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The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

  • Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions) were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5). Patients were grouped as 11 amnesic mild cognitive impairment (aMCI), 23 multi domain mild cognitive impairment (mMCI) and 8 Mild Alzheimer's Dementia (CDR 1). None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ) into two groups: low (IQ < 98.5) and high (IQ > 98.5). Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05). Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural improvement can be reported in these patients after the stimulation program (duration time: 12.53 months SD 5.5).

    Citation: Federerico Filipin, Mónica Feldman, Fernando E. Taragano, María Martelli, Viviana Sánchez, Virginia García, Graciela Tufro, Silvina Heisecke, Cecilia Serrano, Carol Dillon. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study[J]. AIMS Medical Science, 2016, 3(1): 1-14. doi: 10.3934/medsci.2016.1.1

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  • Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions) were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5). Patients were grouped as 11 amnesic mild cognitive impairment (aMCI), 23 multi domain mild cognitive impairment (mMCI) and 8 Mild Alzheimer's Dementia (CDR 1). None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ) into two groups: low (IQ < 98.5) and high (IQ > 98.5). Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05). Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural improvement can be reported in these patients after the stimulation program (duration time: 12.53 months SD 5.5).


    Hybrid differential equations have been considered more important and served as special cases of dynamical systems. Dhage and Lakshmikantham [1] were the first to study ordinary hybrid differential equation and studied the existence of solutions for this boundary value problem. In recent years, with the wide study of fractional differential equations, the theory of hybrid fractional differential equations were also studied by several researchers, see [2,3,4,5,6,7,8,9,10] and the references therein.

    Zhao et al. [2] studied existence and uniqueness results for the following hybrid differential equations involving Riemann-Liouville fractional derivative

    $ D^{q}_{0^{+}}\biggl(\frac{x(t)}{f(t, x(t))}\biggr) = g(t, x(t)), \ \ a.e. t\in J = [0, T] $
    $ x(0) = 0, $

    where $ 0 < q < 1, f\in C(J\times R\rightarrow R\backslash \{0\}) $ and $ g\in C(J\times R, R). $

    Zidane Baitiche et al. [11] considered the following boundary value problem of nonlinear fractional hybrid differential equations involving Caputo's derivative

    $ ^{C}D^{\alpha}_{0^{+}}\biggl(\frac{x(t)}{f(t, x(\mu(t)))}\biggr) = g(t, x(\mu(t))), \ \ t\in I = [0, 1] $
    $ a\biggl[\frac{x(t)}{f(t, x(\mu(t)))}\biggr]\bigg|_{t = 0}+b\biggl[\frac{x(t)}{f(t, x(\mu(t)))}\biggr]\bigg|_{t = 1} = c, $

    where $ 0 < \alpha\leq 1, ^{C}D^{\alpha}_{0^{+}} $ is the Caputo fractional derivative. $ f\in C(I\times R \rightarrow R\backslash\{0\}), g\in C(I\times R, R). $

    As we all known, the hadamard fractional differential equations are also popular in the literature, see [12,13,14,15,16], so some authors began to study the theory of fractional hybrid differential equation of hadamard type.

    Zidane Baitiche et al. [17] studied the existence of solutions for fractional hybrid differential equation of hadamard type with dirichlet boundary conditions

    $ _{H}D^{\alpha}\biggl(\frac{x(t)}{f(t, x(t))}\biggr) = g(t, x(t)), \ \ 1 \lt t \lt e, \ 1 \lt \alpha\leq 2, $
    $ x(1) = 0, \ \ \ x(e) = 0, $

    where $ 1 < \alpha\leq 2, \ _{H}D^{\alpha} $ is the Hadamard fractional derivative, $ f\in C([1, e]\times R\rightarrow R\backslash \{0\}) $ and $ g\in C([1, e]\times R, R). $

    In [18], M. Jamil et al. discussed the existence result for the boundary value problem of hybrid fractional integro-differential equations involving Caputo's derivative given by

    $ ^{C}D^{\alpha}\biggl(\frac{^{C}D^{\omega}u(t)-\sum_{i = 1}^{m}I^{\beta_{i}}f_{i}(t, u(t))}{g(t, u(t))}\biggr) = h(t, u(t), I^{\gamma}u(t)), \ \ t\in J = [0, 1], $
    $ u(0) = 0, \ D^{\omega}u(0) = 0, \ u(1) = \delta u(\eta), \ \ 0 \lt \delta \lt 1, \ \ 0 \lt \eta \lt 1, $

    where $ ^{C}D^{\alpha} $ is the Caputo fractional derivative of order $ \alpha, \ ^{C}D^{\omega} $ is the Caputo fractional derivative of order $ \omega, \ 0 < \alpha\leq 1, \ 1 < \omega\leq 2. $

    In order to analyze fractional differential equations in a generic way, a fractional derivative with respect to another function called $ \varphi $-Caputo derivative was proposed [19].

