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Buchmann Godinho D, da Silva Fiorin F, Schneider Oliveira M, Furian AF, Rechia Fighera M, Freire Royes LF. The immunological influence of physical exercise on TBI-induced pathophysiology: Crosstalk between the spleen, gut, and brain. Neurosci Biobehav Rev 2021; 130:15-30. [PMID: 34400178 DOI: 10.1016/j.neubiorev.2021.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 12/16/2022]
Abstract
Traumatic brain injury (TBI) is a non-degenerative and non-congenital insult to the brain and is recognized as a global public health problem, with a high incidence of neurological disorders. Despite the causal relationship not being entirely known, it has been suggested that multiorgan inflammatory response involving the autonomic nervous system and the spleen-gut brain axis dysfunction exacerbate the TBI pathogenesis in the brain. Thus, applying new therapeutic tools, such as physical exercise, have been described in the literature to act on the immune modulation induced by brain injuries. However, there are caveats to consider when interpreting the effects of physical exercise on this neurological injury. Given the above, this review will highlight the main findings of the literature involving peripheral immune responses in TBI-induced neurological damage and how changes in the cellular metabolism of the spleen-gut brain axis elicited by different protocols of physical exercise alter the pathophysiology induced by this neurological injury.
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Affiliation(s)
- Douglas Buchmann Godinho
- Laboratório de Bioquímica do Exercício, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; Programa de Pós-Graduação em Bioquímica Toxicológica, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Fernando da Silva Fiorin
- Programa de Pós-Graduação em Neuroengenharia, Instituto Internacional de Neurociências Edmond e Lily Safra, Instituto Santos Dumont, Macaíba, RN, Brazil
| | - Mauro Schneider Oliveira
- Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Ana Flavia Furian
- Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Michele Rechia Fighera
- Laboratório de Bioquímica do Exercício, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; Centro de Ciências da Saúde, Departamento de Clínica Médica e Pediatria, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Pergolotti M, Deal AM, Bryant AL, Bennett AV, Farley E, Covington K, Lucas K, Williams GR. Senior Sway: Using a Mobile Application to Measure Fall Risk. J Geriatr Phys Ther 2019; 42:E101-E107. [PMID: 31033583 DOI: 10.1519/jpt.0000000000000223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The Senior Sway mobile application uses the iPhone/iPad gyroscope to assess postural sway and motion reaction time. Impairment in postural sway and motion reaction time have the potential to increase risk for future falls. Senior Sway thereby has the potential to provide a quick, easy to use, objective measure for predicting falls in older adults. The purpose of this study was to evaluate the feasibility of the Senior Sway mobile application and its associations with fall risk in community-dwelling older adults. METHODS Adults older than 62 years were recruited from senior centers and community events. Descriptive and bivariate statistics were used to examine feasibility on the basis of enrollment, time required, satisfaction with application, and association with fall risk. RESULTS AND DISCUSSION Fifty-seven adults were recruited. Use of the Senior Sway mobile application was feasible. Ninety-one percent said that they liked the application and reported length of time of assessment was "just right." The average Senior Sway score was 64.0 (range: 47.8-84.0), which was significantly associated with the 30-second sit-to-stand test. In addition, the motor reaction time score was associated with the Timed Up and Go. CONCLUSIONS Senior Sway is a promising application to improve identification of adults at risk for falls and need for rehabilitation but warrants further research.
