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Se sabe que el Análisis de Fluctuaciones sin Tendencia o DFA (Detrended Fluctuations Analysis, por sus siglas en inglés) de las series de tiempo biológicas como el Electrocardiograma (ECG), el Electroencefalograma (EEG) y otras resulta ser una herramienta útil para discriminar entre la salud o la enfermedad. Con el fin de corroborar si existen diferencias entre los DFA de Adultos Mayores (AM) con Deterioro Cognitivo (DC) y sin Deterioro Cognitivo (sDC), se realizaron DFA en dos sujetos, cada uno de ellos diagnosticado con DC o sDC. Se obtuvieron los registros de EEG y Electromiografía (EMG) durante la condición de vigilia con ojos cerrados. Se desarrolló una interfaz amigable en Python con la que se selecciona la serie de tiempo para el cálculo de los DFA. Se observó que en reposo con ojos cerrados, el sujeto con DC presenta mayores valores en regiones frontales que aquel sujeto sDC. Se concluye que el DFA aporta información cuantificable sobre la localización y mecanismos subyacentes al DC que pueden servir para ayudar a monitorear el curso del DC del AM.

Information and Communication Technologies provide great possibilities in the area of health and also represent a motor for change to improve the quality of life of people, particularly the older adult population. The purpose of this article is to present the iBeni web application designed under the Mobile First concept. iBeni web is an application that evaluates and stimulates the cognitive functions of the older adult population and also provides a web and mobile version to the user. To validate the degree of effectiveness of iBeni web, tests were run with 24 users, where 3 rounds were established in the different stages of development of the application. Test analysis indicates that the application and its scaled design mode are rated highly by users. In conclusion, it was possible to demonstrate that cognitive stimulation through a web application with a Mobile First concept is appropriate and enhances the user experience by providing its adaptability in various technological environments.

As information and services are becoming more and more decentralized and they are often available in the cloud, an increasing number of older adults are expected to use Internet-based services –health, education, finance and others. For this reason, it seems important to plan models and/or strategies to allow the older adult population to acquire and enhance digital competencies more easily. The goal of this research is to show a blended workshop based on a Learning Management System (LMS) as a supporting tool for older adults’ digital literacy. This blended workshop was based on the adoption of an instructional model and on prior experiences of the groups of elderly that participated in the face-to-face workshops. This study involved 98 adults aged 60 and above, 72 Females (68.5 ± 6.9) and 26 Males (73.3 ± 7.4). 61 older adults participated in the face-to-face workshop (FFG) on digital literacy and 37 participated in the blended workshop (BLG). Digital literacy increased at the post-evaluation after the workshops but even more for the BLG. Likewise, in the validation of the blended workshop the results were positive regarding ease of use, perceived usefulness, attitude toward using and intention to use, which showed that older adults believe that it is useful to implement this type of supporting systems for developing their digital competencies. Hence, it is possible to conclude that older adults are capable of learning and acquiring digital literacy skills as long as they are strongly motivated or they know the functional benefits related to ICT.

Online learning play a pivotal role for institutions and universities, because these can support active learning approaches to students. For this reason, it seems important to plan models and / or strategies to allow the older adult population to acquire and enhance digital competencies more easily. This article describes an innovative practice of Blended Learning Supported on a Learning Management System (LMS) whose aim is to enable older people developing digital skills through the using of multimedia teaching materials. The sample of older people was made of 53 Old Females (68 ± 7.61) and 28 Old Males (72.5 ± 7.27). 61 older adults participed in the face-to-face workshop on digital literacy and 20 participed in the blended workshop. Later, a Usability Test was summited to the adults who used the LMS. The results showed that the blended workshop is a very good idea as long as it is used as a support system, because if it were adopted in a totally asynchronous manner, they would have difficulties using it due to lack of assistance.

The increasing human longevity around the world calls for new attention models in which the primary caregiver plays a crucial role as a source of care supply. However, primary caregivers’ lack of training, along with high levels of stress, depression and anxiety, can have a negative impact on both the caregiver’s health and the development of caregiving duties. Hence, the objective of the present article is to introduce the eCuidador platform, an innovative tool that seeks to provide assistance and support to primary caregivers by means of a variety of services available in the cloud with the aim of improving caregivers’ health and quality of life. Likewise, we present the results obtained from the pilot test validation, in which the evaluation of the following parameters was carried out: Usability (12), Functionality (10), Design (11), Usefulness (12) and Satisfaction (12). The participants of this pilot test were 12 primary caregivers (91.66% women).

