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Mercier C, Rollason V, Eshmawey M, Mendes A, Frisoni GB. The treatment of behavioural and psychological symptoms in dementia: pragmatic recommendations. Psychogeriatrics 2024; 24:968-982. [PMID: 38638077 DOI: 10.1111/psyg.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/20/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024]
Abstract
Behavioural and psychological symptoms of dementia (BPSD) are a clinical challenge for the lack of a sound taxonomy, frequent presentation with comorbid BPSD, lack of specific pharmacologic interventions, poor base of methodologically sound evidence with randomized clinical trials, contamination from the treatment of behavioural disturbances of young and adult psychiatric conditions, and small efficacy window of psychotropic drugs. We present here a treatment workflow based on a concept-driven literature review based on the notions that (i) the aetiology of BPSD can be mainly neurobiological (so-called 'primary' symptoms) or mainly environmental and functional ('secondary' symptoms) and that this drives treatment; (ii) the clinical efficacy of psychotropic drugs is driven by their specific profile of receptor affinity; (iii) drug treatment should follow the rules of 'start low-go slow, prescribe and revise'. This article argues in support of the distinction between primary and secondary BPSD, as well as their characteristics, which until now have been just sketchily described in the literature. It also offers comprehensive and pragmatic clinician-oriented recommendations for the treatment of BPSD.
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Affiliation(s)
- Camille Mercier
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Center, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Victoria Rollason
- Department of Acute Medicine, Clinical Pharmacology and Toxicology Service, University Hospitals of Geneva, Geneva, Switzerland
| | - Mohamed Eshmawey
- Department of Psychiatry, Geriatric Psychiatry Service, University Hospitals of Geneva, Geneva, Switzerland
| | - Aline Mendes
- Geriatrics and Rehabilitation Department, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Center, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
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Girard-Côté L, Gallais B, Gagnon C, Roussel MP, Morin M, Hébert LJ, Monckton D, Leduc-Gaudet JP, Gouspillou G, Marcangeli V, Duchesne E. Resistance training in women with myotonic dystrophy type 1: a multisystemic therapeutic avenue. Neuromuscul Disord 2024; 40:38-51. [PMID: 38824906 DOI: 10.1016/j.nmd.2024.05.009] [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: 10/05/2023] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 06/04/2024]
Abstract
Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by muscular impairments. Fundamental and clinical positive effects of strength training have been reported in men with DM1, but its impact on women remains unknown. We evaluated the effects of a 12-week supervised strength training on physical and neuropsychiatric health. Women with DM1 performed a twice-weekly supervised resistance training program (3 series of 6-8 repetitions of squat, leg press, plantar flexion, knee extension, and hip abduction). Lower limb muscle strength, physical function, apathy, anxiety and depression, fatigue and excessive somnolence, pain, and patient-reported outcomes were assessed before and after the intervention, as well as three and six months after completion of the training program. Muscle biopsies of the vastus lateralis were also taken before and after the training program to assess muscle fiber growth. Eleven participants completed the program (attendance: 98.5 %). Maximal hip and knee extension strength (p < 0.006), all One-Repetition Maximum strength measures (p < 0.001), apathy (p = 0.0005), depression (p = 0.02), pain interference (p = 0.01) and perception of the lower limb function (p = 0.003) were significantly improved by training. Some of these gains were maintained up to six months after the training program. Strength training is a good therapeutic strategy for women with DM1.
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Affiliation(s)
- Laura Girard-Côté
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada; Neuromuscular Diseases Interdisciplinary Research Group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, Quebec, Canada
| | - Benjamin Gallais
- Neuromuscular Diseases Interdisciplinary Research Group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, Quebec, Canada; ÉCOBES - Research and Transfer, Cegep de Jonquière, Jonquière, Quebec, Canada
| | - Cynthia Gagnon
- Neuromuscular Diseases Interdisciplinary Research Group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, Quebec, Canada; CHU Sherbrooke Research Center, and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Pier Roussel
- Neuromuscular Diseases Interdisciplinary Research Group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, Quebec, Canada; Department of Fundamental Sciences, University of Quebec at Chicoutimi, Saguenay, Quebec, Canada
| | - Marika Morin
- Neuromuscular Diseases Interdisciplinary Research Group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, Quebec, Canada
| | - Luc J Hébert
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Capitale-Nationale Integrated University Health and Social Services Center, Quebec, Quebec, Canada; Department of Radiology and Nuclear Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Darren Monckton
- Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow, UK
| | - Jean-Philippe Leduc-Gaudet
- Research Group in Cellular Signaling, Department of Medical Biology, University of Quebec at Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Gilles Gouspillou
- Département des sciences de l'activité physique, Faculté des sciences, University of Quebec at Montréal (UQAM), Montréal, Quebec, Canada
| | - Vincent Marcangeli
- Département des sciences de l'activité physique, Faculté des sciences, University of Quebec at Montréal (UQAM), Montréal, Quebec, Canada
| | - Elise Duchesne
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada; Neuromuscular Diseases Interdisciplinary Research Group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Capitale-Nationale Integrated University Health and Social Services Center, Quebec, Quebec, Canada; CHU de Québec - Université Laval Research Center, Québec, Québec, Canada.
