Resumo: Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

Abstract: Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

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Abstract Introduction/objective: The healthy aging process involves changes in neurobiological functions at various levels and is associated with a slight impairment in various cognitive domains, such as executive functions (EF), as well as the enhancement of emotional skills. The objective of this study was to compare the use of emotion regulation (ER) strategies in young adults (YA) and older adults (OA) and explore the association between ER skills and EF between age groups. Method: Participants were 40 YA between 18 and 39 years of age (50% women) and 40 OA > 60 years old (50% women), residents in the Federal District, Brazil. Phonological Verbal Fluency (FAS), semantic and switching (animals and fruits) and action tests were administered, along with the Stroop Test. Results: There was a statistically significant correlation of the Cognitive Reappraisal (CR) strategy and both semantic and switching verbal fluency tests in YA, and between the CR strategy and the FAS test and the Stroop Test in OA. That is, executive performance showed a direct relationship with ER in both groups, with greater use of cognitive reappraisal by older adults. Conclusions: The results of this study highlight the relevance of continuing to investigate the relationship between these abilities and analysing in greater depth their alterations during the aging process.

Resumen Introducción/objetivo: El proceso de envejecimiento saludable implica cambios en las funciones neurobiológicas a varios niveles y se asocia con un ligero deterioro en diversos dominios cognitivos, como las funciones ejecutivas (FE), así como con una mejora de las habilidades emocionales. El objetivo de este estudio es comparar el uso de estrategias de regulación emocional (RE) en jóvenes y adultos mayores y explorar la asociación entre habilidades de RE y FE entre los grupos etarios. Método: Participaron 40 jóvenes entre 18 y 39 años (50 % mujeres) y 40 adultos mayores de > 60 años (50 % mujeres), todos residentes en el Distrito Federal (Brasil). Se administraron las pruebas de Fluidez Verbal Fonológica (FAS), semántica y de cambio (animales y frutas) y de acciones, junto al Test de Stroop. Resultados: Hubo una correlación estadísticamente significativa entre la estrategia de reevaluación cognitiva (RC) y las pruebas de fluidez verbal semántica y de cambio en jóvenes y entre la estrategia de RC y la prueba FAS y el Test Stroop en adultos mayores. Eso es, el desempeño ejecutivo mostró relación directa con la RE en ambos grupos, con mayor uso de la RC por parte de los adultos mayores. Conclusiones: Los resultados de este estudio resaltan la pertinencia de continuar investigando la relación entre estas habilidades y analizar con mayor profundidad sus alteraciones durante la edad adulta y el proceso de envejecimiento.

Resumo: A encefalopatia hepática consiste na disfunção ou deterioração cerebral, consequente a condições como a insuficiência hepática e a hipertensão portal, e é classificada no domínio médico como uma complicação clínica grave associada a lesões hepáticas graves. Foi efectuado um estudo de revisão sistemática qualitativa aplicando a declaração PRISMA 2020, utilizando os documentos disponíveis nas diferentes bases de dados e operadores booleanos para a pesquisa. A partir dos documentos selecionados, foi possível obter 840 referências de informação numa primeira pesquisa nas bases de dados e 8 registros de dados. Por fim, obteve-se um total de 16 fontes bibliográficas para a investigação. A encefalopatia hepática é uma síndrome neuropsiquiátrica que inclui comprometimento psicomotor e/ou sensorial, desorientação, incoordenação, comprometimento da memória, confusão, sonolência, estupor e coma, e existem várias ferramentas para o diagnóstico no primeiro nível de cuidados, Um dos principais instrumentos é a anamnese e o exame físico do doente, onde se esperam encontrar achados cognitivos e neuromusculares relacionados com a doença hepática grave. Os estudos complementares incluem testes laboratoriais, os critérios de West Haven, testes psicométricos, testes neurofisiológicos e estudos de neuroimagem, como a ressonância magnética.