Background: Cognitive impairment is considered one of the most feared chronic conditions among the older adult population since its incidence is approximately twice more frequent than that of dementia. In Mexico, no studies or reports of older adults using technology for cognitive interventions have been published, given that institutions usually frame cognitive stimulation tasks in paper and pencil (ie, in the traditional manner). Objective: The objective of this study was to create and analyze the effect, viability, and impact of a mobile app for cognitive stimulation implemented among a group of elderly adults (over 60 years of age) from the state of Hidalgo in Mexico. Methods: This study was a nonprobabilistic pilot trial using convenience sampling. An intervention was implemented among a group of 22 older adults between 60 and 80 years of age over 12 weeks. Half of the older adults were stimulated with the mobile app (experimental group) and the other half followed the traditional paper and pencil training (control group). Assessments with the Mini-Mental State Examination (MMSE) and the Neuropsi, a neuropsychological test validated in Mexico, were done before and after both cognitive stimulations. Results: According to the analyzed data, 6/11 (55%) participants from the experimental group obtained better results in their cognitive skills, and 5 (45%) of the adults maintained their score, given that the participants were able to execute the exercises repetitively. Meanwhile, for the control group, only 3/11 (27%) participants obtained better results in the postevaluation. Significant values for results of the MMSE were obtained in the postevaluation for the experimental group compared to the control group, while results did not show significant differences in the Neuropsi. Regarding the validation of the app, all the participants evaluated its pertinence positively. Conclusions: The intervention data show that the experimental group obtained better results in the postevaluation given that the participants were able to execute the exercises repetitively. The control group could not accomplish this since they had to respond on the manual and no further attempts were provided. However, both groups increased their score in the neuropsychological evaluations. This suggests that a longer and more frequent intervention is required. Registered Report Identifier: RR1-10.2196/9603

BACKGROUND Cognitive impairment is considered one of the most feared chronic conditions among the older adult population since its incidence is approximately twice more frequent than that of dementia. In Mexico, no studies or reports of older adults using technology for cognitive interventions have been published, given that institutions usually frame cognitive stimulation tasks in paper and pencil (ie, in the traditional manner). OBJECTIVE The objective of this study was to create and analyze the effect, viability, and impact of a mobile app for cognitive stimulation implemented among a group of elderly adults (over 60 years of age) from the state of Hidalgo in Mexico. METHODS This study was a nonprobabilistic pilot trial using convenience sampling. An intervention was implemented among a group of 22 older adults between 60 and 80 years of age over 12 weeks. Half of the older adults were stimulated with the mobile app (experimental group) and the other half followed the traditional paper and pencil training (control group). Assessments with the Mini-Mental State Examination (MMSE) and the Neuropsi, a neuropsychological test validated in Mexico, were done before and after both cognitive stimulations. RESULTS According to the analyzed data, 6/11 (55%) participants from the experimental group obtained better results in their cognitive skills, and 5 (45%) of the adults maintained their score, given that the participants were able to execute the exercises repetitively. Meanwhile, for the control group, only 3/11 (27%) participants obtained better results in the postevaluation. Significant values for results of the MMSE were obtained in the postevaluation for the experimental group compared to the control group, while results did not show significant differences in the Neuropsi. Regarding the validation of the app, all the participants evaluated its pertinence positively. CONCLUSIONS The intervention data show that the experimental group obtained better results in the postevaluation given that the participants were able to execute the exercises repetitively. The control group could not accomplish this since they had to respond on the manual and no further attempts were provided. However, both groups increased their score in the neuropsychological evaluations. This suggests that a longer and more frequent intervention is required. REGISTERED REPORT IDENTIFIER RR1-10.2196/9603

