoga, pilates, and dance. Objective: The aim of this study is to delineate the sociodemographic profile of physically active older adults based on the specific type of physical activity they participate in. Procedure: A sample of 358 individuals aged over 60 years (M = 69.66, SD = 4.74) participated in the study, utilizing the Quality of Life Scale and a sociodemographic questionnaire, specifically the CUBRECAVI. Results: The findings indicate that older adults engaged in gymnastics are more likely to possess lower academic qualifications (p < .001), lower income (p < .001), and be women (p = .003). Additionally, single and divorced individuals participate in dance activities at a higher rate compared to other activities (p = .004).Conclusion: In summary, the choice of physical activity among older adults is associated with their educational level, income, gender, and marital status. Keywords: older adults; aging; physical activity; sport; socioeconomic differences; education; income; gender.