Resumen: La encefalopatía hepática consiste en la disfunción o deterioro cerebral, consecuente a afecciones como insuficiencia hepática e hipertensión portal, en el ámbito médico es catalogada como una grave complicación clínica asociada al daño hepático severo. Se llevó a cabo un estudio cualitativo de revisión sistemática aplicando la declaración PRISMA 2020, en donde se utilizó los documentos disponibles en las diferentes bases de datos y con la aplicación de los operadores booleanos para su búsqueda. De los documentos seleccionados se pudieron obtener 840 referencias de información en una primera búsqueda en las bases de datos y 8 registros de datos. Finalmente, para la investigación se consiguió un total de 16 fuentes bibliográficas. La encefalopatía hepática se compone de un síndrome neuro-psiquiátrico que incluye deterioro psicomotor y/o sensitivo, desorientación, incoordinación, alteración de la memoria, confusión, somnolencia, estupor y coma, existen diversas herramientas para el diagnóstico desde el primer nivel de atención, una de las principales es la anamnesis y la exploración física del paciente donde se espera encontrar hallazgos cognitivos y neuromusculares relacionados a la enfermedad hepática grave, entre los estudios complementarios se emplea principalmente exámenes de laboratorio, Criterios de West Haven, prueba psicométrica, prueba neurofisiológica y estudios de neuroimagen como resonancia magnética.

Abstract: Hepatic encephalopathy consists of brain dysfunction or deterioration, consequent to conditions such as hepatic insufficiency and portal hypertension, and in the medical field it is cataloged as a serious clinical complication associated with severe liver damage. A qualitative study of systematic review was carried out applying the PRISMA 2020 statement, using the documents available in the different databases and Boolean operators for the search. From the selected documents it was possible to obtain 840 references of information in a first search in the databases and 8 data records. Finally, a total of 16 bibliographic sources were obtained for the research. Hepatic encephalopathy is composed of a neuropsychiatric syndrome that includes psychomotor and/or sensory impairment, disorientation, incoordination, memory alteration, confusion, somnolence, stupor and coma, there are several tools for diagnosis from the first level of care, One of the main ones is the anamnesis and physical examination of the patient where it is expected to find cognitive and neuromuscular findings related to severe liver disease, among the complementary studies are mainly used laboratory tests, West Haven Criteria, psychometric test, neurophysiological test and neuroimaging studies such as magnetic resonance imaging.

INTRODUCTION: The rising prevalence of stroke in sub-Saharan Africa necessitates the exploration of the role of occupational therapy in rehabilitation of stroke. In the southern African country of South Africa, occupational therapy aligns with healthcare policies and laws, and this article presents a review of synthesized evidence of occupational therapy intervention in stroke care and rehabilitation. METHOD: Rapid review methodology was used to develop a research question about cerebrovascular accident - intervention by occupational therapists., The Cochrane Library and MEDLINE databases were searched for relevant articles published between 2018 and 2023. Twenty four articles met the inclusion criteria and were analysed according to quantitative and qualitative parameters. RESULTS: Evidence of occupational therapy intervention with post-stroke upper limb impairment was found in 37,5% of articles. Occupational therapy for global improvement in function, cognitive rehabilitation, balance, social participation, work, and leisure comprised 45,8% of articles, and one article each reported evidence for occupational therapy addressing ADL and caregiver interventions. CONCLUSION: Evidence from the past five years reflect diverse occupational therapy interventions with clients with stroke. Gaps in recent evidence remain in relation to context-specific interventions, especially from low- and middle-income countries. IMPLICATIONS FOR PRACTICE Occupational therapists adopt a holistic approach to stroke rehabilitation, tailoring interventions to address the multifaceted needs and goals of individual stroke survivors. The effectiveness of individualised, occupation-based approaches across various domains are highlighted. • Therapists stay informed and up to date about emerging technologies and evidence-based practice to enhance their effectiveness in stroke rehabilitation. • This review provides evidence of the prevalence of upper limb impairments post-stroke, which will enable therapists to be well-versed in the diverse intervention approaches for upper limb rehabilitation as outlined in the literature reviewed, including technologies like Brain Computer Interface, Mental Practice, Mirror Therapy, and Action Observation Therapy. • Occupational therapy is vital in addressing cognitive impairments in stroke survivors, and practitioners can apply the evidence provided on interventions such as Virtual Reality and computer-assisted cognitive rehabilitation that have shown promise in improving cognition and ADL.

ABSTRACT Introduction: A narrative review was carried out of the studies published from 2016 to 2021 on the clinical, etiological, imaging and therapeutic aspects of the different clinical forms of vascular cerebral disease in the elderly. The databases of Medline (PubMed), SciELO, Cochrane and Google Scholar were consulted. Original articles, published in peer-reviewed journals, that included patients over 65 years of age, with a diagnosis of cerebral vascular disease, were taken into account. Objective: Update on the particularities of cerebral vascular disease in older adults. Development: In cerebrovascular disease of the elderly, particular conditions are observed: biological, psychological and social, which are less frequent or may even be absent in younger age groups. Large vessel atherosclerosis, cardioembolism, small vessel disease, and cerebral amyloid angiopathy are the predominant etiologies, although other causes may exist. Vascular cognitive impairment represents the second cause of dementia and is a clinical form of presentation of cerebral vascular disease in this age group. Conclusions: Cerebrovascular disease in the elderly presents particular characteristics that are summarized in: greater comorbidity and richness of risk factors, which require a systemic, dialectically interrelated and personalized diagnostic approach, in which neuroimaging occupies a unique place. importance; which, in interaction with the clinic, will allow a more comprehensive diagnosis and evolutionary follow-up of these patients.

