Seventh webinar - "RESEARCH AND LONGEVITY: Seeking positive answers for long lives".

Preventing boredom in institutionalised elderly people

One of the main objectives of civil society is to ensure the physical and mental well-being of older people. Researchers have shown that boredom is one of the major problems in old age, especially for those living in institutions. Their sustained suffering causes physical and mental problems. Although many institutions are implementing person-centred prevention models capable of fighting this risk factor all over the world, including some European countries, in Spain we are not even taking this phenomenon into account. The poster/communication proposal, entitled "Prevention of boredom in institutionalised elderly", aims to publicise a project in development in which he is currently working and to which he will dedicate the next few years, hosted by institutions such as the Complutense University of Madrid, the organisation The Eden Alternative Spain and the International Society for Boredom Studies, consisting of 1) giving visibility to the problem of the scarcity of research in Spain on the proven problem of boredom in elderly institutionalised people, 2) to carry out the first basic research study in our country to analyse the relevance of this problem in our institutions, 3) to learn about the philosophy and export some of the experience of initiatives such as The Eden Alternative in the field of boredom prevention in institutionalised elderly and, finally, 4) to create a model of primary prevention of boredom in institutions for the elderly adapting some of the approaches of The Eden Alternative to the needs and resources of Spain.

Speaker

Josefa Ros Velasco

Postdoctoral researcher at the Complutense University of Madrid, where she directs, from October 2021, the project "Pre-bored. Well-being and prevention of boredom in Spanish nursing homes", funded by the European programme UNA4CAREER (Marie Sklodowska-Curie Actions/UCM), which aims to understand the causes and consequences of the experience of boredom in public nursing homes in the Community of Madrid and to propose solutions consistent with the needs of the elderly and the resources of the institutions. Previously, she was a postdoctoral researcher in the Postdoctoral Research Fellowships at Harvard University for Distinguished Junior Scholars programme (from September 2017 to August 2021). She is a specialist in Boredom Studies from a multidisciplinary perspective. She is also the founder and president of the International Society of Boredom Studies. She is the author of the book La enfermedad del aburrimiento, soon to be published by Alianza Editorial, and editor of collective works such as Suicide in modern literature (Springer, 2021), The faces of depression in literature (Peter Lang, 2020), The culture of boredom (BRILL, 2020) or Boredom is in your mind (Springer, 2019). She is also a contributor to the CENIE blog "Envejecer en sociedad", where she publishes popular articles on the issue of boredom in the elderly. For her academic achievements she has received distinctions such as the Alumni-UCM Research Award (2021), the Julián Marías Award for Researchers in Humanities and Social Sciences with excellent careers under 40 years of age from the Community of Madrid (2020) or the Lincoln Book Prize for Excellence in Teaching and Service from Harvard University (2019).

"The frailty of older adults raises complex health and social care issues". 

Aims: To present the research project: Frailty and end-of-life care (Prevalence of frailty and aggressiveness of end-of-life care in the elderly admitted to an emergency department). 

Material and methods: single-centre study, started in March 2021 and expected to end in December 2022, comprising 3 successive phases: 1st phase - (current phase) data collection of all episodes of use of the Emergency Department of the Castelo Branco Local Health Unit, in 2019, by individuals aged 65 years or older (about 24 thousand); 2nd phase Classification of users, in frailty groups according to the Rockwood Clinical Scale and comparisons between the results extracted and the groups formed; 3rd phase - In groups classified as moderate frailty; severe frailty; very severe frailty and end-stage frailty, where death occurs within 1 year of the emergency episode, criteria for aggressiveness of care in the last 30 days prior to death will be described. 

Results: At the time of writing this poster we are in phase 1, with about 2,000 episodes collected. We aim to be able to gather evidence that shows the real scenario and the extent of the problem. 

Conclusions: The frail elderly are the most in need of social and health care, so the diagnosis of frailty can be used as a potential organiser of care. May this research work be a contribution to the knowledge of reality.

Speaker

Ângela Simões

PhD in Nursing from the University of Lisbon. Visiting Professor at the Escola de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco.

Nurse Specialist of the In-Hospital Support and Palliative Care Team of the Castelo Branco Health Unit. Researcher integrated in the Interdisciplinary Research Unit - Functional Ageing Communities (Age.Comm) of the Castelo Branco Polytechnic Institute.