    By mixing idea of the above works, we derived an existence result for the nonlocal boundary value problems of hybrid $ \varphi $-Caputo fractional integro-differential equations

    $ CDα φ(CDβ φu(t)mi=1Iωi φfi(t,u(t),Iμ1 φu(t),,Iμn φu(t))g(t,u(t),Iγ1 φu(t),,Iγp φu(t)))=h(t,u(t)),tJ=[0,1], $ (1.1)
    $ u(0)=0, CDβ φu(0)=0, u(1)=kj=1δju(ξj), $ (1.2)

    where $ 0 < \alpha\leq 1, \ 1 < \beta\leq 2, \ ^{C}D^{\alpha\ \varphi} $ is the $ \varphi $-Caputo fractional derivative of order $ \alpha, \ ^{C}D^{\beta\ \varphi} $ is the $ \varphi $-Caputo fractional derivative of order $ \beta, $ the function $ \varphi:\ [0, 1]\rightarrow R $ is a strictly increasing function such that $ \varphi\in C^{2}[0, 1] $ with $ \varphi'(x) > 0 $ for all $ x\in [0, 1], \ I^{\mu\ \varphi} $ denote the $ \varphi $-Riemann-Liouville fractional integral of order $ \mu, \ g\in C(J\times R^{p+1}, R\backslash \{0\}), \ h\in C(J\times R, R) $ and $ f_{i}\in C(J\times R^{n+1}, R) $ with $ f_{i}(0, \underbrace{0, \cdot\cdot\cdot, 0}_{n+1}) = 0, \ w_{i} > 0, \ i = 1, 2, \cdot\cdot\cdot, m, \ \mu_{1}, \cdot\cdot\cdot, \mu_{n} > 0 $ and $ \gamma_{1}, \cdot\cdot\cdot, \gamma_{p} > 0, \ 0 < \delta_{j} < 1, \ j = 1, 2, \cdot\cdot\cdot, k, \ 0 < \xi_{1} < \xi_{2} < \cdot\cdot\cdot < \xi_{k} < 1. $

    It is notable that the fractional hybrid integro-differential equation presented in this paper is the novel in the sense that the fractional derivative with respect to another function called $ \varphi $-Caputo fractional derivative. Note that the hybrid fractional integro-differential equations involving Caputo's derivative in [18] is a special case of our hybrid $ \varphi $-Caputo fractional integro-differential equations with $ \varphi(t) = t. $ Moreover, all dependent functions $ f_{i} $ and $ g $ in our paper are in the form of multi-term. Furthermore, our problem is more general than the work in [8], as we consider the problem with multi-point boundary conditions, while the authors in [8] only investigated two-point boundary condition.

    The organization of this work is as follows. Section 2 contains some preliminary facts that we need in the sequel. In section 3, we present the solution for the hybrid fractional integro-differential equation (1.1), (1.2) and then prove our main existence results. Finally, we illustrate the obtained results by an example.

    In the following and throughtout the text, $ a > 0 $ is a real, $ x:[a, b]\rightarrow R $ an integrable function and $ \varphi\in C^{2}[a, b] $ an increasing function such that with $ \varphi'(t)\neq 0 $ for all $ t\in [a, b]. $

    Definition 2.1 The $ \varphi $-Riemann-Liouville fractional integral of $ x $ of order $ \alpha $ is defined as follows

    $ I^{\alpha\ \varphi}_{a^{+}}x(t): = \frac{1}{\Gamma (\alpha)}\int_{a}^{t}\varphi'(s)(\varphi(t)-\varphi(s))^{\alpha-1}x(s)ds. $

    Definition 2.2 The $ \varphi $-Riemann-Liouville fractional derivative of $ x $ of order $ \alpha $ is defined as follows

    $ D^{\alpha\ \varphi}_{a^{+}}x(t): = \biggl( \frac{1}{\varphi'(t)}\frac{d}{dt}\biggr)^{n}I^{n-\alpha\ \varphi}_{a^{+}}x(t) = \frac{1}{\Gamma (n-\alpha)}\biggl(\frac{1}{\varphi'(t)}\frac{d}{dt}\biggr)^{n}\int_{a}^{t}\varphi'(s)(\varphi(t)-\varphi(s))^{n-\alpha-1}x(s)ds, $

    here $ n = [\alpha]+1. $

    Remark 2.1 Let $ \alpha, \beta > 0, $ then the relation holds

    $ I^{\alpha\ \varphi}_{a^{+}}I^{\beta\ \varphi}_{a^{+}}x(t) = I^{\alpha+\beta\ \varphi}_{a^{+}}x(t). $