RESUMEN Introducción: Se realizó una revisión narrativa de los estudios publicados desde 2016 hasta 2021 sobre los aspectos clínicos, etiológicos, imagenológicos y terapéuticos de las diferentes formas clínica de la enfermedad cerebral vascular en los ancianos. Se consultaron las bases de datos de Medline (PubMed), SciELO, Cochrane y Google Académico. Se tuvieron en cuenta los artículos originales, publicados en revistas con revisión por pares, que incluyeran pacientes mayores de 65 años, con diagnóstico de enfermedad vascular cerebral. Objetivo: Actualizar sobre las particularidades de la enfermedad vascular cerebral en el adulto mayor. Desarrollo: En la enfermedad cerebrovascular del adulto mayor se observan condiciones particulares: biológicas, psicológicas y sociales, que son menos frecuente o incluso pueden estar ausentes, en los grupos etarios más jóvenes. La arterioesclerosis de grandes vasos, el cardioembolismo, la enfermedad de pequeños vasos y la angiopatía cerebral amiloidea constituyen las etiologías predominantes, aunque pueden existir otras causas. El deterioro cognitivo vascular representa la segunda causa de demencia y es una forma clínica de presentación de la enfermedad vascular cerebral en este grupo etario. Conclusiones: La enfermedad cerebrovascular en el adulto mayor, presenta características particulares que se resumen en: mayor comorbilidad y riqueza de factores de riesgo, que obligan a un enfoque diagnóstico sistémico, dialécticamente interrelacionado y personalizado, en el cual las neuroimágenes ocupan un lugar de singular importancia; que, en interacción con la clínica, permitirán un diagnóstico y seguimiento evolutivo más integral de estos pacientes.

ABSTRACT Foundation: Traumatic brain injury is one of the main causes of morbidity and mortality in the child population; it involves several physical, social and cognitive alterations in survivors. Objective: To characterize pediatric patients admitted for craniocerebral trauma. Methods: An observational, descriptive, cross-sectional study was carried out in patients aged 0 to 17 years old, admitted for craniocerebral trauma from January 2018 to December 2020. The data were collected from the individual medical history and provincial statistical registry. Results: The age group that contributed the most patients was between 1 and 9 years old with 52.6%. The male sex predominated (65.6%). Falls were the main cause of trauma (64.8%). Regarding the triennium studied, the year 2020 showed a decrease in cases. 45.7% of the cases came from the Cienfuegos municipality. 90.9% of patients had mild neurological impairment upon admission. Focal lesions represented 84.4% of the TBI-specific lesions found. Conclusions: Craniocerebral trauma was more frequent in male sex and urban origin transitional and schoolchildren. Falls were the most relevant cause and neurological condition was mild in the majority of patients. There were no complications or deaths.

RESUMEN Fundamento: El traumatismo craneoencefálico es una de las principales causas de morbilidad y mortalidad en la población infantil; conlleva varias alteraciones a nivel físico, social y cognitivo en los sobrevivientes. Objetivo: Caracterizar pacientes en edad pediátrica, ingresados por trauma craneoencefálico. Métodos: Se realizó un estudio observacional, descriptivo, transversal en pacientes de 0 a 17 años, ingresados por trauma craneoencefálico en el período enero 2018-diciembre 2020. Los datos se recogieron de la historia clínica individual y registro estadístico provincial. Resultados: El grupo etario que más pacientes aportó fue el de entre 1 y 9 años con un 52,6 %. Predominó el sexo masculino (65,6 %). Las caídas constituyeron la principal causa del trauma (64,8 %). Con respecto al trienio estudiado, el año 2020 mostró una disminución de casos. El 45,7 % de los casos procedían del municipio de Cienfuegos. Un 90,9 % de los pacientes presentaron un compromiso neurológico leve al ingreso. Las lesiones focales representaron el 84,4 % de las lesiones específicas del traumatismo craneoencefálico encontradas. Conclusiones: El trauma craneoencefálico fue más frecuente en los transicionales y escolares del sexo masculino y procedencia urbana. Las caídas fueron la causa más relevante y el compromiso neurológico fue leve en la mayoría de los pacientes. No hubo complicaciones, ni fallecidos.

