http://speiro.usma.ac.pa/handle/123456789/550 2026-04-14T11:55:32Z http://speiro.usma.ac.pa/handle/123456789/629 EVALUACIÓN DE UN PROGRAMA DE INTERVENCIONES COGNITIVAS Y FÍSICAS EN ADULTOS MAYORES EN LA CIUDAD DE PANAMÁ DURANTE 2023 Y 2024 Pauli-Quirós, Elianne Introduction: Dementia, as the most severe form of cognitive impairment, is the leading cause of disability in older adults and currently affects nearly 50 million people globally, with projections reaching 82 million by 2030 and 152 million by 2050. Likewise, the prevalence of dementia, one of the highest globally in Latin America and the Caribbean, is on the rise due to rapid population aging, social inequalities and associated risk factors. Currently, pharmacological interventions to delay cognitive decline have proven to be insufficient. On the other hand, non-pharmacological approaches have gained attention in recent years because they are therapies with minimal risk, which are aimed at preventing deterioration, improving clinical symptoms and decreasing the burden on caregivers. Evidence suggests that physical and cognitive interventions may have a positive effect on the health of older adults. Objective: To evaluate the effect of a program of physical and cognitive interventions on cognition, subjective well-being and physical health in older adults living in Panama City, Panama. Methods: This was a three-arm, single-blind, randomized controlled trial experimental intervention study. The sample consisted of 43 participants aged 60-80 years. Participants who entered the study completed a sociodemographic interview, clinical scales, a battery of cognitive tests and a physical assessment at pre-assessment. After randomization, they were divided into three groups: 1) experimental group 1 (n=15) participated in cognitive and physical interventions, including computerized cognitive training in CogniFit, group sessions of cognitive stimulation and training, and walks 3 to 5 times a week; 2) experimental group 2 (n=15) participated exclusively in walks; and 3) active control group (n=13) received informative talks about health once a month. In addition, experimental groups 1 and 2 participated in group walks once a month. After the intervention, a post-evaluation was carried out applying the same initial measures. Results: Improvements in performance on neuropsychological tests were observed when comparing pre- and post-assessment scores for the three groups. In terms of cognitive outcomes, the combined group showed significant 7 improvements in global cognition (MoCA) and the executive function of abstraction (INECO Refrains subtest). The group that received only physical interventions presented improvements in learning (CERAD Short-term Memory test and Short-term Visual Reproductive), visuospatial skills (Short-term Visual Reproduction Test) and long-term memory (Long-term Visual Reproduction Test). In the control group, increases in learning subtest scores (Short-term Visual Reproduction Test) and the executive function of inhibition (Hayling subtest of the INECO) were observed. In addition, improvements were observed for the combined group in depression (GDS - 15) and quality of life (WHOQoL-OLD total) scores. No significant differences were found between pre- and post-assessment in physical variables for any group. Conclusion: The results obtained suggest that a multidomain intervention program can positively impact cognition and quality of life in older adults. Likewise, physical activity may positively impact cognition. This study could serve as a basis for the implementation of multimodal interventions at the community level aimed at the prevention of cognitive decline. 2024-01-01T00:00:00Z http://speiro.usma.ac.pa/handle/123456789/628 ASOCIACIÓN ENTRE DISCRIMINACIÓN, SALUD MENTAL, IDENTIDAD Y NIVELES DE CORTISOL EN UNA MUESTRA LGBTQ+ EN PANAMÁ EN EL AÑO 2023 Chavarría Muñoz, Carlos Alfredo Discrimination against lesbian, gay, bisexual, transgender and queer (LGBTQ+) people can affect overall health, causing psychiatric symptoms such as anxiety, depression, substance abuse and suicidal ideation and behavior. It has been evidenced that vulnerability factors in LGBTQ+ people are related to discrimination and hateful behaviors, generating low self-esteem and psychopathological symptoms. Data on the Latin American region indicate that cases of discriminatory acts against LGBTQ+ people are on the rise. According to the Registry of Violence against Lesbian, Gay, Bisexual, Trans and Intersex persons in the Americas of the Organization of American States, Panama is one of the countries in the region that reports cases of discrimination against LGBTQ+ persons, however, there is no data that establish the incidence of these cases. Chronic exposure to experiences of discrimination can lead to imbalances in mental health and in the biological stress regulation system. The objective of this vii research was to identify the association between perceived discrimination, mental health, and cortisol levels in a sample of LGBTQ+ people in Panama in the year 2023. This study has a cross-sectional design with a quantitative approach and a descriptive correlational non-experimental scope. The sample consisted of 48 LGBTQ+ participants of legal age residing in Panama. Sociodemographic data were collected, and the following scales were used: the Perceived Discrimination Scale, the Depression, Anxiety and Stress Scale and the Dimensions of Sexual Orientation Identity Scale for Lesbians, Gays and Bisexuals. Two saliva samples were collected to assess morning and evening cortisol using an in vitro immunological test. A Pearson correlation was performed to analyze the relationship between perceived discrimination, mental health, identity and cortisol levels. The results