    Definition 2.3 Let $ \alpha > 0 $ and $ x\in C^{n-1}[a, b], $ the $ \varphi $-Caputo fractional derivative of $ x $ of order $ \alpha $ is defined as follows

    $ ^{C}D^{\alpha\ \varphi}_{a^{+}}x(t): = D^{\alpha\ \varphi}_{a^{+}}\biggl[x(t)-\sum\limits_{k = 0}^{n-1} \frac{x_{\varphi}^{[k]}(a)}{k!} (\varphi(t)-\varphi(a))^{k}\biggr], \ n = [\alpha]+1\ \mbox{for}\ \alpha \not\in N, \ n = \alpha\ \mbox{for} \ \alpha \in N, $

    where $ x_{\varphi}^{[k]}(t): = \biggl(\frac{1}{\varphi'(t)}\frac{d}{dt}\bigamma)^{k}x(t). $

    Theorem 2.1 [20] Let $ x: [a, b]\rightarrow R. $ The following results hold:

    1. If $ x\in C[a, b], $ then $ ^{C}D^{\alpha\ \varphi}_{a^{+}}I^{\alpha\ \varphi}_{a^{+}}x(t) = x(t); $

    2. If $ x\in C^{n-1}[a, b], $ then

    $ I^{\alpha\ \varphi\ C}_{a^{+}} D^{\alpha\ \varphi}_{a^{+}}x(t) = x(t)-\sum\limits_{k = 0}^{n-1} \frac{x_{\varphi}^{[k]}(a)}{k!} (\varphi(t)-\varphi(a))^{k}. $

    Lemma 2.2 [18] Let $ S $ be a nonempty, convex, closed, and bounded set such that $ S\subseteq E, $ and let $ A:E\rightarrow E $ and $ B:S\rightarrow E $ be two operators which satisfy the following :

    $ (H_{1}) \; A $ is contraction;

    $ (H_{2}) \; B $ is compact and continuous, and

    $ (H_{3}) \; u = Au+Bv, \ \forall v\in S\Rightarrow u\in S. $

    Then there exists a solution of the operator equation $ u = Au+Bu. $

    Let $ E = C(J, R) $ be a Banach space equipped with the norm

    $ \|u\| = \sup\limits_{t\in J}|u(t)|\ \ \ \mbox{and}\ \ (uv)(t) = u(t)v(t), \ \ \forall\ t\in J. $

    Then $ E $ is a Banach algebra with the above norm and multiplication.

    Lemma 3.1 Suppose that $ \alpha, \beta, \omega_{i}, i = 1, 2, \cdot\cdot\cdot, m, \gamma_{i}, i = 1, 2, \cdot\cdot\cdot, p, \mu_{i}, i = 1, 2, \cdot\cdot\cdot, n, \delta_{j}, \xi_{j}, j = 1, 2, \cdot\cdot\cdot, k $ and functions $ g, h, f_{i}, i = 1, 2, \cdot\cdot\cdot, m $ satisfy problem (1.1), (1.2). Then the unique solution of (1.1), (1.2) is given by

    $ u(t)=t0(φ(t)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(t,u(t),Iμ1 φu(t),,Iμn φu(t))+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))[10(φ(1)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(1,u(1),Iμ1 φu(1),,Iμn φu(1))kj=1δjξj0(φ(ξj)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτdskj=1δjmi=1Iωi+β φfi(ξj,u(ξj),Iμ1 φu(ξj),,Iμn φu(ξj))], $ (3.1)

    where

    $ Iωi+β φfi(t,u(t),Iμ1 φu(t),,Iμn φu(t))=t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds; $
    $ Iωi+β φfi(1,u(1),Iμ1 φu(1),,Iμn φu(1))=10(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds; $
    $ Iωi+β φfi(ξj,u(ξj),Iμ1 φu(ξj),,Iμn φu(ξj))=ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds. $

    Proof. We apply $ \varphi $-Riemann-Liouville fractional integral $ I^{\alpha\ \varphi} $ on both sides of (1.1), by Theorem 2.1, we have

