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Divandari N, Bird ML, Vakili M, Jaberzadeh S. The Association Between Cognitive Domains and Postural Balance among Healthy Older Adults: A Systematic Review of Literature and Meta-Analysis. Curr Neurol Neurosci Rep 2023; 23:681-693. [PMID: 37856048 PMCID: PMC10673728 DOI: 10.1007/s11910-023-01305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE OF REVIEW This review aims to explore which cognitive domain is more closely associated with which type of balance (static or dynamic). RESENT FINDING Based on recent reviews, inhibitory control, a part of cognition, plays a crucial role in balance performance. Previous reviews report significant links between cognition, mobility, and physical function in older adults. However, evidence regarding the relationship between cognition and balance scores remains inconclusive. The strength of association between cognition and balance appears to be domain-specific and task-specific. Executive function exhibits the strongest correlation with balance, while episodic memory shows a small link with dynamic balance. Processing speed and global cognition demonstrate moderate correlations. Additionally, there is a slight association between cognitive domains and static balance. Further research is needed to elucidate the underlying mechanisms and develop targeted interventions for managing balance-related concerns that are domain-specific and task-specific.
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Affiliation(s)
- Nahid Divandari
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia.
| | - Marie-Louise Bird
- School of Health Sciences, University of Tasmania, Newnham Tasmania 7248, Launceston, Australia
| | - Mahdi Vakili
- Mowbray Medical Clinic, Invermay, TAS, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia
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Edelstein J, Messenger L, Kinney AR, Graham JE, Malcolm MP. Predicting Receipt and Types of Occupational Therapy Services for Patients with Arousal Deficits in the Neuro Critical Care Unit. Occup Ther Health Care 2023; 37:445-460. [PMID: 35200095 DOI: 10.1080/07380577.2022.2041781] [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: 10/04/2021] [Accepted: 02/08/2022] [Indexed: 10/19/2022]
Abstract
Occupational therapy has been identified as a required service in the neuro critical care unit (NCCU), however who receives occupational therapy services and what services they receive are not well understood. We sought to determine if arousal deficits impacted patients' likelihood to receive an occupational therapy evaluation or specific types of occupational therapy interventions in the NCCU. When compared to patients without arousal deficits, patients who were experiencing agitation or light sedation, but not deep sedation, were more likely to receive occupational therapy interventions in the therapeutic activities category. Arousal deficits were not associated with receipt of occupational therapy services or occupational therapy interventions in the self-care or therapeutic exercise categories. Determining predictors of occupational therapy services will help ensure the timely delivery of services by improving the allocation of resources and identifying potential gaps in care.
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Affiliation(s)
- Jessica Edelstein
- Department of Occupational Therapy, Colorado State University, CO, USA
| | - Lindsey Messenger
- Department of Occupational Therapy, Colorado State University, CO, USA
| | - Adam R Kinney
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs, Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - James E Graham
- Department of Occupational Therapy, Colorado State University, CO, USA
| | - Matt P Malcolm
- Department of Occupational Therapy, Colorado State University, CO, USA
- Colorado School of Public Health, Colorado State, CO, USA
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Park M, Song R, Ju K, Shin JC, Seo J, Fan X, Gao X, Ryu A, Li Y. Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials. BMC Geriatr 2023; 23:352. [PMID: 37280512 DOI: 10.1186/s12877-023-04070-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways. PURPOSE The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach. METHODS A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software. RESULTS Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011). CONCLUSION This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.
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Affiliation(s)
- Moonkyoung Park
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Rhayun Song
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea.
