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El espectro de enfermedades neurodegenerativas que afectan principalmente a la cognición y el comportamiento abarca desde la enfermedad preclínica asintomática hasta el deterioro cognitivo muy leve y la demencia franca. En este artículo se procedió a  la revisión  de los criterios actuales para el diagnóstico de la demencia con cuerpos de Lewy, segunda causa más frecuente de demencia neurodegenerativa en personas mayores de 65 años luego de la enfermedad de Alzheimer (EA) y las afasias progresivas primarias que se distinguen por producir un compromiso temprano y aislado de las funciones lingüísticas, y en cuya evolución desarrollan un síndrome complejo caracterizado, además del compromiso del lenguaje, por la presencia de deterioro cognitivo progresivo, trastornos de conducta y compromiso de los sistemas motores. También pueden representar la forma de comienzo de una variante atípica de la enfermedad de Alzheimer (EA), no siendo raras las formas mixtas o no caracterizables.

Psychotic symptoms can manifest at any age, but in the elderly they represent a real diagnostic challenge. Thought disorders, hallucinations (usually visual), mood disorders with delusions, impairment of social interaction and occasionally verbal or physical aggression may be observed (Karon & VandenBos, 1998). Since the first descriptions of classical psychiatry, attempts have been made to define the psychoses observed in the elderly and determine whether they are primary "psychiatric" syndromes or, conversely, whether they can be attributed to other pathologies. Thus, different concepts have emerged, such as Late Onset Psychosis or Late-Onset Schizophrenia, Very Late-Onset Psychosis or Very Late-Onset Schizophrenia-Like Psychosis – VLOSL), Late-Life Psychosis, etc., Competing Interests: The authors have no conflicts of interest to declare, (CC BY NC ND)

Background: Social support is crucial for persons with multiple sclerosis (MS). We sought to analyze differences in perceived social support in persons with MS vs controls; to study associations between perceived social support, clinical measures, and health-related quality of life (HRQOL) variables in persons with MS; and to establish a predictive value of perceived social support for HRQOL., Methods: We studied 151 persons with MS (mean ± SD: age, 42.01 ± 9.97 years; educational level, 14.05 ± 3.26 years) and 89 controls (mean ± SD: age, 41.46 ± 12.25 years; educational level, 14.60 ± 2.44 years) using the Medical Outcomes Study Social Support Survey (MOS-SSS), Expanded Disability Status Scale, Fatigue Severity Scale, Beck Depression Inventory, and Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. Parametric and nonparametric statistical methods were used accordingly; P < .05., Results: Persons with MS exhibited lower scores on the MOS-SSS's overall support index ( t 238 = -1.98, P = .04) and on each functional subscale ( t 238 = -2.56 to -2.19, P < .05). No significant differences were found on the social support structural component ( P > .05). Significant associations were observed between social support and depression and fatigue ( r = -0.20 to -0.29, P < .05) and with MusiQoL dimensions ( r = -0.18 to 0.48, P < .05). Multiple regression analysis showed all 4 tested models contributed to HRQOL-explained variance (41%-47%). The emotional/informational support model explained the most HRQOL variability (47%)., Conclusions: Persons with MS perceived reduced social support, presenting lower functional scores than controls. Perceived social support proved to be a predictor of HRQOL. These findings should be considered during therapeutic treatment., Competing Interests: FINANCIAL DISCLOSURES: The authors declare no conflicts of interest., (© 2023 Consortium of Multiple Sclerosis Centers.)

Background: Multiple sclerosis (MS) is a neurological chronic disease that causes a number of physical, cognitive and emotional symptoms. The identification of these factors will allow mitigating unemployment and improve quality of life of patients. The Buffalo Vocational Monitoring Survey (BVMS) is a tool to characterize Work-Challenged patients., Objective: To describe and analyze BVMS data in people with multiple sclerosis (PwMS) from Argentina. To study the association with physical, cognitive and psychiatric morbidity in employed patients, comparing the performance of MS Work-Challenged and MS Work-Stable patients, with and without accommodations., Methods: 119 MS patients were administered the Argentina adaptation of the BVMS, and completed measures of physical disability, fatigue, depression, cognitive processing speed, memory and verbal fluency., Results: 65.54% of the patients were employed and 19.32% were unemployed, the remaining having roles of housewife, students and disability retirees. Within the employed subgroup, 60.26% were working as employees and 39.74% were self-employed. Cognitive and clinical variables differentiate patients with and without negative events and accommodations (p >  0.05)., Conclusions: This Spanish version BVMS is considered a new tool to monitor employment difficulties in Spanish-speaking MS patients. MS Work-Challenged had a higher depression, fatigue and worse performance in cognitive variables.

Objectives: To study the relationship between perceived fatigue and heath related quality of life (HRQoL), social support and cognition in an Argentinean population of patients with MS (PwMS)., Patients and Methods: 128 PwMS were studied, 75 women (58 %). Mean age: 40 ± 10.49 years-old, education: 14 ± 3.04, Expanded Disability Status Scale (EDSS): 2.43 ± 1.87, evolution: 10.07 ± 7.23 years., Instruments: Fatigue Severity Scale (FSS); EDSS; Beck's Depression Inventory II (BDI-II); International Quality of Life questionnaire (MusiQoL); Medical Outcomes Study Social Support Survey (MOS); BICAMS Battery, 7/24 Spatial Recall Test, Paced Auditory Serial Task (PASAT-3), Word list generation task (WLG)., Results: Sixty-six patients (51.6 %) presented fatigue. Significant differences were found between fatigued and non-fatigued patients in EDSS and BDI II (p < 0.001). Fatigue was associated with age, EDSS and BDI II (p < 0.05). When analyzing differences in HRQoL between fatigued and non-fatigued patients statistically significant differences were found in MusiQol (p < 0.05). FSS proved to be an independent predictor of HRQoL (typified β =-0.612 and -0.287, p < 0.05). Fatigued patients had fewer friends in their social support network (p = 0.031) and worse performance in PASAT. FSS was established as an independent predictor of PASAT (β = -0.280, p = 0.009) CONCLUSION: Fatigue is one of the most common symptoms in Multiple Sclerosis (MS) and has a great impact on patients daily life. This study highlights the importance of studying fatigue and treating it properly, since otherwise, it contributes to the dysfunction of patients daily life with psychological and social consequences., (Copyright © 2020 Elsevier B.V. All rights reserved.)