ABSTRACT Foundation: As the number of older adults aged 60 years and older increases, there is an urgent need to look for alternatives to reduce the incidence of amnestic mild cognitive impairment. A promising means that has been showing results is the use of the Internet and the use of online applications. Objective: To identify the association between the use of online applications and amnestic mild cognitive impairment in older adults. Methods: Analytical observational study, case-control type, carried out in family doctor's office number 1, at the Ramón López Peña Teaching Polyclinic health area, Santiago de Cuba province, from July to December 2023. The studied population were 182 older adults, 60-years or older (45 cases and 135 controls). The association was studied with the following variables: age, sex, level of education, online applications used and frequency of use. Results: 64.4% of the patients were between 70 and 79 years old. Female was the predominant sex, with 57.8%. Secondary education had a percentage of 53.3%. Very frequent use of online applications was shown in only 17.8% of the cases. Facebook was the most used application by 84.4%. Conclusions: A protective association was identified between online applications and amnestic mild cognitive impairment in older adults.

RESUMEN Fundamento: A medida que aumenta el número de adultos de 60 años y más, urge la necesidad de buscar alternativas para reducir la incidencia del deterioro cognitivo leve amnésico. Un medio prometedor que ha venido mostrando resultados es el uso del Internet y el empleo de las aplicaciones en línea. Objetivo: Identificar la asociación entre el uso de las aplicaciones en línea y el deterioro cognitivo leve amnésico en adultos mayores. Métodos: Estudio observacional analítico, de tipo casos y controles, realizado en el consultorio médico de familia número 1, del área de salud Policlínico Docente Ramón López Peña, provincia Santiago de Cuba, desde julio a diciembre del año 2023. La población de estudio estuvo constituida por 182 adultos mayores, con 60 años o más (45 casos y 135 controles). Se estudió la asociación con las siguientes variables: edad, sexo, nivel de escolaridad, aplicaciones en línea usadas y frecuencia de su uso. Resultados: El 64,4 % de los pacientes tenía edades entre 70 a 79 años. El sexo predominante fue el femenino, con un 57,8 %. La educación secundaria tuvo un porcentaje de 53,3 %. El uso muy frecuente de las aplicaciones en línea se mostró solamente en un 17,8 % de los casos. Facebook fue la aplicación más usada por el 84,4 %. Conclusiones: Se identificó una asociación protectora entre las aplicaciones en línea y el deterioro cognitivo leve amnésico en adultos mayores.

Abstract Objective: The SARS-CoV-2 virus pandemic affected people deprived of liberty in Colombia, a vulnerable group due to unfavorable prison conditions and deficient protection measures. The objective of the study was to analyze the effects of SARS-CoV-2 on cognitive function and subjective perception of executive functions in this group. Methods: A cross-sectional study was conducted in 47 men deprived of liberty between 18 and 55 years of age, in the department of Valle del Cauca, Colombia. The Montreal Cognitive Assessment Test (MoCA) and the BANFE-2 Battery were used. The participants provided informed consent and affirmed having tested positive in the polymerase chain reaction (PCR) test. Results: It was determined that, 97.9% of individuals deprived of liberty had a positive PCR test, and 76.6% exhibited normal cognitive function in the MoCA Test. The subjective perception of executive functioning was recorded with normal parameters, at 68.1% according to the BANFE-2. A negative correlation was found between the MoCA Test (orientation subtest) and reported categories of SARS-CoV-2 virus symptoms. In addition, the abstraction MoCA variable showed an inverse relationship of (−3.19). Conclusions: The study demonstrated a negative correlation between cognitive impairment and SARS-CoV-2 symptoms in people deprived of liberty. Most of the participants presented normal cognitive and executive functioning, indicating a proportional inverse relationship between the variables evaluated.

