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Luo Q, Tian Z, Hu Y, Wang C. Effects of Aerobic Exercise on Executive and Memory Functions in Patients With Alzheimer's Disease: A Systematic Review. J Aging Phys Act 2024; 32:541-553. [PMID: 38521051 DOI: 10.1123/japa.2023-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/05/2023] [Accepted: 01/20/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Alzheimer's disease threatens the health of older adults, particularly by disrupting executive and memory functions, and many studies have shown that aerobic exercise prevents and improves the symptoms associated with the disease. OBJECTIVE The objective was to systematically review the effects of aerobic exercise on executive and memory functions in patients with Alzheimer's disease and to determine the effect factors and mechanisms of the design of aerobic exercise intervention programs. METHOD Relevant literature was searched in three databases (PubMed, Web of Science, and EBSCO) from January 1, 2014 to March 1, 2023, using a subject-word search method. Data on 10 items, including author and country, were extracted from the literature after screening. The quality of the literature was evaluated using the Physiotherapy Evidence Database scale, and a systematic review was performed. RESULTS Twelve papers from seven countries were ultimately included, embodying 11 randomized controlled trials and one study with a repeated-measures design. The overall quality of the studies was good as 657 study participants, aged 45 years and older who had varying degrees of Alzheimer's disease and significant symptoms, were included. Aerobic exercise was found to have a significant positive impact on executive and memory functions in people with Alzheimer's disease. CONCLUSION The effects of aerobic exercise on aspects of executive function were mainly characterized by improvements in inhibitory control, working memory, and cognitive flexibility, whereas the effects on aspects of memory function were mainly characterized by improvements in logical memory, situational memory, and short-term memory.
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Affiliation(s)
- Qiaoyou Luo
- College of Physical Education, Hunan University, Changsha, HUN, China
| | - Zuguo Tian
- College of Physical Education, Hunan University, Changsha, HUN, China
| | - Yuting Hu
- College of Physical Education, Hunan University, Changsha, HUN, China
| | - Chaochao Wang
- College of Physical Education, Hunan University, Changsha, HUN, China
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2
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Xu Z, Tang J, Yi W. Evidence mapping and quality assessment of systematic reviews on exercise intervention for Alzheimer's disease. Complement Ther Med 2024; 84:103065. [PMID: 38955283 DOI: 10.1016/j.ctim.2024.103065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/23/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND A significant body of literature suggests that exercise can reverse cognitive impairment and ameliorate somatic function in patients with Alzheimer's disease (AD). Systematic reviews (SRs), a common approach of evidence-based medicine, concentrate on a specific issue of a research area. The objective of this work is to provide an overview of existing evidence on the effects of exercise intervention in AD patients and report related health outcomes by reviewing SRs. METHODS SRs on exercise intervention in AD patients were retrieved from the PubMed, the Cochrane Library, CBMdisc, Scopus, Web of Science, Embase (via Ovid), China National Knowledge Infrastructure, and WanFang databases from the time of inception to February 2023. The quality of the SRs was evaluated utilizing the A Measurement Tool to Assess Systematic Review 2 (AMSTAR 2) checklist. The results were reported according to the population-intervention-comparison-outcome (PICO) framework and the corresponding evidence mapping was illustrated in tables and bubble plots. RESULTS A total of 26 SRs met the eligibility criteria. In terms of methodological quality, 10 SRs were rated as "critically low", 13 SRs were rated as "low", and 3 SRs were rated as "moderate". Exercise was found to exert a beneficial effect on cognitive function, functional independence, physical function, and neuropsychiatric symptoms in patients with AD. CONCLUSION Exercise intervention benefits AD patients mainly by improving cognitive function, physical function, functional independence, and neuropsychiatric symptoms. However, due to the low-to-moderate methodology of most SRs included in this analysis, further investigations are required to support our current findings.
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Affiliation(s)
- Zhengdong Xu
- Department of Physical Education, Shanghai University of Engineering Science, Shanghai, China
| | - Jiaxing Tang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Wenjuan Yi
- Middle School Affiliated to Qingpu Teachers Training College of Shanghai, Shanghai, China; School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
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Blackwell J, Ray M. Exploring the Lived Experiences of Physical Activity in Community-Dwelling Adults Living With Dementia and Their Carers. J Aging Phys Act 2024:1-8. [PMID: 38849122 DOI: 10.1123/japa.2023-0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 06/09/2024]
Abstract
People living with dementia have the same right to well-being as anyone else, including physical activity. Yet, physical activity levels among people with dementia are lower than in the general population, and while the physical activity health benefits are well established, little is known about how people living with dementia experience physical activity. To explore these physical activity experiences, we visited six community settings in one English county and conducted informal interviews with 18 people who were either living with dementia and community dwelling (n = 4), caring for or who had cared for someone with dementia (n = 10), or providing a support service for people living with dementia and their carers (n = 4). Findings highlight both the challenges and facilitators presented by organized groups, service provider skills and qualities, and environmental factors. Additionally, these factors were influential in shaping the physical activity experience of people living with dementia. The findings may be relevant for people providing or planning support services, commissioners, policymakers, and researchers.
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Affiliation(s)
- Joanna Blackwell
- School of Health and Social Care, College of Health and Science, University of Lincoln, Lincoln, United Kingdom
| | - Mo Ray
- School of Health and Social Care, College of Health and Science, University of Lincoln, Lincoln, United Kingdom
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Post EM, Kraemer WJ. Physiological Mechanisms That Impact Exercise Adaptations for Individuals With Down Syndrome. J Strength Cond Res 2023; 37:e646-e655. [PMID: 38015740 DOI: 10.1519/jsc.0000000000004658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
ABSTRACT Post, EM, and Kraemer, WJ. Physiological mechanisms that impact exercise adaptations for individuals with Down syndrome. J Strength Cond Res 37(12): e646-e655, 2023-Down syndrome (DS) is the most common chromosomal disorder diagnosed in the United States since 2014. There is a wide range of intellectual severities, with the average IQ of individuals with DS at approximately 50 and adults without intellectual delay at approximately 70-130. Individuals with DS vary from mild to severe cognitive impairment, depending on the phenotypic penetration on the 21st chromosome, with the average cognitive capacity equivalent to a cognitive functioning of an 8- to 9-year-old child. To have successful health, all aspects of health must be considered (i.e., overall health, fitness, and social). Both aerobic training and resistance training (RT) are favored for a healthy lifestyle. Resistance training specifically can help improve motor function and overall activities of daily living. Although many motivational and environmental barriers for individuals with DS can make exercising difficult, there are many ways to overcome those barriers (both intrinsically and extrinsically). Individuals with DS should strive for 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise a week or a combination of both. The individual should also strive for 2 or more days a week of strengthening activities, such as RT, involving all muscle groups. These activities will help improve many aspects of life, leading to a better quality of life. Regular group exercise activity can help increase self-confidence and success socially in life. This review will focus on the underlying biological mechanisms related to DS, their influence on exercise, and the roles exercise plays in mediating positive health, physical fitness, and social lifestyle outcomes.
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Affiliation(s)
- Emily M Post
- Department of Health and Sports Science, Otterbein University, Westerville, Ohio
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut; and
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia
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Yue L, Chen WG, Liu SC, Chen SB, Xiao SF. An explainable machine learning based prediction model for Alzheimer's disease in China longitudinal aging study. Front Aging Neurosci 2023; 15:1267020. [PMID: 38020780 PMCID: PMC10655104 DOI: 10.3389/fnagi.2023.1267020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. Accurate prediction and diagnosis of AD and its prodromal stage, i.e., mild cognitive impairment (MCI), is essential for the possible delay and early treatment for the disease. In this paper, we adopt the data from the China Longitudinal Aging Study (CLAS), which was launched in 2011, and includes a joint effort of 15 institutions all over the country. Four thousand four hundred and eleven people who are at least 60 years old participated in the project, where 3,514 people completed the baseline survey. The survey collected data including demographic information, daily lifestyle, medical history, and routine physical examination. In particular, we employ ensemble learning and feature selection methods to develop an explainable prediction model for AD and MCI. Five feature selection methods and nine machine learning classifiers are applied for comparison to find the most dominant features on AD/MCI prediction. The resulting model achieves accuracy of 89.2%, sensitivity of 87.7%, and specificity of 90.7% for MCI prediction, and accuracy of 99.2%, sensitivity of 99.7%, and specificity of 98.7% for AD prediction. We further utilize the SHapley Additive exPlanations (SHAP) algorithm to visualize the specific contribution of each feature to AD/MCI prediction at both global and individual levels. Consequently, our model not only provides the prediction outcome, but also helps to understand the relationship between lifestyle/physical disease history and cognitive function, and enables clinicians to make appropriate recommendations for the elderly. Therefore, our approach provides a new perspective for the design of a computer-aided diagnosis system for AD and MCI, and has potential high clinical application value.
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Affiliation(s)
- Ling Yue
- The Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu-gang Chen
- School of Computer and Information Engineering and Henan Engineering Research Center of Intelligent Technology and Application, Henan University, Kaifeng, China
| | - Sai-chao Liu
- School of Computer and Information Engineering and Henan Engineering Research Center of Intelligent Technology and Application, Henan University, Kaifeng, China
| | - Sheng-bo Chen
- School of Computer and Information Engineering and Henan Engineering Research Center of Intelligent Technology and Application, Henan University, Kaifeng, China
| | - Shi-fu Xiao
- The Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Borges-Machado F, Teixeira L, Carvalho J, Ribeiro O. Does Multicomponent Physical Exercise Training Work for Dementia? Exploring the Effects on Cognition, Neuropsychiatric Symptoms, and Quality of Life. J Geriatr Psychiatry Neurol 2023; 36:376-385. [PMID: 36574616 PMCID: PMC10394955 DOI: 10.1177/08919887221149152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To explore the effects of a multicomponent training (MT) physical exercise intervention in the cognitive function, neuropsychiatric symptoms, and quality of life of older adults with major neurocognitive disorder (NCD). METHODS Quasi-experimental controlled trial. Thirty-six individuals (25 female) were equally distributed to an exercise group (aged 74.33 ± 5.87 years) or a control group (aged 81.83 ± 6.18 years). The Alzheimer's Disease Assessment Scale - Cognitive (ADAS-Cog), the Neuropsychiatric Inventory (NPI) and the Quality of Life - Alzheimer's Disease (QoL-AD) tests were performed before and after the intervention. RESULTS There was no clear interaction effect factor of intervention on ADAS-Cog (B = 1.33, 95% CI: -2.61 - 5.28, P = .513), NPI (B = -8.35, 95% CI: -18.48 - 1.72, P = .115), and QoL-AD (B = 2.87, 95% CI: .01 - 5.73, P = .058). CONCLUSIONS The 6-month MT physical exercise intervention did not present evidence of slowing down cognitive decline neither improving neuropsychiatric symptomatology, and quality of life of older adults with major NCD. Future studies with larger samples are needed to better understand the impact of physical exercise interventions using MT methodology on specific cognitive abilities, neuropsychiatric symptoms, and quality of life domains.
