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Jeong MK, Park KW, Ryu JK, Kim GM, Jung HH, Park H. Multi-Component Intervention Program on Habitual Physical Activity Parameters and Cognitive Function in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126240. [PMID: 34207701 PMCID: PMC8296099 DOI: 10.3390/ijerph18126240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Abstract
Age-related dementia refers to a state in which someone experiences multiple cognitive function impairment due to degenerative brain disease, and which causes difficulties in their daily life or social life. Dementia is the most common and serious obstacle in later life. Early intervention in the case of patients who are in the mild cognitive impairment (MCI) stage among the high-risk group can maintain and improve their cognitive function. The purpose of the current trial is aimed at investigating the association between a multi-component (exercise with cognitive) intervention program and habitual physical activity parameters on cognitive functions in MCI patients. Neuropsychological cognitive and depression assessments were performed by neuropsychologists according to normalized methods, including the Korean mini-mental State examination (K-MMSE) and modified Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog) and cognitive assessment tool (attention, processing speed), and the Korean version of the geriatric depression scale (SGDS-K), both at baseline and at a 12 weeks follow-up. The 12-week multi-component intervention improved cognitive function and habitual physical activity parameters in patients with MCI relative to controls. A multi-component intervention program for patients with MCI is considered to be an effective method of dementia prevention by improving global (ADAS-Cog) and frontal (trail-making test, digit symbol substitution test) cognition and habitual physical activity parameters such as moderate to vigorous physical activity and step count. In addition, it is important to encourage habitual physical activities to ensure that exercise intervention strategies are carried out at the duration and intensity required for improving physical and cognitive wellbeing and obtaining health benefits.
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Affiliation(s)
- Min-Ki Jeong
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (M.-K.J.); (H.-H.J.)
| | - Kyung-Won Park
- Busan Metropolitan Dementia Center, Busan 49201, Korea;
- Department of Neurology, College of Medicine, Dong-A University, Busan 49201, Korea
| | - Je-Kwang Ryu
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea;
| | - Gwon-Min Kim
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea;
| | - Hyun-Hun Jung
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (M.-K.J.); (H.-H.J.)
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea;
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
- Correspondence: ; Tel.: +82-51-200-7517
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Sarkar A, Sarmah D, Datta A, Kaur H, Jagtap P, Raut S, Shah B, Singh U, Baidya F, Bohra M, Kalia K, Borah A, Wang X, Dave KR, Yavagal DR, Bhattacharya P. Post-stroke depression: Chaos to exposition. Brain Res Bull 2020; 168:74-88. [PMID: 33359639 DOI: 10.1016/j.brainresbull.2020.12.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022]
Abstract
Cerebral ischemia contributes to significant disabilities worldwide, impairing cognitive function and motor coordination in affected individuals. Stroke has severe neuropsychological outcomes, the major one being a stroke. Stroke survivors begin to show symptoms of depression within a few months of the incidence that overtime progresses to become a long-term ailment. As the pathophysiology for the progression of the disease is multifactorial and complex, it limits the understanding of the disease mechanism completely. Meta-analyses and randomized clinical trials have shown that intervening early with tricyclic antidepressants and selective serotonin receptor inhibitors can be effective. However, these pharmacotherapies possess several limitations that have given rise to newer approaches such as brain stimulation, psychotherapy and rehabilitation therapy, which in today's time are gaining attention for their beneficial results in post-stroke depression (PSD). The present review highlights numerous factors like lesion location, inflammatory mediators and genetic abnormalities that play a crucial role in the development of depression in stroke patients. Further, we have also discussed various mechanisms involved in post-stroke depression (PSD) and strategies for early detection and diagnosis using biomarkers that may revolutionize treatment for the affected population. Towards the end, along with the preclinical scenario, we have also discussed the various treatment approaches like pharmacotherapy, traditional medicines, psychotherapy, electrical stimulation and microRNAs being utilized for effectively managing PSD.
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Affiliation(s)
- Ankan Sarkar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Deepaneeta Sarmah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Aishika Datta
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Harpreet Kaur
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Priya Jagtap
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Swapnil Raut
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Birva Shah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Upasna Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Falguni Baidya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Mariya Bohra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Kiran Kalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Anupom Borah
- Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam, India
| | - Xin Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Kunjan R Dave
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Dileep R Yavagal
- Department of Neurology and Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Pallab Bhattacharya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India.
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Affiliation(s)
- John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, Room M238, St Louis, MO 63104, USA.