Resumen Objetivo: La pandemia del virus SARS-CoV2 afectó a las personas privadas de la libertad en Colombia, un grupo vulnerable debido a las condiciones desfavorables en las cárceles y las deficientes medidas de protección. Analizar el efecto del SARS-CoV-2 en la función cognitiva y percepción subjetiva de las funciones ejecutivas en este grupo. Métodos: Se realiza un estudio transversal en 47 hombres privados de libertad de 18 a 55 años, en el departamento del Valle del Cauca, Colombia. Se utilizando el Test Montreal Cognitive Assessment (MoCA) y la Batería Banfe-2, los participantes suministran su consentimiento informado y afirman haber dado positivo en la prueba de PCR. Resultados: Se determina que el 97.9% de las personas privadas de la libertad tienen la prueba PCR positiva y un funcionamiento cognitivo normal del 76.6% en el test de MoCA. La percepción subjetiva del funcionamiento ejecutivo fue normal en un 68.1% según la BANFE-2. Se encontró una correlación negativa entre el Test de MoCA (subprueba de orientación) y las categorías de síntomas notificados del virus SARS-CoV2. Además, la variable MoCA de abstracción mostró una relación inversa de (−3.19). Conclusiones: El estudio demuestra una correlación negativa entre el deterioro cognitivo y los síntomas del SARS-CoV2 en personas privadas de la libertad. La mayoría de los participantes presentan un funcionamiento cognitivo y ejecutivo normal, indicando una relación inversa proporcional entre las variables evaluadas.

ABSTRACT Introduction: Worldwide, because of the demographic transition, the proportion of older adults has increased, which has been reflected in an increase in the prevalence of major neurocognitive disorder (MND). This phenomenon is especially important in low- and middle-income countries such as Colombia, given the high economic and social costs it entails. The objective was to analyze the association between socioeconomic variables with the presence of cognitive impairment in Colombian older adults. Methods: The records of 23,694 adults over 60 years-of-age surveyed for SABE Colombia 2015, that took a stratified sample by conglomerates and were representative of the adult population over 60 years-of-age. This instrument assessed cognitive impairment using the abbreviated version of the Minimental (AMMSE) and collected information on multiple socioeconomic variables. Results: 19.7% of the older adults included in the survey were reviewed with cognitive impairment by presenting a score < 13 in the AMMSE. There was a higher prevalence of cognitive impairment in women (21.5%) than in men (17.5%). The socioeconomic variables were shown to impact the prevalence of deterioration, especially being currently working (OR = 2.74; 95%CI, 2.43-3.09) as a risk factor and having attended primary school as a protective factor (OR = 0.30; 95%CI, 0.28-0.32), differentially according to gender. Conclusions: An association between socioeconomic and sociodemographic factors with cognitive impairment in Colombian older adults was evidenced. Despite the above, a differential impact dependent on sex is suggested.

RESUMEN Introducción: Producto de la transición demográfica, en todo el mundo ha aumentado la proporción de adultos mayores, lo que se refleja en un aumento de la prevalencia del trastorno neurocognitivo mayor (TNM). Este fenómeno resulta especialmente importante en países de ingresos bajos y medios como Colombia, dados los importantes costos económicos y sociales que acarrea. El objetivo es analizar la asociación entre variables socioeconómicas y sociodemográficas y el deterioro cognitivo en adultos mayores colombianos. Métodos: Se evaluaron los registros de 23.694 adultos mayores de 60 arios encuestados para SABE Colombia 2015, que utilizó un muestreo estratificado por conglomerados y fue representativa de la población adulta mayor de 60 años. Este instrumento evaluó el deterioro cognitivo mediante la versión abreviada del Mini Mental (AMMSE) y recolectó información sobre múltiples variables socioeconómicas y sociodemográficas. Resultados: Se consideró con deterioro cognitivo al 19,7% de los adultos mayores incluidos en la encuesta con puntuaciones < 13 en el AMMSE. Hubo una mayor prevalencia de deterioro cognitivo en mujeres (21,5%) que en varones (17,5%). Las variables socioeconómicas mostraron un impacto en la prevalencia de deterioro, en especial estar trabajando actualmente (OR = 2,74; IC95%, 2,43-3,09) como factor de riesgo y haber cursado al menos primaria como factor protector (OR = 0,30; IC95%, 0,28-0,32). Esta asociación se comportó de manera diferencial según el sexo. Conclusiones: Se evidencio una asociación entre factores socioeconómicos y sociodemográficos con el deterioro cognitivo en adultos mayores colombianos. Pese a lo anterior, se sugiere un impacto diferencial dependiente del sexo. © 2022 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.

ABSTRACT Introduction: Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Tele-rehabilitation grew at this time as an alternative therapeutic tool. In this study we analyzed remote cognitive rehabilitation in neurodevelopmental disorders. Methods: This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months. Results: After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorization, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents. Conclusions: Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.

