BackgroundNew technologies could facilitate changes in lifestyle and improve public health. However, no large randomized, controlled studies providing scientific evidence of the benefits of their use have been made. The aims of this study are to develop and validate a smartphone application, and to evaluate the effect of adding this tool to a standardized intervention designed to improve adherence to the Mediterranean diet and to physical activity. An evaluation is also made of the effect of modifying habits upon vascular structure and function, and therefore on arterial aging.Methods/DesignA randomized, double-blind, multicenter, parallel group clinical trial will be carried out. A total of 1215 subjects under 70 years of age from the EVIDENT trial will be included. Counseling common to both groups (control and intervention) will be provided on adaptation to the Mediterranean diet and on physical activity. The intervention group moreover will receive training on the use of a smartphone application designed to promote a healthy diet and increased physical activity, and will use the application for three months. The main study endpoints will be the changes in physical activity, assessed by accelerometer and the 7-day Physical Activity Recall (PAR) interview, and adaptation to the Mediterranean diet, as evaluated by an adherence questionnaire and a food frequency questionnaire (FFQ). Evaluation also will be made of vascular structure and function based on central arterial pressure, the radial augmentation index, pulse velocity, the cardio-ankle vascular index, and carotid intima-media thickness.DiscussionConfirmation that the new technologies are useful for promoting healthier lifestyles and that their effects are beneficial in terms of arterial aging will have important clinical implications, and may contribute to generalize their application in favor of improved population health.Trial registrationClinical Trials.gov Identifier: NCT02016014

BackgroundThere are caregivers who see their quality of life (QoL) impaired due to the demands of their caregiving tasks, while others manage to adapt and overcome the crises successfully. The influence of the family function in the main caregiver's situation has not been the subject of much evaluation. The aim of this study is to analyse the relationship between the functionality of the family and the QoL of caregivers of dependent relatives.MethodsWe conducted a cross-sectional study including 153 caregivers. Setting: Two health centers in the city of Salamanca(Spain). Caregiver variables analysed: demographic characteristics, care recipient features; family functionality (Family APGAR-Q) and QoL (Ruiz-Baca-Q) perceived by the caregiver. Five multiple regressions are performed considering global QoL and each of the four QoL dimensions as dependent variables. The Canonical Correspondence Analysis (CCA) was used to study the influence of the family function questionnaire on QoL.ResultsFamily function is the only one of the variables evaluated that presented an association both with global QoL and with each of the four individual dimensions (p < 0.05). Using the CCA, we found that the physical and mental well-being dimensions are the ones which present a closer relationship with family functionality, while social support is the quality dimension that is least influenced by the Family APGAR-Q.ConclusionWe find an association between family functionality and the caregiver's QoL. This relation holds for both the global measure of QoL and each of its four individual dimensions.

Background: Loneliness has been associated with physical and mental health problems. It has also been considered a serious social problem that increases the use and costs of health services. The most widely used instrument in Europe for measuring loneliness is the de Jong Gierveld Loneliness Scale (DJGLS). The aim of this study was to examine the psychometric properties of the 11-item DJGLS by means of the Rasch model, and its convergent and discriminant validity. Methods: Participants were a representative sample of Spanish community-dwelling adults aged 60 and older. We evaluated sociodemographic variables, health, social support, social activity, and subjective well-being measures. Results: Person and item fit statistics, and standardized residual principal component analysis revealed that the DJGLS was essentially unidimensional. However, we found DIF across marital status and living arrangements. Moderate to high associations were found between loneliness and depression, self-rated loneliness, positive and negative emotions, and satisfaction with life. The DJGLS differentiated between well known-groups according to gender, marital status, living arrangements, health, structural and functional aspects of social networks, and social activity. Conclusions: The DJGLS is a valid and reliable instrument for measuring loneliness in Spanish older adults. The addition of a few items in order to improve the measurement range is strongly recommended. Our findings are consistent with previous research indicating that loneliness is an important aspect of mental health and subjective well-being, and support the use of the scale to detect vulnerable population in old age.

Developmental theories suggest age-related changes in the structure of affect. Paradoxically, the internal structure of the Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988) has not been tested in Spanish older adults by means of confirmatory factor analysis (CFA) despite it is the most widely used measure of emotional well-being in later life. The aim of this study was to examine competing models of the internal structure of the Spanish version of the PANAS, its measurement invariance, reliability, and external validity. Participants were a representative sample of 585 community-dwelling people aged 60 and over, who also completed depression, loneliness and life satisfaction measures. Results showed that the orthogonal two-factor model with correlated errors (RMSEA = .057, 90% CI [.051, .063], SRMR = .084, CFI = .97, NNFI = .97) was the best fitting solution. Measurement invariance analyses confirmed that the two-independent factor structure can be used across young-old and very old people, as well as in both males and females. It showed good reliability (PA: α = .93, NA: α = .83), criterion, convergent and discriminant validity (p < .01). Our discussion highlights the role of age and culture in the experience and expression of emotions.