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Objective To evaluate the long-term, real-life effects on non-motor symptoms (NMS) of opicapone compared to entacapone in levodopa-treated people with Parkinson’s disease (PwP). Methods A retrospective data analysis, with pre- and post-opicapone initiation data of 17 PwP with motor fluctuations compared to a comparable group of 18 PwP introduced on entacapone. The primary outcome was changes in the NMS Scale (NMSS) total score after 1-year follow-up. Secondary outcomes included changes in the NMSS domains, and Parkinson’s Disease Sleep Scale (PDSS) total and item scores after the same time span. Results Groups were comparable for baseline demographics and Parkinson’s-related features (p ≥ 0.314) as well as duration of follow-up (1.33 ± 0.66 years for PwP on opicapone and 1.23 ± 0.49 years for those on entacapone; p = 0.858). PwP who were introduced on opicapone showed no changes in NMSS and PDSS total scores after 1 year (p = 0.605 and p = 0.507, respectively), whereas PwP who were introduced on entacapone showed significant worsening of NMSS and PDSS total scores at follow-up (p = 0.005 and p = 0.001, respectively). In neither group changes in individual NMSS domains from baseline to follow-up were observed (p ≥ 0.288 for entacapone and p ≥ 0.816 for opicapone, respectively). In PwP on entacapone significant worsening was seen in the distressing dreams, hallucinations, and limb numbness items of the PDSS (p ≤ 0.05). Conclusions Introduction of opicapone in real-life PwP with motor fluctuations seems to stabilise NMS burden and aspects of sleep dysfunction, in contrast to entacapone where there was a worsening of NMS burden and PDSS scores over 1 year follow-up.

Introduction: The protection of children is a major driver of behavior among those in charge of their care. We evaluated whether compliance with preventive measures against SARS-CoV-2 infection among adults living with children was different from that of those not living with them, in 2020. Methods: We used the COSMO-SPAIN (N = 867) and the nationally representative ENE-COVID (N = 29,926) surveys to estimate prevalence of compliance (95% confidence interval). Logistic model based standardization methods were applied to estimate standardized prevalence differences (SPrD) to the overall distribution of age, sex, education, history of COVID-19, and residence of other >60 yrs in the household. Results: We observed that adults living with children more frequently avoided bars (SPrDENE-COVID: 4.2%; 95% CI: 2.3-6.1), crowded places (SPrDCOSMO: 8.0%; 95% CI: 0.6-15.1) and did not use public transportation (SPrDENE-COVID: 4.9%; 95% CI: 3.0-6.7). They were also more worried about work and family conciliation (SPrDCOSMO: 12.2%; 95% CI: 4.8-19.5) and about closure of education centers (SPrDCOSMO: 26.5%; 95% CI: 19.4-33.6). Discussion: In general, adults living with children adopted slightly more frequently social distancing measures. IJ was hosted in the National Center of Epidemiology, thanks to a grant of Women for Africa 6th edition, with the contribution of ENDESA. COSMO-SPAIN was funded by Carlos III Health Institute and ENE-COVID was funded by Spanish Ministry of Health, Carlos III Health Institute, and Spanish National Health System. Sí

[ES] En la pandemia de COVID-19, tanto el comportamiento individual como el colectivo son determinantes en el control de la propagación de la enfermedad, pero las restricciones adoptadas para atajar esta crisis de salud pública han afectado al bienestar físico y mental de la población. Conocer las percepciones y actitudes de los ciudadanos ayuda a identificar las necesidades de la población y adoptar medidas de respuesta a la pandemia más efectivas y participativas. El estudio COSMO-Spain analiza las preocupaciones, percepciones y actitudes de la población en relación a la pandemia, el grado de adherencia a las medidas preventivas y otras variables relacionadas, como la percepción de riesgo. Este estudio, impulsado por la OMS, se ha realizado desde julio de 2020 cada dos meses, a través de un cuestionario online a muestras representativas de la población española. Los resultados muestran que las actitudes de la población han ido cambiando en el tiempo influenciadas por factores individuales y contextuales. Debido la naturaleza evolutiva de esta pandemia, las campañas de educación y sensibilización deben ser dinámicas y actualizarse continuamente en función de los datos. [EN] Both individual and population behavior are determining factors in controlling the spread of the COVID-19 pandemic. However, the restrictions have impacted the mental and physical well-being of citizens, the social cohesion, the economic stability, as well as the community resilience. In this complex scenario, understanding the feelings and attitudes of the population helps us to identify their needs and adopt response measures to control the pandemic in a more consensual and effective way. The COSMO-Spain study explores the concerns, perceptions, and attitudes of the population about the pandemic to find out the acceptance and adherence to behavioral prevention measures, as well as to analyze the citizens’ risk perception, well-being and trust in information sources and institutions. The COSMO-Spain study has been carried out every two months since July 2020, through an online questionnaire to representative cross-sectional samples of the Spanish population, composed by 1000 people each. The results up to December 2021 show that the attitudes of the population are dynamic and evolve over time, influenced not only by individual factors, but also by contextual ones. Due to the changing nature of this pandemic, education and awareness campaigns need to be dynamic and continually updated based on real data. El estudio COSMO-Spain ha sido financiado por el Instituto de Salud Carlos III. Sí