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Akbuga Koc E, Yazici-Mutlu Ç, Cinar N, Sahiner T. Comparison of the effect of online physical exercise and computerized cognitive stimulation in patients with Alzheimer's disease during the Covid-19 pandemic. Complement Ther Clin Pract 2024; 57:101881. [PMID: 38959564 DOI: 10.1016/j.ctcp.2024.101881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/27/2024] [Accepted: 06/30/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION To investigate the effect of physical exercise alone and in combination with cognitive stimulation on cognition, physical function, and quality of life in patients with Alzheimer's Disease (PwAD). METHODS The study was a randomized controlled, single-blinded trial with pre-and post-treatment and follow-up assessments conducted at the private hospital and home environment in PwAD. Seventy-five (N = 75) participants diagnosed with AD were enrolled, but sixty (N = 60) participants (mean age 77.8 years, standard deviation (SD) 6.7) were randomized as physical exercise group (PEG) (n = 20), physical exercise and cognitive stimulation group (PE + CSG) (n = 20) and control group (CG) (n = 20). Participants in PEG and PE + CSG performed an online supervised physical exercise program (SPEP) given biweekly for 12 weeks. Additionally, the cognitive stimulation (CS) program was offered for at least three or five days for 12 weeks for PE + CSG. No treatment was given for the CG. The primary outcome measures were cognition, balance, functional mobility (FM), upper extremity muscle strength (UEMS) and lower extremity muscle strength (LEMS), and quality of life (QoL). Furthermore, depression, basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were measured secondarily. RESULTS PE + CSG demonstrated significant improvement in cognition, balance, FM, UEMS, IADL and reduction in depression compared to the CG (p < 0.05). Besides, participants in the PE + CSG had statistically superior QoL and IADL than the PEG (p < 0.05). CONCLUSIONS The addition of CS to the SPEP was a safe and effective method to gain statistically significant improvements in cognition, balance, FM, UEMS, IADL, and reduction in depression in PwAD.
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Affiliation(s)
- Ebru Akbuga Koc
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Çiğdem Yazici-Mutlu
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Nilgun Cinar
- Maltepe University, Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
| | - Turker Sahiner
- Memorial Hospital, Department of Neuorology, Istanbul, Turkey.
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McArthur C, Alizadehsaravi N, Affoo R, Cooke K, Douglas N, Earl M, Flynn T, Ghanouni P, Hunter S, Kalu M, Middleton L, Moody E, Smith C, Verlinden L, Weeks L. Effectiveness of physical rehabilitation on physical functioning and quality of life for long-term care residents with dementia: a systematic review and meta-analysis. JBI Evid Synth 2024:02174543-990000000-00322. [PMID: 38915237 DOI: 10.11124/jbies-23-00431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVE The objective of this review was to evaluate the effectiveness of physical rehabilitation versus non-rehabilitation comparators on physical functioning and quality of life for long-term care (LTC) residents with dementia. INTRODUCTION LTC residents living with dementia often have impaired physical functioning and quality of life. Physical rehabilitation can improve physical functioning and quality of life for individuals living with dementia; however, many LTC residents with dementia do not receive physical rehabilitation and providers are unsure what interventions to employ. A synthesis of studies examining physical rehabilitation will help guide practice in the LTC sector where most residents live with dementia. Previous syntheses have focused on all residents in LTC, specific professions, interventions, or people with dementia in the community. Our review focuses on LTC residents with dementia and a broader definition of physical rehabilitation. INCLUSION CRITERIA This review includes studies that evaluate physical rehabilitation in comparison with non-rehabilitation controls among LTC residents with any severity of dementia. We included studies that measure the effect on activities of daily living, performance-based physical functioning, and self- or proxy-rated quality of life. METHODS Searches were conducted in APA PsycINFO (EBSCOhost), CINAHL (EBSCOhost), PubMed (National Library of Medicine), Embase, Scopus, and the Cochrane CENTRAL database with no date or language limitations. Two independent reviews assessed the studies against the inclusion criteria. Two independent reviewers extracted data and conducted a quality assessment using a structured extraction form. Certainty of evidence was ascertained using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Where possible, studies