    $ \frac{^{C}D^{\beta\ \varphi}u(t)-\sum_{i = 1}^{m}I^{\omega_{i}\ \varphi}f_{i}(t, u(t), I^{\mu_{1}\ \varphi}u(t), \cdot\cdot\cdot, I^{\mu_{n}\ \varphi}u(t))} {g(t, u(t), I^{\gamma_{1}\ \varphi}u(t), \cdot\cdot\cdot, I^{\gamma_{p}\ \varphi}u(t))} = I^{\alpha\ \varphi}h(t, u(t))+c_{0}, $

    then by $ u(0) = 0, \ ^{C}D^{\beta\ \varphi}u(0) = 0, \ f_{i}(0, \underbrace{0, \cdot\cdot\cdot, 0}_{n+1}) = 0, $ we get $ c_{0} = 0. $ i.e,

    $ CDβ φu(t)=g(t,u(t),Iγ1 φu(t),,Iγp φu(t))t0(φ(t)φ(s))α1Γ(α)φ(s)h(s,u(s))ds+mi=1Iωi φfi(t,u(t),Iμ1 φu(t),,Iμn φu(t)). $ (3.2)

    Apply again fractional integral $ I^{\beta\ \varphi} $ on both sides of (3.2) and by Theorem 2.1, we get

    $ u(t)=t0(φ(t)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(t,u(t),Iμ1 φu(t),,Iμn φu(t))+c1+c2(φ(t)φ(0)), $ (3.3)

    $ u(0) = 0, \ f_{i}(0, \underbrace{0, \cdot\cdot\cdot, 0}_{n+1}) = 0 $ yield $ c_{1} = 0, $ thus equation (3.3) is reduced to

    $ u(t)=t0(φ(t)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(t,u(t),Iμ1 φu(t),,Iμn φu(t))+c2(φ(t)φ(0)), $ (3.4)

    specially.

    $ u(1)=10(φ(1)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(1,u(1),Iμ1 φu(1),,Iμn φu(1))+c2(φ(1)φ(0)), $
    $ u(ξj)=ξj0(φ(ξj)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(ξj,u(ξj),Iμ1 φu(ξj),,Iμn φu(ξj))+c2(φ(ξj)φ(0)), $

    from $ u(1) = \sum\limits_{j = 1}^{k}\delta_{j}u(\xi_{j}), $ we have

    $ c2=1kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))[10(φ(1)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+mi=1Iωi+β φfi(1,u(1),Iμ1 φu(1),,Iμn φu(1))kj=1δjξj0(φ(ξj)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτdskj=1δjmi=1Iωi+β φfi(ξj,u(ξj),Iμ1 φu(ξj),,Iμn φu(ξj))]. $

    Consequently, we can get the desired result. The proof is completed.

    Theorem 3.2 Suppose that functions $ g\in C(J\times R^{p+1}, R\backslash \{0\}), \ h\in C(J\times R, R) $ and $ f_{i}\in C(J\times R^{n+1}, R) $ with $ f_{i}(0, \underbrace{0, \cdot\cdot\cdot, 0}_{n+1}) = 0. $ Furthermore, assume that

    $ (C_{1}) $ there exist bounded mapping $ \sigma: [0, 1]\rightarrow R^{+}, \ \lambda: [0, 1]\rightarrow R^{+} $ such that

    $ |g(t, k_{1}, k_{2}, \cdot\cdot\cdot, k_{p+1})-g(t, k_{1}^{'}, k_{2}^{'}, \cdot\cdot\cdot, k_{p+1}^{'})|\leq \sigma(t)\sum\limits_{i = 1}^{p+1}|k_{i}-k_{i}^{'}| $

    for $ t\in J $ and $ (k_{1}, k_{2}, \cdot\cdot\cdot, k_{p+1}), (k_{1}^{'}, k_{2}^{'}, \cdot\cdot\cdot, k_{p+1}^{'})\in R^{p+1}, $ and

    $ |h(t, u)-h(t, v)|\leq \lambda(t)|u-v| $ for $ t\in J $ and $ u, v\in R; $

    $ (C_{2}) $ there exist $ \phi_{i}, \Omega, \chi\in C(J, R^{+}), i = 1, 2, \cdot\cdot\cdot, m $ such that

    $ |f_{i}(t, k_{1}, k_{2}, \cdot\cdot\cdot, k_{n+1})|\leq \phi_{i}(t), \ \forall\ (t, k_{1}, k_{2}, \cdot\cdot\cdot, k_{n+1})\in J\times R^{n+1}, $
    $ |h(t, u)|\leq \Omega(t), \ \forall\ (t, u)\in J\times R, $
    $ |g(t, k_{1}, k_{2}, \cdot\cdot\cdot, k_{p+1})|\leq \chi(t), \ \forall\ (t, k_{1}, k_{2}, \cdot\cdot\cdot, k_{p+1})\in J\times R^{p+1}; $

