Population ageing within Europe has major social and economic consequences. One of the most devastating conditions that predominantly affects older people is dementia. The SMART4MD (Support Monitoring and Reminder Technology for Mild Dementia) project aims to develop and test a health application specifically designed for people with mild dementia. The aim of this feasibility study was to evaluate the design of the SMART4MD protocol, including recruitment, screening, baseline examination and data management, and to test the SMART4MD application for functionality and usability before utilization in a full-scale study. The feasibility study tested the protocol and the app in Spain and Sweden. A total of nineteen persons with cognitive impairment, and their informal caregivers, individually performed a task-based usability test of the SMART4MD app model in a clinical environment, followed by four-week testing of the app in the home environment. By employing a user-centered design approach, the SMART4MD application proved to be an adequate and feasible interface for an eHealth intervention. In the final usability test, a score of 81% satisfied users was obtained. The possibility to test the application in all the procedures included in the study generated important information on how to present the technology to the users and how to improve these procedures.
Background: Individuals with amnestic Mild Cognitive Impairment (aMCI) are at heightened risk of developing Alzheimer's dementia. In recent years, much attention has been given to the search for new interventions to slow down the progression of cognitive decline of these patients. Wearable digital camera devices are one form of new technology that captures images of one’s life events, so they constitute a promising method to be used as a means to stimulate recent autobiographical memory. Objective: This preliminary study investigates the ability of a new cognitive intervention based on exposure to recent autobiographical memory captured by wearable cameras to improve episodic memory in patients with aMCI. Method: Seventeen subjects wore a wearable camera while they went about their daily activities. The images captured were converted into eight different 3-minute films containing the most relevant information of each event. The intervention involved eight individualized weekly sessions during which patients were exposed to a different autobiographical event each week. Besides, several specific questions were formulated within each session. Clinical questionnaires assessing cognitive reserve, premorbid intelligence, depression, and anxiety were administered at baseline. Measures of objective episodic memory were applied at baseline and at post-treatment. Results: Significant improvements were observed at post-treatment in memory measures, and significant associations were found between memory change scores and age and cognitive reserve. Anyway, these associations did not reach statistical significance after adjusting for multiple comparisons. Conclusion: The present study provides preliminary evidence that aMCI patients may benefit from a cognitive intervention program based on re-experiencing recent autobiographical events. However, future studies incorporating a control group will be needed to confirm these preliminary findings.
Background/Objective. Excessive body weight has been related to lower cognitive performance. One of the mechanisms through which excess body weight may affect cognition is inflammation. Our study aims at distinguishing between the effects of body mass index (BMI) and those related to systemic inflammation on different aspects of cognition in adolescents with obesity and overweight. Subjects/Methods. One hundred and five adolescents with overweight or obesity between 12 and 21 years participated in the study. Levels of high sensitivity C-reactive protein, interleukin 6, tumour necrosis factors α (TNFα) and fibrinogen were determined from blood samples. Cognitive performance was evaluated, and six cognitive composites were obtained: working memory, cognitive flexibility, inhibitory control, decision-making, verbal memory, and fine motor speed. A single multivariate generalised lineal model was used to assess the influence of the four inflammatory biomarkers, as well as participants’ BMI, sex and age on the 6 cognitive indexes. Results. An inverse relationship between BMI and inhibitory control (F = 5.688, p = .019; β = − .212, p = .031), verbal memory (F = 5.404, p = .022; β = − .255, p = .009) and fine motor speed (F = 9.038, p = .003; β = − .319, p = .001) was observed. Levels of TNFα and fibrinogen were inversely related to inhibitory control (F = 5.055, p = .027; β = − .226, p = .021) and verbal memory (F = 4.732, p = .032; β = − .274, p = .005), respectively. Conclusions. Our data indicate that some components of executive functions, together with verbal memory, are sensitive to specific obesity-related inflammatory agents at early ages.
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