Coginitive Dysfunction

Mexico exhibits a high prevalence of dementia, exceeding 8%, and it is estimated that by 2050 around 3.5 million older adults will be living with this condition. In light of this scenario, it becomes a priority to intervene on the factors associated with the development of dementia through preventive strategies, particularly via multicomponent programs that integrate physical activity, cognitive training, and other components aimed at modifying lifestyles, applied early, before the appearance of clinical symptoms. In order to expand access to this type of intervention for older adults with limited time or resources for face-to-face care, the implementation of preventive programs remotely through the use of digital media has been proposed. Web platforms constitute an accessible and cost-effective alternative for delivering complex interventions, such as the 'Mind and Movement for Cognitive Health (MeMo-Salud-Cog)' program, designed to promote lifestyles conducive to cognitive health and which has shown promising preliminary results in overall cognitive function, memory, executive function, and attention. However, the use of digital systems by older adults may be limited by barriers associated with ageing (cognitive, sensory, physical, and motivational), as well as social aspects (education and social isolation) or cultural factors (beliefs and perceived usefulness), which can affect the continuity of their participation. In this context, the present proposal suggests adapting the MeMo-Salud-Cog program to a remote modality, through a website and remote monitoring by healthcare professionals, with the aim of evaluating its feasibility based on usability, satisfaction, effect, and adherence, as well as analyzing perceived acceptability, emphasizng the barriers and benefits of remote intervention. The investigators will employ a mixed design combining quantitative and qualitative methods, with a pre-post evaluation without a control group in the quantitative part and semi-structured interviews in the qualitative part (pilot study). The study population will consist of independent individuals aged 60 to 75 years affiliated with IMSS at the Family Medicine Unit 1 and 28, with or without cognitive complaints, but without impairment (MMSE ≥ 24), functional independence, at least one vascular risk factor, with a mobile phone or computer, and an informed consent letter.

Reasons such as sleep disorders, depression, decreased independence in daily living activities and decreased quality of life, which are seen in the majority of liver cirrhosis patients, can cause cognitive dysfunction, especially attention. It is known that physical dysfunctions are observed in patients with liver cirrhosis along with cognitive dysfunction. Sarcopenia is the most important of these dysfunctions. Sarcopenia is the progressive, widespread loss of muscle mass, function and strength. The aim of this study is to determine the effects of face-to-face and home-based progressive strengthening exercise program performed 3 times a week for 12 weeks on muscle strength, muscle mass, functionality and cognitive functions in individuals with liver cirrhosis. It is also aimed to test the feasibility and effectiveness of the home-based exercise method in individuals with liver cirrhosis. Another aim of our study is to determine the exercise dose required to improve muscle strength, muscle mass, functionality and cognitive functions in individuals with liver cirrhosis and the duration of treatment effectiveness through follow-up.