    $ (C_{3}) $ there exists $ r > 0 $ such that

    $ (1+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|)(χΩ(φ(1)φ(0))αΓ(α+1)(φ(1)φ(0))βΓ(β+1)+mi=1ϕi(φ(1)φ(0))ωi+βΓ(ωi+β+1))r; $ (3.5)
    $ (χλ+Ωσp+1i=1(φ(1)φ(0))γiΓ(γi+1))(φ(1)φ(0))αΓ(α+1)(1+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|)(φ(1)φ(0))βΓ(β+1)<1, $ (3.6)

    where $ \Omega^{*} = \sup\limits_{0\leq t\leq 1}|\Omega(t)|, \ \phi_{i}^{*} = \sup\limits_{0\leq t\leq 1}|\phi_{i}(t)|, \ i = 1, 2, \cdot\cdot\cdot, p, \ \chi^{*} = \sup\limits_{0\leq t\leq 1}|\chi(t)|, \ \lambda^{*} = \sup\limits_{0\leq t\leq 1}|\lambda(t)|, \ \sigma^{*} = \sup\limits_{0\leq t\leq 1}|\sigma(t)|. $

    Then the hybrid problem (1.1), (1.2) has at least one solution.

    Proof. Define a subset $ S $ of $ E $ as

    $ S = \{u\in E :\ \|u\|\leq r\}, $

    where $ r $ satisfies inequality (3.5). Clearly $ S $ is closed, convex and bounded subset of the Banach space $ E. $ Define two operators $ A:E\rightarrow E $ by

    $ Au(t)=t0(φ(t)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))10(φ(1)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))ξj0(φ(ξj)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds, $ (3.7)
    $ Bu(t)=mi=1t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds. $ (3.8)

    Then $ u(t) $ is a solution of problem (1.1), (1.2) if and only if $ u(t) = Au(t)+Bu(t). $ We shall show that the operators $ A $ and $ B $ satisfy all the conditions of Lemma 2.2. We split the proof into several steps.

    Step 1. We first show that $ A $ is a contraction mapping. Let $ u(t), v(t)\in S, $ we write

    $ G(s)=g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτg(s,v(s),Iγ1 φv(s),,Iγp φv(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,v(τ))dτ, $

    then by $ (C_{1}) $ we have

    $ |G(s)|=|g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτg(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,v(τ))dτ+g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,v(τ))dτg(s,v(s),Iγ1 φv(s),,Iγp φv(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,v(τ))dτ||g(s,u(s),Iγ1 φu(s),,Iγp φu(s))|s0(φ(s)φ(τ))α1Γ(α)φ(τ)|h(τ,u(τ))h(τ,v(τ))|dτ+s0(φ(s)φ(τ))α1Γ(α)φ(τ)|h(τ,v(τ))|dτ|g(s,u(s),Iγ1 φu(s),,Iγp φu(s))g(s,v(s),Iγ1 φv(s),,Iγp φv(s))|χλuv(φ(s)φ(0))αΓ(α+1)+Ω(φ(s)φ(0))αΓ(α+1)σp+1i=1(φ(s)φ(0))γiΓ(γi+1)uv(χλ+Ωσp+1i=1(φ(1)φ(0))γiΓ(γi+1))(φ(1)φ(0))αΓ(α+1)uv, $

    thus we have

    $ |Au(t)Av(t)|t0(φ(t)φ(s))β1Γ(β)φ(s)G(s)ds+φ(t)φ(0)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|10(φ(1)φ(s))β1Γ(β)φ(s)G(s)ds+φ(t)φ(0)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|kj=1δjξj0(φ(ξj)φ(s))β1Γ(β)φ(s)G(s)ds(χλ+Ωσp+1i=1(φ(1)φ(0))γiΓ(γi+1))(φ(1)φ(0))αΓ(α+1)(1+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|)(φ(1)φ(0))βΓ(β+1)uv, $

    which implies

    $ Au(t)Av(t)[(χλ+Ωσp+1i=1(φ(1)φ(0))γiΓ(γi+1))(φ(1)φ(0))αΓ(α+1)(1+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|)(φ(1)φ(0))βΓ(β+1)]uv, $

    in view of (3.6), this shows that $ A $ is a contraction mapping.

