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The increasing prevalence of dementia demands innovative solutions; however, existing technological products often lack tailored support for individuals living with this condition. The Living Lab approach, as a collaborative innovation method, holds promise in addressing this issue by actively involving end-users in the design and development of solutions adapted to their needs. Despite this potential, the approach still faces challenges due to its lack of recognition as a research methodology and its absence of tailored guidelines, particularly in dementia care, prompting inquiries into its effectiveness. This narrative review aims to fill this gap by identifying and analysing digital health Living Labs focusing on dementia solutions. Additionally, it proposes guidelines for enhancing their operations, ensuring sustainability, scalability, and greater impact on dementia care. Fifteen Living Labs were identified and analyzed. Based on trends, best practices, and literature, the guidelines emphasize user engagement, interdisciplinary collaboration, technological infrastructure, regulatory compliance, transparent innovation processes, impact measurement, sustainability, scalability, dissemination, and financial management. Implementing these guidelines can enhance the effectiveness and long-term impact of Living Labs in dementia care, fostering new collaborations globally.

ObjectiveTo analyze the validity of self and informant reports, depressive symptomatology, and some sociodemographic variables to predict the risk of cognitive decline at different follow-up times.MethodsA total of 337 participants over 50 years of age included in the CompAS and classified as Cognitively Unimpaired (CU), Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) groups were assessed at baseline and three follow-ups. A short version of the QAM was administered to assess the severity of subjective cognitive complaints (SCCs), and the GDS-15 was used to evaluate the depressive symptoms. At each follow-up assessment, participants were reclassified according to the stability, regression or progression of their conditions. Logistic regression analysis was used to predict which CU, SCD and MCI participants would remain stable, regress or progress at a 3rd follow-up by using self- and informant-reported complaints, depressive symptomatology, age and education at baseline and 2nd follow-ups as the predictive variables.ResultsOverall, self-reported complaints predicted progression between the asymptomatic and presymptomatic stages. As the objective deterioration increased, i.e., when SCD progressed to MCI or dementia, the SCCs reported by informants proved the best predictors of progression. Depressive symptomatology was also a predictor of progression from CU to SCD and from SCD to MCI.ConclusionA late increase in self-reported complaints make valid estimates to predict subjective decline at asymptomatic stages. However, an early increase in complaints reported by informants was more accurate in predicting objective decline from asymptomatic stages. Both, early and late decrease in self-reported complaints successfully predict dementia from prodromic stage. Only late decrease in self-reported complaints predict reversion from prodromic and pre-symptomatic stages.

Background: The role of neuropsychiatric symptoms (NPS) as early markers of cognitive impairment progression along the cognitive impairment continuum needs further research. Our objective was to estimate to which extent NPS, measured with the Mild Behavioral Impairment Checklist (MBI‐C), predict time‐to‐cognitive‐worsening during follow‐up in a sample of older adults recruited from primary care centers while controlling for other related variables (i.e., age, gender, years of education, comorbidity, and cognitive complaints). Method: A multivariate Cox proportional hazard regression model was performed using the 'Enter method'. Two hundred twenty‐six participants from the Compostela Aging Study (CompAS) were included in the analyses (none censored). Participants were diagnosed at baseline as Cognitively Unimpaired (CU = 144), Subjective Cognitive Decline (SCD = 37), and Mild Cognitive Impairment (MCI = 45) (Table 1). The event was defined as stability or worsening in cognitive status over a follow‐up of 17‐75 months, during which three evaluations were performed. Stability was considered when the diagnosis remained stable and worsening when progression to MCI or dementia occurred. The groups at baseline (CU, SCD, MCI) were entered into the model as strata. MBI‐C total score at baseline was introduced as a covariate and adjusted by age, gender, years of education, comorbidity, and SCCs from participants and informants. Results: The tested model was statistically significant [overall significance: ‐2 Log Likelihood = 1620.73, χ2 = 17.63, df = 7, p <.014]. MBI‐C total score was the only significant variable [β =.038, SE =.014, Wald = 7.77, p <.005]. Its corresponding hazard ratio was 1.039 (95% CI 1.011‐1.068), indicating that for one unit increase in the MBI‐C total score, the risk of worsening increases by 1.039 for a month (Table 2). Figure 1 shows the survival function using covariates for each group. The greatest differences were observed in the time interval 20‐60 months, and especially between the MCI and CU. SCD curve remained stable during that period and was more similar to the MCI curve. Conclusion: Our results indicated that MBI‐C can significantly predict time to worsening along the cognitive impairment continuum. Further, differences between MCI and CU participants' trajectories were especially pronounced around 40‐60 months, with SCD falling between the two groups. [ABSTRACT FROM AUTHOR]

