BackgroundThe interest in applying information and communications technology (ICT) in older adult health care is frequently promoted by the increasing and unsustainable costs of health care services. In turn, the unprecedented growth of the elderly population around the globe has urged institutions, companies, industries, and governments to respond to older adults’ medical needs.ObjectiveThe aim of this review is to systematically identify the opportunities that ICT offers to health services, specifically for patients with dementia and their families.MethodsA systematic review of the literature about ICT applications that have been developed to assist patients with Alzheimer’s disease (AD) and their primary caregivers was conducted. The bibliographic search included works published between January 2005 and July 2015 in the databases Springer Link, Scopus, and Google Scholar. Of the published papers, 902 were obtained in the initial search, of which 214 were potentially relevant. Included studies fulfilled the following inclusion criteria: (1) studies carried out between the years of 2005 and 2015, (2) studies were published in English or Spanish, (3) studies with titles containing the keywords, (4) studies with abstracts containing information on ICT applications and AD, and (5) studies published in indexed journals, proceedings, and book chapters.ResultsA total of 26 studies satisfied the inclusion criteria for the current review. Among them, 16 were aimed at the patient with AD and 10 at the primary caregivers and/or family members. The studies targeted applications that included assistive technology (44%, 7/16), telecare (37%, 6/16), and telemedicine (31%, 5/16). The information systems (56%, 9/16) and Internet (44%, 7/16) were the most commonly used enabling technologies for the studies. Finally, areas of attention more covered by the studies were care (56%, 9/16), treatment (56%, 9/16), and management (50%, 8/16). Furthermore, it was found that 20 studies (77%, 8/26) evaluated their ICT applications through carrying out tests with patients with dementia and caregivers.ConclusionsThe key finding of this systematic review revealed that the use of ICT tools can be strongly recommended to be used as a lifestyle in the elderly in order to improve the quality of life for the elderly and their primary caregivers. Since patients with AD are completely dependent in most activities, it is necessary to give attention to their primary caregivers to avoid stress and depression. In addition, the use of ICT in the daily life of caregivers can help them understand the disease process and manage situations in a way that is beneficial for both parties. It is expected that future developments concerning technological projects can support this group of people.
As information and services are becoming more and more decentralized and they are often available in the cloud, an increasing number of older adults are expected to use Internet-based services-health, education, finance and others. For this reason, it seems important to plan models and/or strategies to allow the older adult population to acquire and enhance digital competencies more easily. The goal of this research is to show a blended workshop based on a Learning Management System (LMS) as a supporting tool for older adults' digital literacy. This blended workshop was based on the adoption of an instructional model and on prior experiences of the groups of elderly that participated in the face-to-face workshops. This study involved 98 adults aged 60 and above, 72 Females (68.5 ± 6.9) and 26 Males (73.3 ± 7.4). 61 older adults participated in the face-to-face workshop (FFG) on digital literacy and 37 participated in the blended workshop (BLG). Digital literacy increased at the post-evaluation after the workshops but even more for the BLG. Likewise, in the validation of the blended workshop the results were positive regarding ease of use, perceived usefulness, attitude toward using and intention to use, which showed that older adults believe that it is useful to implement this type of supporting systems for developing their digital competencies. Hence, it is possible to conclude that older adults are capable of learning and acquiring digital literacy skills as long as they are strongly motivated or they know the functional benefits related to ICT.