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Wilkins KM, Blazek MC, Brooks WB, Lehmann SW, Popeo D, Wagenaar D. Six Things All Medical Students Need to Know About Geriatric Psychiatry (and How To Teach Them). ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:693-700. [PMID: 28255854 DOI: 10.1007/s40596-017-0691-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/15/2017] [Indexed: 06/06/2023]
Affiliation(s)
| | - Mary C Blazek
- University of Michigan School of Medicine, Ann Arbor, MI, USA
| | | | - Susan W Lehmann
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dennis Popeo
- New York University School of Medicine, New York, NY, USA
| | - Deborah Wagenaar
- Michigan State University Colleges of Human and Osteopathic Medicine, East Lansing, MI, USA
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Saracino RM, Rosenfeld B, Nelson CJ. Towards a new conceptualization of depression in older adult cancer patients: a review of the literature. Aging Ment Health 2016; 20:1230-1242. [PMID: 26312455 PMCID: PMC4925309 DOI: 10.1080/13607863.2015.1078278] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Identifying depression in older adults with cancer presents a set of unique challenges, as it combines the confounding influences of cancer and its treatment with the developmental changes associated with aging. This paper reviews the phenomenology of depression in older adults, and individuals diagnosed with cancer. METHOD PsychInfo, PubMed, Web of Science, and Google Scholar databases were searched for English-language studies addressing the phenomenology, symptoms, or assessment of depression in older adults and those with cancer. RESULTS The Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria that appear to be relevant to both older adults and cancer patients are anhedonia, concentration difficulties, sleep disturbances, psychomotor retardation/agitation, and loss of energy. Possible alternative criteria that may be important considerations included constructs such as loss of purpose, loneliness, and irritability in older adults. Among cancer patients, tearfulness, social withdrawal, and not participating in treatment despite ability to do so were identified as potentially important symptoms. CONCLUSIONS Current DSM criteria may not adequately assess depression in older cancer patients and alternative criteria may be important to inform the understanding and identification of depression in this population. Enhancing diagnostic accuracy of depression is important as both the over-diagnosis and under-diagnosis is accompanied with significant costs. Thus, continued research exploring the phenomenology and identifying effective indicators of depression in older cancer patients is needed.
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Affiliation(s)
- Rebecca M. Saracino
- Department of Psychology, Fordham University, Bronx, NY 10458, USA,Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA,Corresponding author.
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, Bronx, NY 10458, USA,Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
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Lee YC. A study of the relationship between depression symptom and physical performance in elderly women. J Exerc Rehabil 2015; 11:367-71. [PMID: 26730389 PMCID: PMC4697787 DOI: 10.12965/jer.150257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 12/05/2015] [Indexed: 01/08/2023] Open
Abstract
Depression is a general public health problem; there is an association between regular exercise or vigorous physical activity and depression. Physical activity has positive physical, mental, and emotional effects. The purpose of this study was to examine the relationship between depression symptom and physical performance in elderly women. A total of 173 elderly women aged 65 to 80 participated in this study. We evaluated elderly women using the 6-min walk, grip-strength, 30-sec arm curl, 30-sec chair stand, 8-foot up and go, back scratch, and chair sit and reach, and unipedal stance, measured the body mass index (BMI), and depression symptom assessed using Korean version of the Geriatric Depression Scale (GDS-K). The collected data were analyzed using descriptive statistics, correlation analysis, paired t-tests, and simple linear regression using IBM SPSS Statistics ver. 21.0. There were significant correlations between GDS-K and the 6-min walk, 30-sec chair stand, 30-sec arm curl, chair sit and reach, 8-foot up and go, and grip strength tests (P<0.05), but not BMI, back strength, and unipedal stance. When divided into two groups (GDS-K score≥14 and GDS-K score<14), there was a difference between the two groups in the 6-min walk, 30-sec chair stand, 30-sec arm curl test, chair sit and reach, 8-foot up and go test, and grip strength test performances. Physical performance factors were strongly associated with depression symptom, suggesting that physical performance improvements may play an important role in preventing depression.
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Affiliation(s)
- Yang Chool Lee
- Department of Physical Education, Gachon University, Seognam, Korea
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Guinta GM, Graham RL. Special populations: Treatment resistant mood disorders. Ment Health Clin 2014. [DOI: 10.9740/mhc.n207186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Mood disorders are highly prevalent throughout the United States, and high rates of relapse, recurrence, and treatment failure lead to treatment resistance. This article will review the available literature and treatment recommendations for treatment resistant mood disorders in special populations including: geriatrics, children and adolescents, pregnancy, and comorbid substance use disorders.
