1
|
O'Leary TP, Brown RE. Age-related changes in species-typical behaviours in the 5xFAD mouse model of Alzheimer's disease from 4 to 16 months of age. Behav Brain Res 2024; 465:114970. [PMID: 38531510 DOI: 10.1016/j.bbr.2024.114970] [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: 01/15/2024] [Revised: 03/12/2024] [Accepted: 03/23/2024] [Indexed: 03/28/2024]
Abstract
Alzheimer's disease (AD) patients show age-related decreases in the ability to perform activities of daily living and the decline in these activities is related to the severity of neurobiological deterioration underlying the disease. The 5xFAD mouse model of AD shows age-related impairments in sensory- motor and cognitive function, but little is known about changes in species-typical behaviours that may model activities of daily living in AD patients. Therefore, we examined species-typical behaviours used as indices of exploration (rearing) and compulsivity (grooming) across six tests of anxiety-like behaviour or motor function in female 5xFAD mice from 3 to 16 months of age. Robust decreases in rearing were found in 5xFAD mice across all tests after 9 months of age, although few differences were observed in grooming. A fine-scale analysis of grooming, however, revealed a previously unresolved and spatially restricted pattern of grooming in 5xFAD mice at 13-16 months of age. We then examined changes in species-typical behaviours in the home-cage, and show impaired nest building in 5xFAD mice at all ages tested. Lastly, we examined the relationship between reduced species typical behaviours in 5xFAD mice and the presentation of freezing behaviour, a commonly used measure of memory for conditioned fear. These results showed that along with cognitive and sensory-motor behaviour, 5xFAD mice have robust age-related impairments in species-typical behaviours. Therefore, species typical behaviours in 5xFAD mice may help to model the decline in activities of daily living observed in AD patients, and may provide useful behavioural phenotypes for evaluating the pre-clinical efficacy of novel therapeutics for AD.
Collapse
Affiliation(s)
- Timothy P O'Leary
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| |
Collapse
|
2
|
Enduru N, Fernandes BS, Zhao Z. Dissecting the shared genetic architecture between Alzheimer's disease and frailty: a cross-trait meta-analyses of genome-wide association studies. Front Genet 2024; 15:1376050. [PMID: 38706793 PMCID: PMC11069310 DOI: 10.3389/fgene.2024.1376050] [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: 01/24/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction: Frailty is the most common medical condition affecting the aging population, and its prevalence increases in the population aged 65 or more. Frailty is commonly diagnosed using the frailty index (FI) or frailty phenotype (FP) assessments. Observational studies have indicated the association of frailty with Alzheimer's disease (AD). However, the shared genetic and biological mechanism of these comorbidity has not been studied. Methods: To assess the genetic relationship between AD and frailty, we examined it at single nucleotide polymorphism (SNP), gene, and pathway levels. Results: Overall, 16 genome-wide significant loci (15 unique loci) (p meta-analysis < 5 × 10-8) and 22 genes (21 unique genes) were identified between AD and frailty using cross-trait meta-analysis. The 8 shared loci implicated 11 genes: CLRN1-AS1, CRHR1, FERMT2, GRK4, LINC01929, LRFN2, MADD, RP11-368P15.1, RP11-166N6.2, RNA5SP459, and ZNF652 between AD and FI, and 8 shared loci between AD and FFS implicated 11 genes: AFF3, C1QTNF4, CLEC16A, FAM180B, FBXL19, GRK4, LINC01104, MAD1L1, RGS12, ZDHHC5, and ZNF521. The loci 4p16.3 (GRK4) was identified in both meta-analyses. The colocalization analysis supported the results of our meta-analysis in these loci. The gene-based analysis revealed 80 genes between AD and frailty, and 4 genes were initially identified in our meta-analyses: C1QTNF4, CRHR1, MAD1L1, and RGS12. The pathway analysis showed enrichment for lipoprotein particle plasma, amyloid fibril formation, protein kinase regulator, and tau protein binding. Conclusion: Overall, our results provide new insights into the genetics of AD and frailty, suggesting the existence of non-causal shared genetic mechanisms between these conditions.
Collapse
Affiliation(s)
- Nitesh Enduru
- Center for Precision Health, McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Brisa S. Fernandes
- Center for Precision Health, McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Zhongming Zhao
- Center for Precision Health, McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
3
|
Gao X, Wang K, Sun F, De Fries CM, Xu F, Huang P, Feng Y. Associates of Perceived Quality of Life in Chinese Older Adults Living with Cognitive Impairment. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:368-380. [PMID: 35855574 DOI: 10.1080/01634372.2022.2103865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/17/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study is to examine perceived quality of life in Chinese older adults living with cognitive impairment and explore its associations with caregivers' characteristics. Questionnaires were administered in person to 271 caregiver-care recipient dyads from urban communities in mainland China in 2019. We used the 40-item Alzheimer's Disease-related Quality of Life tool and asked caregiver respondents to indicate care recipients' life conditions. The questionnaire asked caregivers about their sociodemographic characteristics, levels of informal social support, caregiver burden, and depressive symptoms. Caregivers' higher levels of caregiver burden (β = > -0.19, p < .01) and depressive symptoms (β = > -0.19, p < .01) amongst caregivers were significantly associated with lower quality of life among care recipients. Informal support from relatives and friends to caregivers did not significantly affect quality of life of care recipients. The results suggested that reducing caregivers' burden and depressive symptoms are essential to promote quality of life of care recipients. Formal support from health professionals, service organizations, and communities are urgently called to promote the wellbeing of Chinese families affected by cognitive impairment.
Collapse
Affiliation(s)
- Xiang Gao
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Fang Xu
- Department of internal medicine, Huazhong University of Science and Technology Hospital, Wuhan, Hubei, China
| | - Peijun Huang
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Feng
- University Library, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| |
Collapse
|
4
|
Dai Q, Su H, Zhou Z, Li C, Zou J, Zhou Y, Song R, Liu Y, Xu L, Zhou Y. Psychometric Evaluation of the Chinese Version of Mild Cognitive Impairment Questionnaire among Older Adults with Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:498. [PMID: 36612819 PMCID: PMC9819359 DOI: 10.3390/ijerph20010498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There is a lack of instruments for measuring quality of life (QOL) in Chinese patients with mild cognitive impairment (MCI). This study aimed to translate the Mild Cognitive Questionnaire (MCQ) into the Chinese language and to evaluate the reliability and construct validity of the MCQ-Chinese among older adults with MCI. METHODS Linguistic translation and validation of the questionnaire were conducted according to the MCQ developer and Oxford University Innovation guidelines. After a pilot test, the final version of the MCQ-Chinese was applied to a convenience sample of older adults with MCI (n = 186). Cronbach's alpha and confirmatory factor analyses were used to assess the reliability and construct validity of the MCQ-Chinese. In addition, non-parametric analysis was used to assess convergent and discriminant validity. RESULTS The total scale and all the factors had good internal consistency, with Cronbach's alpha values ranging from 0.90 to 0.92. Confirmatory factor analysis indicated satisfactory goodness of fit for the 2-factor MCQ. The MCQ-Chinese had a good convergent validity, and the discriminant validity was confirmed with a significant difference in MCQ scores in different health conditions. CONCLUSIONS MCQ-Chinese is a reliable tool for assessing QOL among Chinese older adults with MCI.