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Affiliation(s)
- Flávia Borges-Machado
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
- Faculty of Sports, University of Porto, Porto, Portugal
- ITR – Laboratory for Integrative and Translational Research in Population Health, Faculty of Sports, University of Porto, Porto, Portugal
| | - Laetitia Teixeira
- ICBAS - Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
- RISE – Health Research Network, ICBAS, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, University of Aveiro and ICBAS-UP, Portugal
| | - Joana Carvalho
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
- Faculty of Sports, University of Porto, Porto, Portugal
- ITR – Laboratory for Integrative and Translational Research in Population Health, Faculty of Sports, University of Porto, Porto, Portugal
| | - Oscar Ribeiro
- CINTESIS - Center for Health Technology and Services Research, University of Aveiro and ICBAS-UP, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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Papatsimpas V, Vrouva S, Papathanasiou G, Papadopoulou M, Bouzineki C, Kanellopoulou S, Moutafi D, Bakalidou D. Does Therapeutic Exercise Support Improvement in Cognitive Function and Instrumental Activities of Daily Living in Patients with Mild Alzheimer's Disease? A Randomized Controlled Trial. Brain Sci 2023; 13:1112. [PMID: 37509042 PMCID: PMC10377697 DOI: 10.3390/brainsci13071112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
This randomized controlled trial aims to investigate the effect of 12 weeks of therapeutic exercise on cognitive function and daily activities in patients with mild Alzheimer's disease (AD). A total of 171 patients with mild AD from the Amarousion Day Care Center of the Alzheimer Society of Athens and the Athens General Hospital "G. Gennimatas" were randomly divided into three groups. Group A (aerobic and resistance exercise, n = 57), group B (resistance exercise, n = 57), and group C (control group, n = 57). Group A followed a weekly program consisting of 5 days with 30 min walking and 3 days with resistance exercises for about 45 min. Group B followed only a resistance exercise program, the same as group A. Group C did not participate in any exercise program. After the intervention, cognitive function was assessed with the Cognitive Examination-Revised (ACE-R), Trail Making Test A-B (TMT A-B), and Digit Span Test Forward and Backward (DST F-B) and daily activities with the instrumental activities of daily living scale (IADLs). A significant intervention effect was observed for all outcome measures (global cognitive function and instrumental activities of daily living). ANCOVA Bonferroni corrected post hoc tests revealed that the aerobic and resistance group improved compared to the control group on all measurement scales. The resistance group also showed an improvement compared to the control group. No significant effects were found between the aerobic and resistance group and the resistance group in any of the outcome measures.
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Affiliation(s)
- Vasileios Papatsimpas
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Department of Physical Therapy, General Hospital of Athens G. GENNIMATAS, 11527 Athens, Greece
| | - Sotiria Vrouva
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Department of Physical Therapy, 401 Army General Hospital of Athens, 11525 Athens, Greece
| | - George Papathanasiou
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | - Marianna Papadopoulou
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | | | | | - Dimitra Moutafi
- Pathological Department, General Hospital Konstantopouleio, 14233 Nea Ionia, Greece
| | - Daphne Bakalidou
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
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Lopera F, Custodio N, Rico-Restrepo M, Allegri RF, Barrientos JD, Garcia Batres E, Calandri IL, Calero Moscoso C, Caramelli P, Duran Quiroz JC, Jansen AM, Mimenza Alvarado AJ, Nitrini R, Parodi JF, Ramos C, Slachevsky A, Brucki SMD. A task force for diagnosis and treatment of people with Alzheimer's disease in Latin America. Front Neurol 2023; 14:1198869. [PMID: 37497015 PMCID: PMC10367107 DOI: 10.3389/fneur.2023.1198869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Alzheimer's disease (AD) represents a substantial burden to patients, their caregivers, health systems, and society in Latin America and the Caribbean (LAC). This impact is exacerbated by limited access to diagnosis, specialized care, and therapies for AD within and among nations. The region has varied geographic, ethnic, cultural, and economic conditions, which create unique challenges to AD diagnosis and management. To address these issues, the Americas Health Foundation convened a panel of eight neurologists, geriatricians, and psychiatrists from Argentina, Brazil, Colombia, Ecuador, Guatemala, Mexico, and Peru who are experts in AD for a three-day virtual meeting to discuss best practices for AD diagnosis and treatment in LAC and create a manuscript offering recommendations to address identified barriers. In LAC, several barriers hamper diagnosing and treating people with dementia. These barriers include access to healthcare, fragmented healthcare systems, limited research funding, unstandardized diagnosis and treatment, genetic heterogeneity, and varying social determinants of health. Additional training for physicians and other healthcare workers at the primary care level, region-specific or adequately adapted cognitive tests, increased public healthcare insurance coverage of testing and treatment, and dedicated search strategies to detect populations with gene variants associated with AD are among the recommendations to improve the landscape of AD.
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Affiliation(s)
- Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Nilton Custodio
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | | | - Ricardo F. Allegri
- Department of Cognitive Neurology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | | | - Estuardo Garcia Batres
- Geriatric Unit, New Hope, Interior Hospital Atención Medica Siloé, Ciudad de Guatemala, Guatemala
| | - Ismael L. Calandri
- Department of Cognitive Neurology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | - Cristian Calero Moscoso
- Department of Neurology, HCAM Memory and Behavior Unit, University of Hospital Carlos Andrade Marin HCAM, Quito, Ecuador
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculty of Medicine, University of Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juan Carlos Duran Quiroz
- Faculty of Medicine, Department of Functional Sciences, Physiology Division, Universidad Mayor de San Andres, La Paz, Bolivia
| | | | - Alberto José Mimenza Alvarado
- Memory Disorders Clinic, Neurological Geriatrics Program, Department of Geriatrics, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Group, Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Jose F. Parodi
- Centro de Investigación del Envejecimiento, Facultad de Medicina, Universidad de San Martín de Porres, Lima, Peru
| | - Claudia Ramos
- Antioquia Neurosciences Group, University of Antioquia, Medellin, Colombia
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), University of Chile, Santiago, Chile
| | - Sonia María Dozzi Brucki
- Cognitive and Behavioral Neurology Group, Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Hao Z, Liu K, Zhou L, Chen P. Precious but convenient means of prevention and treatment: physiological molecular mechanisms of interaction between exercise and motor factors and Alzheimer's disease. Front Physiol 2023; 14:1193031. [PMID: 37362440 PMCID: PMC10285460 DOI: 10.3389/fphys.2023.1193031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
Disproportionate to the severity of Alzheimer's disease (AD) and the huge number of patients, the exact treatment and prevention of AD is still being explored. With increasing ageing, the search for means to prevent and treat AD has become a high priority. In the search for AD, it has been suggested that exercise may be one of the more effective and less costly means of preventing and treating AD, and therefore a large part of current research is aimed at exploring the effectiveness of exercise in the prevention and treatment of AD. However, due to the complexity of the specific pathogenesis of AD, there are multiple hypotheses and potential mechanisms for exercise interventions in AD that need to be explored. This review therefore specifically summarises the hypotheses of the interaction between exercise and AD from a molecular perspective, based on the available evidence from animal models or human experiments, and explores them categorised according to the pathologies associated with AD: exercise can activate a number of signalling pathways inhibited by AD (e.g., Wnt and PI3K/Akt signalling pathways) and reactivate the effects of downstream factors regulated by these signalling pathways, thus acting to alleviate autophagic dysfunction, relieve neuroinflammation and mitigate Aβ deposition. In addition, this paper introduces a new approach to regulate the blood-brain barrier, i.e., to restore the stability of the blood-brain barrier, reduce abnormal phosphorylation of tau proteins and reduce neuronal apoptosis. In addition, this paper introduces a new concept." Motor factors" or "Exerkines", which act on AD through autocrine, paracrine or endocrine stimulation in response to movement. In this process, we believe there may be great potential for research in three areas: (1) the alleviation of AD through movement in the brain-gut axis (2) the prevention and treatment of AD by movement combined with polyphenols (3) the continued exploration of movement-mediated activation of the Wnt signalling pathway and AD.
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Affiliation(s)
- Zikang Hao
- Department of Physical Education, Laoshan Campus, Ocean University of China, Qingdao, China
| | - Kerui Liu
- Department of Sports Medicine, Daiyue Campus, Shandong First Medical University, Tai’an, Shandong, China
| | - Lu Zhou
- Department of Sports Medicine, Daiyue Campus, Shandong First Medical University, Tai’an, Shandong, China
| | - Ping Chen
- Department of Physical Education, Laoshan Campus, Ocean University of China, Qingdao, China
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10
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Matziorinis AM, Flo BK, Skouras S, Dahle K, Henriksen A, Hausmann F, Sudmann TT, Gold C, Koelsch S. A 12-month randomised pilot trial of the Alzheimer's and music therapy study: a feasibility assessment of music therapy and physical activity in patients with mild-to-moderate Alzheimer's disease. Pilot Feasibility Stud 2023; 9:61. [PMID: 37076884 PMCID: PMC10114372 DOI: 10.1186/s40814-023-01287-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND The Alzheimer's and Music Therapy (ALMUTH) study is the first randomised controlled trial (RCT) design with 12 months of active non-pharmacological therapy (NPT) implementing music therapy (MT) and physical activity (PA) for participants with Alzheimer's disease (AD). The aim of the present article is to retrospectively examine the inclusion of mild-to-moderate Alzheimer's Disease patients into the main ALMUTH study protocol and to determine if continued inclusion of AD patients is warranted. METHODS The randomised pilot trial was conducted as a parallel three-arm RCT, reflecting the experimental design of the ALMUTH study. The trial was conducted in Bergen, Norway, and randomisation (1:1:1) was performed by an external researcher. The study was open label and the experimental design features two active NPTs: MT and PA, and a passive control (no intervention, CON) in Norwegian speaking patients with AD who still live at home and could provide informed consent. Sessions were offered once per week (up to 90 min) up to 40 sessions over 12 months. Baseline and follow-up tests included a full neuropsychological test battery and three magnetic resonance imaging (MRI) measurements (structural, functional, and diffusion weighted imaging). Feasibility outcomes were assessed and were determined as feasible if they met the target criteria. RESULTS Eighteen participants with a diagnosis of mild-to-moderate AD were screened, randomised, and tested once at baseline and once after 12-months. Participants were divided into three groups: MT (n = 6), PA (n = 6), and CON (n = 6). Results of the study revealed that the ALMUTH protocol in patients with AD was not feasible. The adherence to the study protocol was poor (50% attended sessions), with attrition and retention rates at 50%. The recruitment was costly and there were difficulties acquiring participants who met the inclusion criteria. Issues with study fidelity and problems raised by staff were taken into consideration for the updated study protocol. No adverse events were reported by the patients or their caregivers. CONCLUSIONS The pilot trial was not deemed feasible in patients with mild-to-moderate AD. To mitigate this, the ALMUTH study has expanded the recruitment criteria to include participants with milder forms of memory impairment (pre-AD) in addition to expanding the neuropsychological test battery. The ALMUTH study is currently ongoing through 2023. TRIAL REGISTRATION Norsk Forskningsråd (NFR) funded. Regional Committees for Medical and Health Research Ethics (REC-WEST: reference number 2018/206). CLINICALTRIALS gov: NCT03444181 (registered retrospectively 23 February 2018, https://clinicaltrials.gov/ct2/show/NCT03444181 ).
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Affiliation(s)
- A M Matziorinis
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
| | - B K Flo
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - S Skouras
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - K Dahle
- Kompetansesenter for Demens, Bergen Kommune, Norway
| | - A Henriksen
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - F Hausmann
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - T T Sudmann
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - C Gold
- NORCE Norwegian Research Centre AS, Bergen, Norway
- Grieg Academy Department of Music, University of Bergen, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - S Koelsch
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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San-Millán I. The Key Role of Mitochondrial Function in Health and Disease. Antioxidants (Basel) 2023; 12:antiox12040782. [PMID: 37107158 PMCID: PMC10135185 DOI: 10.3390/antiox12040782] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
The role of mitochondrial function in health and disease has become increasingly recognized, particularly in the last two decades. Mitochondrial dysfunction as well as disruptions of cellular bioenergetics have been shown to be ubiquitous in some of the most prevalent diseases in our society, such as type 2 diabetes, cardiovascular disease, metabolic syndrome, cancer, and Alzheimer's disease. However, the etiology and pathogenesis of mitochondrial dysfunction in multiple diseases have yet to be elucidated, making it one of the most significant medical challenges in our history. However, the rapid advances in our knowledge of cellular metabolism coupled with the novel understanding at the molecular and genetic levels show tremendous promise to one day elucidate the mysteries of this ancient organelle in order to treat it therapeutically when needed. Mitochondrial DNA mutations, infections, aging, and a lack of physical activity have been identified to be major players in mitochondrial dysfunction in multiple diseases. This review examines the complexities of mitochondrial function, whose ancient incorporation into eukaryotic cells for energy purposes was key for the survival and creation of new species. Among these complexities, the tightly intertwined bioenergetics derived from the combustion of alimentary substrates and oxygen are necessary for cellular homeostasis, including the production of reactive oxygen species. This review discusses different etiological mechanisms by which mitochondria could become dysregulated, determining the fate of multiple tissues and organs and being a protagonist in the pathogenesis of many non-communicable diseases. Finally, physical activity is a canonical evolutionary characteristic of humans that remains embedded in our genes. The normalization of a lack of physical activity in our modern society has led to the perception that exercise is an "intervention". However, physical activity remains the modus vivendi engrained in our genes and being sedentary has been the real intervention and collateral effect of modern societies. It is well known that a lack of physical activity leads to mitochondrial dysfunction and, hence, it probably becomes a major etiological factor of many non-communicable diseases affecting modern societies. Since physical activity remains the only stimulus we know that can improve and maintain mitochondrial function, a significant emphasis on exercise promotion should be imperative in order to prevent multiple diseases. Finally, in populations with chronic diseases where mitochondrial dysfunction is involved, an individualized exercise prescription should be crucial for the "metabolic rehabilitation" of many patients. From lessons learned from elite athletes (the perfect human machines), it is possible to translate and apply multiple concepts to the betterment of populations with chronic diseases.