This study aims at describing the evolution of Spanish population preventive practices during the COVID-19 pandemic of the between January and June 2021, and differences by age group. Data was drawn from the COSMO-Spain online survey, rounds (R) 4, 5 and 6. Multiple linear regression models with preventive practices as dependent variable were performed. Preventive practices (p = 0.001) and concern about coronavirus (p = 0.003) decreased throughout the three rounds, knowledge decreased from R4 to R6 (p = 0.002) and health literacy had a higher value in R6 (p

Erratum to: “The Movement Disorder Society Nonmotor Rating Scale: Initial Validation Study”, by Ray Chaudhuri et al. (Mov Disord 2020; 35: 116-133). Mov Disord. 2020 Jan;35(10):116-133. https://doi.org/10.1002/mds.28266 Background: The Movement Disorder Society-sponsored Nonmotor Rating Scale is an update of the existing Parkinson's disease Nonmotor Symptoms Scale modified to address some limitations in Nonmotor Symptoms Scale scoring, structure, and symptom coverage. Methods: PD patients were recruited from movement disorder centers in an international, multicenter study. The Movement Disorder Society Nonmotor Rating Scale, consisting of 13 domains plus a subscale for nonmotor fluctuations, was rater administered, along with the Nonmotor Symptoms Scale and other clinical assessments. Standard reliability and validity testing were conducted. Results: Four hundred and two PD patients were recruited (mean age ± standard deviation, 67.42 ± 9.96 years; mean age at PD onset ± standard deviation, 59.27 ± 10.67 years; median Hoehn and Yahr stage 2 (interquartile range 2-3). Data quality was satisfactory for all Movement Disorder Society Nonmotor Rating Scale domains except sexual (6.7% missing data). There were no floor or ceiling effects for the Movement Disorder Society Nonmotor Rating Scale and nonmotor fluctuations total score; domains had no ceiling effects, but some floor effects (13.5%-83.5%). The Movement Disorder Society Nonmotor Rating Scale and nonmotor fluctuations total score internal consistency were acceptable (average Cronbach's alpha, 0.66 and 0.84, respectively); interrater reliability was excellent (intraclass correlation coefficient, >0.95); for test-retest reliability, the intraclass correlation coefficient was 0.84 for the Movement Disorder Society Nonmotor Rating Scale and 0.70 for Movement Disorder Society nonmotor fluctuations total score, and precision was excellent for the Movement Disorder Society Nonmotor Rating Scale (standard error of measurement, 25.30) and fair for nonmotor fluctuations (standard error of measurement, 7.06). Correlations between Movement Disorder Society Nonmotor Rating Scale score and the corresponding Nonmotor Symptoms Scale and Movement Disorder Society UPDRS scores were high. There were no significant sex or age effects. The Movement Disorder Society Nonmotor Rating Scale score increased with increasing PD duration, disease severity, and PD medication dose (all P

Background Identifying predictors of incident cognitive impairment (CI), one of the most problematic long‐term outcomes, in Parkinson's disease (PD) is highly relevant for personalized medicine and prognostic counseling. The Nonmotor Symptoms Scale (NMSS) provides a global clinical assessment of a range of NMS, reflecting NMS burden (NMSB), and thus may assist in the identification of an “at‐risk” CI group based on overall NMSB cutoff scores. Methods To investigate whether specific patterns of PD NMS profiles predict incident CI, we performed a retrospective longitudinal study on a convenience sample of 541 nondemented PD patients taking part in the Nonmotor Longitudinal International Study (NILS) cohort, with Mini‐Mental State Examination (MMSE), NMSS, and Scales for Outcomes in PD Motor Scale (SCOPA Motor) scores at baseline and last follow‐up (mean 3.2 years) being available. Results PD patients with incident CI (i.e., MMSE score ≤ 25) at last follow‐up (n = 107) had severe overall NMSB level, significantly worse NMSS hallucinations/perceptual problems and higher NMSS attention/memory scores at baseline. Patients with CI also were older and with more advanced disease, but with no differences in disease duration, dopamine replacement therapy, sex, and comorbid depression, anxiety, and sleep disorders. Conclusions Our findings suggest that a comprehensive baseline measure of NMS and in particular hallucinations and perceptual problems assessed with a validated single instrument can be used to predict incident CI in PD. This approach provides a simple, holistic strategy to predict future CI in this population., A comprehensive baseline measure of NMS and in particular hallucinations and perceptual problems assessed with a validated single instrument can be used to predict incident cognitive impairment in PD. This approach provides a simple, holistic strategy to predict future cognitive impairment in this population.