| | - Kyoungok Ju
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Jacqueline C Shin
- Indiana State University, Department of Psychology, Terre Haute, IN, 47802, USA
| | - Jisu Seo
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xing Fan
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xianqi Gao
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Ahyun Ryu
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Yuelin Li
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
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Barnes S, Chowdhury S, Gatto NM, Fraser GE, Lee GJ. Omega-3 fatty acids are associated with blood-brain barrier integrity in a healthy aging population. Brain Behav 2021; 11:e2273. [PMID: 34327870 PMCID: PMC8413753 DOI: 10.1002/brb3.2273] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 12/03/2022] Open
Abstract
In aging populations, omega-3 polyunsaturated fatty acids (PUFAs) have been associated with better cognitive function, slower rates of cognitive decline, and lower risk of developing dementia. Animal studies have shown that diets rich in omega-3 PUFAs reduce blood-brain barrier (BBB) disruption associated with aging, but this has yet to be observed in humans. Forty-five healthy subjects (mean age, 76 years) were recruited and underwent cognitive assessment (verbal learning and memory, language, processing speed, executive function, and motor control) and measurement of PUFAs. Forty of the same subjects also underwent magnetic resonance imaging (MRI) to measure BBB integrity (Ktrans using dynamic contrast-enhanced MRI). The long chain omega-3 score (DHA+EPA) was negatively correlated with Ktrans values in the internal capsule, indicating higher omega-3 levels were associated with greater BBB integrity in this region (r = -0.525, p = .004). Trends were observed for a positive correlation between the long chain omega-3 score and both memory and language scores, but not with executive function, speed, or motor control. The omega-6 score was not significantly correlated with any cognitive scores or Ktrans values. The significant correlations between long chain omega-3 levels and BBB integrity provide a possible mechanism by which omega-3 PUFAs are associated with brain health.
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Affiliation(s)
- Samuel Barnes
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, California, USA
| | - Shilpy Chowdhury
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, California, USA.,Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Nicole M Gatto
- School of Community and Global Health, Claremont Graduate University, Claremont, California, USA
| | - Gary E Fraser
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Grace J Lee
- Department of Psychology, School of Behavioral Health, Loma Linda University, Loma Linda, California, USA
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O'Shea DM, Davis JD, Tremont G. Verbal memory is associated with adherence to COVID-19 protective behaviors in community dwelling older adults. Aging Clin Exp Res 2021; 33:2043-2051. [PMID: 34131881 PMCID: PMC8204921 DOI: 10.1007/s40520-021-01905-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Abstract
Background Adherence to protective behaviors is central to limiting the spread of COVID-19 and associated risk of serious illness and mortality in older populations. Whether cognition predicts adherence to protective behaviors has not been examined in older adults. Aims To examine whether specific cognitive abilities predict adherence to COVID-19 protective behaviors in older adults, independent of other relevant factors. Methods Data from 431 older adults (i.e., ≥ 65 years) who took part in the COVID-19 module of the Health and Retirement Study were included in the present study. Separate binary logistic regression models were used to examine whether performance on measures of immediate and delayed recall and working memory predicted adherence to COVID-19 protective behaviors, controlling for demographics, level of COVID-19 concern, depressive symptoms, and medical conditions. Results For every unit increase in immediate and delayed recall, the probability of adhering to COVID-19 protective behaviors increased by 47% and 69%, respectively. There was no association between the measure of working memory and adherence. Discussion It is of public interest to understand the factors that reduce adherence to protective behaviors so that we can better protect those most vulnerable and limit community spread. Our findings demonstrate that reduced memory predicts non-adherence to COVID-19 protective behaviors, independent of virus concern, and other relevant demographic and health factors. Conclusions Public health strategies aimed at increasing adherence to COVID-19 protective behaviors in community dwelling older adults, should account for the role of reduced cognitive function in limiting adherence.
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Affiliation(s)
- Deirdre M O'Shea
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.