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Affiliation(s)
- Iñigo San-Millán
- Department of Human Physiology and Nutrition, University of Colorado, Colorado Springs, CO 80198, USA
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Department of Medicine, Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Screening for preclinical Alzheimer's disease: Deriving optimal policies using a partially observable Markov model. Health Care Manag Sci 2023; 26:1-20. [PMID: 36044131 DOI: 10.1007/s10729-022-09608-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/21/2022] [Indexed: 11/04/2022]
Abstract
Alzheimer's Disease (AD) is believed to be the most common type of dementia. Even though screening for AD has been discussed widely, there is no screening program implemented as part of a policy in any country. Current medical research motivates focusing on the preclinical stages of the disease in a modeling initiative. We develop a partially observable Markov decision process model to determine optimal screening programs. The model contains disease free and preclinical AD partially observable states and the screening decision is taken while an individual is in one of those states. An observable diagnosed preclinical AD state is integrated along with observable mild cognitive impairment, AD and death states. Transition probabilities among states are estimated using data from Knight Alzheimer's Disease Research Center (KADRC) and relevant literature. With an objective of maximizing expected total quality-adjusted life years (QALYs), the output of the model is an optimal screening program that specifies at what points in time an individual over 50 years of age with a given risk of AD will be directed to undergo screening. The screening test used to diagnose preclinical AD has a positive disutility, is imperfect and its sensitivity and specificity are estimated using the KADRC data set. We study the impact of a potential intervention with a parameterized effectiveness and disutility on model outcomes for three different risk profiles (low, medium and high). When intervention effectiveness and disutility are at their best, the optimal screening policy is to screen every year between ages 50 and 95, with an overall QALY gain of 0.94, 1.9 and 2.9 for low, medium and high risk profiles, respectively. As intervention effectiveness diminishes and/or its disutility increases, the optimal policy changes to sporadic screening and then to never screening. Under several scenarios, some screening within the time horizon is optimal from a QALY perspective. Moreover, an in-depth analysis of costs reveals that implementing these policies are either cost-saving or cost-effective.
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13
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Graciani AL, Gutierre MU, Coppi AA, Arida RM, Gutierre RC. MYELIN, AGING, AND PHYSICAL EXERCISE. Neurobiol Aging 2023; 127:70-81. [PMID: 37116408 DOI: 10.1016/j.neurobiolaging.2023.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023]
Abstract
Myelin sheath is a structure in neurons fabricated by oligodendrocytes and Schwann cells responsible for increasing the efficiency of neural synapsis, impulse transmission, and providing metabolic support to the axon. They present morpho-functional changes during health aging as deformities of the sheath and its fragmentation, causing an increased load on microglial phagocytosis, with Alzheimer's disease aggravating. Physical exercise has been studied as a possible protective agent for the nervous system, offering benefits to neuroplasticity. In this regard, studies in animal models for Alzheimer's and depression reported the efficiency of physical exercise in protecting against myelin degeneration. A reduction of myelin damage during aging has also been observed in healthy humans. Physical activity promotes oligodendrocyte proliferation and myelin preservation during old age, although some controversies remain. In this review, we will address how effective physical exercise can be as a protective agent of the myelin sheath against the effects of aging in physiological and pathological conditions.
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14
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Lonnemann N, Korte M, Hosseini S. Repeated performance of spatial memory tasks ameliorates cognitive decline in APP/PS1 mice. Behav Brain Res 2023; 438:114218. [PMID: 36403672 DOI: 10.1016/j.bbr.2022.114218] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a burden on the public health system because it is a neurodegenerative disease that is incurable and for which there is no successful treatment. AD patients suffer from symptoms for many years, with progressive loss of cognitive and functional abilities. In addition to the features of AD, described as amyloid plaques and neurofibrillary tangles, neuroinflammatory processes, genetic factors, and lifestyle also play important roles. Increasing evidence for lifestyle factors includes possible changes due to smoking, social engagement, and physical activity. METHODS Morris water maze behavioral tasks were performed to analyze the formation of spatial memory. APPswe/PS1dE9 mice with a remarkable increase in amyloid-β production associated with certain behavioral abnormalities comparable to AD symptoms and age-matched wild-type littermates were trained several times at 3, 6, 9, and 12 months of age and compared with untrained groups at 9 and 12 months of age. Performance during the acquisition phase, in the reference memory test, and in searching strategies were analyzed. RESULTS 9- and 12-month-old APP/PS1 mice showed cognitive impairment, especially in the reference memory test and searching strategies. This cognitive deterioration was reversed in 9- and 12-month-old APP/PS1 mice that had been previously trained several times. Even in the reversal test, in which memory formation must be adapted to the new platform position, several trained APP/PS1 mice performed better. CONCLUSION Repeated spatial memory training in the water maze showed positive effects on memory formation in APP/PS1 mice. Interestingly, the cohort that had been previously trained several times was able to use increased hippocampus-dependent strategies, similar to the WT mice. This may suggest that cognitively demanding and physically active tasks can improve cognitive function.
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Affiliation(s)
- Niklas Lonnemann
- Department of Cellular Neurobiology, Zoological Institute, TU Braunschweig, 38106 Braunschweig, Germany
| | - Martin Korte
- Department of Cellular Neurobiology, Zoological Institute, TU Braunschweig, 38106 Braunschweig, Germany; Helmholtz Centre for Infection Research, Neuroinflammation and Neurodegeneration Group, 38124 Braunschweig, Germany
| | - Shirin Hosseini
- Department of Cellular Neurobiology, Zoological Institute, TU Braunschweig, 38106 Braunschweig, Germany; Helmholtz Centre for Infection Research, Neuroinflammation and Neurodegeneration Group, 38124 Braunschweig, Germany.
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López-Ortiz S, Lista S, Valenzuela PL, Pinto-Fraga J, Carmona R, Caraci F, Caruso G, Toschi N, Emanuele E, Gabelle A, Nisticò R, Garaci F, Lucia A, Santos-Lozano A. Effects of physical activity and exercise interventions on Alzheimer's disease: an umbrella review of existing meta-analyses. J Neurol 2023; 270:711-725. [PMID: 36342524 DOI: 10.1007/s00415-022-11454-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION During the last decade, physical activity (PA) (or "exercise") has been identified as one of the main modifiable factors that influence the development of Alzheimer's disease (AD) pathophysiology. We performed an umbrella review to summarize the evidence on the association between PA/exercise and the risk of developing AD risk, and the effect of exercise interventions on the progression of AD. METHODS A systematic search was performed in PubMed, SportDiscus, Cochrane Library and Web of Science (March 2022) to identify meta-analyses assessing the association between PA and the incidence of AD, and assessing the effect of exercise interventions on patients with AD. RESULTS Twenty-one studies were included. The results with strongest evidence revealed the positive effects of PA on AD risk. Specifically, meeting the WHO recommendations for PA was associated with a lower risk of AD. They also revealed positive effects of exercise on cognitive function, physical performance, and functional independence. CONCLUSIONS There is strong evidence of a protective effect of regular PA against AD risk; however, the dose-response association remains unclear. Physical exercise seems to improve several dimensions in patients with AD, although research is warranted to elucidate the exercise characteristics that promote the greatest benefits.
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Affiliation(s)
- Susana López-Ortiz
- i+HeALTH, European University Miguel de Cervantes, 47012, Valladolid, Spain.
| | - Simone Lista
- i+HeALTH, European University Miguel de Cervantes, 47012, Valladolid, Spain.,Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, 34295, Montpellier, France
| | - Pedro L Valenzuela
- Research Institute of the Hospital, 12 de Octubre ('imas12'), 28041, Madrid, Spain
| | - José Pinto-Fraga
- i+HeALTH, European University Miguel de Cervantes, 47012, Valladolid, Spain
| | - Ricardo Carmona
- i+HeALTH, European University Miguel de Cervantes, 47012, Valladolid, Spain.,Research Institute of the Hospital, 12 de Octubre ('imas12'), 28041, Madrid, Spain
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, 95125, Catania, Italy.,Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018, Troina, Italy
| | - Giuseppe Caruso
- Department of Drug and Health Sciences, University of Catania, 95125, Catania, Italy.,Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018, Troina, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133, Rome, Italy.,Department of Radiology, "Athinoula A. Martinos" Center for Biomedical Imaging, 02129, Boston, USA.,Harvard Medical School, 02115, Boston, USA
| | | | - Audrey Gabelle
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, 34295, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), INSERM Montpellier, 34000, Montpellier, France
| | - Robert Nisticò
- Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, 00161, Rome, Italy.,School of Pharmacy, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133, Rome, Italy.,Casa di Cura "San Raffaele Cassino", 03043, Cassino, Italy
| | - Alejandro Lucia
- Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670, Madrid, Spain.,Research Institute of the Hospital, 12 de Octubre ('imas12'), 28041, Madrid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, 47012, Valladolid, Spain.,Research Institute of the Hospital, 12 de Octubre ('imas12'), 28041, Madrid, Spain
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Abstract
BackgroundWomen in many cohorts have a higher risk for Alzheimer's disease (AD), the most common form of dementia. Sex is a biological construct whereby differences in disease manifestation and prevalence are rooted in genetic differences between XX and XY combinations of chromosomes. This chapter focuses specifically on sex-driven differences in dementia, as opposed to differences driven by gender - a social construct referring to the societal norms that influence people's roles, relationships, and positional power throughout their lifetime.MethodsUsing a narrative review, this chapter explored the characteristics and risk factors for the dementias, alongside a discussion of sex differences including loss of sex steroid hormones in middle-aged women, differences in the prevalence of cardiovascular diseases and engagement in lifestyle protective factors for dementia.ResultsThe sex difference in AD prevalence may exist because of systematic and historic differences in risk and protective factors for dementia, including level of education obtained and socioeconomic status differences, which can impact on health and dementia risk.Levels of sex steroids decline significantly after menopause in women, whereas this is more gradual in men with age. Animal and cell culture studies show strong biological plausibility for sex steroids to protect the ageing brain against dementia. Sex steroid hormone replacement therapy has in some observational studies shown to protect against AD, but treatment studies in humans have mainly shown disappointing results. Cardiovascular disease (CVD) shares midlife medical risk (e.g. hypertension, hyperlipidaemia, obesity etc.) factors with AD and other forms of dementia, but also with related lifestyle risk - and protective factors (e.g. exercise, not smoking etc.). Men tend to die earlier of CVD, so fewer survive to develop AD at an older age. Those who do survive may have healthier lifestyles and fewer risk factors for both CVD and AD. An earlier age at menopause also confers great risk for both without hormone treatment.DiscussionIt could be the case that the decline in sex steroids around the menopause make women more susceptible to lifestyle-related risk factors associated with dementia and CVD, but this remains to be further investigated. Combining hormone treatment with lifestyle changes in midlife (e.g. exercise) could be an important preventative treatment for dementia and CVD in later life, but this also requires further research.