Purpose: To validate the Parkinson’s Fatigue Scale (PFS-16) in advanced Parkinson Disease (APD) patients using the scale’s Spanish version. Patients and methods: In a clinical study for Levodopa-Carbidopa Intestinal Gel (LCIG), 59 patients were assessed over six months using the PFS-16 and other instruments. The psychometric properties of the PFS-16 were then analyzed. Results: Patients (60.7% men) were aged 68.02±7.43 years. PD duration was 12.57±5.97 years. Median Hoehn and Yahr (HY) stage of patients in “on” was 2 (range: 1–4). There were excellent data quality and acceptability for the PFS-16 as a whole, except for moderate-to-high ceiling effects in its items. Two factors explained 67% of the variance, yet parallel analysis demonstrated the unidimensional nature of the PFS-16, whose internal consistency was satisfactory (Cronbach’s alpha=0.93; item homogeneity coefficient=0.19, and item total-corrected correlations=0.50–0.84). PFS-16 total score showed moderate-to-high correlations with fatigue-specific questions within clinical tools, namely item 20 of the Beck Depression Inventory (rS=0.65) and item 4 of the Non-Motor Symptoms Scale (rS=0.33). Weak-to-moderate correlations were observed between the PFS-16 and measures of anxiety, depression, apathy, and quality of life. There were no significant differences in PFS-16 total scores when grouped by age, sex, time from diagnosis, HY, and CGI-S. After treatment with LCIG, the relative change in PFS-16 total score was −17.6% and the effect size (Cohen’s d) was 0.92. Moderate correlations between changes in the PFS-16 and several other clinical tools were also found. Conclusion: In APD patients, the PFS-16 showed satisfactory acceptability, internal consistency, construct validity, and responsiveness.

La mejora de las condiciones de vida y los avances de la medicina han facilitado un considerable aumento de la esperanza de vida y, como consecuencia, un importante envejecimiento poblacional. En España, las personas mayores de 65 años representan casi el 20% de la población, y se prevé que este porcentaje crezca significativamente en los próximos años. Afrontar esta situación demográfica es uno de los principales retos de la sociedad en la actualidad. Uno de los desafíos más relevantes es ocuparse de lo que se ha denominado «epidemia de la soledad», es decir, el impacto negativo que la soledad no deseada y el aislamiento social tienen en la salud mental y la calidad de vida de las personas mayores. En España, un 20% de las personas mayores de 65 años declara niveles altos de soledad, un 25% de aislamiento social y 1 de cada 4 sufre depresión. La evidencia científica apunta también a que su abordaje mediante intervenciones multidisciplinares y multidimensionales, sustentadas por recursos institucionales y comunitarios apropiados, tiene un impacto positivo en la calidad de vida y en la salud mental de las personas mayores. La soledad y la mala salud mental que padecen las personas mayores requiere de medidas urgentes orientadas a promover, entre ellas, un buen estado de salud y una calidad de vida óptima. Este documento presenta recomendaciones de actuación basadas en la investigación realizada por el Proyecto QASP - Quality of Life and Aging in Spain, Sweden and Portugal. A melhoria das condições de vida e os avanços da medicina permitiram um aumento considerável da esperança de vida e, como consequência, um expressivo envelhecimento da população. Em Portugal, as pessoas com 65 e mais anos representam hoje 22.3% da população residente, e prevê-se que este valor aumente significativamente nos próximos anos. Enfrentar esta realidade demográfica é um dos principais desafios da sociedade. Um dos desafios mais relevantes é a gestão do que já se designou de “epidemia da solidão”, ou seja, o impacto negativo que a solidão não desejada e o isolamento social têm na saúde mental e na qualidade de vida dos mais velhos. Em Portugal, estudos comunitários indicam que entre 14% e 36% das pessoas com 65 e mais anos refere sentir sentimentos de solidão, e que cerca de 27% apresenta distress psicológico. A evidência científica dá-nos conta, também, que a abordagem a estas problemáticas deve considerar intervenções multidisciplinares e multidimensionais, sustentadas por recursos institucionais e comunitários apropriados, já que as mesmas têm um impacto positivo na qualidade de vida e na saúde mental das pessoas mais velhas. A solidão e os problemas de saúde mental requerem medidas urgentes destinadas à promoção da saúde e da qualidade de vida. Este documento apresenta um conjunto de recomendações baseadas no Projeto QASP – Quality of Life and Aging in Spain, Sweden and Portugal. Policy brief elaborado por el proyecto de investigación QASP, financiado por el Instituto de Salud Carlos III, Subprograma Estatal de Generación de Conocimiento de la Acción Estratégica en Salud Intramural AESI 2018, Ref: PI18CIII/00046. No

