1
|
Hopkins J, McVeigh J, Hill K, Ellis KA, Jacques A, Burton E. Associations between physical activity, sedentary behaviour and cognitive domain performance of people living with mild cognitive impairment in the community. Aust Occup Ther J 2024; 71:527-539. [PMID: 38616178 DOI: 10.1111/1440-1630.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Physical activity is known to positively influence cognitive performance. For adults with mild cognitive impairment (MCI), the relationship between physical activity levels and cognitive performance is unknown. This cross-sectional study aimed to determine if cognitive performance [as measured by the Montreal Cognitive Assessment (MoCA)] of people living in the community with MCI is associated with their physical activity levels or sedentary behaviour. METHODS ActivPAL™ accelerometers were used to objectively measure physical activity and sedentary behaviour for seven full days. Cognitive performance was measured using the MoCA. CONSUMER AND COMMUNITY INVOLVEMENT No involvement other than as research participants RESULTS: Eighty-two participants from the Balance on the Brain randomised controlled trial were included. Most participants were retired (88%), with 33 (40%) reporting a fall in the last year. The median MoCA score was 24 (IQR 22-26). Participants achieved a mean of 6296 (±2420) steps per day and were sedentary for 10.6 (±2) hours per day. The only physical activity outcomes that had a fair, positive correlation were moderate- to vigorous-intensity physical activity measures of total stepping time and total number of steps (with a cadence of ≥100 steps/min) with the orientation MoCA domain score (r(82) = 0.36, p ≤ 0.001 and r(82) = 0.37, p ≤ 0.001, respectively). Higher total sedentary time had a weak, positive correlation with better visuospatial/executive performance (r(82) = 0.23, p = 0.041). The orientation outcomes remained significant when analysed in an adjusted logistic regression model. CONCLUSION This study found that performance in the MoCA orientation domain had a fair-positive correlation with moderate-intensity physical activity (i.e., stepping time and step count with a cadence of ≥100 steps/min) as measured by a thigh-worn accelerometer for community-dwelling older adults with MCI. When considering the relationship between cognitive domains and sedentary behaviour, consideration may be needed regarding whether cognitive enhancing activities (such as crosswords and other brain games) are being performed, which may confound this relationship. Further investigation is required to confirm these results.
Collapse
Affiliation(s)
- Jane Hopkins
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Joanne McVeigh
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- School of Physiology, Movement Physiology Laboratory, University of Witwatersrand, Johannesburg, South Africa
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Keith Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, Australia
| | - Kathryn A Ellis
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Angela Jacques
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Elissa Burton
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
2
|
Puthusseryppady V, Bregola A, Camino J, Backhouse T, Mioshi E. Is Carer Management Style Associated with Longitudinal Functional Decline in Dementia? J Alzheimers Dis 2023; 96:1139-1149. [PMID: 37955085 DOI: 10.3233/jad-230075] [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: 11/14/2023]
Abstract
BACKGROUND Various intrinsic (related to dementia) and extrinsic (not related to dementia) factors have been suggested to contribute separately to disability in people living with dementia (PLwD). OBJECTIVE To investigate if the combination of specific intrinsic and extrinsic factors at baseline is associated with longitudinal declines in activities of daily living (ADL) performance of PLwD at 12-month follow-up. METHODS 141 community-dwelling PLwD-carer dyads were assessed on their global cognition (ACE-III), apathy (CBI-R), carer management styles (DMSS), medical comorbidities (CCI), and ADL performance (DAD) at baseline, and for a subset of participants (n = 53), at 12-month follow-up. Multiple linear regression models were run to assess: 1) the relationships between PLwD's DAD scores and the remaining variables at baseline and 2) whether these variables' scores at baseline were associated with longitudinal change in the PLwD's DAD scores. RESULTS At baseline, having lower ACE-III (β= 0.354, p < 0.001), higher CBI-R (β= -0.284, p < 0.001), higher DMSS criticism (β= -0.367, p = 0.013), lower DMSS encouragement (β= 0.370, p = 0.014), and higher CCI scores (β= -2.475, p = 0.023) were significantly associated with having lower DAD scores. The PLwD's DAD scores significantly declined from baseline to follow-up (p < 0.001, d = 1.15), however this decline was not associated with the baseline scores of any of the independent variables. Instead, it was associated with declines in the PLwD's ACE-III scores from baseline to follow-up (β= 1.021, p = 0.001). CONCLUSIONS In our limited sample, cognitive changes seem to be the main factor underlying longitudinal decline in ADL performance for PLwD. Carer management styles appear associated with current ADL performance but not with longitudinal ADL decline.