The design of a narrative video game for cognitive training of memory and executive functions in older adults with subjective and objective cognitive impairment is reported along with preliminary results on preferences (Study 1), user interaction experience (Study 2), and efficacy of the game (Study 3). A study of aesthetic preferences in backgrounds and avatars was implemented in 13 older adults, who were asked for their opinion on the acceptability of the plot. After completion of the design, a user interaction study was conducted in a sample of 19 older adults. In addition, a Matched Paired Experimental Design (MPED) was implemented as a preliminary test of the efficacy of the narrative video game in a sample of 22 participants with Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI). Preferences for free violence content in videogames was supported in our sample of low-frequency adult gamers and acceptability of the plot was high. The video game was rated favourably by the older adults in terms of user preferences and acceptability. The results of the preliminary MPED study suggest that the video game could be a useful tool for cognitive training in SCD and MCI older adults. [ABSTRACT FROM AUTHOR]

Resumen Antecedentes y objetivos: El Informe de Cuidados de Enfermería (ICE) recoge cuidados enfermeros durante la estancia hospitalaria. CONECTA72 es un programa para asegurar el seguimiento de cuidados al alta, y su hilo conductor es el ICE. La enfermera gestora de casos (EGC) focaliza su actividad en la práctica avanzada del cuidado. El objetivo es conocer la opinión de los médicos/as del Área Sanitaria de Ferrol sobre ICE, CONECTA72 y EGC. Métodos: Estudio observacional descriptivo con 172 facultativos especialistas y residentes. Participación voluntaria, mediante cuaderno de datos ad hoc enviado por correo electrónico tras los correspondientes permisos. Resultados: Resultados: El 78,1% conocen la existencia del ICE; 73,1% lo habían leído en alguna ocasión, 88,6% cree conveniente que los pacientes lo reciban. 61,6% conocen CONECTA72, aunque el 23,2% no han participado en él. El 83,2% creen conveniente la existencia de EGC. Conclusiones: El ICE es un instrumento efectivo para dar continuidad a los cuidados, pero existe un desconocimiento importante sobre cuándo se realiza y su contenido. Parece necesario promocionar CONECTA72, ya que es desconocido por un tercio del personal médico; aunque no parece que su existencia pueda suplir la figura de EGC.

Background: Although there is evidence that measures of verbal fluency, naming and word memory can be good predictors of progression to dementia, language change and the main variables predicting it are not yet fully characterized. Recent research draws attention to the need to consider cognitive reserve, functional, and neurobiological indicators together to explain changes (Facal et al., 2021). Method: The study sample was drawn from the participants of the Compostela Aging Study who completed the third and fourth follow‐up assessments, with about 18 months between assessments. Sample included 24 persons with MCI, 42 with subjective cognitive decline and 41 cognitively unimpaired participants. Language performance was assessed via Boston naming test, semantic, phonemic, and ideational fluency. The difference in performance between the assessments (T4‐T3) was calculated. General linear regression (GLR) models were developed, including the change in each language variable as dependent, and years of education, gait speed (timed‐up and go test), grip strength and mean cortical thickness in the left and right hemispheres as covariates. Results: Though cross‐sectional differences were found in the four language measures, no differences were found in language change measures (Figure 1). The GLR model with the Boston naming test as the dependent variable was the only significant (F = 5.52, p<.01, η2 = 0.26, B‐1 = 0.99). Of the five covariates included in the model, grip strength was significant (F = 21.17, p<.01, η2 = 0,21, B‐1 = 0.99). Conclusion: Naming tests can be good markers of linguistic change in the continuum from healthy cognitive aging to dementia (Flores‐Vázquez et al., 2022). Although this is a first approximation, and 18 months can be a too short time to register significant changes, this work stress the importance of jointly analyzing cognitive reserve, functional and neurobiological predictors. References: Facal, D., Burgo, C., Spuch, C., Gaspar, P. & Campos‐Magdaleno, M. (2021) Cognitive Frailty: An Update. Frontiers in Psychology 12,813398. https://doi.org/10.3389/fpsyg.2021.813398 Flores‐Vázquez, J.F., Contreras‐López, J.J., Stegement, R., Castellanos‐Maya, O., Ćurčic‐Blake, B., Andrés, P., Sosa‐Ortiz, A.L., Aleman, A., Enriquez‐Geppert, E. (2022). Extended FNAME performance is preserved in subjective cognitive decline but highly affected in amnestic mild cognitive impairment. Neuropyshology 37, 6, 650‐660. https://doi.org/10.1037/neu0000874 [ABSTRACT FROM AUTHOR]