were pooled in meta-analyses; otherwise, a narrative synthesis was performed. RESULTS Thirty-three studies were included (n = 3072 participants); 27 were randomized control trials and the remaining 6 were non-randomized trials. The overall risk of bias of the included studies was low to unclear. Many of the included studies focused on increasing activity or walking, while few were individually tailored or at an intensity appropriate to induce therapeutic effects on physical function. Physical function was also measured via several outcome measures, limiting our ability to pool results. There was low certainty evidence that physical rehabilitation improved activities of daily living (12 RCTs, 1348 participants, SMD 0.78; 95% CI 0.27 to 1.30) and the Short Physical Performance Battery Score (3 RCTs, 258 participants, MD 3.01 points; 95% CI 1.37 to 4.66) compared with non-rehabilitation interventions. There was low to moderate certainty evidence that physical rehabilitation demonstrated no change in the 30-Second Sit to Stand Test (2 RCTs, 293 participants, MD 0.79 repetitions; 95% CI -0.45 to 2.03), 6-Minute Walk Test (4 RCTs, 363 participants, MD 17.32 meters; 95% CI -29.41 to 64.05), gait speed (4 RCTs, 400 participants, MD 0.10 meters/seconds; 95% CI -0.02 to 0.22), Timed Up and Go Test (3 studies, 275 participants, MD -2.89 seconds; 95% CI -6.62 to 0.84), or quality of life (4 RCTs, 419 participants, SMD 0.20; 95% CI -0.08 to 0.47). CONCLUSIONS This review demonstrates that physical rehabilitation may improve activities of daily living for LTC residents living with dementia, though the evidence is of low certainty. The effect of physical rehabilitation on specific functional tasks, like gait speed and quality of life, are less clear. Future research should examine the effects of individualized, progressive interventions on outcome measures that reflect the capacity and preferences of LTC residents with more advanced dementia. REVIEW REGISTRATION PROSPERO CRD42022308444.
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Affiliation(s)
- Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | | | - Rebecca Affoo
- School of Communication Sciences and Disorders, Dalhousie University, Halifax, NS, Canada
| | - Karen Cooke
- Physiotherapy Department, Halifax, NS, Canada
| | - Natalie Douglas
- Deparment of Communicative Disorders, University of Louisiana Lafeyette: Lafeyette, LA, United States
| | - Marie Earl
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | | | - Parisa Ghanouni
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
| | - Susan Hunter
- School of Physiotherapy, Western University, London, ON, Canada
| | - Michael Kalu
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Laura Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | | | | | - Lori Weeks
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
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Hung L, Park J, Levine H, Call D, Celeste D, Lacativa D, Riley B, Riley N, Zhao Y. Technology-based group exercise interventions for people living with dementia or mild cognitive impairment: A scoping review. PLoS One 2024; 19:e0305266. [PMID: 38870211 PMCID: PMC11175425 DOI: 10.1371/journal.pone.0305266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/28/2024] [Indexed: 06/15/2024] Open
Abstract
Older people living with dementia or mild cognitive impairment (MCI) are more vulnerable to experiencing social isolation and loneliness due to their cognitive and physical impairments. Increasingly integrating technology into group exercises contributed to the improved resilience and well-being of older adults living with dementia and MCI. The purpose of this scoping review was to identify the various types, feasibility, outcome measures, and impacts of technology-based group exercise interventions for people with dementia or MCI. We utilized the Joanna Briggs Institute approach, a three-step process. A comprehensive literature search on five databases-CINAHL, MEDLINE, Embase, Web of Science, and PsycInfo-until January 2024 yielded 1,585 publications; the final review included 14 publications that recruited a total of 379 participants, with mean age of 69 (SD = 4.21) years to 87.07 (SD = 3.92) years. Analysis of data showed three types of technology-based group exercise interventions for people with dementia or MCI: (a) exergames, (b) virtual cycling or kayak paddling, and (c) video-conferencing platforms. In addition, we identified three key impacts: (a) feasibility and accessibility; (b) physical, psychosocial, and cognitive benefits; and (c) adaptations necessary for persons with dementia or MCI. Our study suggests that technology-based group exercise interventions are feasible and acceptable to persons with dementia or MCI. Future studies should involve individuals with dementia and their caregivers in the design and implementation of technology-based group exercise programs.