Solanezumab and Crenezumab are two humanized antibodies targeting Amyloid-β (Aβ) which are currently tested in multiple clinical trials for the prevention of Alzheimer's disease. However, there is a scientific discussion ongoing about the target engagement of these antibodies. Here, we report the immunohistochemical staining profiles of biosimilar antibodies of Solanezumab, Crenezumab and Bapineuzumab in human formalin-fixed, paraffin-embedded tissue and human fresh frozen tissue. Furthermore, we performed a direct comparative immunohistochemistry analysis of the biosimilar versions of the humanized antibodies in different mouse models including 5XFAD, Tg4-42, TBA42, APP/PS1KI, 3xTg. The staining pattern with these humanized antibodies revealed a surprisingly similar profile. All three antibodies detected plaques, cerebral amyloid angiopathy and intraneuronal Aβ in a similar fashion. Remarkably, Solanezumab showed a strong binding affinity to plaques. We also reaffirmed that Bapineuzumab does not recognize N-truncated or modified Aβ, while Solanezumab and Crenezumab do detect N-terminally modified Aβ peptides Aβ4-42 and pyroglutamate Aβ3-42. In addition, we compared the results with the staining pattern of the mouse NT4X antibody that recognizes specifically Aβ4-42 and pyroglutamate Aβ3-42, but not full-length Aβ1-42. In contrast to the biosimilar antibodies of Solanezumab, Crenezumab and Bapineuzumab, the murine NT4X antibody shows a unique target engagement. NT4X does barely cross-react with amyloid plaques in human tissue. It does, however, detect cerebral amyloid angiopathy in human tissue. In Alzheimer mouse models, NT4X detects intraneuronal Aβ and plaques comparable to the humanized antibodies. In conclusion, the biosimilar antibodies Solanezumab, Crenezumab and Bapineuzumab strongly react with amyloid plaques, which are in contrast to the NT4X antibody that hardly recognizes plaques in human tissue. Therefore, NT4X is the first of a new class of therapeutic antibodies.
The current sanitary crisis due to COVID-19 has further evidenced the enormous digital exclusion of older adults. Furthermore, the crisis has urged older adults to adopt new technologies to facilitate their tasks, as well as to provide them with an effective means against loneliness and social isolation caused by the confinement. In light of this, Digital Literacy is necessary for all those excluded from the digital era, who are characterized mainly by little or no ability to effectively use technologies. Nevertheless, detailed studies showing the leap from mixed (Blended Learning, BL) to digital literacy in the elderly have not been published. The objective of the present research was to analyze the level of Digital Literacy with the Digital Literacy Evaluation (DILE) of two groups of elderly adults with different levels of literacy (Group 1: G1, and Group 2: G2) during three stages: BL (Aug–Dec 2019); Transition (Feb–Jun 2020); and Digital (Aug–Dec 2020). Comparisons were made before each educational level (pre-pre-pre) and after each educational level (post-post-post) and during consecutive periods before and after each semester (pre vs post) and throughout different educational levels (G1: Basic 1, B1; Basic 2, B2; and intermediate 1, I1; and G2: Intermediate 1 to 3, I1, I2, and I3). Subsequently, considering all the elderly who had passed at least one of the literacy levels, we worked with a total sample of 176 older adults. The comparisons showed that, before the pandemic, G1’s pre digital literacy levels increased between B1 and B2 and that the differences continued with that increasing trend between the B1 level and the I1 completely digital treatment, and the same was observed for post measurements. On the other hand, for the G2, the differences in the DILE were statistically significant between the pre-condition of I2 (before the pandemic) and the I3 (completely digital treatment); and between the pre-conditions of I1 and I3; the same results were obtained for post treatments. Also, pre vs post scores on the DILE were statistically significant and older adults increased progressively their digital literacy despite the COVID-19 pandemic and jumped to the digital age.
Castillo et al. Neurodegeneration Revisited cognitive impairment, dementia, and cerebrovascular events such as stroke. Second, we suggest that the persistence of senescent cells in neuronal circuits may favor, together with systemic metabolic diseases, neurodegeneration to occur. Third, we argue that neurodegeneration may start in response to altered body and brain trophic interactions established via the hardwire that connects peripheral targets with central neuronal structures or by means of extracellular vesicle (EV)-mediated communication. Lastly, we elaborate on how lifespan body dysbiosis may be linked to the origin of neurodegeneration. We highlight the existence of bacterial products that modulate the gut-brain axis causing neuroinflammation and neuronal dysfunction. As a concluding section, we end by recommending research avenues to investigate these etiological paths in the future. We think that this requires an integrated, interdisciplinary conceptual research approach based on the investigation of the multimodal aspects of physiology and pathophysiology. It involves utilizing proper conceptual models, experimental animal units, and identifying currently unused opportunities derived from human data. Overall, the proposed etiological paths and experimental recommendations will be important guidelines for future cross-discipline research to overcome the translational roadblock and to develop causative treatments for neurodegenerative diseases.
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