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Menengi̇ç KN, Yeldan İ, Çınar N, Şahiner T. Effectiveness of motor-cognitive dual-task exercise via telerehabilitation in Alzheimer’s disease: An online pilot randomized controlled study. Clin Neurol Neurosurg 2022; 223:107501. [DOI: 10.1016/j.clineuro.2022.107501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/12/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
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A Bibliometric and Visual Analysis of Exercise Intervention Publications for Alzheimer’s Disease (1998–2021). J Clin Med 2022; 11:jcm11195903. [PMID: 36233770 PMCID: PMC9571385 DOI: 10.3390/jcm11195903] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common cause of dementia worldwide, posing a considerable economic burden to patients and society as a whole. Exercise has been confirmed as a non-drug intervention method in the related literature on AD. However, at present, there are still few bibliometric studies on AD exercise research. In order to fill the gap, this paper aims to intuitively analyze the growth in AD exercise literature published from 1998 to 2021 using bibliometrics, providing historical insights for scientific research circles. The main source of literature retrieval is the Web of Science database. Using the Boolean operator tools “OR” and “AND” combined with keywords related to “exercise” and “Alzheimer’s disease”, we conducted a title search and obtained 247 documents. Using Microsoft Excel, Datawrapper, and Biblioshiny, this study carried out a bibliometric analysis of countries, institutions, categories, journals, documents, authors, and keyword plus terms. The study found that the number of papers published from 2016 to 2021 had the greatest increase, which may have been influenced by the Global Dementia Report 2015 and COVID-19. Interdisciplinary cooperation and the research results published in high-scoring journals actively promoted research and development in the AD exercise field. The United States and the University of Minnesota system play a central role in this field. In future, it will be necessary to explore the effectiveness and feasibility of multi-mode interventions on an active lifestyle, including exercise, in different groups and environments worldwide. This study may provide a direction and path for future research by showing the global overview, theme evolution, and future trends of research results in the AD exercise field.
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Chadwick C, Hussain A, Carone L, Yates J, Dening T. Going for gold: Sports and exercise groups for people with dementia and carers contribute to their well-being. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:953822. [DOI: 10.3389/fresc.2022.953822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/15/2022] [Indexed: 11/11/2022]
Abstract
BackgroundInterventions involving exercise appear to have positive effects, both for people with dementia and for their carers. Quality of life and well-being are especially important outcomes. This study investigated how a sports and exercise group for people with dementia and their carers could contribute to the well-being of those attending the group.MethodsThe study was a qualitative investigation, comprising semi-structured interviews, a focus group and observations. Participants included people with dementia and carers attending the group sessions, as well as staff providing the programme. The group sessions were provided weekly by the charitable trust of a leading sports venue. Data were analysed using thematic analysis.ResultsA total of 16 participants were interviewed, including four people with dementia, eight carers, and four members of staff. Five main themes were identified: “Support to keep active and engaged is highly valued by people with dementia and carers”; “The challenges of being a carer are significant but sharing the experience really helps”; “People with dementia can have flourishing social lives”; “The group helps to maintain identity despite physical and role changes”; and “There are practical aspects of the group that make it appealing”.DiscussionPeople with dementia enjoy physical activity and experience the benefits of it. The sports and exercise group had an important role in providing access to activities that people with dementia and their carers value and enjoy, but would be difficult to undertake without a facilitated and safe environment. The group benefited the well-being of both people with dementia and carers in various ways, with peer support being of particular importance for carers.
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New Possibilities in the Therapeutic Approach to Alzheimer’s Disease. Int J Mol Sci 2022; 23:ijms23168902. [PMID: 36012193 PMCID: PMC9409036 DOI: 10.3390/ijms23168902] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 01/17/2023] Open
Abstract
Despite the fact that Alzheimer’s disease (AD) is the most common cause of dementia, after many years of research regarding this disease, there is no casual treatment. Regardless of the serious public health threat it poses, only five medical treatments for Alzheimer’s disease have been authorized, and they only control symptoms rather than changing the course of the disease. Numerous clinical trials of single-agent therapy did not slow the development of disease or improve symptoms when compared to placebo. Evidence indicates that the pathological alterations linked to AD start many years earlier than a manifestation of the disease. In this pre-clinical period before the neurodegenerative process is established, pharmaceutical therapy might prove invaluable. Although recent findings from the testing of drugs such as aducanumab are encouraging, they should nevertheless be interpreted cautiously. Such medications may be able to delay the onset of dementia, significantly lowering the prevalence of the disease, but are still a long way from having a clinically effective disease-modifying therapy.
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Hearn R, Selfe J, Cordero MI, Dobbin N. The effects of active rehabilitation on symptoms associated with tau pathology: An umbrella review. Implications for chronic traumatic encephalopathy symptom management. PLoS One 2022; 17:e0271213. [PMID: 35862387 PMCID: PMC9302815 DOI: 10.1371/journal.pone.0271213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 06/24/2022] [Indexed: 12/02/2022] Open
Abstract
Objective This review sought to address an evidence gap and lay a foundation for future Chronic Traumatic Encephalopathy (CTE) management studies by evaluating and appraising the literature which reports the effect that active rehabilitation has on other tauopathies, a group of conditions with hyperphosphorylation and aggregation of tau protein that can lead to neurodegeneration. Design Umbrella review. Data source Meta-analyses and systematic reviews were identified using CINAHL, Medline, Cochrane, Web of Science, PubMed, and SPORTDiscus. Eligibility Systematic review or meta-analyses that examine the effect active rehabilitation has on outcome measures of symptoms associated with CTE. Studies with men and women diagnosed with Alzheimer’s disease, Parkinson’s disease, Lewy Body dementia, Frontotemporal degeneration/dementia or Corticobasal degeneration. All types of active rehabilitation were included. Control group was usual care, no intervention, or light-intensity physical activity. Results Twelve reviews were included. A large pooled standardized mean difference (SMD) was observed for balance (SMD = 0.88, P<0.001) and motor function (SMD = 0.83, P<0.001). A moderate pooled SMD was observed for cognitive function (SMD = 0.66, P<0.116). A small pooled SMD was observed for mobility (SMD = 0.45, P = 0.002). A trivial pooled SMD was observed for gait speed/velocity (SMD = 0.11, P = 0.372). No findings for mood/behavioral symptoms. All pooled effects demonstrated substantial to considerable heterogeneity (74.3% to 91.9%, P<0.001). Conclusions A positive effect of active rehabilitation was observed in patients with tau pathologies suffering from motor, vestibular and cognitive impairments supporting the use of active rehabilitation for CTE management; however, the findings need to be considered with caution given the limited research in some of the tau pathologies, large between-study heterogeneity and wide 95% prediction intervals.
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Affiliation(s)
- Rachael Hearn
- Faculty of Health, Department of Health Professions, Psychology, & Social Care, Manchester Metropolitan University, Manchester, United Kingdom
- * E-mail:
| | - James Selfe
- Faculty of Health, Department of Health Professions, Psychology, & Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Maria I. Cordero
- Faculty of Health, Department of Psychology, Psychology, & Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Nick Dobbin
- Faculty of Health, Department of Health Professions, Psychology, & Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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Balbim GM, Falck RS, Barha CK, Starkey SY, Bullock A, Davis JC, Liu-Ambrose T. Effects of exercise training on the cognitive function of older adults with different types of dementia: a systematic review and meta-analysis. Br J Sports Med 2022; 56:bjsports-2021-104955. [PMID: 35577539 DOI: 10.1136/bjsports-2021-104955] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the effect of exercise training on the cognitive function of older adults living with different types of dementia, as well as potential moderators of exercise efficacy. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Central, PsycINFO, Embase, Medline and CINAHL. ELIGIBILITY CRITERIA Peer-reviewed, randomised controlled trials, in English (1990-present), which examined the effects of exercise training on the cognitive function of older adults living with dementia. STUDY APPRAISAL AND SYNTHESIS Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0 and Physiotherapy Evidence Database Scale). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test. RESULTS Twenty-eight studies (n=2158) were included in the qualitative review and 25 in the meta-analysis. For all-cause dementia, a small effect of exercise training on cognitive function was observed (g=0.19; 95% CI 0.05 to 0.33; p=0.009). Type of dementia and exercise training characteristics did not moderate the effects of exercise training on cognitive function (p>0.05). Adherence to the intervention moderated the cognitive outcome effect size such that greater mean adherence was associated with greater cognitive outcome effect sizes (b=0.02; SE=0.01; p=0.005). CONCLUSION Exercise training showed small benefits for the cognitive function of older adults living with all-cause dementia. More research and standardised reporting of exercise training characteristics can strengthen the evidence for what works best for which types of dementia. PROSPERO REGISTRATION NUMBER CRD42020198716.
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Affiliation(s)
- Guilherme Moraes Balbim
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Ryan S Falck
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Cindy K Barha
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samantha Y Starkey
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexis Bullock
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- Faculty of Management, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
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23
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Ribarič S. Physical Exercise, a Potential Non-Pharmacological Intervention for Attenuating Neuroinflammation and Cognitive Decline in Alzheimer's Disease Patients. Int J Mol Sci 2022; 23:ijms23063245. [PMID: 35328666 PMCID: PMC8952567 DOI: 10.3390/ijms23063245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
This narrative review summarises the evidence for considering physical exercise (PE) as a non-pharmacological intervention for delaying cognitive decline in patients with Alzheimer’s disease (AD) not only by improving cardiovascular fitness but also by attenuating neuroinflammation. Ageing is the most important risk factor for AD. A hallmark of the ageing process is a systemic low-grade chronic inflammation that also contributes to neuroinflammation. Neuroinflammation is associated with AD, Parkinson’s disease, late-onset epilepsy, amyotrophic lateral sclerosis and anxiety disorders. Pharmacological treatment of AD is currently limited to mitigating the symptoms and attenuating progression of the disease. AD animal model studies and human studies on patients with a clinical diagnosis of different stages of AD have concluded that PE attenuates cognitive decline not only by improving cardiovascular fitness but possibly also by attenuating neuroinflammation. Therefore, low-grade chronic inflammation and neuroinflammation should be considered potential modifiable risk factors for AD that can be attenuated by PE. This opens the possibility for personalised attenuation of neuroinflammation that could also have important health benefits for patients with other inflammation associated brain disorders (i.e., Parkinson’s disease, late-onset epilepsy, amyotrophic lateral sclerosis and anxiety disorders). In summary, life-long, regular, structured PE should be considered as a supplemental intervention for attenuating the progression of AD in human. Further studies in human are necessary to develop optimal, personalised protocols, adapted to the progression of AD and the individual’s mental and physical limitations, to take full advantage of the beneficial effects of PE that include improved cardiovascular fitness, attenuated systemic inflammation and neuroinflammation, stimulated brain Aβ peptides brain catabolism and brain clearance.
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Affiliation(s)
- Samo Ribarič
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
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Cognitive and Physical Intervention in Metals’ Dysfunction and Neurodegeneration. Brain Sci 2022; 12:brainsci12030345. [PMID: 35326301 PMCID: PMC8946530 DOI: 10.3390/brainsci12030345] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
Metals—especially iron, copper and manganese—are important elements of brain functions and development. Metal-dysregulation homeostasis is associated with brain-structure damage to the motor, cognitive and emotional systems, and leads to neurodegenerative processes. There is more and more evidence that specialized cognitive and motor exercises can enhance brain function and attenuate neurodegeneration in mechanisms, such as improving neuroplasticity by altering the synaptic structure and function in many brain regions. Psychological and physical methods of rehabilitation are now becoming increasingly important, as pharmacological treatments for movement, cognitive and emotional symptoms are limited. The present study describes physical and cognitive rehabilitation methods of patients associated with metal-induced neurotoxicity such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, Huntington’s disease and Wilson’s disease. In our review, we describe physical (e.g., virtual-reality environments, robotic-assists training) and psychological (cognitive training, cognitive stimulation, neuropsychological rehabilitation and cognitive-behavioral and mindfulness-based therapies) methods, significantly improving the quality of life and independence of patients associated with storage diseases. Storage diseases are a diverse group of hereditary metabolic defects characterized by the abnormal cumulation of storage material in cells. This topic is being addressed due to the fact that rehabilitation plays a vital role in the treatment of neurodegenerative diseases. Unfortunately so far there are no specific guidelines concerning physiotherapy in neurodegenerative disorders, especially in regards to duration of exercise, type of exercise and intensity, as well as frequency of exercise. This is in part due to the variety of symptoms of these diseases and the various levels of disease progression. This further proves the need for more research to be carried out on the role of exercise in neurodegenerative disorder treatment.