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Affiliation(s)
- Lillian Hung
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- IDEA Lab, University of British Columbia, Vancouver, British Columbia, Canada
| | - Juyong Park
- Phyllis & Harvey Sandler School of Social Work, College of Social Work & Criminal Justice, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - Hannah Levine
- Charles E. Schmidt College of Medicine, Marcus Institute of Integrative Health at FAU Medicine, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - David Call
- Independent Patient Partner, Panama, Florida, United States of America
| | - Diane Celeste
- Independent Family Partner, Panama, Florida, United States of America
| | - Dierdre Lacativa
- Independent Family Partner, Panama, Florida, United States of America
| | - Betty Riley
- Independent Family Partner, Panama, Florida, United States of America
| | - Nathanul Riley
- Independent Patient Partner, Panama, Florida, United States of America
| | - Yong Zhao
- IDEA Lab, University of British Columbia, Vancouver, British Columbia, Canada
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Andrews M, Cheema BS, Siette J. Barriers and facilitators to implementation of physical activity programs for individuals with dementia living in aged care homes: A systematic review. Arch Gerontol Geriatr 2024; 126:105535. [PMID: 38936317 DOI: 10.1016/j.archger.2024.105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/27/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes. METHODS A search was conducted using the databases Medline, PubMed, PsycINFO, CINAHL, Embase, and ProQuest, and captured articles were assessed for inclusion in the review. Included studies were appraised using the Mixed Methods Appraisal Tool (MMAT). Data extraction was performed for study characteristics, identified barriers and facilitators to physical activity implementation, and synthesised narratively. RESULTS Following full-text screening, 13 articles were included in the review. Reporting quality was high in the majority of studies (69 %). Overall, barriers to implementation of physical activity programs were linked to factors related to the resident or the aged care facility, rather than inherently with the physical activity itself. The most identified barriers were understaffing (62 %), resident fatigue or lack of motivation (46 %), distrust of staff (31 %), and fear of injury (31 %). The most identified facilitators were having a structured physical activity protocol (46 %), opportunities for social interaction (38 %), instructor-led sessions (38 %) and offering an individually tailored program (31 %). CONCLUSIONS Addressing barriers of understaffing and resident fatigue whilst simultaneously offering structured, personalised group physical activity programs led by instructors may help optimise implementation. Future research should focus on developing tailored implementation plans, evaluating their effectiveness and cost-effectiveness, and identifying best practices to support the delivery of physical activity interventions in residential aged care settings. PROSPERO REGISTRATION NUMBER CRD42022372308.
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Affiliation(s)
- Mitchell Andrews
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Birinder S Cheema
- School of Health Sciences, Translational Health Research Institute and the National Institute of Complementary Medicine, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia.
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Hadley R, Mathie E, Pike E, Goodman C. Physical Activity Inclusion in Dementia-Friendly Communities: A Mixed Methods Study. J Aging Phys Act 2024; 32:376-386. [PMID: 38281484 DOI: 10.1123/japa.2022-0371] [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: 11/25/2022] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 01/30/2024]
Abstract
Dementia-friendly communities (DFCs) are a policy-endorsed approach to community engagement in England that promotes social inclusion to enable people affected by dementia to live well. Research suggests that physical activity is beneficial in encouraging social connection and improving health. A mixed method sequential study design in England involving a national survey (n = 31) and semistructured interviews (n = 65) in three DFCs was carried out. The aim was to understand how DFCs enable people affected by dementia to participate in physical activities. An evaluation framework for DFCs was used to organize and interpret the data, and analysis was informed by the inclusive (social) citizen lens. Findings showed that DFCs offered a range of adapted dementia-inclusive and dementia-specific activities; however, people were not routinely offered information at time of diagnosis. Local authorities (councils) were key to enable access to information and infrastructure change to support sustainable inclusion within their local community.