Although the International Affective Picture System (IAPS) is used to evaluate emotions (valence, arousal, and dominance evoked by a large set of photographs), bizarre images in works of art have not been assessed with the IAPS procedures. Understood here as strange, non-sense, and absurd mental contents or expressions accompanied by surprise and confusion emotions, bizarreness was assessed after healthy adult volunteers assigned this specified variable to 140 Grete Stern's photomontages overtly intended to illustrate strange, absurd, and non-sensical contents in dream reports. The images were presented to 21 Young Males (YM) and 30 Young Females (YF) who were instructed to use the IAPS Self-Assessment Manikin, along with an additional bizarre-to-normal scale, to evaluate their response to them. The valence and the bizarre-to-normal ratings showed a dissimilar pattern of distribution between genders. Ratings of scales were different, and a greater variation in scales occurred according to gender. When bizarreness was appraised, gender differences became more evident especially for YF, who rated half of the images as bizarre, and with a diminished feeling of control, while the neutral and normal images were deemed more pleased and controlled. Valence, bizarreness, and dominance formed a different component than arousal in both groups. Negative correlations between valence and dominance, and between valence and bizarreness were also found in both groups, plus a positive one for dominance and bizarreness in YF, along with curvilinear relationships among all scales. On a second experiment, 10 photomontages evaluated by YF as bizarre or as normal were administered to 18 Old Males (OM) and 28 Old Females (OF). OF's arousal showed less neutral evaluations than OM's. In OF the bizarre images evoked either more excitation or calmness than in OM. The distribution of the bizarre-to-normal scale was significantly different across the evaluations in YM, YF, OM, and OF. The use of this extended IAPS instrument to explore bizarreness and emotional variables in response to art images seems suitable and potentially valuable to characterize bizarre, absurd, or non-sensical mental states and their brain correlates.

Background: The interest in applying information and communications technology (ICT) in older adult health care is frequently promoted by the increasing and unsustainable costs of health care services. In turn, the unprecedented growth of the elderly population around the globe has urged institutions, companies, industries, and governments to respond to older adults’ medical needs. Objective: The aim of this review is to systematically identify the opportunities that ICT offers to health services, specifically for patients with dementia and their families. Methods: A systematic review of the literature about ICT applications that have been developed to assist patients with Alzheimer’s disease (AD) and their primary caregivers was conducted. The bibliographic search included works published between January 2005 and July 2015 in the databases Springer Link, Scopus, and Google Scholar. Of the published papers, 902 were obtained in the initial search, of which 214 were potentially relevant. Included studies fulfilled the following inclusion criteria: (1) studies carried out between the years of 2005 and 2015, (2) studies were published in English or Spanish, (3) studies with titles containing the keywords, (4) studies with abstracts containing information on ICT applications and AD, and (5) studies published in indexed journals, proceedings, and book chapters. Results: A total of 26 studies satisfied the inclusion criteria for the current review. Among them, 16 were aimed at the patient with AD and 10 at the primary caregivers and/or family members. The studies targeted applications that included assistive technology (44%, 7/16), telecare (37%, 6/16), and telemedicine (31%, 5/16). The information systems (56%, 9/16) and Internet (44%, 7/16) were the most commonly used enabling technologies for the studies. Finally, areas of attention more covered by the studies were care (56%, 9/16), treatment (56%, 9/16), and management (50%, 8/16). Furthermore, it was found that 20 studies (77%, 8/26) evaluated their ICT applications through carrying out tests with patients with dementia and caregivers. Conclusions: The key finding of this systematic review revealed that the use of ICT tools can be strongly recommended to be used as a lifestyle in the elderly in order to improve the quality of life for the elderly and their primary caregivers. Since patients with AD are completely dependent in most activities, it is necessary to give attention to their primary caregivers to avoid stress and depression. In addition, the use of ICT in the daily life of caregivers can help them understand the disease process and manage situations in a way that is beneficial for both parties. It is expected that future developments concerning technological projects can support this group of people. [JMIR Rehabil Assist Technol 2016;3(1):e6]

A deep interest in Information Technology and Communication (ICT) in the elderly is often driven by growing and unsustainable costs of health services. The unprecedented growth of the older population in Mexico and around the world, forces us to confront — in an urgent way — the health care needs of the elderly by institutions, businesses, industry and government. In this paper we integrate the knowledge we have so far about the elderly with Alzheimer's disease (AD) and the opportunities offered by ICTs to him/her and his/her primary caregiver.