    Step 2. The operator $ B $ is compact and continuous on S.

    First, we show that $ B $ is continuous on S. Let $ \{u_{n}\} $ be a sequence of functions in S converging to a function $ u\in S. $ Then by Lebesgue dominated convergence theorem,

    $ limnBun(t)=limn[mi=1t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,un(s),Iμ1 φun(s),,Iμn φun(s))ds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,un(s),Iμ1 φun(s),,Iμn φun(s))ds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,un(s),Iμ1 φun(s),,Iμn φun(s))ds].=mi=1t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)limnfi(s,un(s),Iμ1 φun(s),,Iμn φun(s))ds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)limnfi(s,un(s),Iμ1 φun(s),,Iμn φun(s))ds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)limnfi(s,un(s),Iμ1 φun(s),,Iμn φun(s))ds=mi=1t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φ(s),,Iμn φu(s))ds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds=Bu(t). $

    This shows that $ B $ is continuous on $ S. $ It is sufficient to show that $ B(S) $ is a uniformly bounded and equicontinuous set in $ E. $

    First, we note that

    $ |Bu(t)|mi=1t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)|fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))|ds+φ(t)φ(0)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)|fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))|ds+(φ(t)φ(0))kj=1δj|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)|fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))|dsmi=1ϕi(φ(1)φ(0))ωi+βΓ(ωi+β+1)+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|mi=1ϕi(φ(1)φ(0))ωi+βΓ(ωi+β+1)=(1+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|)mi=1ϕi(φ(1)φ(0))ωi+βΓ(ωi+β+1). $

    This shows that $ B $ is uniformly bounded on $ S. $

    Next, we show that $ B $ is an equicontinuous set in $ E. $ Let $ t_{1}, t_{2}\in J $ with $ t_{1} < t_{2} $ and $ u\in S. $ Then we have

    $ |Bu(t2)Bu(t1)|=|mi=1t20(φ(t2)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))dsmi=1t10(φ(t1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds+φ(t2)φ(t1)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds(φ(t2)φ(t1))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,u(s),Iμ1 φu(s),,Iμn φu(s))ds|mi=1ϕiΓ(ωi+β)[|t10[(φ(t2)φ(s))ωi+β1(φ(t1)φ(s))ωi+β1]φ(s)ds+t2t1[(φ(t2)φ(s))ωi+β1φ(s)ds|+φ(t2)φ(t1)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|10(φ(1)φ(s))ωi+β1φ(s)ds+(φ(t2)φ(t1))kj=1δj|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|ξj0(φ(ξj)φ(s))ωi+β1φ(s)ds]mi=1ϕiΓ(ωi+β+1)[|(φ(t2)φ(0))ωi+β(φ(t1)φ(0))ωi+β|+φ(t2)φ(t1)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|(φ(1)φ(0))ωi+β+(φ(t2)φ(t1))kj=1δj|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|(φ(ξj)φ(0))ωi+β]. $

    Let $ h(t) = (\varphi(t)-\varphi(0))^{\omega_{i}+\beta}. $ Then $ h $ is continuously differentiable function. Consequently, for all $ t_{1}, t_{2}\in [0, 1], $ without loss of generality, let $ t_{1} < t_{2}, $ then there exist positive constants $ M $ such that

    $ |h(t_{2})-h(t_{1})| = |h'(\xi)||t_{2}-t_{1}|\leq M|t_{2}-t_{1}|, \ \ \ \xi\in (t_{1}, t_{2}). $

    On the other hand, for $ \varphi\in C^{'}[0, 1], $ thus there exist positive constants $ N $ such that $ |\varphi(t_{2})-\varphi(t_{1})| = |\varphi'(\xi)||t_{2}-t_{1}|\leq N|t_{2}-t_{1}|, \ \ \ \xi\in (t_{1}, t_{2}), $ from which we deduce

    $ |Bu(t_{2})-Bu(t_{1})|\rightarrow 0\ \ \ \ \mbox{as}\ \ t_{2}-t_{1}\rightarrow 0. $

    Therefore, it follows from the Arzela-Ascoli theorem that $ B $ is a compact operator on $ S. $

    Step 3. Next we show that hypothesis $ (H_{3}) $ of Lemma 2.2 is satisfied. Let $ v\in S, $ then we have