Collapse
Affiliation(s)
- Vaisakh Puthusseryppady
- School of Health Sciences, University of East Anglia, Norwich, UK
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Allan Bregola
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Julieta Camino
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Tamara Backhouse
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
3
|
Validation of PARADISE 24 and Development of PARADISE-EDEN 36 in Patients with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116949. [PMID: 35682531 PMCID: PMC9180224 DOI: 10.3390/ijerph19116949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 02/01/2023]
Abstract
Dementia was one of the conditions focused on in an EU (European Union) project called “PARADISE” (Psychosocial fActors Relevant to brAin DISorders in Europe) that later produced a measure called PARADISE 24, developed within the biopsychosocial model proposed in the International Classification of Functioning Disability and Health (ICF). The aims of this study are to validate PARADISE 24 on a wider sample of patients with mild to moderate dementia to expand PARADISE 24 by defining a more specific scale for dementia, by adding 18 questions specifically selected for dementia, which eventually should be reduced to 12. We enrolled 123 persons with dementia, recruited between July 2017 and July 2019 in home care and long-term care facilities, in Italy, and 80 participants were recruited in Warsaw between January and July 2012 as part of a previous cross-sectional study. The interviews with the patient and/or family were conducted by health professionals alone or as a team by using the Paradise data collection protocol. The psychometric analysis with the Rasch analysis has shown that PARADISE 24 and the selection of 18 additional condition-specific items can be expected to have good measurement properties to assess the functional state in persons with dementia.
Collapse
|
4
|
Exploring the Ability to Perform Activities of Daily Living and Cognitive Status after Hospitalization with COVID-19: A Multiple Case Study. Occup Ther Int 2022; 2022:4605989. [PMID: 35418813 PMCID: PMC8983263 DOI: 10.1155/2022/4605989] [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: 11/30/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Multidisciplinary rehabilitation including occupational therapy after COVID-19 is recommended. However, evidence on how COVID-19 affects the ability to perform activities of daily living (ADL) is sparse. Objective The aim of this study was to explore the ability to perform ADL and cognitive status in patients with COVID-19 at time of discharge and three months postdischarge. Methods This prospective multiple case study included adults with COVID-19, who at time of discharge had decreased ADL performance compared to habitual functional level. Data collection included Assessment of Motor and Process Skills (AMPS) and Montreal Cognitive Assessment (MoCA) at discharge and three-month follow-up. Exploratory analysis was used to identify similarities and trends within and across cases. Results Eleven patients were included. 75% had a significant increase in motor ability measures, and 27% had a significant increase in process ability measures at follow-up. 67% of follow-up cases showed mild cognitive impairment, where executive functioning and memory were most predominant. Conclusions The ability to perform ADL was affected at discharge and at three-month follow-up. Furthermore, mild cognitive impairment was present at both hospital discharge and follow-up in most cases. Significance. Occupational therapists can apply performance-based assessments to identify the need for rehabilitation of ADL in patients with COVID-19 during and posthospitalization.
Collapse
|
5
|
Kim J, Cha B, Lee D, Kim JM, Kim M. Effect of Cognition by Repetitive Transcranial Magnetic Stimulation on Ipsilesional Dorsolateral Prefrontal Cortex in Subacute Stroke Patients. Front Neurol 2022; 13:823108. [PMID: 35185773 PMCID: PMC8848770 DOI: 10.3389/fneur.2022.823108] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/10/2022] [Indexed: 12/15/2022] Open
Abstract
Objective To demonstrate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the ipsilesional dorsolateral prefrontal cortex (DLPFC) on neurological recovery in patients with subacute phase stroke. Methods Patients with supratentorial hemispheric stroke who were hospitalized for intensive rehabilitation in the subacute phase were enrolled for this retrospective analysis. Two groups of patients were selected: the rTMS group who received high-frequency (20 Hz) rTMS ≥ 5 times over the ipsilesional DLPFC, and a control group who did not receive any rTMS. The patients were further divided into groups with right- or left-side brain lesions. Functional measurements for cognitive ability, mood, speech, and activities of daily living, which were assessed at baseline and at the 1-month follow-up as a routine clinical practice, were used for analyses. Results Among 270 patients with available clinical data, 133 (women, 51; age, 61.0 ± 13.8 years) met the inclusion criteria and were enrolled for analysis. There were no differences in demographic data and functional scores at baseline between the rTMS (n = 49) and control (n = 84) groups. The rTMS group showed a higher gain in the mini-mental status examination (MMSE) total score and subscores of all domains, forward digit span, and FIM-cognition than the control group (P < 0.05). Among the patients with left hemispheric lesions (n = 57), the rTMS group showed better outcomes in cognition and depression through scores of total and “attention and concentration” subscores of MMSE, FIM-cognition, and the geriatric depression scale (P < 0.05). Among the patients with right hemispheric lesions (n = 76), the rTMS group showed better outcomes in cognition through the MMSE total score and subscores of “attention and concentration,” “registration,” and “recall,” and scores of both forward and backward digit spans (P < 0.05). Conclusion High-frequency rTMS over the ipsilesional DLPFC has beneficial effects on the recovery of cognition on both sides as well as mood in patients with left-sided hemispheric lesions.
