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Objectives: This study aimed to carry out a pilot validation of Affect-GRADIOR, a computer-based emotion recognition test, with older adults. The study evaluated its usability, reliability and validity for the screening of people with Alzheimer´s disease (AD) and amnestic mild cognitive impairment (aMCI). Methods: The test was administered to 212 participants (76.37 ± 6.20 years) classified into three groups (healthy controls, n = 69; AD, n = 84; and aMCI, n = 59) on the basis of detailed neurological, neuropsychological, laboratory and neuro-imaging evidence. Data on usability were collected by means of a questionnaire and automated evaluation. Results: The validated test comprised 53 stimuli and 7 practice items (one per emotion). Participants reported that Affect-GRADIOR was accessible and user-friendly. It had high internal consistency (ordinal Cronbach's α = 0.96). Test-retest reliability correlations were significant and robust (r = 0.840, p < 0.001). Exploratory factor analysis supported a seven-factor model of the emotions assessed (neutral expression, happiness, surprise, disgust, sadness, anger and fear). Receiver operating characteristic curve analyses suggested that the test discriminated healthy older adults from AD and aMCI cases. Correct answer score improved MMSE predictive power from 0.547 to 0.560 (Cox & Snell R2, p = 0.012), and Affect-GRADIOR speed of processing score improved MMSE predictive power from 0.547 to 0.563 (Cox & Snell R2, p = 0.010). Conclusions: Affect-GRADIOR is a valid instrument for the assessment of the facial recognition of emotions in older adults with and without cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a "GRADIOR" computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia. Method: This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group (n = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60–90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2–3 weekly sessions for 4 months with a duration of 30 min Data analysis: Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann–Whitney was used. Results: The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit p-value of the model was 0.02. Conclusions: good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent. [ABSTRACT FROM AUTHOR]

Background: Computer-based cognitive training programs have been developed with promising results on the maintenance/improvement of cognitive performance in people with dementia.Objective: The objective was to evaluate the effectiveness of the cognitive rehabilitation program "GRADIOR" in people with mild cognitive impairment and mild dementia.Method: This study was a single-blind multicenter randomized clinical trial. Participants were recruited from hospitals/day centers. The experimental group (EG) and control group (CG) received computer-based cognitive training (CCT) and routine daily care, respectively. Outcome measures at T0: baseline, T1: at 4 months, T2: at 12 months were compared within and between-groups.Results: Significant differences or important effect sizes were detected at the intragroup and intergroup level for most variables, observing a trend of improvement and/or maintenance at 4 months by Visual Reasoning of Cambridge Cognitive Examination (CAMCOG), Digit and Arithmetic of WAIS-III, Semantic Verbal Fluency, Mini-Mental State Exam (MMSE), Trail Making Test (TMT)-A-Mistakes and at 12 months by Visual Reasoning of CAMCOG, Digit Symbol of WAIS-III, TMT-B-mistakes, Visual Memory of Rivermead Behavioural Memory Test, Lexical Verbal Fluency-P, Yesavage's Geriatric Depression Scale (GDS), TMT-A-time scales whose objective was to evaluate some executive functions and/or the memory. The CG presented a worsening trend for most of the measures towards 12 months. There was also a significant interaction between "time and group" for MMSE (F = 8.971; p = 0.03; η2 = 0.019) and the GDS (F = 3.414; p = 0.04; η2 = 0.041), as well as small effect sizes for TMT-A-time (F = 1.641; p = 0.21; η2 = 0.021) and TMT-A-mistakes (F = 0.908; p = 0.41; η2 = 0.019).Conclusion: CCT with GRADIOR has been proved to benefit cognitive functions (ISRCTN:15742788). [ABSTRACT FROM AUTHOR]

Background: Cognitive rehabilitation is a highly individualised, non-pharmacological intervention for people with mild cognitive impairment (MCI) and dementia, which in recent years has also been developed for various IT platforms.Methods: In this study, we aim to evaluate the effectiveness of the cognitive rehabilitation software GRADIOR in a multi-centre, single-blinded randomised controlled trial with people with MCI and mild dementia. A total of 400 people with MCI and mild dementia will be randomly allocated to one of four groups. This trial will compare the cognitive rehabilitation treatment using the GRADIOR programme with a psychosocial stimulation intervention (PSS) using the ehcoBUTLER platform, with a combined treatment consisting of GRADIOR and ehcoBUTLER, and with a group receiving treatment as usual during a period of 1 year.Discussion: The outcomes of this clinical trial will be to determine any relevant changes in cognition, mood, quality of life, activities of daily living and quality of patient-carer relationship after 4 months and 1 year of intervention in a cross-sectional group comparison. Participants will be followed-up for 1 year to investigate potential long-term effects of the conducted treatments.Trial Registration: Current Controlled Trials ISRCTN, ID: 15742788 . Registered on 12 June 2017. [ABSTRACT FROM AUTHOR]