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Guest PC. Proteomic Mapping of the Human Myelin Proteome. Methods Mol Biol 2022; 2343:191-202. [PMID: 34473323 DOI: 10.1007/978-1-0716-1558-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Alzheimer's disease (AD) is a degenerative cognitive condition that affects individuals with an increasing prevalence in older age groups. There are currently five drugs on the market for AD but no new effective ones have been discovered for decades. There has been increasing interest in the use of natural remedies such as special diets and plant extracts but these require further study. Based on the known effects on white matter and neuronal conductance in Alzheimer's disease, we present a protocol for proteomic analysis of myelin-enriched brain fractions as a way of identifying potential biomarkers of efficacy. This fingerprint could be used in screening assays for novel compounds for treatment of AD.
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Affiliation(s)
- Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil.
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López-Ortiz S, Valenzuela PL, Seisdedos MM, Morales JS, Vega T, Castillo-García A, Nisticò R, Mercuri NB, Lista S, Lucia A, Santos-Lozano A. Exercise interventions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev 2021; 72:101479. [PMID: 34601135 DOI: 10.1016/j.arr.2021.101479] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/04/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
AIMS To assess the potential multi-domain benefits of exercise interventions on patients with Alzheimer's disease (AD), as well as to determine the specific effects of different exercise modalities (aerobic, strength, or combined training). METHODS A systematic search was conducted in PubMed and Web of Science until March 2021 for randomized controlled trials assessing the effect of exercise interventions (compared with no exercise) on patients with AD. Outcomes included cognitive function (mini-mental state examination [MMSE] test), physical function (e.g., 6-minute walking test [6MWT]), functional independence (Barthel index), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). A random-effects meta-analysis was conducted. RESULTS 28 studies (total n = 1337 participants, average age 79-90 years) were included in the systematic review, of which 21 could be meta-analyzed. Although considerable heterogeneity was found, exercise interventions induced several significant benefits, including in Barthel index (n = 147 patients, mean difference [MD]=8.36 points, 95% confidence interval [CI]=0.63-16.09), 6MWT (n = 369, MD=84 m, 95% CI=44-133)), and NPI (n = 263, MD=-4.4 points, 95% CI=-8.42 to -0.38). Benefits were also found in the MMSE test, albeit significance was only reached for aerobic exercise (n = 187, MD=2.31 points, 95% CI 0.45-4.27). CONCLUSIONS Exercise interventions appear to exert multi-domain benefits in patients with AD.
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Affiliation(s)
- Susana López-Ortiz
- i+HeALTH, European University Miguel de Cervantes, 47012 Valladolid, Spain.
| | - Pedro L Valenzuela
- Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María M Seisdedos
- i+HeALTH, European University Miguel de Cervantes, 47012 Valladolid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - Tomás Vega
- Public Health Directorate, Regional Ministry of Health (Dirección General de Salud Pública, Consejería de Sanidad), Castilla y León, 47007 Valladolid, Spain
| | | | - Robert Nisticò
- Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, 00161 Rome, Italy; School of Pharmacy, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Simone Lista
- Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; School of Pharmacy, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Alejandro Lucia
- Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; CIBER en Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain; Research Institute of the Hospital 12 de Octubre ('imas12'), 28041 Madrid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, 47012 Valladolid, Spain; Research Institute of the Hospital 12 de Octubre ('imas12'), 28041 Madrid, Spain.
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Borges-Machado F, Silva N, Farinatti P, Poton R, Ribeiro Ó, Carvalho J. Effectiveness of Multicomponent Exercise Interventions in Older Adults With Dementia: A Meta-Analysis. THE GERONTOLOGIST 2021; 61:e449-e462. [PMID: 32652005 PMCID: PMC8599205 DOI: 10.1093/geront/gnaa091] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Multicomponent training (MT) combines aerobic, strength, postural, and balance exercises and may be a promising intervention strategy for dementia. This meta-analysis study aims to systematize evidence concerning the effectiveness of MT in physical fitness, cognition, and functionality on activities of daily living (ADL) in older adults with dementia and to identify moderation patterns regarding training variables. RESEARCH DESIGN AND METHODS 4 databases were systematically searched to locate potential trials through March 2019. A total of 2,312 records were identified and a final set of 17 manuscripts reviewed; of these, 6 satisfied all eligibility criteria. RESULTS Samples sizes ranged from 27 to 170 participants; MT programs lasted between 4 weeks and 12 months, took place from a daily basis to twice a week, and sessions ranged from 30 to 60 min. The TESTEX scale was used to analyze the methodological quality, and the funnel plots to assess the risk of bias. This meta-analysis revealed that MT interventions benefit older adults with dementia regarding ADL performance (effect size = 0.313 [0.16-0.46]; p < .01), but the evidence was not sufficiently robust to determine the effectiveness of MT on cognitive function and physical fitness, particularly, on agility. DISCUSSION AND IMPLICATIONS MT may be an important nonpharmacological strategy to enhance ADL functionality on older adults with dementia. Findings suggest that long-term interventions are more prevalent than high-frequency and longer duration exercise sessions. Further evidence is needed for acknowledging its benefits in specific cognitive abilities and physical fitness. This meta-analysis is registered in PROSPERO (no. CRD42020141545).
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Affiliation(s)
- Flávia Borges-Machado
- CIAFEL—Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
- Faculty of Sport, University of Porto, Portugal
| | - Nádia Silva
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Brazil
- Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, Brazil
| | - Roberto Poton
- Centro Universitário IBMR, Laureate International Universities, Rio de Janeiro, Brazil
| | - Óscar Ribeiro
- CINTESIS—Center for Health Technology and Services Research, Porto, Portugal
- Department of Education and Psychology, University of Aveiro, Portugal
| | - Joana Carvalho
- CIAFEL—Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
- Faculty of Sport, University of Porto, Portugal
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Exercise mimetics: harnessing the therapeutic effects of physical activity. Nat Rev Drug Discov 2021; 20:862-879. [PMID: 34103713 DOI: 10.1038/s41573-021-00217-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 02/05/2023]
Abstract
Exercise mimetics are a proposed class of therapeutics that specifically mimic or enhance the therapeutic effects of exercise. Increased physical activity has demonstrated positive effects in preventing and ameliorating a wide range of diseases, including brain disorders such as Alzheimer disease and dementia, cancer, diabetes and cardiovascular disease. This article discusses the molecular mechanisms and signalling pathways associated with the beneficial effects of physical activity, focusing on effects on brain function and cognitive enhancement. Emerging therapeutic targets and strategies for the development of exercise mimetics, particularly in the field of central nervous system disorders, as well as the associated opportunities and challenges, are discussed.
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Zhao X, Li D, Zhang L, Niu Y, Wang W, Niu B. Mesenchymal stem cell therapies for Alzheimer's disease: preclinical studies. Metab Brain Dis 2021; 36:1687-1695. [PMID: 34213730 DOI: 10.1007/s11011-021-00777-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/06/2021] [Indexed: 12/17/2022]
Abstract
Alzheimer's disease (AD) is a chronic, progressive, and fatal neurodegenerative disorder that is characterized by memory failure, cognitive impairment, as well as behavioral and psychological manifestations. Drugs can only moderately manage, but not alleviate, clinical symptoms. Results, based on animal models, have demonstrated that cell therapy is a promising strategy for treating neurodegenerative disorders. The homing effect of mesenchymal stem cells (MSCs) replaces damaged cells, while some scholars believe that the paracrine effects play a crucial role in treating diseases. In fact, these cells have rich sources, exhibit high proliferation rates, low tumorigenicity, and immunogenicity, and have no ethical concerns. Consequently, MSCs have been used across various disease aspects, such as regulating immunity, nourishing nerves, and promoting regeneration. Deterioration of public health status have exposed both Alzheimer's patients and researchers to various difficulties during epidemics. In this review, we discuss the advances and challenges in the application of mesenchymal stem cell therapy for treatment of Alzheimer's disease.
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Affiliation(s)
- Xiaorong Zhao
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Dandan Li
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Li Zhang
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yuhu Niu
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Wenzhuo Wang
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Bo Niu
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
- Department of Biotechnology, Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China.
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Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses. J Aging Phys Act 2021; 30:535-551. [PMID: 34489364 DOI: 10.1123/japa.2021-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/11/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.
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Abstract
Dementia is an eurodegenerative disorder, which causes significant disability, especially among the elderly population worldwide. The affected person shows a progressive cognitive decline, which interferes with the independence in performing the activities of daily living. Other than the cognitive domain, the patient tends to have neuropsychiatric, behavioral, sensorimotor, speech, and language-related issues. It is expected that the global burden of the disease will rise with more people entering the geriatric age group. By 2050 close, to 140 million people will be living with one or the other type of dementia. Alzheimer's disease contributes to more than 60% of cases worldwide, followed by vascular dementia. Pharmacotherapy has a limited role to play in the treatment, and at present, no drug is available, which can halt or reverse the progress of the disease. World Health Organization has mandated rehabilitation as a core recommendation in the global action plan on the public health response to dementia. Rehabilitation services are widely recognized as a practical framework to maximize independence and community participation in dementia care. The rehabilitation program is customized to achieve the desired goals, as each person has different experiences, preferences, motivations, strengths, and requirements based on type, course, and severity of the illness. It is an interdisciplinary-team approach with the involvement of several health care professionals. This article reviews the existing literature and outlines the effective rehabilitation strategies concisely in dementia care.
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Affiliation(s)
- Anupam Gupta
- Dept. of Neurological Rehabilitation, NIMHANS, Bangalore, Karnataka, India
| | - Naveen B Prakash
- Dept. of Neurological Rehabilitation, NIMHANS, Bangalore, Karnataka, India
| | - Gourav Sannyasi
- Dept. of Neurological Rehabilitation, NIMHANS, Bangalore, Karnataka, India
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Cardona MI, Afi A, Lakicevic N, Thyrian JR. Physical Activity Interventions and Their Effects on Cognitive Function in People with Dementia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168753. [PMID: 34444501 PMCID: PMC8394441 DOI: 10.3390/ijerph18168753] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Physical activity (PA) has emerged as an alternative nonpharmacological approach to effectively address the effects of dementia. The primary aim was to identify and summarize PA interventions and their effects on cognitive function among persons with dementia (PwD). METHODS A systematic review was conducted with a meta-analysis using different electronic databases, such as PubMed, Embase, APA PsycNET, and the Web of Science. The identified and selected studies were randomized controlled trials (RCTs) that were written in English, published between 2000 and 2020, and implemented among PwD who received a PA intervention and whose cognitive function was measured at baseline and during a follow-up. RESULTS Twenty-two PA intervention studies met the eligibility criteria and showed a medium-size effect on the cognitive function of PwD, 0.4803 (95% CI = 0.1901-0.7704), with a high percentage of heterogeneity (I2 = 86%, p ≤ 0.0001). Moreover, this review complements other reviews by including eight studies that have not previously been considered. Overall, studies have methodological limitations. However, six studies implemented in the past five years have shown more robust methodological designs, including larger sample sizes and more comprehensive measurement tools. CONCLUSION It is not yet possible to draw a conclusion on the ideal PA intervention for this population due to the high proportion of heterogeneity within the included studies. More emphasis is needed on the intensity of PA monitoring and adherence to such programs.