Collapse
Affiliation(s)
- Qingmin Dai
- Ecology College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China
| | - Hong Su
- Department of Nursing, Daqing Campus, University of Harbin Medical, 39 Shinyo Road, Daqing 163319, China
| | - Zanhua Zhou
- Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China
| | - Caifu Li
- Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China
| | - Jihua Zou
- Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China
| | - Ying Zhou
- Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China
| | - Rhayun Song
- Nursing College, Chungnam National University, 266 Munwha-dong, Daejeon 35015, Republic of Korea
| | - Yang Liu
- Department of Nursing, Daqing Campus, University of Harbin Medical, 39 Shinyo Road, Daqing 163319, China
| | - Lijuan Xu
- Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui 323000, China
| | - Yuqiu Zhou
- Department of Nursing, Daqing Campus, University of Harbin Medical, 39 Shinyo Road, Daqing 163319, China
| |
Collapse
|
5
|
Weigert H, Stuckenschneider T, Pickert L, Rossi A, Meyer AM, Nelles G, Schulz RJ, Stahl W, Schneider S, Polidori MC. Influence of a 12-Month Structured Exercise Program on the Micronutrient-Cognitive Fitness-Physical Association Profiles in Mild Cognitive Impairment. J Alzheimers Dis Rep 2022; 6:711-722. [PMID: 36606208 PMCID: PMC9741747 DOI: 10.3233/adr-220039] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Preventive lifestyle strategies have shown promise to slow down or prevent age-related cognitive decline. However, evidence on the reciprocal longitudinal relationships between nutrition biomarkers and cognitive and physical performance is lacking. Studying nutritional, cognitive, and physical profiles over time may help to overcome this knowledge gap. Objective To investigate the relationship of plasma levels of the robust nutritional- and antioxidant defense-related biomarkers carotenoids and tocopherols with both indicators of cognitive and physical performance in persons with mild cognitive impairment (MCI) participating in a structured exercise program. Methods Data from 40 participants with MCI of the NeuroExercise study were analyzed. Participants had undergone a blood withdrawal for the analysis of plasma concentrations of six carotenoids, two tocopherols and retinol prior to and after one-year of structured exercise. All participants had undergone a broad spectrum of cognitive and physical performance tests. Results Significant associations between lipophilic micronutrients and cognitive/physical measures were observed that were previously found to play a role in cognitive and physical frailty. In particular, lutein, zeaxanthin, and lycopene are confirmed as robust, reliable, and stable indicators of nutritional defense. Importantly, these micronutrients were associated with cognitive measures prior to the physical training program and to a more prominent extent with indicators of motoric function after the physical exercise program. Conclusion Specific profiles of lipophilic micronutrients are associated to cognitive performance measures and, especially after a structured exercise program, to indicators of physical performance.
Collapse
Affiliation(s)
- Hannah Weigert
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Tim Stuckenschneider
- Geriatric Medicine, Department for Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany,Institute of Movement and Neuroscience, German Sport University, Cologne, Germany,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Lena Pickert
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Andrea Rossi
- Geriatric Care Unit, Central Hospital Bolzano, Bolzano, Italy
| | - Anna M. Meyer
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Gereon Nelles
- Outpatient Clinic NeuroMedCampus Hohenlind, Cologne, Germany
| | | | - Wilhelm Stahl
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Stefan Schneider
- Institute of Movement and Neuroscience, German Sport University, Cologne, Germany,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - M. Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany,Cologne Excellence Cluster on Cellular Stress- Responses in Aging- Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany,Correspondence to: M. Cristina Polidori, Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany. Tel.: +49 221 47832753; E-mail:
| | | |
Collapse
|
6
|
Wang K, Gao X, Sun F, De Fries CM, Levkoff SE. Evaluation of the Reliability and Validity of the Alzheimer's Disease-Related Quality of Life Instrument among Older Adults with Cognitive Impairment in Mainland China. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:649-663. [PMID: 34889717 DOI: 10.1080/01634372.2021.2010856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study is to examine the reliability and validity of the ADRQL instrument among older adults with cognitive impairment in mainland China. Three hundred older adults with cognitive impairment and their primary family caregivers from Wuhan participated in structured interviews. Cronbach's α and Kuder-Richardson Formula 20 were used to examine internal consistency reliability. Confirmatory factor analysis, Heterotrait-Monotrait ratios, and ordinary least square regression were used to assess the factorial validity, discriminant validity, and criterion validity. The ADRQL had acceptable reliability and validity, which can be used to assess overall quality of life for this population.
Collapse
Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Xiang Gao
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Sue E Levkoff
- College of Social Social Work, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
7
|
Huang X, Zhang M, Fang J, Zeng Q, Wang J, Li J. Classifying and characterizing the development of self-reported overall quality of life among the Chinese elderly: a twelve-year longitudinal study. BMC Public Health 2022; 22:1139. [PMID: 35672842 PMCID: PMC9175517 DOI: 10.1186/s12889-022-13314-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background To promote healthy aging, the information about the development of quality of life (QoL) is of great importance. However, the explorations of the heterogeneity in the change of QoL under the Chinese context were limited. This study aimed to identify potential different development patterns of QoL and the influential factors using a longitudinal, nationally representative sample of the Chinese elderly. Methods We adopted a five-wave longitudinal dataset from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and a total of 1645 elderly were obtained. The sample had a mean age of 72.7 years (SD = 6.64) and was 47.2% male. Overall QoL was measured through self-report during the longitudinal process. We utilized the conditional growth mixture model (GMM) with time-invariant covariates (TICs) to explore various development patterns and associated factors. Results Three distinct trajectories of self-reported overall QoL were identified: the High-level Steady Group (17.08%), the Mid-level Steady Group (63.10%), and the Low-level Growth Group (19.82%). Results also indicated that several factors predicted distinct trajectories of self-reported overall QoL. Those elderly who received enough financial resources, had adequate nutrition, did not exhibit any disability, engaged in leisure activities, and did less physical labor or housework at the baseline were more likely to report a higher level of overall QoL over time. Conclusions There existed three development patterns of self-reported overall QoL in elders, and the findings provided valuable implications for the maintenance and improvement of QoL among the Chinese elderly. Future studies could examine the influence of other confounding factors.
Collapse
Affiliation(s)
- Xitong Huang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Minqiang Zhang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China. .,Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China. .,Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China. .,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China.
| | - Junyan Fang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Qing Zeng
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Jinqing Wang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Jia Li
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| |
Collapse
|
8
|
Arrieta H, Rezola-Pardo C, Sanz B, Virgala J, Lacunza-Zumeta M, Rodriguez-Larrad A, Irazusta J. Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study. Biol Res Nurs 2022; 24:530-540. [PMID: 35574636 DOI: 10.1177/10998004221100797] [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: 11/15/2022]
Abstract
PURPOSE To compare the capacity of blood myostatin concentration and physical, cognitive, and affective function tests to predict frailty among long-term care (LTC) residents. METHODS This cross-sectional analysis used baseline data from three randomized controlled trials involving 260 older adults in 14 LTC centers. Serum myostatin levels were analyzed by enzyme-linked immunosorbent assay. Frailty, physical fitness, cognitive and affective functions were assessed using validated tests and scales. RESULTS The Timed Up and Go, gait speed, 6-minute walk, and Berg Balance Scale had excellent capabilities in identifying frail individuals in accordance with Fried's Frailty Phenotype (FFP). The best tests for identifying frailty in accordance with the Clinical Frailty Scale (CFS) were Timed Up and Go and Berg Balance Scale. For the Tilburg Frailty Indicator (TFI), the best tests were Quality of Life in Alzheimer's Disease (QoL-AD) and Goldberg Anxiety. Myostatin, along with physical, cognitive, and affective function tests, improved the capability of the hand grip, arm-curl, Montreal Cognitive Assessment, Goldberg Anxiety, Goldberg Depression, and QoL-AD to identify frailty according to FFP, while myostatin improved CFS-defined frailty identification by the hand grip, arm-curl, 6-minute walk test, Berg Balance Scale, 30-second chair-stand, gait speed, Montreal Cognitive Assessment, Goldberg Anxiety, and De Jong-Gierveld Loneliness Scale. CONCLUSION Among LTC residents, serum myostatin was associated with being frail according to FFP and CFS. However, this measure was less discriminating of frailty than physical fitness tests (for FFP and CFS) and affective function parameters (for TFI). However, evaluated concurrently with physical, cognitive, and affective parameters, myostatin improved the capabilities of these measures to predict CFS-defined frailty.