Collapse
Affiliation(s)
- Jongwook Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Byoungwoo Cha
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Doyoung Lee
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
- Rehabilitation and Regeneration Research Center, CHA University School of Medicine, Seongnam, South Korea
| | - MinYoung Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
- Rehabilitation and Regeneration Research Center, CHA University School of Medicine, Seongnam, South Korea
- *Correspondence: MinYoung Kim
| |
Collapse
|
6
|
Fox ST, Thompson LE, Rowland JTJ. The relationship between common cognitive screening tests (Standardised Mini-Mental State Examination and Rowland Universal Dementia Assessment Scale) and the Cognitive Functional Independence Measure. Australas J Ageing 2021; 41:106-115. [PMID: 34585484 DOI: 10.1111/ajag.12998] [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: 01/27/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess whether the Cognitive Functional Independence Measure (Cog-FIM) is correlated with the Standardised Mini-Mental State Examination (SMMSE) and Rowland Universal Dementia Assessment Scale (RUDAS) and whether there is agreement between the Cog-FIM and these two tests. METHODS Functional Independence Measure assessments were undertaken on 98 subacute patients. Forty-eight (48) patients were administered the SMMSE, and 50 were administered the RUDAS. Agreement was examined using the Bland-Altman plot. RESULTS Correlation was observed between the Cog-FIM and both the SMMSE and the RUDAS. The Bland-Altman analysis demonstrated agreement between the Cog-FIM and RUDAS, but not the Cog-FIM and SMMSE. The limits of agreement between the Cog-FIM and RUDAS were -13 to 13. CONCLUSION The Cog-FIM is correlated with the RUDAS, but the agreement is unclear. Despite agreement of the means, the limits of agreement are large, which may suggest a clinically meaningful difference. The study should be repeated with a larger sample size.
Collapse
Affiliation(s)
- Sarah Therese Fox
- Internal Medicine Services, The Prince Charles Hospital, Brisbane, Qld, Australia
| | | | - Jeffrey T J Rowland
- Internal Medicine Services, The Prince Charles Hospital, Brisbane, Qld, Australia
| |
Collapse
|
7
|
Morris P, Bulman D. Lucidity in the Context of Advanced Neurodegenerative Disorders: A Concept Analysis. J Gerontol Nurs 2020; 46:42-50. [DOI: 10.3928/00989134-20201106-06] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022]
|
8
|
Abstract
Dementia is characterized by a decline in memory, language, problem-solving and in other cognitive domains that affect a person's ability to perform everyday activities and social functioning. It is consistently agreed that cognitive impairment is an important risk factor for developing functional disabilities in patients with dementia. Functional status can be conceptualized as the ability to perform self-care, self- maintenance and physical activity. A person with dementia usually requires help with more complex tasks, such as managing bills and finances, or simply maintaining a household. Good functional performance is fundamental for elderly people to maintain independency and avoid institutionalization. The purpose of this review is to describe functional changes in demented patients, evaluating the variability in subgroups of dementias.
Collapse
Affiliation(s)
- Gabriele Cipriani
- MD,Versilia Hospital, Neurology Unit, Lido di Camaiore (Lu), Italy.,MD, Versilia Hospital, Psychiatry Unit, Lido di Camaiore (Lu), Italy
| | - Sabrina Danti
- PhD, Clinical and Health Psychology Unit, Hospital of Pontedera, Pontedera (PI), Italy
| | - Lucia Picchi
- PsyD, Clinical Psychology Unit, Hospital of Leghorn, Leghorn (LI), Italy
| | - Angelo Nuti
- MD,Versilia Hospital, Neurology Unit, Lido di Camaiore (Lu), Italy
| | - Mario Di Fiorino
- MD, Versilia Hospital, Psychiatry Unit, Lido di Camaiore (Lu), Italy
| |
Collapse
|
9
|
Zakharova‐Luneva E, Cooke DM, Okano S, Hurst C, Geffen S, Eagles R. The relationship between cognition and functional outcomes in rehabilitation: FIMCog vs. MoCA. Geriatr Gerontol Int 2020; 20:336-342. [DOI: 10.1111/ggi.13884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/14/2019] [Accepted: 01/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Deirdre M Cooke
- Rehabilitation UnitMater Private Hospital South Brisbane Queensland Australia
| | - Satomi Okano
- Statistics UnitQIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Cameron Hurst
- Statistics UnitQIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Saul Geffen
- Rehabilitation UnitMater Private Hospital South Brisbane Queensland Australia
| | - Roslyn Eagles
- Rehabilitation UnitMater Private Hospital South Brisbane Queensland Australia
| |
Collapse
|