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Resumen: Objetivo: Establecer un decálogo de competencias en autocuidado para guiar la educación durante los programas de rehabilitación cardiaca (RC) en pacientes con insuficiencia cardiaca con fracción de eyección preservada (IC-FEp), mediante un consenso multidisciplinario. Diseño: Estudio e-Delphi en tres rondas a partir de un cuestionario inicial de 23 competencias basado en las principales recomendaciones de las guías de RC y autocuidado. Emplazamiento: Enmarcado bajo la ética de un ensayo clínico aleatorizado desarrollado en el Hospital Regional de Málaga. La encuesta se diseñó y difundió como un cuestionario en línea. Participantes: El panel de expertos integró dos pacientes con IC-FEp, y 13 profesionales de medicina interna (n = 3), cardiología (n = 2), fisioterapia (n = 3), enfermería (n = 3) y terapia ocupacional (n = 2). Método: El análisis de resultados incluyó el índice de validez de contenido (IVC), porcentaje de acuerdo (PA%), concordancia mediante kappa de Fleiss (k) y alpha de Krippendorff (α). Resultados: Tras la tercera ronda, se identificaron 20 competencias en autocuidado agrupadas en 12 dominios, con consenso suficiente para su inclusión en el decálogo. Conclusiones: El decálogo de competencias en autocuidado generado a partir del consenso multidisciplinar proporciona una guía para la educación en pacientes con IC-FEp, abordando de manera sistemática y adaptada a los pacientes los contenidos educativos en la práctica clínica habitual de los programas de RC. Abstract: Objectives: To develop a decalogue of self-care competencies to manage educational intervention during Cardiac Rehabilitation (CR) programs in Heart Failure with preserved Ejection Fraction (HFpEF) patients through multidisciplinary consensus. Design: 3-round e-Delphi study using an initial questionnaire of 23 competencies based on the main recommendations of the CR and self-care guidelines. Site: It was framed under the ethics of a randomised clinical trial developed at the Regional Hospital of Malaga. The survey was designed and disseminated as an online questionnaire. Participants: The expert panel comprised two patients with HFpEF and 13 healthcare professionals from Internal Medicine (n = 3), Cardiology (n = 2), Physiotherapy (n = 3), Nursing (n = 3) and Occupational Therapy (n = 2). Method: The analysis of results included the content validity index, the percentage of agreement, and the concordance using Fleiss Kappa and Krippendorff's alpha. Results: After the third round, 20 self-care competencies were identified, grouped into 12 domains, with sufficient consensus for their inclusion in the decalogue. Conclusions: The decalogue of self-care competencies generated from the multidisciplinary consensus guides education in patients with HFpEF, systematically addressing educational content tailored to patients for clinical practice in CR programs.

Summary: Background: Neuroimaging studies often quantify tau burden in standardized brain regions to assess Alzheimer disease (AD) progression. However, this method ignores another key biological process in which tau spreads to additional brain regions. We have developed a metric for calculating the extent tau pathology has spread throughout the brain and evaluate the relationship between this metric and tau burden across early stages of AD. Methods: 445 cross-sectional participants (aged ≥ 50) who had MRI, amyloid PET, tau PET, and clinical testing were separated into disease-stage groups based on amyloid positivity and cognitive status (older cognitively normal control, preclinical AD, and symptomatic AD). Tau burden and tau spatial spread were calculated for all participants. Findings: We found both tau metrics significantly elevated across increasing disease stages (p