Collapse
Affiliation(s)
- Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Janire Virgala
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| |
Collapse
|
9
|
Markotegi M, Irazusta J, Sanz B, Rodriguez-Larrad A. Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program. Exp Gerontol 2021; 155:111580. [PMID: 34601075 PMCID: PMC8492068 DOI: 10.1016/j.exger.2021.111580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 lockdowns restricted physical activity levels for individuals in many countries. In particular, older adults experienced limited access to their usual activities, including physical exercise programs. How such restrictions and interruptions in physical exercise programs might impact the physical and mental health of older adults has not yet been studied. We sought to analyse changes in the physical and mental health of older adults enrolled in a group-based multicomponent physical exercise (MPE) program that was interrupted due to the COVID-19 pandemic. We followed 17 participants of this program from October 2018 to October 2020, including the interruption of the program during the pandemic. The MPE program included strength, balance, and stretching exercises. We compared anthropometric and cardiovascular parameters, physical fitness, frailty, quality of life, and psychoaffective status of participants before and during the COVID-19 pandemic. Most parameters followed the same pattern, improving after 8 months of the first MPE season (Oct. 2018-Jun. 2019), worsening after 4 months of summer rest, improving from October 2019 to January 2020 in the second MPE season (Oct. 2019-Jan. 2020), and severely worsening after 7 months of program interruption. We show that an MPE program has clear benefits to the physical and psychoaffective health of older adults, and interruption of these programs could adversely impact participants. These results highlight the need to maintain physical exercise programs or facilitate engagement in physical activity and reduce sedentary behaviour in older adults, particularly in situations such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mikel Markotegi
- Fundación Siel Bleu, Spain; Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| |
Collapse
|
10
|
Umegaki H, Bonfiglio V, Komiya H, Watanabe K, Kuzuya M. Association Between Sarcopenia and Quality of Life in Patients with Early Dementia and Mild Cognitive Impairment. J Alzheimers Dis 2021; 76:435-442. [PMID: 32474472 DOI: 10.3233/jad-200169] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cognitive impairment is linked to decreased quality of life (QOL), but few studies have investigated the impact of comorbid sarcopenia. OBJECTIVE The aim of this study was to elucidate the association of sarcopenia with QOL in patients with early dementia and mild cognitive impairment. METHODS Individuals with a Clinical Dementia Rating of 0.5 or 1 and a Mini-Mental State Examination score of 20-30 underwent a battery of neuropsychological assessments administered by a group of well-trained clinical psychologists. The EQ-5D was completed by both the patients and their main caregivers. EQ-5D utility and visual analog scale scores were measured. Sarcopenia was defined according to the criteria published in the 2019 consensus update by the Asian Working Group for Sarcopenia. RESULTS Patients with sarcopenia had significantly lower scores on the Digit Symbol Substitution Test and Trail Making Test Part A. There was a significant negative association between sarcopenia and both self- and proxy-rated EQ-5D utility scores independent of potential confounding factors. However, there was no association between QOL visual analog scale scores and sarcopenia. CONCLUSION Given that sarcopenia is often found in individuals with cognitive impairment, early detection by timely screening and effective intervention may help to maintain or improve QOL in this population. However, this study could not determine whether reduced QOL is a direct consequence of sarcopenia.
Collapse
Affiliation(s)
- Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Viviana Bonfiglio
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan.,Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| |
Collapse
|
11
|
Stuckenschneider T, Sanders ML, Devenney KE, Aaronson JA, Abeln V, Claassen JAHR, Guinan E, Lawlor B, Meeusen R, Montag C, Olde Rikkert MGM, Polidori MC, Reuter M, Schulz RJ, Vogt T, Weber B, Kessels RPC, Schneider S. NeuroExercise: The Effect of a 12-Month Exercise Intervention on Cognition in Mild Cognitive Impairment-A Multicenter Randomized Controlled Trial. Front Aging Neurosci 2021; 12:621947. [PMID: 33519425 PMCID: PMC7840533 DOI: 10.3389/fnagi.2020.621947] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/11/2020] [Indexed: 01/04/2023] Open
Abstract
Exercise intervention studies in mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease (AD), have demonstrated inconsistent yet promising results. Addressing the limitations of previous studies, this trial investigated the effects of a 12-month structured exercise program on the progression of MCI. The NeuroExercise study is a multicenter randomized controlled trial across three European countries (Ireland, Netherlands, Germany). Hundred and eighty-three individuals with amnestic MCI were included and were randomized to a 12-month exercise intervention (3 units of 45 min) of either aerobic exercise (AE; n = 60), stretching and toning exercise (ST; n = 65) or to a non-exercise control group (CG; n = 58). The primary outcome, cognitive performance, was determined by an extensive neuropsychological test battery. For the primary complete case (CC) analyses, between-group differences were analyzed with analysis of covariance under two conditions: (1) the exercise group (EG = combined AE and ST groups) compared to the CG and (2) AE compared to ST. Primary analysis of the full cohort (n = 166, 71.5 years; 51.8% females) revealed no between-group differences in composite cognitive score [mean difference (95% CI)], 0.12 [(−0.03, 0.27), p = 0.13] or in any cognitive domain or quality of life. VO2 peak was significantly higher in the EG compared to the CG after 12 months [−1.76 (−3.39, −0.10), p = 0.04]. Comparing the two intervention groups revealed a higher VO2peak level in the aerobic exercise compared to the stretching and toning group, but no differences for the other outcomes. A 12-month exercise intervention did not change cognitive performance in individuals with amnestic MCI in comparison to a non-exercise CG. An intervention effect on physical fitness was found, which may be an important moderator for long term disease progression and warrants long-term follow-up investigations. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT02913053, identifier: NCT02913053.
Collapse
Affiliation(s)
- Tim Stuckenschneider
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany.,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Marit L Sanders
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands
| | - Kate E Devenney
- Discipline of Physiotherapy, Trinity College, Dublin, Ireland
| | - Justine A Aaronson
- Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Vera Abeln
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Jurgen A H R Claassen
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands
| | - Emer Guinan
- Discipline of Physiotherapy, Trinity College, Dublin, Ireland
| | - Brian Lawlor
- Mercer's Institute for Successful Aging, St. James's Hospital and Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Romain Meeusen
- Department of Human Physiology & Sports Medicine, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands
| | - M Cristina Polidori
- Aging Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Reuter
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany.,Department of Psychology, University of Bonn, Bonn, Germany
| | - Ralf-Joachim Schulz
- Geriatrics Department, University of Cologne Medical Faculty, Cologne, Germany
| | - Tobias Vogt
- Institute of Professional Sport Education and Sport Qualifications, German Sport University, Cologne, Germany.,Waseda University, Faculty of Sport Sciences, Tokorozawa, Japan
| | - Bernd Weber
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
| | - Roy P C Kessels
- Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany.,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| |
Collapse
|
12
|
Banning LCP, Janssen EPCJ, Hamel REG, de Vugt M, Köhler S, Wolfs CAG, Oosterveld SM, Melis RJF, Olde Rikkert MGM, Kessels RPC, Pijnenburg YAL, Koene T, van der Flier WM, Scheltens P, Visser PJ, Verhey FRJ, Aalten P, Ramakers IHGB. Determinants of Cross-Sectional and Longitudinal Health-Related Quality of Life in Memory Clinic Patients Without Dementia. J Geriatr Psychiatry Neurol 2020; 33:256-264. [PMID: 31645191 PMCID: PMC7361660 DOI: 10.1177/0891988719882104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To identify determinants within 3 different domains (ie, somatic comorbidities, cognitive functioning, and neuropsychiatric symptoms [NPS]) of health-related quality of life (HRQoL) over time in memory clinic patients without dementia. METHODS This longitudinal multicenter cohort study with a 3-year observation period recruited 315 individuals (age: 69.8 ± 8.6, 64.4% males, Mini-Mental State Examination score 26.9 ± 2.6). A multivariable explanatory model was built using linear mixed effects models (forward selection per domain) to select determinants for self-perceived HRQoL over time, as measured by the EuroQoL-5D visual analogue scale (EQ VAS). RESULTS Mean HRQoL at study entry was 69.4 ± 15.6. The presence of agitation, appetite and eating abnormalities, and eyes/ears/nose (ie, sensory impairment) comorbidities were associated with a change in HRQoL over time. Agitation was most strongly associated with HRQoL over time. CONCLUSIONS The association of somatic comorbidities and NPS in memory clinic patients with course of HRQoL shows that these should receive more awareness, detection, and monitoring by clinicians.