Dr. Ângela Simões is a specialist in palliative and chronic care nursing. She holds a Master's degree in supportive treatment and palliative care for cancer patients from the University of Salamanca.

As a result of her training and the functions she performs, in 2017 she developed the thesis "The Promotion and Preservation of Dignity in the context of care in Nursing Homes". This research work was published in several scientific journals and edited as a book in 2019, considered mandatory reading for all those involved in elderly care. Winner of the "Nunes Correia Verdades de Farias" Awards, 2020, area B - Progress in Medicine in its application to the elderly, awarded by the Santa Casa da Misericórdia de Lisboa.

In recent years, she has dedicated her research to issues related to the promotion of dignity in the care of the elderly, including the study of frailty and end-of-life care. Currently with the project "Prevalence of frailty and aggressiveness of end-of-life care in elderly people admitted to an emergency department" which received the Isabel Correia Levy Research Grant, 2020 edition, from the Portuguese Association of Palliative Care.

Research and intervention in the early detection of cognitive impairment

Objectives: The objective of the Edades Project is to obtain specific diagnostic indices of MCI and the early detection of the initial stages of Alzheimer's disease. This will be done using a quasi-experimental, cross-sectional and longitudinal research design (according to hypothesis), with repeated measures and control of variables such as cognitive reserve, emotional state, biomarkers and other influential variables. 

Material and methods: Professional and scientific convection criteria will be used for the classification of MCI and Alzheimer's disease. A neuropsychological assessment will be carried out through protocols with validated tests. Information will be collected on history and variables influencing deterioration and the possibility of performing biomarkers. This will provide a baseline/diagnostic assessment, a follow-up protocol every 4/6 months and a final assessment over 4 years. Randomisation to groups will be carried out. 

Results: At present, the project has 153 applications, of which 106 assessments have been carried out (29 men and 77 women), with an average age of 69.8 years (range: 53 to 91).  Twenty users are involved in the intervention. In the descriptives of the measures carried out we find a mean of 23.67 in the MMSE, a mean of 8.48 in the ADAS-Cog and 96.6% of users who have a CDR with 1 or less; the mode being 0.5 (DCL). 

Conclusions: The ages project will provide results on aspects influencing MCI and its conversion to dementia within its translational research design.

Speaker 

José Antonio Sánchez Martín

Contracted PDI. Researcher of the "Edades Project" for the Usal.

Master in Gerontology and Neuropsychology at the University of Salamanca.

PhD student in the Biosciences Programme: Biology and Clinic of Cancer and Translational Medicine.

Collaborating lecturer in the Master's Degree in specialised care for people and relatives of people with Alzheimer's disease at the University of Salamanca and in the Master's Degree in General Health Psychology at the University of Salamanca.

After graduating in psychology and specialising in gerontology, José Antonio Sánchez is working on several research and intervention projects as a result of collaboration between the University of Salamanca and public institutions. The first one was to set up a "Unit of Evaluation and Intervention in Dependency" (Peñaranda de Bracamonte Town Council) and later in the development of the "PACID: Programme of integral cognitive activation in dementia" (State Reference Centre for the care of people with Alzheimer's disease and their families). She joined the research group in neurophysiology, cognition and behaviour of the INCYL (Institute of Neurosciences of Castilla y León).

After these experiences of research and intervention in the public sector and the master's degree in neuropsychology, a private initiative arises linked to the research of European H2020 funds. She works as Chief Scientific Officer of "AlzhUp", a project aimed at creating a cognitive stimulation app with an important scientific and applied component.

Since 2018, he belongs to the neuroscience research group at IBSAL (Institute of Biomedical Research of Salamanca). Where he worked as evaluator and study coordinator in several clinical studies in dementia, depression and schizophrenia. Currently he continues to collaborate in the clinical trials unit directed by Dr. Montejo (IP IBSAL and Head of the Community Psychiatry Unit).

In November 2020 he starts a new challenge in the "Edades Project". It develops its project in coherence with its professional line in translational research, where progress in knowledge and research results is transferred to the application of the results in the field of cognitive impairment. 

Research team - https://proyectoedades.com (professional team section).

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