Computer-based cognitive interventions have moderate effects in cognition and [corrected] anxiety and small effects in depression in PWD. No significant effects were found on activities of daily living. They led to superior results compared to non-computer-based interventions in cognition. Further research is needed on cognitive recreation and cognitive stimulation. There is also a need for longer term [corrected] follow-up to examine the potential retention of treatment effects, and for the design of specific outcome measures.

BackgroundFew data are available on the prevalence of cognitive impairment (CI) in Spain, and the existing information shows important variations depending on the geographical setting and the methodology employed. The aim of this study was to determine the prevalence of CI in individuals aged over 65 in an urban area, and to analyze its associated risk factors.MethodsDesign: A descriptive, cross-sectional, home questionnaire-based study; Setting: Populational, urban setting. Participants: The reference population comprised over-65s living in the city of Salamanca (Spain) in 2009. Randomized sampling stratified according to health district was carried out, and a total of 480 people were selected. In all, 327 patients were interviewed (68.10%), with a mean age of 76.35 years (SD: 7.33). Women accounted for 64.5% of the total. Measurements: A home health questionnaire was used to obtain the following data: age, sex, educational level, family structure, morbidity and functionality. All participants completed a neuropsychological test battery. The prevalence data were compared with those of the European population, with direct adjustment for age and sex. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment - no dementia (CIND), and dementia.ResultsThe prevalence of CI among these over-65s was 19% (14.7% CIND and 4.3% dementia). The age-and sex-adjusted global prevalence of CI was 14.9%. CI increased with age (p < 0.001) and decreased with increasing educational level (p < 0.001). Significant risk factors were found with the multivariate analyses: age (OR = 1.08, 95%CI: 1.03-1.12), anxiety-depression (OR = 3.47, 95%CI: 1.61-7.51) and diabetes (OR = 2.07, 95%CI: 1.02-4.18). In turn, years of education was found to be a protective factor (OR = 0.79, 95%CI: 0.70-0.90). Although CI was more frequent among women and in people living without a partner, these characteristics were not significantly associated with CI risk.ConclusionsThe observed raw prevalence of CI was 19% (14.9% after adjusting for age and sex). Older age and the presence of diabetes and anxiety-depression increased the risk of CI, while higher educational level reduced the risk.

Parametric statistical methods are typically used for analyzing test scores, even though they are ordinal at best. The Meyers and Meyers' Rey-Osterrieth Complex Figure four-category scoring system has been evaluated with the Rasch Rating Scale Model, and disordered thresholds have been found. However, Rasch-modeling dichotomized data led to good fit for both normal (n = 219) and Traumatic Brain Injury (n = 54) samples and generalized validity for these groups, as well as for male and female groups. The logarithmic transformation of the item and person data performed by the model converts the ordinal data to yield interval scaled data. This is desirable not only from a scientific perspective, but also from the point of view of interpretability and communicability.

Capacity to recognize facial expressions of emotions can be improved through specific rehabilitation in people with AD, and gains are still present at a one month follow up. These findings have implications for the design of rehabilitation techniques for people with AD that may lead to improved quality of life and social interactions for this population.

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Objectives: The reduction in cognitive decline depends on timely diagnosis. The aim of this systematic review was to analyze the current available Information and Communication Technologies´ (ICT) based instruments for cognitive decline early screening and detection in terms of usability, validity and reliability.Methods: Electronic searches identified 1785 articles of which 34 met the inclusion criteria and were grouped according to their main purpose into test batteries, measures of isolated tasks, behavioral measures and diagnostic tools.Results: Thirty one instruments were analyzed. Fifty two percent were PC based, 26% Tablet, 13% laptop and one was mobile phone based. The most common input method was touchscreen (48%). The instruments were validated with a total of 4307 participants: 2146 were healthy older adults (M = 73.59, SD = 5.12); 1104 had dementia (M = 74.65, SD = 3.98) and 1057 mild cognitive impairment (M = 74.84, SD = 4.46). Only 6% were administered at home, 19% reported outcomes about usability and 22% about understandability. One study reported users' experience. Twenty-three percent of the instruments included information about convergent validity and 34% about discriminant validity; most of them obtained acceptable values of specificity and sensitivity. The methodological quality of the studies was good, the weakest methodological area being usability. Most of the instruments obtained acceptable values of specificity and sensitivity.3 Conclusions: It is necessary to create home delivered instruments and to include usability and users´ experience studies in their design. Involvement of people with cognitive decline in all phases of the development process is of great importance to obtain valuable and user-friendly products. It would be advisable for researchers to make an effort to provide cut-off points for their instruments.

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EhcoBUTLER is an Information and Communication Technology (ICT) solution funded by the European Union (H2020; ID: 643566) and intended especially for elderly people with mild cognitive impairment (MCI) to improve their health, independence and quality of life, particularly at the social level. The purpose of this study is to assess the acceptability of ehcoBUTLER based on a survey delivered to potential users and actors involved in their care, exploring their expectations and preferences, while anticipating the system's functional requirements. The survey was delivered online to 313 participants (11% end users, 25% informal caregivers, 48% formal caregivers and 16% administration/management staff) from eight countries. Participants rated the different functionalities of ehcoBUTLER positively, 86.1% perceiving it as an interesting and useful system. Likewise, they assessed it as a commercially attractive product (75.1%). End users expressed a stronger preference for the social module. Nevertheless, they would be ready to pay a low monthly price for ehcoBUTLER. Professionals would be willing to pay choosing its functionalities modularly, but they would also expect it to be funded by the National Health System, centres or businesses. The conclusion is that all participants found ehcoBUTLER interesting, useful and ergonomic. However, to effectively implement it, it is necessary to bridge the digital gap and address the issue of insufficient investment in products aimed at older adults with cognitive impairment. To supplement cognitive training systems with social, emotional or entertainment functionalities could improve adherence to their use.