Given that the dorsolateral prefrontal cortex is involved in executive functions and is deactivated and decoupled from posterior associative regions during REM sleep, that Gamma temporal coupling involved in information processing is enhanced during REM sleep, and that adult humans spend about 90 min of every 24h in REM sleep, it might be expected that REM sleep deprivation would modify Gamma temporal coupling and have a deteriorating effect on executive functions. We analyzed EEG Gamma activity and temporal coupling during implementation of a rule-guided task before and after REM sleep deprivation and its effect on verbal fluency, flexible thinking and selective attention. After two nights in the laboratory for adaptation, on the third night subjects (n=18) were randomly assigned to either selective REM sleep deprivation effectuated by awakening them at each REM sleep onset or, the same number of NREM sleep awakenings as a control for unspecific effects of sleep interruptions. Implementation of abstract rules to guide behavior required greater activation and synchronization of Gamma activity in the frontopolar regions after REM sleep reduction from 20.6% at baseline to just 3.93% of total sleep time. However, contrary to our hypothesis, both groups showed an overall improvement in executive task performance and no effect on their capacity to sustain selective attention. These results suggest that after one night of selective REM sleep deprivation executive functions can be compensated by increasing frontal activation and they still require the participation of supervisory control by frontopolar regions.

Converging evidence from animal and human studies suggest that rapid eye movement (REM) sleep modulates emotional processing. The aim of the present study was to explore the effects of selective REM sleep deprivation (REM-D) on emotional responses to threatening visual stimuli and their brain correlates using functional magnetic resonance imaging (fMRI). Twenty healthy subjects were randomly assigned to two groups: selective REM-D, by awakening them at each REM sleep onset, or non-rapid eye movement sleep interruptions (NREM-I) as control for potential non-specific effects of awakenings and lack of sleep. In a within-subject design, a visual emotional reactivity task was performed in the scanner before and 24 h after sleep manipulation. Behaviorally, emotional reactivity was enhanced relative to baseline (BL) in the REM deprived group only. In terms of fMRI signal, there was, as expected, an overall decrease in activity in the NREM-I group when subjects performed the task the second time, particularly in regions involved in emotional processing, such as occipital and temporal areas, as well as in the ventrolateral prefrontal cortex, involved in top-down emotion regulation. In contrast, activity in these areas remained the same level or even increased in the REM-D group, compared to their BL level. Taken together, these results suggest that lack of REM sleep in humans is associated with enhanced emotional reactivity, both at behavioral and neural levels, and thus highlight the specific role of REM sleep in regulating the neural substrates for emotional responsiveness.

De acuerdo con el manual estandarizado para la clasificación del sueño en el ser humano, tres variables fisiológicas marcan el inicio del sueño con movimientos oculares rápidos (MOR): la desincronización electroencefalográfica (EEG), los movimientos oculares rápidos y la pérdida de tono muscular. De estos tres indicadores, uno de ellos, los movimientos oculares rápidos, es una manifestación intermitente o fásica que consiste en movimientos que pueden ser aislados o emitirse en salvas de varios movimientos, pero que no está presente de manera continua. Los otros dos, la desincronización EEG y la atonía, aparecen desde el inicio y se mantienen durante todo el episodio de sueño MOR. Sin embargo, la actividad EEG del sueño MOR en el ser humano es muy semejante, bajo inspección visual, al EEG de la etapa 1, por lo que el EEG y los movimientos oculares rápidos no permiten determinar por sí solos el inicio del sueño MOR, por lo que la atonía muscular se hace indispensable para ello. A pesar de que la caída de tono muscular es uno de los principales indicadores del sueño con movimientos oculares rápidos (MOR) y de la importancia que tiene la actividad muscular durante esta etapa del sueño para comprender mejor los trastornos en que se encuentra alterada la pérdida del tono muscular, como la narcolepsia y el trastorno conductual del sueño MOR, son muy escasas las investigaciones sobre el curso temporal de la caída del tono muscular durante la transición del sueño NMOR al MOR en el ser humano...