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Affiliation(s)
- Rebecca Hadley
- Centre for Applied Clinical, Health and Care Research (CACHE), University of Hertfordshire, Hatfield, United Kingdom
| | - Elspeth Mathie
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, Hatfield, United Kingdom
- NIHR Applied Research Collaboration (ARC) East of England (EoE), Cambridge, United Kingdom
| | - Elizabeth Pike
- Institute of Sport, University of Hertfordshire, Hatfield, United Kingdom
| | - Claire Goodman
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, Hatfield, United Kingdom
- NIHR Applied Research Collaboration (ARC) East of England (EoE), Cambridge, United Kingdom
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McCartney A, Crosswell J, Rafnsson SB, Hoe J. The effectiveness of structured physical activity on agitation in people with dementia: a rapid review. Aging Ment Health 2024:1-11. [PMID: 38683159 DOI: 10.1080/13607863.2024.2345129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/13/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Managing agitation and other behaviours that challenge is a significant dementia care challenge. The priority is to find effective non-pharmacological interventions as drug treatments can have significant side effects. This review evaluates the effectiveness of structured physical activity on agitation in dementia. METHOD Our rapid review searched four electronic databases, Cochrane CENTRAL, MEDLINE, CINAHL and Embase, for interventional studies using a structured physical activity programme in people with dementia and studied the effect of this activity on behaviours that challenge. Study quality was assessed using CASP criteria and data was narratively synthesised. RESULTS We included 13 studies in this review (four rated as high quality), involving a total of 1546 participants. Results were analysed according to exercise type, frequency and intensity of the intervention. Exercise is effective in reducing agitation and studies with higher adherence to exercise demonstrated more positive effects on agitation and behaviours that challenge. CONCLUSION Physical activity can be effective in reducing agitation in older adults with dementia. Further research is needed to clarify the type of intervention that is most beneficial. Strategies to make physical activity more acceptable and available to people with dementia need to be established.
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Affiliation(s)
- A McCartney
- Estuary View Medical Centre, Whitstable Medical Practice, Kent, United Kingdom
| | - J Crosswell
- Estuary View Medical Centre, Whitstable Medical Practice, Kent, United Kingdom
| | - S B Rafnsson
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
| | - J Hoe
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
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Neudorf B, Dinh C, Barnes V, Stergiou-Dayment C, Middleton L. Enhancing Minds in Motion® as a virtual program delivery model for people living with dementia and their care partners. PLoS One 2024; 19:e0291166. [PMID: 38241269 PMCID: PMC10798436 DOI: 10.1371/journal.pone.0291166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/23/2023] [Indexed: 01/21/2024] Open
Abstract
The Alzheimer Society of Ontario's Minds in Motion (MiM) program improves physical function and well-being of people living with dementia (PLWD) and their care partners (CP) (Regan et al., 2019). With the COVID-19 pandemic, there was an urgent need to transition to a virtual MiM that was similarly safe and effective. The purpose of this mixed methods study is to describe the standardized, virtual MiM and evaluate its acceptability, and impact on quality of life, and physical and cognitive activity of participants. Survey of ad hoc virtual MiM practices and a literature review informed the design of the standardized MiM program: 8 weeks of weekly 90-minute sessions that included 45-minutes of physical activity and 45-minutes of cognitive stimulation in each session. Participants completed a standardized, virtual MiM at one of 6 participating Alzheimer Societies in Ontario, as well as assessments of quality of life, physical and cognitive activity, and program satisfaction pre- and post-program. In all, 111 PLWD and 90 CP participated in the evaluation (average age of 74.6±9.4 years, 61.2% had a college/university degree or greater, 80.6% were married, 48.6% of PLWD and 75.6% of CP were women). No adverse events occurred. MiM participants rated the program highly (average score of 4.5/5). PLWD reported improved quality of life post-MiM (p = <0.01). Altogether, participants reported increased physical activity levels (p = <0.01) and cognitive activity levels (p = <0.01). The virtual MiM program is acceptable, safe, and effective at improving quality of life, cognitive and physical activity levels for PLWD, and cognitive and physical activity levels among CP.