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Affiliation(s)
- Maria Isabel Cardona
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Rostock/Greifswald, Ellernholzstr. 1–2, 17489 Greifswald, Germany; (A.A.); (J.R.T.)
- Correspondence: ; Tel.: +49-383-486-7593; Fax: +49-383-4861-9551
| | - Adel Afi
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Rostock/Greifswald, Ellernholzstr. 1–2, 17489 Greifswald, Germany; (A.A.); (J.R.T.)
| | - Nemanja Lakicevic
- Sport and Exercise Sciences Research Unit, University of Palermo, 90133 Palermo, Italy;
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Rostock/Greifswald, Ellernholzstr. 1–2, 17489 Greifswald, Germany; (A.A.); (J.R.T.)
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1–2, 17489 Greifswald, Germany
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Hale JM, Bijlsma MJ, Lorenti A. Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors. SSM Popul Health 2021; 15:100855. [PMID: 34258375 PMCID: PMC8255239 DOI: 10.1016/j.ssmph.2021.100855] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/31/2021] [Accepted: 06/24/2021] [Indexed: 11/26/2022] Open
Abstract
Evidence suggests that contemporaneous labor force participation affects cognitive function; however, it is unclear whether it is employment itself or endogenous factors related to individuals’ likelihood of employment that protects against cognitive decline. We exploit innovations in counterfactual causal inference to disentangle the effect of postponing retirement on later-life cognitive function from the effects of other life-course factors. With the U.S. Health and Retirement Study (1996–2014, n = 20,469), we use the parametric g-formula to estimate the effect of postponing retirement to age 67. We also study whether the benefit of postponing retirement is affected by gender, education, and/or occupation, and whether retirement affects cognitive function through depressive symptoms or comorbidities. We find that postponing retirement is protective against cognitive decline, accounting for other life-course factors (population: 0.34, 95% confidence interval (CI): 0.20,0.47; individual: 0.43, 95% CI: 0.26,0.60). The extent of the protective effect depends on subgroup, with the highest educated experiencing the greatest mitigation of cognitive decline (individual: 50%, 95% CI: 32%,71%). By using innovative models that better reflect the empirical reality of interconnected life-course processes, this work makes progress in understanding how retirement affects cognitive function. Research is inconclusive as to employments' protection against cognitive decline. Causal inference models can better reflect interconnected life-course processes. The parametric g-formula shows a substantial protective effect of ongoing employment. Protective effect holds for all subgroups, but is greatest for the highest educated.
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Affiliation(s)
- Jo Mhairi Hale
- School of Geography and Sustainable Development, University of St Andrews, Scotland, UK.,Max Planck Institute for Demographic Research, Rostock, Germany
| | - Maarten J Bijlsma
- Max Planck Institute for Demographic Research, Rostock, Germany.,Groningen Research Institute of Pharmacy, Unit Pharmacotherapy, Epidemiology & Economics (PTEE), University of Groningen, The Netherlands
| | - Angelo Lorenti
- Max Planck Institute for Demographic Research, Rostock, Germany
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A Randomized Controlled Trial Protocol to Test the Efficacy of a Dual-Task Multicomponent Exercise Program vs. a Simple Program on Cognitive and Fitness Performance in Elderly People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126507. [PMID: 34208766 PMCID: PMC8296364 DOI: 10.3390/ijerph18126507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The necessity of improve the life quality in elderly people is well-known. The aim of this study was to determine the effects of physical and cognitive training programs, as well as their combination on the cognitive functions and physical capacities in women over 80 years old. METHODS Forty-three women took part in this study (80.86 ± 5.03 years). They were divided into four groups (three experimental groups and one control group). Experimental group 1 performed cognitive training. Experimental group 2 did physical-cognitive training, and Experimental Group 3 accomplished physical training. All of training programs had duration of eight weeks (five sessions of 60 min per week). We measured cognitive variables with the Stroop test, D2 test, and Trail Making test. Physical variables were measured with handgrip strength, Minute Step Test, and visual-acoustic reaction time. RESULTS Control group reduces his physical and cognitive capacities, while the three experimental groups increase these capacities. We found a strong correlation between the increase of physical and cognitive capacities. CONCLUSION Eight weeks of training physical, cognitive or mixed, increased physical and cognitive functions of elderly people which may reduce the negative effects of the aging process.
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Farina N, Williams A, Clarke K, Hughes LJ, Thomas S, Lowry RG, Banerjee S. Barriers, motivators and facilitators of physical activity in people with dementia and their family carers in England: dyadic interviews. Aging Ment Health 2021; 25:1115-1124. [PMID: 32067474 DOI: 10.1080/13607863.2020.1727852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Physical activity may have a number of physical and mental health benefits for people with dementia and their carers. However, there is limited evidence about factors that influence physical activity participation in these groups. This study therefore looks at the barriers, facilitators and motivators of physical activity in people with dementia, from both the perspective of the person with dementia and their carer. METHOD Thirty participants (15 sets of community-dwelling people with dementia and their family carers) were recruited from the South East of England. The participants took part in semi-structured dyadic interviews about their views of physical activity. Interviews were analysed using inductive thematic analysis at an individual level and comparisons were made between the groups. RESULTS Common motivator themes across persons with dementia and family carers were emotional and physical wellbeing, and social connectedness. Physical health was seen as a common barrier in both groups. Physical activity in the person with dementia was encouraged and supported by the family carer. For the carer, their caring role, and limited time acted as barriers to their participation. CONCLUSION Themes such as social connectedness, positive emotion and health were seen as key motivators to physical activity, which indicate that people with dementia and carers use physical activity as a means to maintain and improve their quality of life. Supporting family members to better facilitate such activities could encourage physical activity in people with dementia.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Alice Williams
- Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Kirsty Clarke
- Global and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Laura J Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Serena Thomas
- Research and Development, Sussex Partnership NHS Foundation Trust, Hove, UK
| | - Ruth G Lowry
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
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Yokogawa M, Taniguchi Y, Yoneda Y. Physical therapy processes-interactions between a physical therapist and an older client with dementia. Physiother Theory Pract 2021; 38:2149-2159. [PMID: 33849393 DOI: 10.1080/09593985.2021.1913776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: In Japan, the population aging rate highlights the need to examine various care provisions for older adults with dementia, including physical therapy. However, despite its positive effects, there are also many challenges associated with providing physical therapy for older adults with dementia.Objective: This qualitative case study examined the interactions between a physical therapist and a patient with dementia and the process by which physical therapy was provided to her.Methods: This study utilized a modified grounded theory approach to analyze the interview of one physical therapist, a woman with four years of clinical experience who specializes in physical therapy for older adults who provided a 20-minute physical therapy session to her client, a woman in her 80s with dementia who sought to maintain her ability to perform activities of daily living and preserve her independence. Data were collected in January 2017.Results: Fifteen concepts that represent aspects of the services that the therapist provided to her client were identified. Five distinct categories were derived: 1) foundations of the relationship; 2) understanding individual factors; 3) supporting execution of functional activities; 4) assessing cognitive function; and 5) support to ensure safety in daily living.Conclusion: Physical therapists help older adults with dementia execute functional activities, which helps ensure their safety and independence, and fosters strong therapist-client relationships. Future studies should interview multiple physical therapists to generate additional concepts. Further, quantifying these concepts and developing tools to assess clients will improve care provision and inform physical therapists with limited experience in treating patients with dementia.
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Affiliation(s)
- Masami Yokogawa
- Department of Physical Therapy, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yoshimi Taniguchi
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yumi Yoneda
- Rehabilitation Division, Enyama Kenko Clinic, Nanao, Japan
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the challenges of providing equitable health care for people with dementia in the United States. An estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available, making Alzheimer's the sixth-leading cause of death in the United States and the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated in 2020 by the COVID-19 pandemic. More than 11 million family members and other unpaid caregivers provided an estimated 15.3 billion hours of care to people with Alzheimer's or other dementias in 2020. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $256.7 billion in 2020. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2021 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $355 billion. Despite years of efforts to make health care more equitable in the United States, racial and ethnic disparities remain - both in terms of health disparities, which involve differences in the burden of illness, and health care disparities, which involve differences in the ability to use health care services. Blacks, Hispanics, Asian Americans and Native Americans continue to have a higher burden of illness and lower access to health care compared with Whites. Such disparities, which have become more apparent during COVID-19, extend to dementia care. Surveys commissioned by the Alzheimer's Association recently shed new light on the role of discrimination in dementia care, the varying levels of trust between racial and ethnic groups in medical research, and the differences between groups in their levels of concern about and awareness of Alzheimer's disease. These findings emphasize the need to increase racial and ethnic diversity in both the dementia care workforce and in Alzheimer's clinical trials.
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Carvalho J, Borges-Machado F, Barros D, Sampaio A, Marques-Aleixo I, Bohn L, Pizarro A, Teixeira L, Magalhães J, Ribeiro Ó. "Body & Brain": effects of a multicomponent exercise intervention on physical and cognitive function of adults with dementia - study protocol for a quasi-experimental controlled trial. BMC Geriatr 2021; 21:156. [PMID: 33663414 PMCID: PMC7934383 DOI: 10.1186/s12877-021-02104-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dementia is a leading cause of death and disability that was declared as one of the greatest health and social care challenges of the twenty-first century. Regular physical activity and exercise have been proposed as a non-pharmacological strategy in disease prevention and management. Multicomponent Training (MT) combines aerobic, strength, balance and postural exercises and might be an effective training to improve both functional capacity and cognitive function in individuals with dementia (IwD). Nevertheless, data on the effects of MT in IwD are still limited and the extent to which IwD can retain improvements after an exercise intervention still needs to be elucidated. The aim of "Body & Brain" study is to investigate the effects of a 6-month MT intervention and 3-month detraining on the physical and cognitive function of IwD. Additionally, we aim to explore the impact of this intervention on psychosocial factors and physiologic markers related to dementia. METHODS This study is a quasi-experimental controlled trial using a parallel-group design. The study sample consists of community-dwelling individuals aged ≥60 years who are clinically diagnosed with dementia or major neurocognitive disorder. Participants will be either allocated into the intervention group or the control group. The intervention group will participate in MT biweekly exercise sessions, whereas the control group will receive monthly sessions regarding physical activity and health-related topics for 6 months. The main outcomes will be physical function as measured by the Short Physical Performance Battery (SPPB) and cognitive function evaluated using the Alzheimer Disease Assessment Scale - Cognitive (ADAS-Cog) at baseline, after 6-months and 3-months after the end of intervention. Secondary outcomes will be body composition, physical fitness, daily functionality, quality of life, neuropsychiatric symptoms and caregiver's burden. Cardiovascular, inflammatory and neurotrophic blood-based biomarkers, and arterial stiffness will also be evaluated in subsamples. DISCUSSION If our hypothesis is correct, this project will provide evidence regarding the efficacy of MT training in improving physical and cognitive function and give insights about its impact on novel molecular biomarkers related to dementia. This project may also contribute to provide guidelines on exercise prescription for IwD. TRIAL REGISTRATION ClinicalTrials.gov - identifier number NCT04095962 ; retrospectively registered on 19 September 2019.