Collapse
Affiliation(s)
- Leonie C. P. Banning
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Eveline P. C. J. Janssen
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands,Mondriaan Department of Old Age Psychiatry, Heerlen, the Netherlands
| | | | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands,Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Claire A. G. Wolfs
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands,Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Saskia M. Oosterveld
- Department of Geriatrics & Radboudumc Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rene J. F. Melis
- Department of Geriatrics & Radboudumc Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marcel G. M. Olde Rikkert
- Department of Geriatrics & Radboudumc Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Roy P. C. Kessels
- Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands,Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, the Netherlands
| | - Yolande A. L. Pijnenburg
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VUmc Medical Center, Amsterdam, the Netherlands
| | - Ted Koene
- Department of Medical Psychology and Neuroscience Campus Amsterdam, VUmc Alzheimer Center, VUmc Medical Center, Amsterdam, the Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VUmc Medical Center, Amsterdam, the Netherlands,Department of Epidemiology & Biostatistics, VUmc Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VUmc Medical Center, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands,Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VUmc Medical Center, Amsterdam, the Netherlands
| | - Frans R. J. Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands,Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Inez H. G. B. Ramakers
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands,Inez H. G. B. Ramakers, Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands.
| |
Collapse
|
13
|
Auditory event-related potentials in individuals with subjective and mild cognitive impairment. Behav Brain Res 2020; 391:112700. [DOI: 10.1016/j.bbr.2020.112700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/19/2020] [Accepted: 05/08/2020] [Indexed: 12/11/2022]
|
14
|
Samy AL, Kamaruzzaman SB, Krishnaswamy S, Low WY. Predictors of Quality of Life among Older People with Mild Cognitive Impairment Attending Urban Primary Care Clinics. Clin Gerontol 2020; 43:441-454. [PMID: 31107185 DOI: 10.1080/07317115.2019.1608611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To study the prevalence of Mild Cognitive Impairment (MCI) among older people attending primary care clinics and its predictors of QOL. METHODS A cross-sectional study was conducted at two primary care clinics in Kuala Lumpur, Malaysia, recruiting 271 participants by utilizing the universal sampling method. Every patient who attended both the clinics during the study period and met the inclusion and exclusion criteria were approached and briefed about the study. Patients who gave consent were recruited as study participants. Information on sociodemographic, medical condition, and lifestyle behaviors were obtained. The Montreal Cognitive Assessment (MoCA) was used to screen for MCI at a score < 23. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire was used to evaluate QOL. RESULTS Prevalence of MCI was 27.3%. Lower QOL scores were found in the physical (67.3 ± 1.4), psychological (67.3 ± 1.4), social (66.9 ± 1.6) and environmental (71.3 ± 1.3) domains among participants with MCI. Among them, predictors of QOL were depression in the physical domain, age and stroke in the psychological domain, presence of other types of disorders in the social domain and diabetes and stroke in the environmental domain. CONCLUSIONS MCI was prevalent among study participants and were associated with poorer QOL in all domains of QOL. A better understanding of predictors of QOL in older people with MCI is deemed important. CLINICAL IMPLICATION Routine cognitive screening at primary care clinics will facilitate early recognition of MCI and facilitates referral to memory clinics for further assessment and treatment.
Collapse
Affiliation(s)
- Alexander Lourdes Samy
- Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | | | - Saroja Krishnaswamy
- Department of Psychiatry, School of Medicine, University of Western Sydney , New South Wales, Australia
| | - Wah-Yun Low
- Dean's Office, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| |
Collapse
|
15
|
Liu Y, Huang X, Chen W, Chen Y, Wang N, Wu X. The Effects of Yuan-Zhi Decoction and Its Active Ingredients in Both In Vivo and In Vitro Models of Chronic Cerebral Hypoperfusion by Regulating the Levels of A β and Autophagy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:6807879. [PMID: 32184897 PMCID: PMC7060441 DOI: 10.1155/2020/6807879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/29/2020] [Indexed: 12/18/2022]
Abstract
Chronic cerebral hypoperfusion (CCH) is closely related to the occurrence of Alzheimer's disease (AD) in the elderly. CCH can induce overactivation of autophagy, which increases the deposition of amyloid-β (Aβ) plaques in the brain, eventually impairing the cognitive function. Yuan-Zhi decoction (YZD) is a traditional Chinese medicine (TCM) formulation that is used to treat cognitive dysfunction in the elderly, but the specific mechanism is still unclear. In this study, we simulated CCH in a rat model through bilateral common carotid artery occlusion (BCCAO) and treated the animals with YZD. Standard neurological tests indicated that YZD significantly restored the impaired cognitive function after BCCAO in a dose-dependent manner. Furthermore, YZD also decreased the levels of Aβ aggregates and the autophagy-related proteins ATG5 and ATG12 in their hippocampus. An in vitro model of CCH was also established by exposing primary rat hippocampal neurons to hypoxia and hypoglycemia (H-H). YZD and its active ingredients increased the survival of these neurons and decreased the levels of Aβ1-40 and Aβ1-42, autophagy-related proteins Beclin-1 and LC3-II, and the APP secretases BACE1 and PS-1. Finally, both Aβ aggregates showed a positive statistical correlation with the expression levels of the above proteins. Taken together, YZD targets Aβ, autophagy, and APP-related secretases to protect the neurons from hypoxic-ischemic injury and restore cognitive function.
Collapse
Affiliation(s)
- Yan Liu
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiaobo Huang
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Wenqiang Chen
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Yujing Chen
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Ningqun Wang
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiling Wu
- Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| |
Collapse
|
16
|
Yamada T, Nakaaki S, Sato J, Sato H, Shikimoto R, Furukawa TA, Mimura M, Akechi T. Factor structure of the Japanese version of the Quality of Life in Alzheimer's Disease Scale (QOL-AD). Psychogeriatrics 2020; 20:79-86. [PMID: 31020753 DOI: 10.1111/psyg.12459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/16/2019] [Accepted: 04/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The Quality of Life in Alzheimer's Disease Scale (QOL-AD) developed by Logsdon et al. in1999 is believed to be useful for evaluating responses from both patients and their caregivers. We previously confirmed both the reliability and the validity of the Japanese version of the QOL-AD. However, the factor structure of this scale should be confirmed because the QOL-AD covers multiple facets of dementia patients' lives. Thus, we performed a factor analysis of the Japanese QOL-AD. Then, we examined the correlations between each of the identified QOL factor scores and the results of other scales. METHODS The Japanese version of the QOL-AD was given to 132 AD patients and 132 caregivers. Four other tests were also performed at the same time: the Mini-Mental State Examination, the Neuropsychiatric Inventory (NPI), the Hyogo Activities of Daily Living Scale (HADL), and the Short Memory Questionnaire. A factor analysis using Varimax rotation was used to examine the dimensions underlying the QOL-AD. In addition, we examined the Pearson correlations between each of the identified QOL factor scores and the results of the other four tests. RESULTS Factor analyses of both versions of the Japanese QOL-AD (both the patients' and the caregivers' responses) revealed three factors that were named 'psychological wellbeing', 'human relationships', and 'physical and social environment'. The 'psychological wellbeing' factor was significantly correlated with the Mood factor of the NPI. The 'human relationships' factor was significantly correlated with the Psychosis factor of the NPI. The 'physical and social environment' factor was significantly correlated with the HADL. CONCLUSIONS Both the patients' and the caregivers' responses to the Japanese version of the QOL-AD were composed of three factors: 'psychological wellbeing', 'human relationships', and 'physical and social environment'. The present results support the multi-domain concept of QOL proposed by Lawton.