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Affiliation(s)
- Bobby Neudorf
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Christopher Dinh
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | | | | | - Laura Middleton
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
- Research Institute for Aging, Toronto, Ontario, Canada
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Marques-Aleixo I, Sampaio A, Bohn L, Machado F, Barros D, Ribeiro O, Carvalho J, Magalhães J. Neuropsychiatric Symptoms are Related to Blood-biomarkers in Major Neurocognitive Disorders. Curr Aging Sci 2024; 17:74-84. [PMID: 37904566 DOI: 10.2174/1874609816666230816090934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/19/2023] [Accepted: 07/19/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are highly prevalent among individuals with major neurocognitive disorders (MNCD). OBJECTIVE Here, we characterized blood biomarkers (metabolic, inflammatory, neurotrophic profiles and total antioxidant), body composition, physical fitness and quality of life (QoL) in individuals with MNCD according to NPS. METHODS The sample comprised 34 older adults (71.4% women; 74.06±6.03 yrs, with MNCD diagnosis) categorized according to 50th percentile [Low (≤12) or High (≥13)] for NPS (Neuropsychiatric Inventory Questionnaire). Sociodemographic, clinical data, body composition, anthropometric, cognitive assessment (ADAS-Cog), physical fitness (Senior Fitness Test), QoL (QoL-Alzheimer's Disease scale) were evaluated, and blood samples were collected for biochemical analysis. RESULTS Low compared to high NPS group showed higher levels of IL-6, IGF-1and neurotrophic zscore (composite of IGF-1, VEGF-1, BDNF). Additionally, low compared to high NPS group have higher QoL, aerobic fitness and upper body and lower body strength. CONCLUSION The severity of NPS seems to be related to modified neurotrophic and inflammatory outcomes, lower physical fitness, and poor QoL. Strategies to counteract NPS development may preserve the physical and mental health of individuals with MNCD..
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Affiliation(s)
- Inês Marques-Aleixo
- Interdisciplinary Research Centre for Education and Development, Lusófona University, Lisbon, Portugal
- Faculty of Psychology, Education and Sport, Lusófona University, Porto, Portugal
| | - Arnaldina Sampaio
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - Lucimére Bohn
- Interdisciplinary Research Centre for Education and Development, Lusófona University, Lisbon, Portugal
- Faculty of Psychology, Education and Sport, Lusófona University, Porto, Portugal
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - Flavia Machado
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - Duarte Barros
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - Oscár Ribeiro
- CINTESIS - Center for Health Technology and Services Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Joana Carvalho
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - José Magalhães
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
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11
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Pahlavani HA. Exercise therapy to prevent and treat Alzheimer's disease. Front Aging Neurosci 2023; 15:1243869. [PMID: 37600508 PMCID: PMC10436316 DOI: 10.3389/fnagi.2023.1243869] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease in the elderly with dementia, memory loss, and severe cognitive impairment that imposes high medical costs on individuals. The causes of AD include increased deposition of amyloid beta (Aβ) and phosphorylated tau, age, mitochondrial defects, increased neuroinflammation, decreased synaptic connections, and decreased nerve growth factors (NGF). While in animals moderate-intensity exercise restores hippocampal and amygdala memory through increased levels of p-AKT, p-TrkB, and p-PKC and decreased levels of Aβ, tau phosphorylation, and amyloid precursor proteins (APP) in AD. Aerobic exercise (with an intensity of 50-75% of VO2 max) prevents hippocampal volume reduction, spatial memory reduction, and learning reduction through increasing synaptic flexibility. Exercise training induces the binding of brain-derived neurotrophic factor (BDNF) to TrkB and the binding of NGF to TrkA to induce cell survival and neuronal plasticity. After aerobic training and high-intensity interval training, the increase of VEGF, angiopoietin 1 and 2, NO, tPA, and HCAR1 in cerebral vessels causes increased blood flow and angiogenesis in the cerebellum, motor cortex, striatum, and hippocampus. In the hippocampus, exercise training decreases mitochondrial fragmentation, DRP1, and FIS1, improving OPA1, MFN1, MFN2, and mitochondrial morphology. In humans, acute exercise as an anti-inflammatory condition causes an acute increase in IL-6 and an increase in anti-inflammatory factors such as IL-1RA and IL-10. Moderate-intensity exercise also inhibits inflammatory markers such as IFN-γ, IL-1β, IL-6, CRP, TNF-α, sTNFR1, COX-2, and NF-κB. Aerobic exercise significantly increases plasma levels of BDNF, nerve growth factor, synaptic plasticity, motor activity, spatial memory, and exploratory behavior in AD subjects. Irisin is a myokine released from skeletal muscle during exercise and protects the hippocampus by suppressing Aβ accumulation and promoting hippocampal proliferation through STAT3 signaling. Therefore, combined exercise training such as aerobic training, strength training, balance and coordination training, and cognitive and social activities seems to provide important benefits for people with AD.
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de Dios-Rodríguez E, Patino-Alonso C, González-Sánchez S, Tamayo-Morales O, Ripoll J, Mora-Simón S, Unzueta-Arce J, Gómez-Marcos MA, García-Ortiz L, Rodríguez-Sánchez E. Promoting Physical Activity in a Primary Care Practice in People Living with Dementia and Their Family Caregivers. Healthcare (Basel) 2023; 11:healthcare11091255. [PMID: 37174797 PMCID: PMC10178700 DOI: 10.3390/healthcare11091255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG's activity increased by 52.89 aerobic steps at 6 months and the CG's activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: -444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: -659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.