RESUMEN Introducción: Las medidas de distanciamiento social debidas a la pandemia por COVID-19 impidieron que muchos chicos con trastornos del neurodesarrollo pudieran acceder a tratamientos presenciales. La telerrehabilitación creció en este tiempo como una herramienta terapéutica alternativa. El objetivo es analizar la telerrehXbilitación cognitiva en trastornos del neurodesarrollo. Métodos: En este estudio prospectivo, cuasi-experimental (antes-después), se incluyó a 22 pacientes (media de edad, 9,41 arios) con trastornos del neurodesarrollo que realizaron telerrehabilitación con el programa Rehametrics por más de 6 meses. Resultados: Luego de 6 meses de telerrahabilitación, se constató una mejoría estadísticamente significativa con un gran tamaño del efecto en áreas de: atención (sostenida, selectiva y dividida), funciones ejecutivas (memoria de trabajo verbal y visual, categorización, velocidad de procesamiento), habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia) y lenguaje (comprensivo y expresivo). En la Escala de Impedimento Funcional de Weiss mejoraron con significancia estadística todas las áreas (familia, aprendizaje y escuela, autoconcepto, actividades de la vida diaria, actividades de riesgo). Se constata una correlación positiva entre la cantidad de sesiones y la mejoría observada en funciones ejecutivas (memoria de trabajo visual, velocidad de procesamiento), atencionales (atención sostenida, atención dividida) y habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia). No encontramos significancia estadística entre la estructura familiar y la cantidad de sesiones realizadas. Se observó un alto grado de percepción de mejora y satisfacción en los padres. Conclusiones: La telerrehabilitación puede ser una herramienta alternativa segura que, sin reemplazar la presencialidad, puede lograr mejoras cognitivas y funcionales significativas en niños con trastornos del neurodesarrollo.

Abstract Background: Age and HIV are synergistic risk factors for conditions such as HIV-associated neurocognitive disorders (HAND). Yet, it is unclear whether OAWH display different cognitive profiles for HAND. Objective: To describe the cognitive patterns of OAWH treated with combined antiretroviral therapy (cART). Methods: Cross-sectional study that included 330 participants with HIV, aged 50 years or older, cared for at a tertiary care hospital in Mexico City. A short neuropsychological test battery was used to assess a wide spectrum of cognitive functions. The optimal number of cognitive clusters was determined by the silhouette method and a minimization of the Bayesian information criterion. Results: Participants´ mean age was 58.8 years (SD = 6.6), and 12.1% were women. A 3-cluster solution yielded stable Jaccard coefficients (p > 0.70). Cluster 1 showed more significant impairment in visual and verbal memory domains, whereas participants in cluster 3 showed significant impairment in language, and abstraction. Cluster 2 showed no predominance of any domain for alterations. Conclusions: There are different cognitive profiles among OAWH with HAND. These differences may be due to individual patterns of HIV-related and non-HIV-related factors.

Resumen Antecedentes: La edad y el VIH constituyen factores de riesgo sinérgicos de afecciones como los trastornos neurocognitivos asociados al VIH (TNAV). No se ha esclarecido si las personas mayores con VIH presentan perfiles cognitivos diferentes en caso de padecer TNAV. Objetivo: Describir los patrones cognitivos de personas mayores con VIH tratadas con terapia antirretroviral combinada (TARc). Métodos: Estudio transversal que incluyó a 330 participantes con VIH, de 50 años o más, atendidos en un centro hospitalario de tercer nivel en la Ciudad de México. Se utilizó una batería neuropsicológica corta estandarizada a fin de evaluar un amplio espectro de funciones cognitivas. Se determinó el número óptimo de grupos de dominios cognitivos a partir del método de la silueta y minimización del criterio de información bayesiano. Resultados: La edad promedio de los participantes fue de 58.8 años; las mujeres constituyeron 12.1 %. Una solución de tres grupos produjo coeficientes de Jaccard estables (p > 0.70). El grupo 1 mostró deterioro más significativo en la memoria visual y verbal, en tanto que el grupo 3 mostró deterioro significativo en el lenguaje y la abstracción. En el grupo 2 no se registró predominio de ningún dominio en cuanto a alteraciones. Conclusiones: Existen perfiles cognitivos diferentes entre las personas mayores con VIH y TNAV. Estas diferencias pueden deberse a patrones individuales de factores relacionados o no con el VIH.