Collapse
Affiliation(s)
- Takahiro Yamada
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shutaro Nakaaki
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Junko Sato
- Department of Speech-Language-Hearing Therapy, School of Rehabilitation Science Seirei Christopher University, Japan
| | - Hirofumi Sato
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior (Cognitive-Behavioral Medicine), Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| |
Collapse
|
17
|
|
18
|
Evaluation of depression in patients with alzheimer's disease according to the location of medical care. Arch Psychiatr Nurs 2018; 32:688-694. [PMID: 30201196 DOI: 10.1016/j.apnu.2018.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/09/2018] [Accepted: 03/11/2018] [Indexed: 11/22/2022]
|
19
|
Falls and Physical Activity in Persons With Mild to Moderate Dementia Participating in an Intensive Motor Training: Randomized Controlled Trial. Alzheimer Dis Assoc Disord 2018. [PMID: 28628488 DOI: 10.1097/wad.0000000000000201] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physical activity is beneficial in people with dementia. As physical activity increases risk exposure for falls, safety concerns arise. Prior exercise trials in people with dementia have not measured physical activity. Falls in relation to exposure time rather than person-years as outcome measure has been promoted but not investigated in people with dementia. METHODS Patients with mild to moderate dementia (n=110) were randomized to an intensive, progressive strength and functional training intervention or to a low-intensity group training for 12 weeks each. Physical activity was measured with a standardized questionnaire. Falls were documented prospectively by calendars for 12 months. RESULTS During the intervention, physical activity was significantly higher in the intervention group (P<0.001) without an increased fall rate (intervention group vs. CONTROL GROUP 2.89 vs. 1.94; incidence rate ratio, 1.49; 95% confidence interval, 0.66-3.36; P=0.333). In the subgroup of multiple fallers, the number of falls per 1000 hours of activity was significantly lower in the intervention group (8.85 vs. 18.67; P=0.017). CONCLUSIONS Increased physical activity during exercise intervention was safe in people with mild to moderate dementia. Fall rate adjusted for physical activity is a useful and sensitive outcome measure in addition to fall rate per person-years.
Collapse
|
20
|
Association of nutrition and immune-endocrine dysfunction with muscle mass and performance in cognitively impaired older adults. Arch Gerontol Geriatr 2018; 75:20-27. [DOI: 10.1016/j.archger.2017.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/08/2017] [Accepted: 11/14/2017] [Indexed: 12/25/2022]
|
21
|
Godin J, Armstrong JJ, Rockwood K, Andrew MK. Dynamics of Frailty and Cognition After Age 50: Why It Matters that Cognitive Decline is Mostly Seen in Old Age. J Alzheimers Dis 2017; 58:231-242. [DOI: 10.3233/jad-161280] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
22
|
Devenney KE, Sanders ML, Lawlor B, Olde Rikkert MGM, Schneider S. The effects of an extensive exercise programme on the progression of Mild Cognitive Impairment (MCI): study protocol for a randomised controlled trial. BMC Geriatr 2017; 17:75. [PMID: 28330458 PMCID: PMC5361785 DOI: 10.1186/s12877-017-0457-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/03/2017] [Indexed: 02/18/2023] Open
Abstract
Background Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI. Methods/design This randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme. Discussion The results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI. Trial registration ClinicalTrials.gov NCT02913053
Collapse
Affiliation(s)
- Kate E Devenney
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland.
| | - Marit L Sanders
- Department of Geriatric Medicine, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany.,Faculty for Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | | |
Collapse
|
23
|
Rodriguez-Larrad A, Arrieta H, Rezola C, Kortajarena M, Yanguas JJ, Iturburu M, Susana MG, Irazusta J. Effectiveness of a multicomponent exercise program in the attenuation of frailty in long-term nursing home residents: study protocol for a randomized clinical controlled trial. BMC Geriatr 2017; 17:60. [PMID: 28231827 PMCID: PMC5324301 DOI: 10.1186/s12877-017-0453-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/18/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND There is increasing evidence suggesting that cognition and physical frailty interact within a cycle of decline associated with aging which has been called cognitive frailty. Exercise programs have demonstrated to be an effective tool to prevent functional and cognitive decline during aging, but little is known about their potential to restore or maintain functionality in individuals that require long-term nursing care. Besides, WHO has recently highlighted the importance of introducing systematic musculoskeletal health programs for older people living in residential care, as they represent a particularly vulnerable group for the development of noncommunicable diseases. METHODS This is a multicentre randomized controlled trial. 114 participants will be randomly allocated to a usual care group or to an intervention group. Inclusion criteria are as follows: ≥ 70 years, ≥ 50 on the Barthel Index, ≥ 20 on MEC-35 who are capable to stand up and walk independently for 10 m. Subjects in the intervention group will add to the activities scheduled for the control group the participation in a 6 months long multicomponent exercise program designed to improve strength, balance and walking retraining. Study assessments will be conducted at baseline and at 3 and 6 months. The primary outcome is change in function assessed by Short Physical Performance Battery and secondary outcomes include other measurements to assess all together the condition of frailty, which includes functionality, sedentary behaviors, cognitive and emotional status and biological markers. The present study has been approved by the Committee on Ethics in Research of the University of the Basque Country (Humans Committee Code M10/2016/105; Biological Samples Committee Code M30/2016/106). DISCUSSION Results from this research will show if ageing related functional and cognitive deterioration can be effectively prevented by physical exercise in institutionalized elders. It is expected that the results of this research will guide clinical practice in nursing home settings, so that clinicians and policymakers can provide more evidence-based practice for the management of institutionalized elder people. TRIAL REGISTRATION The protocol has been registered under the Australian and New Zealand Clinical Trials Registry (ANZCTR) with the identifier: ACTRN12616001044415 .