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Affiliation(s)
- Mackenzi Pergolotti
- Cancer Outcomes Research Group, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill.,ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, Pennsylvania.,Department of Occupational Therapy, Colorado State University, Fort Collins.,Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill
| | - Allison M Deal
- Cancer Outcomes Research Group, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill
| | - Ashley L Bryant
- Cancer Outcomes Research Group, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill
| | - Antonia V Bennett
- Cancer Outcomes Research Group, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill
| | - Erica Farley
- Department of Occupational Therapy, Colorado State University, Fort Collins.,Teton Therapy, Cheyenne, Wyoming
| | - Kelley Covington
- Department of Occupational Therapy, Colorado State University, Fort Collins
| | - Katie Lucas
- Department of Occupational Therapy, Colorado State University, Fort Collins
| | - Grant R Williams
- Cancer Outcomes Research Group, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill
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Southerland LT, Pearson S, Hullick C, Carpenter CR, Arendts G. Safe to send home? Discharge risk assessment in the emergency department. Emerg Med Australas 2019; 31:266-270. [DOI: 10.1111/1742-6723.13250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Lauren T Southerland
- Department of Emergency MedicineThe Ohio State University Wexner Medical Center Columbus Ohio USA
| | - Scott Pearson
- Department of Emergency MedicineChristchurch Hospital Christchurch New Zealand
| | - Carolyn Hullick
- Faculty of HealthThe University of Newcastle Newcastle New South Wales Australia
- Hunter Medical Research Institute Newcastle New South Wales Australia
| | | | - Glenn Arendts
- School of MedicineThe University of Western Australia Perth Western Australia Australia
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Lucke JA, de Gelder J, Heringhaus C, van der Mast RC, Fogteloo AJ, Anten S, Blauw GJ, de Groot B, Mooijaart SP. Impaired cognition is associated with adverse outcome in older patients in the Emergency Department; the Acutely Presenting Older Patients (APOP) study. Age Ageing 2018; 47:679-684. [PMID: 29177470 DOI: 10.1093/ageing/afx174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/26/2017] [Indexed: 11/14/2022] Open
Abstract
Objective to investigate whether cognitive impairment, measured early after Emergency Department (ED) arrival and irrespective of its cause, is independently associated with functional decline or mortality after 3 and 12 months in older ED patients. Design and setting a prospective multi-centre cohort study in all Acutely Presenting Older Patients visiting the Emergency Department (APOP study) of three hospitals in the Netherlands. Participants 2,130 patients, ≥70 years. Measurements data on demographics, disease severity and geriatric characteristics were collected during the first hour of the ED visit. Cognition was measured using the 6-Item-Cognitive-Impairment-Test ('6CIT'). Cognitive impairment was defined as 6CIT ≥11, self-reported dementia or the inability to perform the cognition test. The composite adverse outcome after 3 and 12 months was defined as a 1-point decrease in Katz Activities of Daily Living (ADL), new institutionalisation or mortality. Multivariable regression analysis was used to assess whether cognitive impairment independently associates with adverse outcome. Results of 2,130 included patients, 588 (27.6%) had cognitive impairment at baseline and 654 patients (30.7%) suffered from adverse outcome after 3 months. Cognitive impairment associated with increased risk for adverse outcome (adjusted odds ratio (OR) 1.72, 95%CI 1.37-2.17). After 12 months, 787 patients (36.9%) suffered from adverse outcome. Again, cognitive impairment independently associated with increased risk for adverse outcome (adjusted OR 1.89, 95%CI 1.46-2.46). ORs were similar for patients who were discharged home versus hospitalised patients. Conclusion cognitive impairment measured during the early stages of ED visit, irrespective of the cause, is independently associated with adverse outcome after 3 and 12 months in older patients.
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Affiliation(s)
- J A Lucke
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - J de Gelder
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - C Heringhaus
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - R C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - A J Fogteloo
- Department of Internal Medicine, section of Acute Care, Leiden University Medical Center, Leiden, The Netherlands
| | - S Anten
- Department of Internal Medicine, section acute care, Alrijne Hospital, the Netherlands
| | - G J Blauw
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - B de Groot
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - S P Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
- Institute for Evidence-based Medicine in Old Age (IEMO), Leiden, The Netherlands
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Spano G, O Caffò A, Bosco A. Cognitive functioning, subjective memory complaints and risky behaviour predict minor home injuries in elderly. Aging Clin Exp Res 2018; 30:985-991. [PMID: 29181769 DOI: 10.1007/s40520-017-0858-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/10/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Home accidents are one of the major causes of death, particularly in older people, young children and women. AIMS The first aim of this study was to explore the role of subjective memory complaints, cognitive functioning and risky behaviour as predictors of home injuries occurred in a year in a sample of healthy Italian older adults. The second aim was to investigate the role of risky behaviour as a mediator in the relationship between subjective and objective cognitive functioning and home injuries. METHODS One hundred thirty-three community-dwelling older people from southern Italy were administered a battery of tests to evaluate cognitive functioning, subjective memory complaints, and risky behaviour during home activities. Risky behaviour was evaluated using the Domestic Behaviour Questionnaire, created specifically for this purpose. The number of home injuries was recorded for a year throughout monthly telephone interviews. A path analysis was performed to test the following model: cognitive functioning and subjective memory complaints directly influence risky behaviour and number of accidents over a year; risky behaviour mediates the impact of cognitive functioning and subjective memory on number of accidents over a year. RESULTS Path analysis confirmed the model tested except the role of risky behaviour as a mediator between cognitive functioning and home accidents. DISCUSSION Risky behaviour could represent a further risk factor in cognitively intact older adults with subjective memory complaints. CONCLUSIONS The assessment of both cognition and behaviour in elderly can make a valuable contribution in preventing home accidents in elderly.