Abstract Background: Dysphagia and cognitive impairment are common in older people. It is linked to alterations in brain areas related to swallowing. Objective: To explore the characteristics of dysphagia using fluoroscopy in patients with mild cognitive impairment (MCI) and dementia. Material and methods: 158 participants from a memory clinic. Specific criteria for MCI and dementia were used. Dysphagia was assessed with EAT-10 (≥3). Those who accepted completed a fluoroscopy study with a barium swallow to evaluate the phases of swallowing; the presence of bronchoaspiration supported the diagnosis of dysphagia. A logistic regression analysis was performed to test the probability between dysphagia and MCI. Results: According to EAT-10, 86 (54.4 %) were at risk of dysphagia, confirmed in 84 by fluoroscopy, 53.8 % MCI group and 46.2 % dementia. An inverse association was observed in the MCI oral phase group (OR 0.23, p < 0.025), and a positive association; in protection phase against regurgitation (OR 3.76, p < 0.056) and laryngeal muscle contraction (OR 3.22, p < 0.045) versus dementia group. Conclusions: The study showed a high frequency of dysphagia in patients with MCI, this highlights the importance of its early detection to improve complications associated with dysphagia.

Resumen Antecedentes: El deterioro cognitivo y la disfagia son comunes en personas mayores. Objetivo: Explorar las características de la disfagia mediante fluoroscopia en pacientes con deterioro cognitivo leve (DCL) y demencia. Material y métodos: Se analizaron 158 adultos de una clínica de memoria. Para evaluar el DCL y la demencia, se emplearon criterios específicos; y para la disfagia, la escala EAT-10. Se realizó fluoroscopia con trago de bario para evaluar las fases de la deglución; la presencia de broncoaspiración apoyó el diagnóstico de disfagia. Se realizó análisis de regresión logística para establecer la relación entre disfagia y DCL. Resultados: Según EAT-10, 86 pacientes (54.4 %) tenían riesgo de disfagia, la cual fue confirmada en 84 mediante fluoroscopia (53.8 % tenía DCL y 46.2 %, demencia). En el grupo con DCL se observó asociación inversa con alteraciones en la fase oral (RM = 0.23, p < 0.025) y asociación positiva con alteraciones en la protección contra la regurgitación (RM = 3.76, p < 0.056) y contracción del músculo laríngeo (RM = 3.22, p < 0.045) versus grupo con demencia. Conclusiones: El estudio mostró alta frecuencia de disfagia en pacientes con DCL, lo que resalta la importancia de su detección temprana para mejorar las complicaciones asociadas.

Abstract Background: Specific dietary compounds are essential for cognitive health. Objective: To examine differences in the consumption of macronutrients and inorganic nutrients between people with a higher and lower risk of cognitive impairment. Material and methods: Cross-sectional analysis of the 3Ollin study. Minimal Mental State Examination determined cognitive status. Two groups were obtained from the median of the score: higher and lower risk of cognitive deterioration. Diet was assessed using two 24-hour recalls. Descriptive statistics and comparison analysis of medians using Mann-Whitney U and Spearman correlation analysis were performed between nutrients and MMSE scores. The results were considered statistically significant when p ≤ 0.05. Results: Data from 425 people were analyzed; the median age was 71 years (P25-P75 = 65-77). In the group with a lower risk of cognitive impairment, a higher consumption of calories, protein, carbohydrates, fiber, folate, phosphorus, ascorbic acid, vitamin E, alpha-tocopherol, vitamin B6, vitamin B12, zinc, selenium, and lycopene were observed. Also, a greater consumption of fruits and vegetables (p < 0.005). Conclusions: There are significant differences in diet between groups at risk for cognitive impairment.

Resumen Antecedentes: Compuestos específicos de la dieta son fundamentales para la salud cognitiva. Objetivo: Examinar las diferencias en el consumo de macronutrimentos y nutrimentos inorgánicos en personas con mayor y menor riesgo de deterioro cognitivo. Material y métodos: Análisis transversal del estudio 3Ollin. El estado cognitivo se determinó con el Examen Mínimo del Estado Mental (MMSE, Mini-Mental State Examination). A partir de la mediana de la puntuación del MMSE se obtuvieron dos grupos: mayor y menor riesgo de deterioro cognitivo. La dieta se evaluó mediante dos recordatorios de 24 horas. Se realizó estadística descriptiva, análisis de comparación de medianas con U de Mann-Whitney y análisis de correlación de Spearman entre los nutrimentos y las puntuaciones del MMSE. Los resultados se consideraron estadísticamente significativos con valor de p ≤ 0.05. Resultados: Se analizaron los datos de 425 personas, la mediana de edad fue 71 años (P25-P75 = 65-77). En el grupo con menor riesgo de deterioro cognitivo se observó un mayor consumo de calorías, proteína, hidratos de carbono, fibra, folato, fósforo, ácido ascórbico, vitamina E, alfa-tocoferol, vitamina B6, vitamina B12, cinc, selenio y licopeno, y un mayor consumo de frutas y verduras en conjunto (p < 0.005). Conclusiones: Existen diferencias significativas en la dieta entre los grupos de riesgo de deterioro cognitivo.