Collapse
Affiliation(s)
- Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia Spain
| | - Haritz Arrieta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia Spain
| | - Chloe Rezola
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia Spain
| | - Maider Kortajarena
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), J. Begiristain Doktorearen pasealekua 105, E-20014 Donostia-San Sebastian, Gipuzkoa Spain
| | - Jose Javier Yanguas
- Matia Instituto Gerontológico, Camino de los Pinos 35, E-20018 Donostia-San Sebastian, Gipuzkoa Spain
| | - Miren Iturburu
- Matia Instituto Gerontológico, Camino de los Pinos 35, E-20018 Donostia-San Sebastian, Gipuzkoa Spain
| | - María Gil Susana
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia Spain
| |
Collapse
|
24
|
Panza F, Seripa D, Solfrizzi V, Tortelli R, Greco A, Pilotto A, Logroscino G. Targeting Cognitive Frailty: Clinical and Neurobiological Roadmap for a Single Complex Phenotype. J Alzheimers Dis 2016; 47:793-813. [PMID: 26401761 DOI: 10.3233/jad-150358] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Late-life cognitive disorders may be prevented by influencing age-related conditions such as frailty, characterized by decreased resistance to stressors and increased risk for adverse health outcomes. In the present review article, we examined clinical and epidemiological studies investigating the possible role of different frailty models in modulating the risk of Alzheimer's disease (AD), dementia, vascular dementia (VaD), mild cognitive impairment (MCI), and late-life cognitive impairment/decline that have been published over the past 3 years. Both deficit accumulation and physical frailty models were associated with late-life cognitive impairment/decline, incident dementia, AD, MCI, VaD, non-AD dementias, and AD pathology, proposing cognitive frailty as a new clinical construct with coexisting physical frailty and cognitive impairment in nondemented older subjects. Two subtypes of this new clinical condition have been recently proposed: "potentially reversible" cognitive frailty and "reversible" cognitive frailty. The physical factors should be physical prefrailty and frailty, while the cognitive impairment of potentially reversible cognitive frailty should be MCI (Clinical Dementia rating Scale = 0.5), while the cognitive impairment of reversible cognitive frailty should be pre-MCI Subjective Cognitive Decline (SCD), as recently proposed by the SCD Initiative Working Group. The mechanisms underlying the cognitive-frailty link are multifactorial and vascular, inflammatory, nutritional, and metabolic influences may be of major relevance. Considering both physical frailty and cognition as a single complex phenotype may be crucial in the prevention of dementia and its subtypes with secondary preventive trials on cognitive frail older subjects.
Collapse
Affiliation(s)
- Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.,Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Davide Seripa
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Rosanna Tortelli
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Antonio Greco
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Alberto Pilotto
- Geriatrics Unit, Department of OrthoGeriatrics, Rehabilitation and Stabilization, Frailty Area, Galliera Hospital NR-HS, Genova, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| |
Collapse
|
25
|
Lisiak M, Uchmanowicz I, Wontor R. Frailty and quality of life in elderly patients with acute coronary syndrome. Clin Interv Aging 2016; 11:553-62. [PMID: 27217737 PMCID: PMC4862345 DOI: 10.2147/cia.s99842] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Frail elderly people are at risk of developing adverse health outcomes such as disability, hospitalization, and mortality. In recent years, the literature has drawn attention to the role of frailty syndrome (FS) in acute coronary syndrome (ACS). There are few studies regarding the relationship between two multidimensional variables such as FS and quality of life (QoL). Objective The aim of the study was to investigate the relationship between FS and early QoL of elderly patients with ACS (≥65 years old). Methods The study was conducted among 91 patients aged 65 years and over with ACS. The MacNew questionnaire was used to evaluate QoL and the Tilburg frailty indicator to evaluate frailty. Results FS was present in 82.4% of patients. The average Tilburg frailty indicator score was 7.43±2.57. A negative correlation between the global values of FS and QoL was shown (r=−0.549, P<0.05). The vulnerability factors that negatively affected early QoL were: FS, marital status, conservative therapy, and hypertension. In multivariate analysis, FS was found to be the independent predictor of worse QoL (β ± standard error −0.277±0.122, P=0.026). Conclusion The presence of FS has a negative impact on early QoL in patients with ACS. The study suggests that in elderly patients with ACS, there is a need to identify frailty in order to implement additional therapeutic and nursing strategies in ACS.
Collapse
Affiliation(s)
- Magdalena Lisiak
- Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | | | - Radosław Wontor
- Department of Cardiology, T. Marciniak Lower Silesian Specialist Hospital, Wroclaw, Poland
| |
Collapse
|
26
|
Lu YYF, Bakas T, Yang Z, Weaver MT, Austrom MG, Haase JE. Feasibility and Effect Sizes of the Revised Daily Engagement of Meaningful Activities Intervention for Individuals With Mild Cognitive Impairment and Their Caregivers. J Gerontol Nurs 2016; 42:45-58. [PMID: 26934973 PMCID: PMC4819326 DOI: 10.3928/00989134-20160212-08] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/07/2016] [Indexed: 11/20/2022]
Abstract
A nurse-led intervention, Daily Engagement of Meaningful Activities (DEMA), was evaluated for feasibility and effect sizes in a two-group randomized pilot study with 36 patient-caregiver dyads (17 DEMA and 19 attention control). Effect sizes were estimated on 10 outcomes: dyad functional ability awareness congruence; patients' meaningful activity performance and satisfaction, confidence, depressive symptoms, communication satisfaction, physical function, and life satisfaction; and caregivers' depressive symptoms and life changes. High feasibility of DEMA was supported by the following indicators: consent (97.7%), session completion (91.7%), and Time 3 measure completion (97.2%). Compared to the attention control group, the DEMA group had higher dyad congruence in functional ability awareness and life satisfaction 3 months post-intervention and improved physical function at 2 weeks post-intervention. Although DEMA showed high feasibility and benefits on some health-related outcomes, further testing of DEMA in a larger randomized controlled clinical trial is needed.
Collapse
|
27
|
Tay L, Lim WS, Chan M, Ye RJ, Chong MS. The Independent Role of Inflammation in Physical Frailty among Older Adults with Mild Cognitive Impairment and Mild-to-Moderate Alzheimer's Disease. J Nutr Health Aging 2016; 20:288-99. [PMID: 26892578 DOI: 10.1007/s12603-015-0617-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the independent and combined effects of inflammation and endocrine dysregulation on (i) baseline frailty status and (ii) frailty progression at one year, among cognitively impaired community dwelling older adults. DESIGN Prospective cohort study. SETTING Tertiary Memory Clinic. METHODS We recruited patients with mild cognitive impairment and mild-moderate Alzheimer's disease. Physical frailty status was assessed at baseline and 1-year. Blood biomarkers of systemic inflammation [interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α)] and anabolic hormones [insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulphate (DHEAS)] were measured at baseline and examined in relation to physical frailty status at baseline and progression at 1-year. Each subject was categorized as (i) neither pro-inflammatory nor endocrine deficient, (ii) pro-inflammatory (IL-6 or TNF-α, or both, being in highest quartile) but not endocrine deficient, (iii) endocrine deficient (IGF-1 or DHEAS, or both, being in lowest quartile) but not pro-inflammatory and (iv) both pro-inflammatory and endocrine deficient. RESULTS Twenty (20.2%) of 99 subjects were physically frail at baseline. There was no association between severity of cognitive impairment and baseline frailty status, but the frail group had significantly greater hippocampal atrophy (median MTA: 2 (2-3) vs 1 (1-2), p=0.010). TNF-α was significantly higher in subjects who were physically frail at baseline (median TNF-α: 1.30 (0.60-1.40) vs 0.60 (0.50-1.30) pg/mL, p=0.035). In multiple logistic regression adjusted for age and gender, a pro-inflammatory state in the absence of concomitant endocrine deficiency was significantly associated with physical frailty at baseline (OR=4.99, 95% C.I 1.25-19.88, p=0.023); this was no longer significant when MTA score was included in the model. Isolated pro-inflammatory state (without endocrine deficiency) significantly increased the odds of frailty progression (OR=4.06, 95% CI 1.09-15.10, p=0.037) at 1-year. The combination pro-inflammatory and endocrine deficient state was not significantly associated with either baseline or progressive physical frailty. CONCLUSION A pro-inflammatory state exerts differential effects on physical frailty, contributing to the increased risk of baseline and progressive frailty only in the absence of a concomitant endocrine deficient state, with potential mediation via neurodegeneration.