Comunicación presentada en las II Jornada del Centro Nacional de Epidemiología - 2021. Se exponen las acciones llevadas a cabo para diseñar el estudio COSMOS-Spain. Se pretendía conocer los factores que influyen en el comportamiento de la población ante una crisis sanitaria y saber cómo se informa. Las teorías del comportamiento indican que la conducta esta influida por el conocimiento, la percepción del riesgo y la autoeficacia.

[EN] Introduction: Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. Methods: All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surveys assessing individual characteristics, COVID-19 infection status and exposure, and mental health status (May 5 - September 7, 2020). We report: probable current mental disorders (Major Depressive Disorder-MDD- [PHQ-8≥10], Generalized Anxiety Disorder-GAD- [GAD-7≥10], Panic attacks, Posttraumatic Stress Disorder -PTSD- [PCL-5≥7]; and Substance Use Disorder -SUD-[CAGE-AID≥2]. Severe disability assessed by the Sheehan Disability Scale was used to identify probable "disabling" current mental disorders. Results: 9,138 healthcare workers participated. Prevalence of screen-positive disorder: 28.1% MDD; 22.5% GAD, 24.0% Panic; 22.2% PTSD; and 6.2% SUD. Overall 45.7% presented any current and 14.5% any disabling current mental disorder. Workers with pre-pandemic lifetime mental disorders had almost twice the prevalence than those without. Adjusting for all other variables, odds of any disabling mental disorder were: prior lifetime disorders (TUS: OR=5.74; 95%CI 2.53-13.03; Mood: OR=3.23; 95%CI:2.27-4.60; Anxiety: OR=3.03; 95%CI:2.53-3.62); age category 18-29 years (OR=1.36; 95%CI:1.02-1.82), caring "all of the time" for COVID-19 patients (OR=5.19; 95%CI: 3.61-7.46), female gender (OR=1.58; 95%CI: 1.27-1.96) and having being in quarantine or isolated (OR= 1.60; 95CI:1.31-1.95). Conclusions: One in seven Spanish healthcare workers screened positive for a disabling mental disorder during the first wave of the COVID-19 pandemic. Workers reporting pre-pandemic lifetime mental disorders, those frequently exposed to COVID-19 patients, infected or quarantined/isolated, female workers, and auxiliary nurses should be considered groups in need of mental health monitoring and support. [ES] Introducción: Los profesionales sanitarios son vulnerables al impacto negativo en salud mental de la pandemia COVID-19. Evaluamos la prevalencia de trastornos mentales y factores asociados durante la primera oleada de la pandemia en sanitarios españoles. Métodos: Se invitó a todos los trabajadores de 18 instituciones sanitarias españolas (6 CCAA) a encuestas en línea evaluando características individuales, estado de infección y exposición a COVID-19 y salud mental (5 Mayo – 7 Septiembre, 2020). Reportamos: probables trastornos mentales actuales (Trastorno depresivo mayor TDD [PHQ-8≥10], Trastorno de ansiedad generalizada TAG [GAD-7≥10], Ataques de pánico, Trastorno de estrés postraumático TEP [PCL-5≥7]; y Trastorno por uso de sustancias TUS [CAGE-AID≥2]. La interferencia funcional grave (Escala de Discapacidad de Sheehan) identificó los probables trastornos “discapacitantes”. Resultados: Participaron 9.138 sanitarios. Prevalencia de cribado positivo: 28,1% TDD; 22,5% TAG, 24,0% Pánico; 22,2% PTE; y 6,2% TUS. En general, el 45,7% presentó algún trastorno mental actual y el 14,5% algún trastorno discapacitante. Los sanitarios con trastornos mentales previos tuvieron el doble de prevalencia que aquellos sin patología mental previa. Ajustando por todas las variables, el trastorno mental incapacitante se asoció positivamente con: trastornos previos (TUS: OR=5.74; 95%CI 2.53-13.03; Ánimo: OR=3.23; 95%CI:2.27-4.60; Ansiedad: OR=3,03; IC 95%: 2,53-3,62); edad 18-29 años (OR=1,36; IC 95%: 1,02-1,82); atender “siempre” a pacientes COVID-19 (OR=5,19; IC 95%: 3,61-7,46), género femenino (OR=1,58; IC 95%: 1,27-1,96) y haber estado en cuarentena o aislado (OR=1,60; IC 95%: 1,31-1,95). Conclusiones: Uno de cada 7 sanitarios españoles presentaron un probable trastorno mental discapacitante durante la primera oleada de COVID-19. Aquéllos con trastornos mentales alguna vez antes de la pandemia, los que están expuestos con frecuencia a pacientes con COVID-19, los infectados o en cuarentena / aislados, las mujeres y las enfermeras auxiliares deben considerarse grupos que necesitan seguimiento y apoyo de su salud mental. This work was supported by Instituto de Salud Carlos III (Ministerio de Ciencia e Innovación)/FEDER (COV20/00711); ISCIII (Sara Borrell, CD18/00049) (PM); FPU (FPU15/05728)); ISCIII (PFIS, FI18/00012); Generalitat de Catalunya (2017SGR452). Sí