Abstract Physical activity shows benefits in cognitive function and the prevention and treatment of depression in older adults with Alzheimer’s disease and healthy ones. So, the purpose of this study was to compare cognitive function and depressive symptoms in two groups: a group of older adults with Alzheimer’s disease and a group of older adults without neurodegenerative diseases, by sex and level of physical activity. The sample was 30 participants divided into two groups: 15 participants with Alzheimer’s disease and 15 participants without neurodegenerative diseases. The instruments used were the Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE). The results revealed that older persons with Alzheimer’s disease exhibit a more significant impairment of cognitive skills (p = .001) and a higher incidence of depressive symptoms (p = .001) compared to older persons without neurodegenerative diseases, with no differences between sex (p > .05). Results show that active older person had higher scores in cognitive abilities (p = .001) and a lower incidence of depression (p = .001). It seems that Alzheimer’s disease, typically associated with cognitive abilities decline and incidence of depressive symptoms, and physical activity influence cognitive performance and depressive symptoms in older people with Alzheimer’s disease and without dementia.

Resumo A atividade física demonstra benefícios na função cognitiva e na prevenção e tratamento da depressão em idosos com doença de Alzheimer e em idosos saudáveis. Assim, o objetivo deste estudo foi comparar a função cognitiva e os sintomas depressivos em dois grupos: um grupo de idosos com doença de Alzheimer e um grupo de idosos sem doenças neurodegenerativas, por sexo e nível de atividade física. A amostra foi de 30 participantes divididos em dois grupos: 15 participantes com doença de Alzheimer e 15 participantes sem doenças neurodegenerativas. Os instrumentos utilizados foram a Escala de Depressão Geriátrica (GDS) e o Mini Exame do Estado Mental (MMSE). Os resultados revelaram que os idosos com doença de Alzheimer apresentam um comprometimento mais significativo das capacidades cognitivas (p = .001) e uma maior incidência de sintomas depressivos (p = .001) em comparação com idosos sem doenças neurodegenerativas, sem diferenças entre sexos (p > .05). Os resultados mostram que os idosos ativos tiveram pontuações mais elevadas nas capacidades cognitivas (p = .001) e uma menor incidência de depressão (p = .001). Parece que a doença de Alzheimer, tipicamente associada ao declínio das capacidades cognitivas e à incidência de sintomas depressivos, e a atividade física influenciam o desempenho cognitivo e os sintomas depressivos em idosos com doença de Alzheimer e sem demência.

Abstract Introduction: Several studies unveiled an association between asymptomatic carotid artery stenosis and cognitive impairment, questioning the “asymptomatic” nature of carotid stenosis. Although there is increasing evidence of the impact of carotid artery stenting (CAS) on cognition, the current literature still contains some unclear data and conflicting results. This study aimed to examine the impact of CAS on various domains of cognitive function in patients with asymptomatic carotid artery stenosis. Methods: Studies published up to February 2023 that evaluated cognitive function in patients with asymptomatic carotid artery stenosis who underwent CAS were searched in PubMed and Scopus databases. All original studies assessing pre- and post-operative cognitive functions in patients with asymptomatic carotid stenosis undergoing CAS were considered eligible for inclusion. Editorials, letters, case reports, review articles, and animal studies were excluded. Results: A total of 1155 articles were identified in our search. After screening, 12 studies were eligible for our review, including 273 CAS in asymptomatic patients. Eleven articles were prospective cohort studies, and one was a randomized controlled trial. The mean age of included patients was 70.1%3.4 years, and approximately 63% of patients were male (n=170 male patients), although two studies did not mention gender. Only seven articles reported the type of anesthesia, and locoregional techniques were used in all cases. Regarding cerebral protection, in eight studies, a distal filter was used; one study used flow reversal; in another, no protection device was used; three studies did not mention if any technique for cerebral protection was used during the procedure. Conclusion: The included studies on cognitive performance after CAS exhibit wide variations in the timing of assessment, specific tests performed, and the use of cerebral protection devices. Additionally, the study populations are small, and several possible confounding factors exist. Thus, a limitation in the analysis is evident, and several attempts to assess the effect of CAS on cognitive function have yielded conflicting conclusions. The debate over the optimal management of asymptomatic carotid patients is ongoing.