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Affiliation(s)
- Joana Carvalho
- Faculdade de Desporto da Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Flávia Borges-Machado
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal.
| | - Duarte Barros
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Arnaldina Sampaio
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Inês Marques-Aleixo
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- Faculdade de Educação Física e Desporto, Universidade Lusófona, Rua de Augusto Rosa 24, 4000-098, Porto, Portugal
| | - Lucimere Bohn
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- Faculdade de Educação Física e Desporto, Universidade Lusófona, Rua de Augusto Rosa 24, 4000-098, Porto, Portugal
| | - Andreia Pizarro
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Laetitia Teixeira
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313, Porto, Portugal
| | - José Magalhães
- Faculdade de Desporto da Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Óscar Ribeiro
- CINTESIS, Centro de Investigação em Tecnologias e Serviços de Saúde, Departamento de Educação e Psicologia, Universidade de Aveiro - Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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Fan J, Ullal A, Beuscher L, Mion LC, Newhouse P, Sarkar N. Field Testing of Ro-Tri, a Robot-Mediated Triadic Interaction for Older Adults. Int J Soc Robot 2021; 13:1711-1727. [PMID: 33643494 PMCID: PMC7897418 DOI: 10.1007/s12369-021-00760-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 01/10/2023]
Abstract
Older adults residing in long term care (LTC) settings commonly experience apathy, a neuropsychiatric condition with adverse consequences of increased morbidity and mortality. Activities that combine social, physical and cognitive stimuli are most effective in engaging older adults with apathy but are time consuming and require significant staff resources. We present the results from an initial pilot field study of our socially assistive robotic (SAR) system, Ro-Tri, capable of multi-modal interventions to foster social interaction between pairs of older adults. Seven paired participants attended two sessions a week for three weeks. Sessions consisted of robot-mediated triadic interactions with three types of activities repeated once over the 3 weeks. Ro-Tri gathered quantitative interaction data, head pose, vocal sound, and physiological signals to automatically evaluate older adults' activity and social engagement. Ro-Tri functioned smoothly without any technical issues. Older adults had > 90% attendance and 100% completion rate and remained engaged with the system throughout the study duration. Participants' visual attention toward the SAR system and their partners increased 7.2% and 4.7%, respectively, with their interaction effort showing an increase of 2.9%. Older adults and LTC staff had positive perceptions with the system. These initial results demonstrate Ro-Tri's ability to engage older adults, encourage social human-to-human interaction, and assess the changes using quantitative metrics. Future studies will determine SAR's impact on apathy in LTC older adults.
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Affiliation(s)
- Jing Fan
- Department of EECS, Vanderbilt University, Nashville, TN USA
| | - Akshith Ullal
- Department of EECS, Vanderbilt University, Nashville, TN USA
| | - Linda Beuscher
- School of Nursing, Vanderbilt University, Nashville, TN USA
| | | | - Paul Newhouse
- Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN USA
- Geriatric Research, Education and Clinical Center, Tennessee Valley Veterans Affairs Medical Center, Nashville, TN USA
| | - Nilanjan Sarkar
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN USA
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Trammell JP, Aguilar SC. Natural Is Not Always Better: The Varied Effects of a Natural Environment and Exercise on Affect and Cognition. Front Psychol 2021; 11:575245. [PMID: 33584411 PMCID: PMC7873912 DOI: 10.3389/fpsyg.2020.575245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
The Attention Restoration Theory (ART) has been widely cited to account for beneficial effects of natural environments on affect and attention. However, the effects of environment and exercise are not consistent. In a within-subjects design, participants completed affective and cognitive measures that varied in attentional demands (memory, working memory, and executive function) both before and after exercise in a natural and indoor environment. Contrary to the hypotheses, a natural environment resulted in lower positive affect and no difference in negative affect compared to an indoor environment. A natural environment resulted in the most improvement for cognitive tasks that required moderate attentional demand: Trail Making Test A and Digit Span Forwards. As predicted, exercise resulted in improved affect and improved executive function (Trail Making Test B). There were no interactions between environment and exercise. These results suggest that ART cannot fully explain the influence of environment on affect and cognition.
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Affiliation(s)
- Janet P Trammell
- Social Science Department, Seaver College, Pepperdine University, Malibu, CA, United States
| | - Shaya C Aguilar
- Social Science Department, Seaver College, Pepperdine University, Malibu, CA, United States
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Moniruzzaman M, Kadota A, Akash MS, Pruitt PJ, Miura K, Albin R, Dodge HH. Effects of physical activities on dementia-related biomarkers: A systematic review of randomized controlled trials. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 6:e12109. [PMID: 33521235 PMCID: PMC7816814 DOI: 10.1002/trc2.12109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/01/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Physical activities (PA) may lead to improved cognition in mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia. The mechanisms mediating potential PA effects are unknown. Assessment of PA effects on relevant biomarkers may provide insights into mechanisms underlying potential PA effects on cognition. METHODS We systematically reviewed randomized controlled trials (RCTs) that studied PA effects on biomarkers in MCI, AD, and dementia populations. We examined whether biological mechanisms were hypothesized to explain associations among PA, biomarkers, and cognitive functions. We used the PubMed database and searched for RCTs with PA until October 31, 2019. RESULTS Of 653 studies examining changes in biomarkers in PA trials, 18 studies met inclusion criteria for the present review. Some studies found favorable effects of PA on neurotrophic and inflammatory biomarkers. AD pathological markers were rarely investigated, with inconclusive results. Most studies were relatively small in sample size, of limited duration, and not all studies compared the changes in biomarkers between the control and experimental groups. DISCUSSION There is only limited use of potentially informative biomarkers in PA trials for MCI, AD, and dementia. Most studies did not examine the role of biomarkers to study associations between PA and cognitive functions in their analyses. Several potential biomarkers remain uninvestigated. Careful use of biomarkers may clarify mechanisms underlying PA effects on cognition. Our review serves as a useful resource for developing future PA RCTs aimed at improving cognitive functions in MCI, AD, and dementias.
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Affiliation(s)
- Mohammad Moniruzzaman
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of Public HealthShiga University of Medical ScienceOtsuJapan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of Public HealthShiga University of Medical ScienceOtsuJapan
| | | | - Patrick J Pruitt
- Institute of Gerontology, Wayne State UniversityDetroitMichiganUSA
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of Public HealthShiga University of Medical ScienceOtsuJapan
| | - Roger Albin
- VAAAHSNeurology Service & GRECCAnn ArborMichiganUSA
- Department of Neurology, Michigan Alzheimer's Disease CenterUniversity of MichiganAnn ArborMichiganUSA
| | - Hiroko H. Dodge
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
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Group-Based Exercise as a Therapeutic Strategy for the Improvement of Mental Outcomes in Mild to Moderate Alzheimer’s Patients in Low Resource Care Facilities. Asian J Sports Med 2021. [DOI: 10.5812/asjsm.106593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Exercise is related to enhanced cognitive functioning and brain plasticity. Exercise might represent a potential adjunctive treatment for neuropsychiatric disorders, such as Alzheimer's disease (AD). Furthermore, group exercise may prove especially useful due to its additional benefits. Objectives: This study aimed to determine the effect of low-cost, group-based exercise on mental outcomes in patients with mild to moderate AD. Methods: Participants with mild to moderate AD were randomized to either a non-exercising control (CON) group or a group-exercise (GEX) group (n = 20 each). The GEX participated in eight weeks of three-times-weekly non-consecutive 45-minute sessions consisting of balance, resistance, aerobic, and flexibility exercises to determine their effect on mental outcomes, namely, cognitive function, activities of daily living (ADLs), and quality of life (QOL). Results: The intervention program showed a significant (P ≤ 0.05) increase in Mini-Mental State Examination (MMSE) scores (P = 0.023). While the GEX were found to have no change in their (Alzheimer’s disease cooperative study activities of daily living) ADCS-ADL scores (P = 0.574). The CON demonstrated a significant, but deleterious 13.77% decrease in their ADCS-ADL scores from pre- to mid-test (P = 0.023) and from pre- to post-test (P = 0.038). Quality of Life-Alzheimer’s Disease (QOL-AD) scores were unchanged in both the GEX and CON. Conclusions: Our results indicate that a low-cost, multidimensional group exercise intervention can positively influence cognitive function and improve patients with mild to moderate AD ability to perform ADLs.
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Abstract
Approximately 30-50% of persons living with HIV manifest some degree of neurocognitive impairment. Even mild-to-moderate forms of HIV-associated neurocognitive disorders (HAND) can result in difficulties with everyday functioning, such as suboptimal medication adherence and impaired driving. Despite the pervasive presence and consequences of HAND, there is a significant unmet need to develop effective behavioral strategies to reduce the incidence and consequences of HAND. Although there is an absence of evidence-based behavioral interventions specific to HAND, the literature reviewed in this chapter suggest the following modifiable lifestyle factors as intervention targets: physical activity, diet, sleep, and antiretroviral medication adherence. Adoption and maintenance of these healthy lifestyle factors may reduce inflammation and oxidative stress, which, in turn, may reduce the incidence and/or severity of HAND.
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Affiliation(s)
- Jessica L Montoya
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Brook Henry
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- HIV Neurobehavioral Research Program, San Diego, CA, USA.
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de Las Heras B, Rodrigues L, Cristini J, Weiss M, Prats-Puig A, Roig M. Does the Brain-Derived Neurotrophic Factor Val66Met Polymorphism Modulate the Effects of Physical Activity and Exercise on Cognition? Neuroscientist 2020; 28:69-86. [PMID: 33300425 DOI: 10.1177/1073858420975712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Val66Met is a polymorphism of the brain-derived neurotrophic factor (BDNF) gene that encodes a substitution of a valine (Val) to methionine (Met) amino acid. Carrying this polymorphism reduces the activity-dependent secretion of the BDNF protein, which can potentially affect brain plasticity and cognition. We reviewed the biology of Val66Met and surveyed 26 studies (11,417 participants) that examined the role of this polymorphism in moderating the cognitive response to physical activity (PA) and exercise. Nine observational studies confirmed a moderating effect of Val66Met on the cognitive response to PA but differences between Val and Met carriers were inconsistent and only significant in some cognitive domains. Only five interventional studies found a moderating effect of Val66Met on the cognitive response to exercise, which was also inconsistent in its direction. Two studies showed a superior cognitive response in Val carriers and three studies showed a better response in Met carriers. These results do not support a general and consistent effect of Val66Met in moderating the cognitive response to PA or exercise. Both Val and Met carriers can improve specific aspects of cognition by increasing PA and engaging in exercise. Causes for discrepancies among studies, effect moderators, and future directions are discussed.
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Affiliation(s)
- Bernat de Las Heras
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lynden Rodrigues
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maxana Weiss
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Anna Prats-Puig
- University School of Health and Sport (EUSES), University of Girona, Girona, Catalunya, Spain
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Zhu L, Li L, Wang L, Jin X, Zhang H. Physical Activity for Executive Function and Activities of Daily Living in AD Patients: A Systematic Review and Meta-Analysis. Front Psychol 2020; 11:560461. [PMID: 33343442 PMCID: PMC7744293 DOI: 10.3389/fpsyg.2020.560461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Objectives: The present study aimed to systematically analyze the effects of physical activity on executive function, working memory, cognitive flexibility, and activities of daily living (ADLs) in Alzheimer's disease (AD) patients and to provide a scientific evidence-based exercise prescription. Methods: Both Chinese and English databases (PubMed, Web of Science, the Cochrane Library, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were used as sources of data to search for randomized controlled trials (RCTs) published between January 1980 and December 2019 relating to the effects of physical activity on executive function, working memory, cognitive flexibility, and ADL issues in AD patients. Sixteen eligible RCTs were ultimately included in the meta-analysis. Results: Physical activity had significant benefits on executive function [standard mean difference (SMD) = 0.42, 95% confidence interval (CI) 0.22–0.62, p < 0.05], working memory (SMD = 0.28, 95% CI 0.11–0.45, p < 0.05), cognitive flexibility (SMD = 0.23, 95% CI −0.02 to 0.47, p < 0.01), and ADLs (SMD = 0.68, 95% CI 0.19–1.16, p < 0.05) among AD patients. Subgroup analysis indicated that, for executive function issues, more than 60 min per session for 16 weeks of moderate-to-high-intensity dual-task exercises or multimodal exercise had a greater effect on AD patients. For working memory and cognitive flexibility issues, 60–90 min of moderate-intensity dual-task exercises 1–4 times/week was more effective. For ADL issues, 30–90 min of multimodal exercise at 60–79% of maximal heart rate (MHR) 3–4 times/week had a greater effect on AD patients. Conclusions: Physical activity was found to lead to significant improvements in executive function, working memory, cognitive flexibility, and ADLs in AD patients and can be used as an effective method for clinical exercise intervention in these patients. However, more objective, scientific, and effective RCTs are needed to confirm this conclusion.