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Affiliation(s)
- Giuseppina Spano
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari "Aldo Moro", Via Crisanzio 42, 70122, Bari, Italy.
| | - Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari "Aldo Moro", Via Crisanzio 42, 70122, Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari "Aldo Moro", Via Crisanzio 42, 70122, Bari, Italy
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Gagnon-Roy M, Hami B, Généreux M, Veillette N, Sirois MJ, Egan M, Provencher V. Preventing emergency department (ED) visits and hospitalisations of older adults with cognitive impairment compared with the general senior population: what do we know about avoidable incidents? Results from a scoping review. BMJ Open 2018; 8:e019908. [PMID: 29666129 PMCID: PMC5905733 DOI: 10.1136/bmjopen-2017-019908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Older cognitively impaired adults present a higher risk of hospitalisation and mortality following a visit to the emergency department (ED). Better understanding of avoidable incidents is needed to prevent them and the associated ED presentations in community-dwelling adults. This study aimed to synthetise the actual knowledge concerning these incidents leading this population to ED presentation, as well as possible preventive measures to reduce them. DESIGN A scoping review was performed according to the Arksey and O'Malley framework. METHODS Scientific and grey literature published between 1996 and 2017 were examined in databases (Medline, Cumulative Index of Nursing and Allied Health, Ageline, Scopus, ProQuest Dissertations/theses, Evidence-based medecine (EBM) Reviews, Healthstar), online library catalogues, governmental websites and published statistics. Sources discussing avoidable incidents leading to ED presentations were included and then extended to those discussing hospitalisation and mortality due to a lack of sources. Data (type, frequency, severity and circumstances of incidents, preventive measures) was extracted using a thematic chart, then analysed with content analysis. RESULTS 67 sources were included in this scoping review. Five types of avoidable incidents (falls, burns, transport accidents, harm due to self-negligence and due to wandering) emerged, and all but transport accidents were more frequent in cognitively impaired seniors. Differences regarding circumstances were only reported for burns, as scalding was the most prevalent mechanism of injury for this population compared with flames for the general senior population. Multifactorial interventions and implications of other professionals (eg, pharmacist, firefighters) were reported as potential interventions to reduce avoidable incidents. However, few preventive measures were specifically tested in this population. CONCLUSIONS Primary research that screens for cognitive impairment and involves actors (eg, paramedics) to improve our understanding of avoidable incidents leading to ED visits is greatly needed. This knowledge is essential to develop preventive measures tailored to the needs of older cognitively impaired adults.
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Affiliation(s)
- Mireille Gagnon-Roy
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, Quebec, Canada
| | - Benyahia Hami
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Research Centre on Aging, Sherbrooke, Quebec, Canada
| | - Mélissa Généreux
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Direction de la Santé Publique de l'Estrie-CIUSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada
| | - Nathalie Veillette
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, Quebec, Canada
| | - Marie-Josée Sirois
- Département de réadaptation, Faculté de médecine, Université Laval, CHU de Québec, Québec, Canada
| | - Mary Egan
- Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Bruyere Institute, Ottawa, Ontario, Canada
| | - Véronique Provencher
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Research Centre on Aging, Sherbrooke, Quebec, Canada
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