Background: Language performance has been considered a potential screening tool in the continuum from healthy cognitive aging to cognitive impairment and dementia. Language impairment and most notably impairment in semantic verbal fluency has been shown to increase with the progress in this continuum (Liampas et al., 2023). Method: The study sample was drawn from the participants of the Compostela Aging Study who completed baseline and two follow‐up assessment, each of them about 18 months after the previous cognitive and neuropsychological evaluation (Pereiro et al., 2021). Sample included 22 persons with uni‐domain mild cognitive impairment (MCI), 20 with multi‐domain MCI, 46 with subjective cognitive decline and 73 cognitively unimpaired participants. Language performance was assessed via Boston naming test, semantic, phonemic and ideational fluency. GLM repeated measures were implemented comparing performance in the three assessments for each of the language measures as a dependent variable, and the diagnostic group as a factor. Age and years of formal education were included as covariates. Result: A significant interaction between time of assessment and group was only found for the Boston naming test (F = 1.75, p<0.05, η2 = 0,03, B‐1 = 0,53). Age, but not education, was a significant covariate for all the language measures. Conclusion: Even though language measures could be relevant to detect early changes in cognitive status, these measures has scarcely been studied in recent literature. According to these preliminary analyses of the longitudinal results of our study, the Boston naming test could be a linguistic marker of cognitive changes in late adulthood. References: Lampas, I., Folia, V., Morfakidou, R., Siokas, V., Yannakoulia, M., Sakka, P., Scarmeas, N., Hadjigeorgiou, G., Dardiotis, E., Kosmidis, M.H. (2023). Language differences among individuals with normal cognition, amnestic and non‐amnestic MCI, and Alzheimer's disease. Archives of Clinical Neuropsychology 38, 525. https://doi.org/10.1093/arclin/acac080 Pereiro, A.X., Valladares‐Rodríguez, S., Felpete, A. Lojo‐Seoane, C., Campos‐Magdaleno, M., Mallo, S.C., Facal, D., Anido‐Rifón, L., Belleville, S., Juncos‐Rabadán, O. (2021). Relevance of complaint severity in predicting the progression of subjective cognitive decline and mild cognitive impairment: A machine learning approach. Journal of Alzheimers Disease 82, 3, 1229‐1242. https://doi.org/10.3233/JAD‐210334. [ABSTRACT FROM AUTHOR]

Background: The importance of coincidence of cognitive complaints between participants without objective impairment and their informants in predicting progression remains unclear (Nosheny et al, 2022). Our objective was to determine whether agreement in dyadic reporting at baseline can predict survival time to progression to MCI or dementia. Method: A sample of 145 participants from the CompAS Study was included in a survival analysis. They were identified at baseline as CU (N = 115) and SCD (N = 30) and re‐diagnosed as CU, SCD, MCI, or dementia from 17 to 76 months of follow‐up. 'Agreement' in the presence of complaints was computed depending on the informant and participant QAM scores (range: 7‐35) at baseline were above or below a cut‐off point (i.e., 10‐11): 1) Overreport by participant (i.e., QAM scores above the established cut‐off for participant and below for informant); 2) Agreement in presence of complaints (i.e., QAM total scores of both coincide in being above the established cut‐off point). The other two categories (i.e., Overreport by informant; Agreement in absence of complaints) were discarded because there were almost no cases. We performed a Cox proportional hazards regression model (no cases censored). The event was defined as stability when the baseline diagnosis remained stable over the follow‐ups and worsening when a change to MCI or dementia. 'Agreement' was introduced as a covariate. Two groups (CU; SCD) identified at baseline entered the model as strata. Result: The model was statistically significant [model fit: ‐2 Log Likelihood = 1029.810, χ2 = 9.721, df = 1, p<.002]. 'Agreement' significantly predicts time survival [β = ‐.471, SE =.161, Wald = 8.569, p <.003] and HR =.575 (95% CI =.404‐.817) indicated that the risk of worsening per month was 42.5% (1‐.575 =.425) smaller for the 'Agreement in presence of complaints' than for the 'Overreport by participant' in both CU and SCD groups (Figures 1 and 2). Conclusion: Our results suggest that compared to the 'Overreport by participant', the dyadic agreement in the presence of complaints decreases the risk of worsening over time. These results could have to do either with a greater awareness of one's own difficulties or with the beneficial effect of agreeing on its detection with informants in pre‐symptomatic stages. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the impacts of the restrictions implemented in LTCF during the COVID-19 pandemic on the psychological and functional status of older adults. Design: A retrospective multicentre study is designed. We hypothesize that the negative effects of the restrictions will lead to a higher rate of decline between the measures taken immediately before and after the lockdown than between the two measures taken before the lockdown. Setting and participants: 365 participants recruited in four Spanish LTCFs in Galicia and Valencia. Methods: Impacts of restrictions on cognitive (MMSE), affective (GDS) and functional status (Barthel index, Tinetti) were analyzed by Linear Mixed Models with random intercepts, random slopes, and personal and contextual factors as covariates. Results: Social measures covaried significantly with the cognitive and functional status but did not predict longitudinal change. MMSE, Barthel index and Tinetti scores decreased significantly across pre- and post-lockdown measurement times, but only the Tinetti scores showed a specific impact of the restrictions. Conclusions: Only performance-based functional measures showed the real impact of restrictions. The findings highlight the importance of having data from several pre-lockdown measurements to enable identification of changes that can be causally attributed to the restrictions. The findings also support the resilience of older adults in mitigating the effect of the restrictions. [ABSTRACT FROM AUTHOR]