The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity.

[EN] The aim of this study was to analyze the psychometric properties of the Brief Resilient Coping Scale (BRCS) for a multiethnic sample of Chilean older people (800). This sample has the particular feature of including non-indigenous (231) and indigenous Aymara (201) and Mapuche (368) people resident in native rural areas. It is a cross-sectional study. Descriptive statistics were calculated for socio-demographic and outcome data, covering mean, standard deviation, frequencies and percentages. For the BRCS, psychometric properties were analyzed according to the principles of Classical Test Theory. The analysis of the psychometric properties of the BRCS for three ethnic groups of older Chilean people shows that this rating scale is acceptable, reliable and valid, although the differences between groups highlight the need for culturally adapted geriatric assessment scales. The BRCS showed satisfactory psychometric characteristics for the studied samples. It is important for medical and social sciences to have ethnically sensitive instruments for the evaluation of psychosocial resources that promote successful aging. [ES] El objetivo de este estudio fue analizar las propiedades psicométricas de la Escala Breve de Afrontamiento Resiliente (BRCS) para una muestra multiétnica de 800 personas mayores chilenas. Esta muestra tiene la particularidad de incluir personas no indígenas (231) e indígenas aymaras (201) y mapuche (368) residentes en áreas rurales nativas. Se llevó a cabo un estudio transversal. Se realizaron análisis descriptivos para las variables sociodemográficos, tales como media, desviación estándar (DE), frecuencias y porcentajes. Para BRCS, las propiedades psicométricas se analizaron de acuerdo con los principios de la Teoría Clásica de las Pruebas. Los análisis de las propiedades psicométricas de BRCS para los tres grupos étnicos de personas mayores chilenas muestran que esta escala es aceptable, confiable y válida, aunque las diferencias entre los grupos resaltan la necesidad de que las escalas de evaluación geriátrica sean adaptadas culturalmente. BRCS mostró características psicométricas satisfactorias para las muestras estudiadas. Es importante para las ciencias médicas y sociales contar con instrumentos étnicamente sensibles para la evaluación de los recursos psicosociales que promueven un envejecimiento exitoso. [PT] O objetivo deste estudo foi analisar as propriedades psicométricas da Escala Breve do Comportamento Resiliente (BRCS) para uma amostra multiétnica de 800 idosos chilenos. Esta amostra tem a particularidade de incluir pessoas não indígenas (231), Aimarás (201) e Mapuche (368) residentes em áreas rurais nativas. Foi realizado um estudo transversal. Foram realizadas análises descritivas para as variáveis sociodemográficas, como média, desvio padrão (DP), frequências e percentuais. Para a BRCS, as propriedades psicométricas foram analisadas segundo os princípios da Teoria Clássica dos Testes. As análises das propriedades psicométricas da BRCS para os três grupos étnicos de idosos chilenos mostram que esta escala é aceitável, confiável e válida, embora as diferenças entre os grupos destacam a necessidade de adaptação cultural das escalas de avaliação geriátrica. BRCS mostrou características psicométricas satisfatórias para as amostras estudadas. É importante para as ciências médicas e sociais contar com instrumentos etnicamente sensíveis para a avaliação dos recursos psicossociais que promovem o envelhecimento bem- -sucedido. This work was supported by the Government of Chile (Proyecto FONDECYT 1170493) and University of Tarapacá (Proyecto UTA MAYOR 3768-20) and the Research Program of the Madrid Autonomous Community, Spain (ENCAGENCN, Ref: H2019/HUM-5698). Sí