showed that younger people present more depressive, anxious and stress symptoms. In addition, a positive correlation was found between discrimination by society and the presence of symptoms of depression and stress. In turn, a positive correlation was found between concern about sexual orientation acceptance and symptoms of anxiety, depression, and stress. A moderated multiple regression model was also performed and showed that perceived group discrimination predicts the occurrence of symptoms of depression, anxiety and stress, being moderated by concern about the acceptance of sexual orientation identity. However, no relationship was found between cortisol levels and psychological variables. These results show that discrimination is related to the quality of mental health of LGBTQ+ people. The present study is the first of its kind to be conducted in Panama and the results contribute to the literature on sexual diversity from a biopsychosocial perspective and promote governmental decision-making based on scientific evidence for the benefit of the health of LGBTQ+ persons. 2024-01-01T00:00:00Z http://speiro.usma.ac.pa/handle/123456789/626 MEDICIÓN DEL IMPACTO DE UN PROGRAMA DE ARTETERAPIA SOBRE LOS ESTADOS EMOCIONALES Y COGNITIVOS DE PERSONAS MAYORES INSTITUCIONALIZADAS EN UN ALBERGUE PÚBLICO DE LA CIUDAD DE PANAMÁ DURANTE EL PERIODO 2024, 2025. YÁNEZ Z., YADYRA la institucionalización de personas mayores va en aumento debido a la falta de atención domiciliaria, recursos económicos y apoyo familiar limitados, aunado a las dificultades para acceder a servicios de salud. Esto se asocia con una alteración del estado emocional y cognitivo y con un mayor riesgo de enfermedades cardiovasculares, metabólicas y, en algunos casos, negligencia o maltrato. La arteterapia ha demostrado ser una intervención no farmacológica eficaz en entornos geriátricos, reduciendo síntomas depresivos y ansiosos, y mejorando la cognición. 2025-01-01T00:00:00Z http://speiro.usma.ac.pa/handle/123456789/623 FACTIBILIDAD Y GRADO DE SATISFACCIÓN DE UNA EVALUACIÓN TELENEUROPSICOLÓGICA EN UNA MUESTRA DE ADULTOS MAYORES QUE TUVIERON O NO COVID-19 EN LA REPÚBLICA DE PANAMÁ, 2023- 2024 Santos Mejía, Luis Guillermo Teleneuropsychology is a modality of neuropsychology that has gained more relevance since the COVID-19 pandemic. However, feasibility of these kind of evaluation is unknown in Panamá. The objective of this study is to describe the feasibility and satisfaction with the application of a teleneuropsychological battery in people 50+ years older in Panamá, and the relation between cognitive health of the participants and suffering COVID-19 previously. This is a descriptive, quantitative, cross-sectional and observational study, with an applied focus. The study´s sample corresponded to 50+ years older adults in Panamá. Participants were contacted to confirm if they complied with inclusion criteria, Telephone Interview for Cognitive Status of Memory (TICS-M) and the National Alzheimer´s Coordinating Center (NACC) Health Questionnaire were applied to confirm if the participant could be assessed virtually. If eligible, sociodemographic questionnaires were applied. Teleneuropsychological assessments were made using a teleneuropsychological battery using zoom and REDCap platforms. COVID-19 background questionnaire was applied and participants were asked to fill a satisfaction formulary. The sample consisted of 67 participants 50+ years older (M=62.16, DE=7.64) that completed the assessments and answered the sociodemographic questionnaires. Participants had high levels of education (M=16.67, DE=1.95). Chronic health issues were majorly reported (M=1.09, DE=0.96) and there were few depressive symptoms (M=1.50, DE=1.83). Regarding the teleneuropsychological tests, there were not significant differences in most of the applied tests when compared by sex, age or COVID-19 background, with the exception of the Multilingual.Naming Test (MINT), with better performances from men compared to women (p < .001), the verbal fluidity test with better performances from men compared to women (p = .032), the Wisconsin 7 Sorting Card Test where younger participants had better results (p = .020) similar to participants who had COVID-19 background (p = .009) and the Oral Trail Making Test B (OTMTB), were participants with COVID-19 background finished the test faster (p = .010). When comparing z scores controlling for education, there were not significant differences in most of the applied tests, with the exception of the RAVLT Delayed (p = 0.01) were men with COVID-19 background recalled more words from the list; and in the OTMTB (p = 0.05) were women with COVID-19 background had more points. Significantly high (p < .05) and very high (p < .001) correlations were found between teleneuropsychological tests that assessed the same domains. 2 factors were identified with a principal component analysis that explained 33.1 % of the variance in the correlation matrix. Finally, most of the sample was satisfied (33.8 %) or very satisfied (60.0 %) with the teleneuropsychological assessment. Feasibility of the teleneuropsychological assessment was described in Panamá with 50+ years older adults without cognitive impairment. No significant relation was found between COVID-19 background and participant´s cognitive health. These results should be verified in future studies. The cognitive profile of the sample corresponded with that of an older adult without cognitive impairment. Significantly high and very high correlations were found between tests that assessed the same domains and 2 factors explained 33 % of the variance in the correlation matrix, all these tests assessed memory. Finally, the sample showed high levels of satisfaction with the cognitive assessment. 2024-01-01T00:00:00Z