EVALUACIÓN DE UN PROGRAMA DE INTERVENCIONES COGNITIVAS Y FÍSICAS EN ADULTOS MAYORES EN LA CIUDAD DE PANAMÁ DURANTE 2023 Y 2024

Abstract

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.