Collapse
Affiliation(s)
- L Tay
- Dr Laura Tay, Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. Phone: 65-6359 6474, Fax: 65-6359 6294, E-Mail:
| | | | | | | | | |
Collapse
|
28
|
Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Martínez-Ramírez A, Millor N, Gómez M, Moneo ABB, Izquierdo M. Do frailty and cognitive impairment affect dual-task cost during walking in the oldest old institutionalized patients? AGE (DORDRECHT, NETHERLANDS) 2015; 37:124. [PMID: 26667940 PMCID: PMC5005870 DOI: 10.1007/s11357-015-9862-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/07/2015] [Indexed: 06/05/2023]
Abstract
The objective of this study was to investigate dual-task costs in several elderly populations, including robust oldest old, frail oldest old with MCI, frail oldest old without MCI, and frail elderly with dementia. Sixty-four elderly men and women categorized into frail without MCI (age 93.4 ± 3.2 years, n = 20), frail with MCI (age 92.4 ± 4.2 years, n = 13), robust (age 88.2 ± 4.1 years, n = 10), and patients with dementia (age 88.1 ± 5.1 years, n = 21). Five-meter gait ability and timed-up-and-go (TUG) tests with single and dual-task performance were assessed in the groups. Dual-task cost in both 5-m habitual gait velocity test and TUG test was calculated by the time differences between single and dual-task performance. The robust group exhibited better 5-m gait and TUG test performances in the single and dual-task conditions compared with the other three groups (P < 0.001), and the frail and frail + MCI groups exhibited better performances than the dementia group (P < 0.001). No significant differences were observed between the frail and frail + MCI groups. However, all groups exhibited lower gait velocities in the verbal and arithmetic task conditions, but the dual-task cost of the groups were similar. Robust individuals exhibited superior single and dual-task walking performances than the other three groups, and the frail and frail + MCI individuals exhibited performances that were superior to those of the patients with dementia. However, the dual-task costs, i.e., the changes in gait performance when elderly participants switch from a single to a dual task, were similar among all four of the investigated groups. Therefore, these results demonstrated that the magnitude of the impairment in gait pattern is independent of frailty and cognitive impairment status.
Collapse
Affiliation(s)
- Eduardo L Cadore
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alvaro Casas-Herrero
- Division of Geriatric Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- Department of Health Sciences, Public University of Navarra, Campus of Tudela, Av. de Tarazona s/n., 31500, Tudela, Navarra, Spain
| | | | - Nora Millor
- Mathematics Department, Public University of Navarra, Navarre, Spain
| | - Marisol Gómez
- Mathematics Department, Public University of Navarra, Navarre, Spain
| | - Ana B Bays Moneo
- Department of Health Sciences, Public University of Navarra, Campus of Tudela, Av. de Tarazona s/n., 31500, Tudela, Navarra, Spain
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarra, Campus of Tudela, Av. de Tarazona s/n., 31500, Tudela, Navarra, Spain.
| |
Collapse
|
29
|
Panza F, Solfrizzi V, Barulli MR, Santamato A, Seripa D, Pilotto A, Logroscino G. Cognitive Frailty: A Systematic Review of Epidemiological and Neurobiological Evidence of an Age-Related Clinical Condition. Rejuvenation Res 2015; 18:389-412. [PMID: 25808052 DOI: 10.1089/rej.2014.1637] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Advancing age is the focus of recent studies on familial and sporadic Alzheimer's disease (AD), suggesting a prolonged pre-clinical phase several decades before the onset of dementia symptoms. Influencing some age-related conditions, such as frailty, may have an impact on the prevention of late-life cognitive disorders. Frailty reflects a nonspecific state of vulnerability and a multi-system physiological change with increased risk for adverse health outcomes in older age. In this systematic review, frailty indexes based on a deficit accumulation model were associated with late life cognitive impairment and decline, incident dementia, and AD. Physical frailty constructs were associated with late-life cognitive impairment and decline, incident AD and mild cognitive impairment, vascular dementia, non-AD dementias, and AD pathology in older persons with and without dementia, thus also proposing cognitive frailty as a new clinical condition with co-existing physical frailty and cognitive impairment in non-demented older subjects. Considering both physical frailty and cognitive impairment as a single complex phenotype may be central in the prevention of dementia and its subtypes with secondary preventive trials on cognitive frail older subjects. The mechanisms underlying the cognitive-frailty link are multi-factorial, and vascular, inflammatory, nutritional, and metabolic influences may be of major relevance. There is a critical need for randomized controlled trials of intervention investigating the role of nutrition and/or physical exercise on cognitive frail subjects with the progression to dementia as primary outcome. These preventive trials and larger longitudinal population-based studies targeting cognitive outcomes could be useful in further understanding the cognitive-frailty interplay in older age.
Collapse
Affiliation(s)
- Francesco Panza
- 1 Geriatric Unit & Laboratory of Gerontology and Geriatrics , Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Vincenzo Solfrizzi
- 2 Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro , Bari, Italy
| | - Maria Rosaria Barulli
- 3 Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari, Italy .,4 Department of Clinical Research in Neurology, University of Bari Aldo Moro , "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Andrea Santamato
- 5 Department of Physical Medicine and Rehabilitation,"OORR Hospital", University of Foggia , Italy
| | - Davide Seripa
- 1 Geriatric Unit & Laboratory of Gerontology and Geriatrics , Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Alberto Pilotto
- 1 Geriatric Unit & Laboratory of Gerontology and Geriatrics , Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy .,6 Geriatric Unit, Azienda ULSS 16 Padova, Hospital S. Antonio , Padova, Italy
| | - Giancarlo Logroscino
- 3 Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari, Italy .,4 Department of Clinical Research in Neurology, University of Bari Aldo Moro , "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| |
Collapse
|
30
|
Cognitive frailty, a novel target for the prevention of elderly dependency. Ageing Res Rev 2015; 20:1-10. [PMID: 25555677 DOI: 10.1016/j.arr.2014.12.004] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 12/12/2014] [Accepted: 12/16/2014] [Indexed: 01/10/2023]
Abstract
Frailty is a complex and heterogeneous clinical syndrome. Cognitive frailty has been considered as a subtype of frailty. In this study, we refine the definition of cognitive frailty based on existing reports about frailty and the latest progress in cognition research. We obtain evidence from the literature regarding the role of pre-physical frailty in pathological aging. We propose that cognitive impairment of cognitive frailty results from physical or pre-physical frailty and comprises two subtypes: the reversible and the potentially reversible. Reversible cognitive impairment is indicated by subjective cognitive decline (SCD) and/or positive fluid and imaging biomarkers of amyloid-β accumulation and neurodegeneration. Potentially reversible cognitive impairment is MCI (CDR=0.5). Based on the severity of cognitive impairment, it is possible to determine the primary and secondary preventative measures for cognitive frailty. We further determine whether SCD is a component of pre-clinical AD or the early stage of other neurodegenerative diseases, which is required for guiding personal clinical intervention.
Collapse
|
31
|
Christensen JJ, Castañeda H. Danger and dementia: caregiver experiences and shifting social roles during a highly active hurricane season. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:825-844. [PMID: 24892232 DOI: 10.1080/01634372.2014.898009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined disaster preparedness and decision-making by caregivers of community-dwelling persons diagnosed with Alzheimer's or a related dementia (ADRD). Interviews were conducted with 20 caregivers in South Florida. Twelve of these interviews include caregiving experiences during the highly active 2004-2005 hurricane seasons. Results indicate that persons in earlier stages of ADRD can, and often do, remain engaged in the disaster preparation and planning process. However, during the early stages, persons may also resist evacuation, even if the caregiver felt it was necessary. During later stages of the disease, caregivers reported less resistance to disaster-related decisions, however, with the tradeoff of less ability to assist with preparation.