    $ |u(t)|=|Au(t)+Bv(t)||Au(t)|+|Bv(t)||t0(φ(t)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))10(φ(1)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))ξj0(φ(ξj)φ(s))β1Γ(β)φ(s)g(s,u(s),Iγ1 φu(s),,Iγp φu(s))s0(φ(s)φ(τ))α1Γ(α)φ(τ)h(τ,u(τ))dτds|+|mi=1t0(φ(t)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,v(s),Iμ1 φv(s),,Iμn φv(s))ds+φ(t)φ(0)kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=110(φ(1)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,v(s),Iμ1 φv(s),,Iμn φv(s))ds(φ(t)φ(0))kj=1δjkj=1δj(φ(ξj)φ(0))(φ(1)φ(0))mi=1ξj0(φ(ξj)φ(s))ωi+β1Γ(ωi+β)φ(s)fi(s,v(s),Iμ1 φv(s),,Iμn φv(s))ds|(1+(φ(1)φ(0))(1+kj=1δj)|kj=1δj(φ(ξj)φ(0))(φ(1)φ(0))|)(χΩ(φ(1)φ(0))αΓ(α+1)(φ(1)φ(0))βΓ(β+1)+mi=1ϕi(φ(1)φ(0))ωi+βΓ(ωi+β+1))r, $

    which implies $ \|u\|\leq r $ and so $ u\in S. $

    Thus all the conditions of Lemma 2.2 are satisfied and hence the operator equation $ u = Au+Bu $ has a solution in $ S. $ In consequence, the problem (1.1), (1.2) has a solution on $ J. $ This completes the proof.

    In this section, we provide an example to illustrate our main result.

    Example 4.1 Consider the following hybrid $ \varphi $-Caputo fractional integro-differential equations

    $ CD12 t4(CD32 t4u(t)2i=1Iωit4fi(t,u(t),I13t4u(t),I43t4u(t))14t2(|u(t)|1+|u(t)|+|I14t4u(t)|1+|I14t4u(t)|+sinI12t4u(t)))=25cos(t4)(|u(t)||u(t)|+1),  tJ=[0,1], $ (4.1)
    $ u(0)=0, CD32 t4u(0)=0, u(1)=13u(13), $ (4.2)

    where

    $ 2i=1Iωit4fi(t,u(t),I13t4u(t),I43t4u(t))=I13t4(t[|u(t)|1+|u(t)|+sin(I13t4u(t))+cos(I43t4u(t))])+I23t4(t10[|u(t)|1+|u(t)|+arctan(I13t4u(t))+sin(I43t4u(t))]). $ (4.3)

    We note that $ \alpha = \frac{1}{2}, \beta = \frac{3}{2}, m = 2, n = 2, p = 2, k = 1, \delta = \frac{1}{3}, \xi = \frac{1}{3}, \omega_{1} = \frac{1}{3}, \omega_{2} = \frac{2}{3}, \mu_{1} = \frac{1}{3}, \mu_{2} = \frac{4}{3}, \gamma_{1} = \frac{1}{4}, \gamma_{2} = \frac{1}{2}, \varphi(t) = \frac{t}{4}, $

    $ f_{1}(t, u(t), I^{\frac{1}{3} \frac{t}{4}}u(t), I^{\frac{4}{3} \frac{t}{4}}u(t)) = t\biggl[ \frac{|u(t)|}{1+|u(t)|}+\sin(I^{\frac{1}{3} \frac{t}{4}}u(t))+\cos (I^{\frac{4}{3} \frac{t}{4}}u(t))\biggr], $
    $ f_{2}(t, u(t), I^{\frac{1}{3} \frac{t}{4}}u(t), I^{\frac{4}{3} \frac{t}{4}}u(t)) = \frac{t}{10}\biggl[ \frac{|u(t)|}{1+|u(t)|}+\arctan(I^{\frac{1}{3} \frac{t}{4}}u(t))+\sin (I^{\frac{4}{3} \frac{t}{4}}u(t))\biggr], $
    $ g(t, u(t), I^{\frac{1}{4} \frac{t}{4}}u(t), I^{\frac{1}{2} \frac{t}{4}}u(t)) = \frac{1}{4}t^{2}\biggl( \frac{|u(t)|}{1+|u(t)|} + \frac{|I^{\frac{1}{4} \frac{t}{4}}u(t)|} {1+|I^{\frac{1}{4} \frac{t}{4}}u(t)|}+\sin I^{\frac{1}{2} \frac{t}{4}}u(t)\biggr), $
    $ h(t, u(t)) = \frac{2}{5}cos(\frac{t}{4})\biggl( \frac{|u(t)|}{|u(t)|+1}\biggr). $