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Affiliation(s)
- Gina M. Guinta
- 1 PGY-2 Psychiatric Pharmacy Resident, Veterans Affairs San Diego Healthcare System
| | - Rebecca L. Graham
- 2 Clinical Pharmacy Specialist – Mental Health, West Palm Beach Veterans Affairs Medical Center
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Abstract
Poststroke depression (PSD) in elderly patients has been considered the most common neuropsychiatric consequence of stroke up to 6-24 months after stroke onset. When depression appears within days after stroke onset, it is likely to remit, whereas depression at 3 months is likely to be sustained for 1 year. One of the major problems posed by elderly stroke patients is how to identify and optimally manage PSD. This review provides insight to identification and management of depression in elderly stroke patients. Depression following stroke is less likely to include dysphoria and more likely characterized by vegetative signs and symptoms compared with other forms of late-life depression, and clinicians should rely more on nonsomatic symptoms rather than somatic symptoms. Evaluation and diagnosis of depression among elderly stroke patients are more complex due to vague symptoms of depression, overlapping signs and symptoms of stroke and depression, lack of properly trained health care personnel, and insufficient assessment tools for proper diagnosis. Major goals of treatment are to reduce depressive symptoms, improve mood and quality of life, and reduce the risk of medical complications including relapse. Antidepressants (ADs) are generally not indicated in mild forms because the balance of benefit and risk is not satisfactory in elderly stroke patients. Selective serotonin reuptake inhibitors are the first choice of PSD treatment in elderly patients due to their lower potential for drug interaction and side effects, which are more common with tricyclic ADs. Recently, stimulant medications have emerged as promising new therapeutic interventions for PSD and are now the subject of rigorous clinical trials. Cognitive behavioral therapy can also be useful, and electroconvulsive therapy is available for patients with severe refractory PSD.
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Affiliation(s)
- Johan Lökk
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
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Quality of Life and Mood in Older Patients After Major Lung Resection. Ann Thorac Surg 2009; 87:1007-12; discussion 1012-3. [DOI: 10.1016/j.athoracsur.2008.12.084] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 12/24/2008] [Accepted: 12/26/2008] [Indexed: 11/24/2022]
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Prescription patterns of psychotropic medications in elderly compared with younger participants who achieved a "recovered" status in the systematic treatment enhancement program for bipolar disorder. Am J Geriatr Psychiatry 2008; 16:922-33. [PMID: 18978253 PMCID: PMC2630050 DOI: 10.1097/jgp.0b013e318187135f] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study compares prescription patterns between young adults and elderly with bipolar disorder who achieved a recovery status during the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). DESIGN STEP-BD is a multicenter National Institute of Mental Health-funded project designed to evaluate the longitudinal outcome of patients with bipolar disorder. The STEP-BD study involved extensive assessment across multiple domains including demographic data, diagnosis, symptom severity, treatment, and clinical status. Patients achieved "recovered" status when they experienced eight consecutive weeks without significant symptoms. PARTICIPANTS The authors analyzed data of all subjects who achieved a recovered status at least once in their participation. MEASUREMENTS The authors compared treatment regimes and doses among young participants with middle age (N = 3,364), 20-59 years old, and older participants 60 and above (N = 246). RESULTS Of the 3,615 STEP-BD participants who had a lifetime diagnosis of bipolar subtypes I or II, 67.6% (N = 2442) achieved a recovered status during their participation. A total of 78.5% (N = 193) of older patients recovered compared with 66.8% of the younger cohort. On average, participants who reached a recovered status took 2.05 medications with no difference between age groups. Lithium was prescribed to 37.8% of younger patients compared with only 29.5% of older participants. The mean dosages taken by younger and older patients differed significantly only for lithium, valproate, and risperidone with elderly individuals prescribed lower daily dosages. Significant reduction in lithium dosing was observed among individuals aged 50 and older and among individuals 60 and older for valproate. Although valproate was more often prescribed, 42.1% of recovered bipolar elder achieved recovery with lithium alone compared with only 21.3% of the younger cohort. CONCLUSION This data shows recovery is achievable in the elderly though more than one medication is often needed regardless of age.
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Stapleton RD, Curtis JR. End-of-life considerations in older patients who have lung disease. Clin Chest Med 2008; 28:801-11, vii. [PMID: 17967296 DOI: 10.1016/j.ccm.2007.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The goal of palliative care is to prevent suffering and manage symptoms, maintain quality of life, and provide physical, emotional, and spiritual support for patients and their loved ones. Research suggests that patients with chronic lung disease receive suboptimal palliative care largely because of inadequate communication with their physicians. When patients have made decisions about life-sustaining therapies, physicians often either do not know patients' wishes or misunderstand them. Clinicians should realize that most patients want more information about end-of-life care and that efforts to initiate and improve communication with their patients are important. This article reviews the potential for enhanced palliative care for older patients with chronic lung disease.
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Affiliation(s)
- Renee D Stapleton
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Harborview Medical Center, Box 359762, 325 Ninth Avenue, Seattle, WA 98104-2499, USA.
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Cabrera MAS, Mesas AE, Garcia ARL, de Andrade SM. Malnutrition and Depression among Community-dwelling Elderly People. J Am Med Dir Assoc 2007; 8:582-4. [DOI: 10.1016/j.jamda.2007.07.008] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 07/18/2007] [Indexed: 11/15/2022]
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