Collapse
|
32
|
Casas-Herrero A, Cadore EL, Zambom-Ferraresi F, Idoate F, Millor N, Martínez-Ramirez A, Gómez M, Rodriguez-Mañas L, Marcellán T, de Gordoa AR, Marques MC, Izquierdo M. Functional capacity, muscle fat infiltration, power output, and cognitive impairment in institutionalized frail oldest old. Rejuvenation Res 2014; 16:396-403. [PMID: 23822577 DOI: 10.1089/rej.2013.1438] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study examined the neuromuscular and functional performance differences between frail oldest old with and without mild cognitive impairment (MCI). In addition, the associations between functional capacities, muscle mass, strength, and power output of the leg muscles were also examined. Forty-three elderly men and women (91.9±4.1 years) were classified into three groups--the frail group, the frail with MCI group (frail+MCI), and the non-frail group. Strength tests were performed for upper and lower limbs. Functional tests included 5-meter habitual gait, timed up-and-go (TUG), dual task performance, balance, and rise from a chair ability. Incidence of falls was assessed using questionnaires. The thigh muscle mass and attenuation were assessed using computed tomography. There were no differences between the frail and frail+MCI groups for all the functional variables analyzed, except in the cognitive score of the TUG with verbal task, which frail showed greater performance than the frail+MCI group. Significant associations were observed between the functional performance, incidence of falls, muscle mass, strength, and power in the frail and frail+MCI groups (r=-0.73 to r=0.83, p<0.01 to p<0.05). These results suggest that the frail oldest old with and without MCI have similar functional and neuromuscular outcomes. Furthermore, the functional outcomes and incidences of falls are associated with muscle mass, strength, and power in the frail elderly population.
Collapse
Affiliation(s)
- Alvaro Casas-Herrero
- 1 Division of Geriatric Medicine, Complejo Hospitalario de Navarra , Pamplona, Navarra, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Gates N, Valenzuela M, Sachdev PS, Fiatarone Singh MA. Psychological well-being in individuals with mild cognitive impairment. Clin Interv Aging 2014; 9:779-92. [PMID: 24855347 PMCID: PMC4020883 DOI: 10.2147/cia.s58866] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Cognitive impairments associated with aging and dementia are major sources of burden, deterioration in life quality, and reduced psychological well-being (PWB). Preventative measures to both reduce incident disease and improve PWB in those afflicted are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, there is very limited information regarding the relationships between early cognitive changes and memory concern, and life quality and PWB in adults with MCI; furthermore, PWB outcomes are too commonly overlooked in intervention trials. The purpose of this study was therefore to empirically test a theoretical model of PWB in MCI in order to inform clinical intervention. METHODS Baseline data from a convenience sample of 100 community-dwelling adults diagnosed with MCI enrolled in the Study of Mental Activity and Regular Training (SMART) trial were collected. A series of regression analyses were performed to develop a reduced model, then hierarchical regression with the Baron Kenny test of mediation derived the final three-tiered model of PWB. RESULTS Significant predictors of PWB were subjective memory concern, cognitive function, evaluations of quality of life, and negative affect, with a final model explaining 61% of the variance of PWB in MCI. DISCUSSION Our empirical findings support a theoretical tiered model of PWB in MCI and contribute to an understanding of the way in which early subtle cognitive deficits impact upon PWB. Multiple targets and entry points for clinical intervention were identified. These include improving the cognitive difficulties associated with MCI. Additionally, these highlight the importance of reducing memory concern, addressing low mood, and suggest that improving a person's quality of life may attenuate the negative effects of depression and anxiety on PWB in this cohort.
Collapse
Affiliation(s)
- Nicola Gates
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CheBA), University of New South Wales, Sydney, NSW, Australia
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Michael Valenzuela
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Perminder S Sachdev
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CheBA), University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Maria A Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Sydney Medical School, The University of Sydney, Lidcombe, NSW, Australia
- Hebrew SeniorLife, Boston, MA, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| |
Collapse
|
34
|
Cadore EL, Moneo ABB, Mensat MM, Muñoz AR, Casas-Herrero A, Rodriguez-Mañas L, Izquierdo M. Positive effects of resistance training in frail elderly patients with dementia after long-term physical restraint. AGE (DORDRECHT, NETHERLANDS) 2014; 36:801-11. [PMID: 24243397 PMCID: PMC4039260 DOI: 10.1007/s11357-013-9599-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/04/2013] [Indexed: 05/13/2023]
Abstract
This study investigated the effects of a multicomponent exercise intervention on muscle strength, incidence of falls and functional outcomes in frail elderly patients with dementia after long-term physical restraint, followed by 24 weeks of training cessation. Eighteen frail elderly patients with mild dementia (88.1 ± 5.1 years) performed a multicomponent exercise program, which consisted of 4 weeks of walking, balance and cognitive exercises, followed by 4 weeks of resistance exercise performed twice weekly [8-12 repetitions at 20-50 % of the one-repetition maximum (1RM)], combined with walking, balance and cognitive exercises. Before and after training, as well as after 24 weeks of training cessation, strength outcomes, Barthel Index, balance, gait ability, rise from a chair ability, dual task performance, incidence of falls and Mini-Mental State Examination were assessed. After the first 4 weeks of training, there was a significant improvement only in the balance test, whereas no additional changes were observed. However, after the second part of the training, the participants required significantly less time for the time-up-and-go test (P < 0.05), and improved the isometric hand grip, hip flexion and knee extension strength, as well as the leg press 1RM (P < 0.01). A significant reduction was also observed in the incidence of falls (P < 0.01). After 24 weeks of training cessation, abrupt decreases were observed in nearly all of the physical outcomes (P < 0.05). The exercise intervention improved strength, balance and gait ability in frail elderly patients with dementia after long-term physical restraint, and these benefits were lost after training cessation.
Collapse
Affiliation(s)
- Eduardo L. Cadore
- />Department of Health Sciences, Public University of Navarre, Campus of Tudela Av. de Tarazona s/n, 31500 Tudela, Navarra Spain
| | - Ana B. Bays Moneo
- />Department of Health Sciences, Public University of Navarre, Campus of Tudela Av. de Tarazona s/n, 31500 Tudela, Navarra Spain
| | | | | | - Alvaro Casas-Herrero
- />Division of Geriatric Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra Spain
| | | | - Mikel Izquierdo
- />Department of Health Sciences, Public University of Navarre, Campus of Tudela Av. de Tarazona s/n, 31500 Tudela, Navarra Spain
| |
Collapse
|
35
|
Life satisfaction and frailty in community-based older adults: cross-sectional and prospective analyses. Int Psychogeriatr 2013; 25:1709-16. [PMID: 23830492 DOI: 10.1017/s1041610213000902] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Frailty may be associated with reduced life satisfaction (LS). The objectives of this paper are to determine if (1) frailty is associated with LS in community-dwelling older adults in cross-sectional analyses; (2) frailty predicts LS five years later; and (3) specific domains of LS are preferentially associated with frailty. METHODS This paper presents analysis of an existing population-based cohort study of 1,751 persons aged 65+ who were assessed in 1991, with follow-up five years later. LS was measured using the terrible-delightful scale, which measures overall LS and LS in specific domains. Frailty was measured using the Brief Frailty Instrument. Analyses were adjusted for age, gender, education, and marital status. RESULTS Frailty was associated with overall LS at time 1 and predicted overall LS at time 2. This was seen in unadjusted analyses and after adjusting for confounding factors. Frailty was associated with all domains of LS at time 1, and predicted LS at time 2 in all domains except housing and self-esteem. However, the effect was stronger for LS with health than with other domains for both times 1 and 2. CONCLUSIONS Frailty is associated with LS, and the effect is strongest for LS with health.
Collapse
|