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Affiliation(s)
- Elena de Dios-Rodríguez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Carmen Patino-Alonso
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Estadística, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Susana González-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Olaya Tamayo-Morales
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Joana Ripoll
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Carrer de l'Escola Graduada, 3, 07002 Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Carrer de l'Escola Graduada, 3, 07002 Palma, Spain
| | - Sara Mora-Simón
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Jaime Unzueta-Arce
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Estadística, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
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Alzheimer's Disease-Biochemical and Psychological Background for Diagnosis and Treatment. Int J Mol Sci 2023; 24:ijms24021059. [PMID: 36674580 PMCID: PMC9866942 DOI: 10.3390/ijms24021059] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
There is a paucity of empirical research on the use of non-pharmacological interventions to both treat and curb the spread of Alzheimer's disease (AD) across the globe. This paper examines the biochemical and clinical outlook and the social implications of the condition in relation to psychological aspects that may indicate a direction for further interventions. There is a scarcity of research on the effectiveness of using various psychological aspects of AD, a disease characterized by a process of transition from health and independence to a dependent state with a progressive loss of memory and functional skills. The paper investigates the biochemical and psychological aspects of AD and their significance for improving quality of life for patients with this disease. Psychological interventions based on, among other factors, biochemical studies, are conducted to improve the emotional wellbeing of AD patients and may assist in slowing down the progression of the disease. To date, however, no effective methods of AD treatment have been established.
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Nora CD, de Lima JD, Teixeira IA, Silva FDO, de Almeida JS, Monteiro FC, Marinho V, Dourado MCN, Deslandes AC. Online physical exercise and the neuropsychiatric symptoms in patients with dementia: a cross-sectional study during the COVID-19 pandemic. Dement Neuropsychol 2022; 16:253-260. [PMID: 36619833 PMCID: PMC9762384 DOI: 10.1590/1980-5764-dn-2021-0079] [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: 08/25/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 01/11/2023] Open
Abstract
Social isolation is necessary during the COVID-19 pandemic but can be harmful to mental health, especially in people with neurocognitive disorders. Although physical exercise can alleviate neuropsychiatric symptoms and improve quality of life (QoL), sedentary behavior increased during the pandemic. Online interventions can contribute to improving physical activity and mental health. Objective The objective of this study was to compare the neuropsychiatric symptoms and QoL of older adults with neurocognitive disorders who participated in an online physical exercise program with sedentary patients during the COVID-19 pandemic. Methods In this cross-sectional study, 25 older patients with neurocognitive disorders (control group=11; online exercise group=14) were evaluated based on Neuropsychiatric Inventory (NPI) and the Quality of Life in Alzheimer's Disease (QoL-AD) scale. Results There were differences between the two groups in the total NPI (U=36.50, p=0.025) and the nighttime behavior disturbances item (U=38.00, p=0.033), both with large effect sizes (ES=-1.03, 95% confidence interval [CI]:-1.83 to -0.16 and ES=-1.06, 95%CI -1.86 to -0.19, respectively). In terms of QoL-AD, a difference was identified only in the memory subitem (U=20.00, p=0.005), with a large ES (1.59, 95%CI 0.59-2.48). Conclusions Older adults with neurocognitive disorders who participated in an online physical exercise program, during the COVID-19 pandemic, showed fewer neuropsychiatric total symptoms, fewer nighttime disturbances episodes, and better subjective memory, compared to their physically inactive counterparts. Randomized controlled trials should be performed to better understand the effect of physical exercise in neuropsychiatric symptoms in dementia patients during periods of social isolation.