    Thus we have

    $ |g(t,u(t),I14t4u(t),I12t4u(t))g(t,v(t),I14t4v(t),I12t4v(t))|σ(t)[1+t14Γ(54)+t12Γ(32)]|u(t)v(t)|=t24[1+t14Γ(54)+t12Γ(32)]|u(t)v(t)|, $
    $ |h(t, u(t))-h(t, v(t))| = \frac{2}{5}\cos(\frac{t}{4})|u(t)-v(t)|. $

    Therefore,

    $ \sigma^{*} = \sup\limits_{0\leq t\leq 1}|\sigma(t)| = \sup\limits_{0\leq t\leq 1}\frac{t^{2}}{4}\biggl[1+ \frac{t^{\frac{1}{4}}}{\Gamma(\frac{5}{4})}+\frac{t^{\frac{1}{2}}}{\Gamma(\frac{3}{2})}\biggr] = \frac{1}{4}\biggl(1+ \frac{1}{\Gamma(\frac{5}{4})}+\frac{1}{\Gamma(\frac{3}{2})}\biggr) = \frac{1}{4}\biggl(1+ \frac{1}{0.9064}+\frac{1}{0.8862}\biggr) = 0.8079; $
    $ \lambda^{*} = \sup\limits_{0\leq t\leq 1}|\lambda(t)| = \sup\limits_{0\leq t\leq 1}\frac{2}{5}\cos(\frac{t}{4}) = 0.4; $
    $ \phi_{1}^{*} = \sup\limits_{0\leq t\leq 1}|\phi_{1}(t)| = \sup\limits_{0\leq t\leq 1}t(1+1+1) = 3; $
    $ \phi_{2}^{*} = \sup\limits_{0\leq t\leq 1}|\phi_{2}(t)| = \sup\limits_{0\leq t\leq 1}\frac{t}{10}(1+\frac{\pi}{2}+1) = \frac{1}{10}\times3.57 = 0.357; $
    $ \Omega^{*} = \sup\limits_{0\leq t\leq 1}|\Omega(t)| = \sup\limits_{0\leq t\leq 1}\frac{2}{5}\cos(\frac{t}{4}) = 0.4; $
    $ \chi^{*} = \sup\limits_{0\leq t\leq 1}|\chi(t)| = \sup\limits_{0\leq t\leq 1}\frac{t^{2}}{4}(1+1+1) = \frac{3}{4} = 0.75. $

    Choose $ r > 0.5, $ then we have

    $ \biggl(1+\frac{\frac{1}{4}\times \frac{4}{3}}{\frac{2}{9}}\biggr)\biggl[0.75\times0.4\times\frac{(\frac{1}{4})^{\frac{1}{2}}}{\Gamma(\frac{3}{2})} \times\frac{(\frac{1}{4})^{\frac{3}{2}}}{\Gamma(\frac{5}{2})}+3\times\frac{(\frac{1}{4})^{\frac{11}{6}}}{\Gamma(\frac{17}{6})}+0.357 \times\frac{(\frac{1}{4})^{\frac{13}{6}}}{\Gamma(\frac{19}{6})}\biggr] = 0.4016\leq r. $

    Moreover,

    $ \biggl(0.75\times 0.4+0.4\times 0.8079\times \biggl(\frac{(\frac{1}{4})^{\frac{1}{4}}}{\Gamma(\frac{5}{4})}+\frac{(\frac{1}{4})^{\frac{1}{2}}}{\Gamma(\frac{3}{2})}\biggr)\biggr) \frac{(\frac{1}{4})^{\frac{1}{2}}}{\Gamma(\frac{3}{2})}\biggl(1+\frac{\frac{1}{4}\times \frac{4}{3}}{\frac{2}{9}}\biggr)\frac{(\frac{1}{4})^{\frac{3}{2}}}{\Gamma(\frac{5}{2})} = 0.097 \lt 1. $

    Now, by using Theorem 3.2, it is deduced that the fractional hybrid integro-differential problem (4.1), (4.2) has a solution.

    Hybrid fractional integro-differential equations have been considered more important and served as special cases of dynamical systems. In this paper, we introduced a new class of the hybrid $ \varphi $-Caputo fractional integro-differential equations. By using famous hybrid fixed point theorem due to Dhage, we have developed adequate conditions for the existence of at least one solution to the hybrid problem (1.1), (1.2). The respective results have been verified by providing a suitable example.

    We express our sincere thanks to the anonymous reviewers for their valuable comments and suggestions. This work is supported by the Natural Science Foundation of Tianjin (No.(19JCYBJC30700)).

    The authors declare no conflict of interest in this paper.

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