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Affiliation(s)
- Lin Zhu
- School of Physical Education, Soochow University, Suzhou, China
| | - Long Li
- School of Physical Education, Soochow University, Suzhou, China
| | - Lin Wang
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Xiaohu Jin
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Huajiang Zhang
- College of Physical Education, Hubei University of Arts and Science, Xiangyang, China
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Bruni AC, Bernardi L, Gabelli C. From beta amyloid to altered proteostasis in Alzheimer's disease. Ageing Res Rev 2020; 64:101126. [PMID: 32683041 DOI: 10.1016/j.arr.2020.101126] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/27/2020] [Accepted: 07/13/2020] [Indexed: 12/14/2022]
Abstract
Alzheimer's disease (AD) is an age related neurodegenerative disorder causing severe disability and important socio-economic burden, but with no cure available to date. To disentangle this puzzling disease genetic studies represented an important way for the comprehension of pathogenic mechanisms. Abnormal processing and accumulation of amyloid-β peptide (Aβ) has been considered the main cause and trigger factor of the disease. The amyloid cascade theory has fallen into crisis because the failure of several anti-amyloid drugs trials and because of the simple equation AD = abnormal Aβ deposition is not always the case. We now know that multiple neurodegenerative diseases share common pathogenic mechanisms leading to accumulation of misfolded protein species. Genome Wide Association studies (GWAS) led to the identification of large numbers of DNA common variants (SNPs) distributed on different chromosomes and modulating the Alzheimer's risk. GWAS genes fall into several common pathways such as immune system and neuroinflammation, lipid metabolism, synaptic dysfunction and endocytosis, all of them addressing to novel routes for different pathogenic mechanisms. Other hints could be derived from epidemiological and experimental studies showing some lifestyles may have a major role in the pathogenesis of many age-associated diseases by modifying cell metabolism, proteostasis and microglia mediated neuroinflammation.
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Affiliation(s)
- Amalia C Bruni
- Regional Neurogenetic Centre, ASP Catanzaro, Lamezia Terme (CZ), Italy.
| | - Livia Bernardi
- Regional Neurogenetic Centre, ASP Catanzaro, Lamezia Terme (CZ), Italy
| | - Carlo Gabelli
- Regional Brain Aging Centre, Azienda Ospedale Università Di Padova, Padova Italy
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Physical Therapy for Gait, Balance, and Cognition in Individuals with Cognitive Impairment: A Retrospective Analysis. Rehabil Res Pract 2020; 2020:8861004. [PMID: 33204533 PMCID: PMC7655244 DOI: 10.1155/2020/8861004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/08/2020] [Accepted: 10/17/2020] [Indexed: 11/29/2022] Open
Abstract
Objectives The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group. Methods Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The mean number of PT sessions over a month was 3.4 (±1.8). Outcomes covered the domains of gait, balance, and cognition with multiple outcomes used to measure different constructs within the balance and gait domains. Results All groups showed improvements in balance and at least one gait outcome measure. Those with MCI improved in every measure of gait and balance performance. Lastly, cognition as measured by Montreal Cognitive Assessment improved in individuals in the AD, VaD, and MCI groups. Conclusion While this retrospective analysis is not appropriate for causal inference, results of one month of physical therapy were associated with decreases in gait, balance, and cognitive impairment in individuals with AD, VaD, DLB<, and MCI. Clinical Implications. While physical therapy is not typically a primary treatment strategy for individuals with cognitive impairment, the results of this study are consistent with the literature that demonstrates improvement from physical therapy for other neurodegenerative diseases. Further clinical and research exploration for physical therapy as a primary treatment strategy in these populations is warranted.
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Sherva R, Gross A, Mukherjee S, Koesterer R, Amouyel P, Bellenguez C, Dufouil C, Bennett DA, Chibnik L, Cruchaga C, del-Aguila J, Farrer LA, Mayeux R, Munsie L, Winslow A, Newhouse S, Saykin AJ, Kauwe JS, Crane PK, Green RC. Genome-wide association study of rate of cognitive decline in Alzheimer's disease patients identifies novel genes and pathways. Alzheimers Dement 2020; 16:1134-1145. [PMID: 32573913 PMCID: PMC7924136 DOI: 10.1002/alz.12106] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/18/2019] [Accepted: 03/11/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Variability exists in the disease trajectories of Alzheimer's disease (AD) patients. We performed a genome-wide association study to examine rate of cognitive decline (ROD) in patients with AD. METHODS We tested for interactions between genetic variants and time since diagnosis to predict the ROD of a composite cognitive score in 3946 AD cases and performed pathway analysis on the top genes. RESULTS Suggestive associations (P < 1.0 × 10-6 ) were observed on chromosome 15 in DNA polymerase-γ (rs3176205, P = 1.11 × 10-7 ), chromosome 7 (rs60465337,P = 4.06 × 10-7 ) in contactin-associated protein-2, in RP11-384F7.1 on chromosome 3 (rs28853947, P = 5.93 × 10-7 ), family with sequence similarity 214 member-A on chromosome 15 (rs2899492, P = 5.94 × 10-7 ), and intergenic regions on chromosomes 16 (rs4949142, P = 4.02 × 10-7 ) and 4 (rs1304013, P = 7.73 × 10-7 ). Significant pathways involving neuronal development and function, apoptosis, memory, and inflammation were identified. DISCUSSION Pathways related to AD, intelligence, and neurological function determine AD progression, while previously identified AD risk variants, including the apolipoprotein (APOE) ε4 and ε2 variants, do not have a major impact.
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Affiliation(s)
- Richard Sherva
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, 72 East Concord St., E-200, Boston, MA 02118, USA
| | - Alden Gross
- Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument St, Johns Hopkins Center on Aging and Health, Suite 2-700, Baltimore, MD 21205, USA
| | - Shubhabrata Mukherjee
- Department of Medicine, University of Washington, Box 359780, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Ryan Koesterer
- Programs in Metabolism and Medical & Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Inserm UMR-1167, Institut Pasteur de Lille, 1 rue du Professeur Calmette, BP 245 - 59019 LILLE cedex, FRANCE
- Institut Pasteur de Lille, Lille, France
- University of Lille, DISTALZ Laboratory of Excellence (LabEx), Lille, France
| | - Celine Bellenguez
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Inserm UMR-1167, Institut Pasteur de Lille, 1 rue du Professeur Calmette, BP 245 - 59019 LILLE cedex, FRANCE
- Institut Pasteur de Lille, Lille, France
- University of Lille, DISTALZ Laboratory of Excellence (LabEx), Lille, France
| | - Carole Dufouil
- Inserm Unit 1219 Bordeaux Population Health, CIC 1401-EC (Clinical Epidemiology), University of Bordeaux, ISPED (Bordeaux School of Public Health), Bordeaux University Hospital, Bordeaux, France
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Lori Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Carlos Cruchaga
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 425 S. Euclid Ave, Office 9607, St. Louis, MO 63110, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- NeuroGenomics and Informatics. Washington University School of Medicine, Saint Louis, USA
| | - Jorge del-Aguila
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 425 S. Euclid Ave, Office 9607, St. Louis, MO 63110, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- NeuroGenomics and Informatics. Washington University School of Medicine, Saint Louis, USA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, 72 East Concord St., E-200, Boston, MA 02118, USA
- Bioinformatics Graduate Program, Boston University, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - Leanne Munsie
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA
| | - Ashley Winslow
- Orphan Disease Center, Perelman School of Medicine, University of Pennsylvania, 125 South 31st Street, Pennsylvania, PA 19104, USA
| | - Stephen Newhouse
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR BioResource Centre Maudsley, NIHR Maudsley Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) & Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
- Health Data Research UK London, University College London, London, UK
- dd Institute of Health Informatics, University College London, London, UK
- The National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London, London, UK
| | - Andrew J. Saykin
- Indiana Alzheimer Disease Center and Department of Radiology and Imaging Sciences, Indiana University School of Medicine, IU Health Neuroscience Center, Suite 4100, 355 West 16th Street, Indianapolis, IN 46202, USA
| | - John S.K. Kauwe
- Department of Biology, Brigham Young University, 105 FPH, Provo, UT 84602, USA
| | | | - Paul K. Crane
- Department of Medicine, University of Washington, Box 359780, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Robert C. Green
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, EC Alumnae Building, Suite 301, 41 Avenue Louis Pasteur, Boston, MA 02115, USA
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Partners HealthCare Personalized Medicine, Boston, MA, USA
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49
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Rahman N, Mihalkovic A, Geary O, Haffey R, Hamilton J, Thanos PK. Chronic aerobic exercise: Autoradiographic assessment of GABA(a) and mu-opioid receptor binding in adult rats. Pharmacol Biochem Behav 2020; 196:172980. [PMID: 32593790 DOI: 10.1016/j.pbb.2020.172980] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 12/21/2022]
Abstract
Exercise programs have shown great potential for both the prevention and treatment of substance use disorder (SUD). As exercise has been shown to have potent effects on physical and psychological health, it is reasonable to examine the mechanism of how exercise can be used as an adjunct treatment for addiction. The present study examined the effects of chronic aerobic (treadmill) exercise on both GABA(a) and mu-opioid receptor levels in the brains of male and female rats. GABA(a) receptor binding, measured by [3H] Flunitrazepam, was increased in the cingulate cortex following exercise, but only in females. Mu-opioid receptor expression, measured by [3H] ([D-Ala2, N-MePhe4, Gly-ol]-enkephalin) (DAMGO), showed no effect of exercise while showing an effect of sex, with increased [3H] DAMGO binding in the brains of sedentary males compared to that of sedentary females. Our findings support the potential role for GABA(a) signaling in the cingulate cortex as part of the mechanism of action of aerobic exercise. These data, along with prior reports, aid our understanding of the neurochemical impact and mechanism of chronic aerobic exercise on neuropsychiatric disease, particularly regarding addiction.
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Affiliation(s)
- Nabeel Rahman
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, United States of America
| | - Abrianna Mihalkovic
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, United States of America; Department of Psychology, University at Buffalo, Buffalo, NY 14203, United States of America
| | - Olivia Geary
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, United States of America
| | - Rylee Haffey
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, United States of America
| | - John Hamilton
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, United States of America; Department of Psychology, University at Buffalo, Buffalo, NY 14203, United States of America
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, United States of America; Department of Psychology, University at Buffalo, Buffalo, NY 14203, United States of America.
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50
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Multimodal Coherent Imaging of Retinal Biomarkers of Alzheimer's Disease in a Mouse Model. Sci Rep 2020; 10:7912. [PMID: 32404941 PMCID: PMC7220911 DOI: 10.1038/s41598-020-64827-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/21/2020] [Indexed: 01/04/2023] Open
Abstract
We acquired depth-resolved light scattering measurements from the retinas of triple transgenic Alzheimer’s Disease (3xTg-AD) mice and wild type (WT) age-matched controls using co-registered angle-resolved low-coherence interferometry (a/LCI) and optical coherence tomography (OCT). Angle-resolved light scattering measurements were acquired from the nerve fiber layer, outer plexiform layer, and retinal pigmented epithelium using image guidance and segmented thicknesses provided by co-registered OCT B-scans. Analysis of the OCT images showed a statistically significant thinning of the nerve fiber layer in AD mouse retinas compared to WT controls. The a/LCI scattering measurements provided complementary information that distinguishes AD mice by quantitatively characterizing tissue heterogeneity. The AD mouse retinas demonstrated higher mean and variance in nerve fiber layer light scattering intensity compared to WT controls. Further, the difference in tissue heterogeneity was observed through short-range spatial correlations that show greater slopes at all layers of interest for AD mouse retinas compared to WT controls. A greater slope indicates a faster loss of spatial correlation, suggesting a loss of tissue self-similarity characteristic of heterogeneity consistent with AD pathology. Use of this combined modality introduces unique tissue texture characterization to complement development of future AD biomarker analysis.
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