| | - Jennifer D Davis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Geoffrey Tremont
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
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Van Der Weijst L, Surmont V, Schrauwen W, Lievens Y. Real Life Data on Patient-Reported Outcomes and Neuro-Cognitive Functioning of Lung Cancer Patients: The PRO-Long Study. Front Oncol 2021; 11:685605. [PMID: 34222010 PMCID: PMC8247464 DOI: 10.3389/fonc.2021.685605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/24/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION This report investigates the impact of systemic treatments (chemotherapy or immunotherapy) with(out) loco-regional radiotherapy, on HRQoL, toxicity and neurocognitive functioning (NCF) in locally advanced and metastatic non-small cell lung cancer patients enrolled in the PRO-Long study. MATERIALS AND METHODS Data on patient-reported HRQoL and fourteen toxicities was collected, while NCF was tested, up to one-year post-treatment. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30. Lung cancer, treatment and neuro-psychological related toxicities were scored with the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events. NCF was evaluated with six neurocognitive tests. Mixed model analyses were conducted to determine statistical significance (p = .01). Meaningful clinical important differences (MCIDs) were applied for changes in HRQoL and NCF data, while toxicities were compared to baseline values. RESULTS In total, 50 patients were enrolled. Overall HRQoL (p = .357) nor its domains (physical, p = .643; role, p = .069; emotional, p = .254; cognitive, p = 494; social, p = .735) changed significantly over time. Meaningful improvements in overall HRQoL were seen in 22, 38 and 39% and deteriorations in 22, 5 and 28% of patients at 2-3, 6 and 12 months respectively post-treatment. Overall toxicity (p = .007), lack of appetite (p = .001), nausea (p = .004) and dysphagia (p = .000) significantly decreased over time. Treatment caused acute toxicity, such as dyspnoea (45%) and memory problems (42%), but also alleviated pre-existing symptoms, including lack of appetite (32%), anxiety (29%) and depression (28%) at 2/3 months. The NCF domains of visual memory (p = .000) and cognitive processing speed (p = .000) showed significant improvements over time. In terms of MCIDs, at 2-3 months (18%) and 6 months (15%), verbal memory was particularly impacted; at 12 months, visual memory (18%) and executive function (18%) deteriorated primarily. CONCLUSION The results suggest that therapy has no significant negative impact on overall HRQoL, its domains, and NCF. About one-third of patients reported a meaningful improved HRQoL at 1 year post-treatment. Treatment caused toxicity, but also alleviated pre-existing symptoms.
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Affiliation(s)
| | - Veerle Surmont
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Wim Schrauwen
- Department of Medical Psychology, Ghent University Hospital, Ghent, Belgium
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
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Liu T, Gatto NM, Chen Z, Qiu H, Lee G, Duerksen-Hughes P, Fraser G, Wang C. Vegetarian diets, circulating miRNA expression and healthspan in subjects living in the Blue Zone. PRECISION CLINICAL MEDICINE 2021; 3:245-259. [PMID: 33391847 PMCID: PMC7757436 DOI: 10.1093/pcmedi/pbaa037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/11/2020] [Accepted: 10/18/2020] [Indexed: 12/21/2022] Open
Abstract
A long-term vegetarian diet plays a role in the longevity and maintenance of the healthspan, but the underlying mechanisms for these observations are largely unknown. Particularly, it is not known whether a long-term vegetarian dietary pattern may affect the circulating miRNA expression in such a way as to modulate the healthspan. The Adventist Health Study-2 (AHS-2) cohort includes a large number of older adults who primarily follow vegetarian dietary patterns and reside in Loma Linda, California, one of five “Blue Zones” in the world in which a higher proportion of the population enjoys a longer than average lifespan. We performed miRNA-seq in 96 subjects selected from the AHS-2 cohort with different dietary patterns. We identified several differentially expressed miRNAs between vegetarians and non-vegetarians, which are involved in immune response and cytokine signaling, cell growth and proliferation as well as age-related diseases such as cardiovascular diseases and neurodegenerative diseases. Overall, our study showed that a vegetarian diet modulates aging-associated circulating miRNAs in a sex-dependent manner of differential expression for certain miRNAs, which may be related in a beneficial manner to the healthspan. Further investigation is needed to validate these miRNAs as potential biomarkers for diet-modulated longevity in humans.
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Affiliation(s)
- Tiantian Liu
- Center for Genomics, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Nicole M Gatto
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA
| | - Zhong Chen
- Center for Genomics, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Hongyu Qiu
- Center of Molecular and Translational Medicine, Institution of Biomedical Science, Georgia State University, Atlanta, GA 30303, USA
| | - Grace Lee
- Department of Psychology, School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Penelope Duerksen-Hughes
- Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Gary Fraser
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Charles Wang
- Center for Genomics, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
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