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Affiliation(s)
- Caroline Dalla Nora
- Universidade Federal do Rio de Janeiro, Instituto de
Psiquiatria, Rio de Janeiro RJ, Brazil
| | - Juliana Dias de Lima
- Universidade Federal do Rio de Janeiro, Instituto de
Psiquiatria, Rio de Janeiro RJ, Brazil
| | - Ivan Abdalla Teixeira
- Universidade Federal do Rio de Janeiro, Instituto de
Psiquiatria, Rio de Janeiro RJ, Brazil
| | | | - Júlia Silva de Almeida
- Universidade Federal do Rio de Janeiro, Instituto de
Psiquiatria, Rio de Janeiro RJ, Brazil
| | | | - Valeska Marinho
- Universidade Federal do Rio de Janeiro, Instituto de
Psiquiatria, Rio de Janeiro RJ, Brazil
| | | | - Andrea Camaz Deslandes
- Universidade Federal do Rio de Janeiro, Instituto de
Psiquiatria, Rio de Janeiro RJ, Brazil
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Dimitriou T, Papatriantafyllou J, Konsta A, Kazis D, Athanasiadis L, Ioannidis P, Koutsouraki E, Tegos T, Tsolaki M. Non-Pharmacological Interventions for Wandering/Aberrant Motor Behaviour in Patients with Dementia. Brain Sci 2022; 12:brainsci12020130. [PMID: 35203894 PMCID: PMC8869749 DOI: 10.3390/brainsci12020130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Aberrant motor behaviour or wandering refers to aimless movement without a specific purpose. Wandering is common in patients with dementia and leads to early institutionalization and caregivers’ burden. Non-pharmacological interventions should be also considered as a first-line solution for the wandering because current pharmacological treatment has serious side-effects. Methods: A cross-over randomised controlled trial (RCT) with 60 participants of all stages and different types of dementia was conducted in Greece. The sample was randomly assigned in 6 different groups of 10 participants each. Every intervention lasted for 5 days, and there were 2 days as a wash-out period. There was no drop-out rate. The measurements used were the Mini Mental State Examination (MMSE), Addenbrooke’s Cognitive Examination Revised (ACE-R), Geriatric Depression Scale (GDS), Functional Rating Scale for Symptoms in Dementia (FRSSD), and Neuropsychiatric Inventory (NPI). The interventions that were evaluated were reminiscence therapy (RT), music therapy (MT), and physical exercise (PE). Results: NPI scores were reduced in the group receiving PE (p = 0.006). When MT (p = 0.018) follows PE, wandering symptoms are reduced further. RT should follow MT in order to reduce wandering more (p = 0.034). The same combination was effective for the caregivers’ burden as well; PE (p = 0.004), MT (p = 0.036), RT (p = 0.039). Conclusions: An effective combination that can reduce wandering symptoms in all stages and types of dementia was found: The best order was PH-MT-RT. The same combination in the same order reduced caregivers’ burden.
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Affiliation(s)
- Tatiana Dimitriou
- 1st Department of Neurology, Aristotle University of Thessaloniki, 44 Salaminos Street, Halandri, 15232 Athens, Greece
- Correspondence: ; Tel.: +30-6978-113357
| | - John Papatriantafyllou
- 3rd Age Center IASIS, 2nd Neurology Department, University of Athens, ‘Attikon’ Hospital, 73 Krimeas str., Glyfada, 16562 Athens, Greece;
| | - Anastasia Konsta
- 1st Department of Psychiatry, “Papageorgiou” General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (L.A.)
| | - Dimitrios Kazis
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
| | - Loukas Athanasiadis
- 1st Department of Psychiatry, “Papageorgiou” General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (L.A.)
| | - Panagiotis Ioannidis
- 2nd Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Efrosini Koutsouraki
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
| | - Thomas Tegos
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
| | - Magda Tsolaki
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
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Li YQ, Yin ZH, Zhang XY, Chen ZH, Xia MZ, Ji LX, Liang FR. Non-pharmacological interventions for behavioral and psychological symptoms of dementia: A systematic review and network meta-analysis protocol. Front Psychiatry 2022; 13:1039752. [PMID: 36523873 PMCID: PMC9744934 DOI: 10.3389/fpsyt.2022.1039752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/14/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Dementia patients often experience behavioral and psychological symptoms (BPSD), which severely affect their quality of life and activities of daily living. Non-pharmacological interventions are effective in treating BPSD, according to multiple clinical trials and systematic reviews. However, the optimal non-pharmacological treatment remains controversial. Therefore, the study aims to evaluate and compare multiple non-pharmacological methods for treating BPSD in order to identify the optimal non-pharmacological intervention. OBJECTIVE This study aims to perform a systematic review and network meta-analysis of evidence on non-pharmacological interventions in the treatment of BPSD, which may potentially guide future research and clinical decisions. METHODS In order to select potentially relevant randomized controlled trials (RCTs), 10 academic databases and 3 clinical trial registries will be systematically searched from inception until the 1 October 2022. Two researchers will independently extract information from eligible articles. The primary outcome is the severity of BPSD. Herein, Pairwise and Bayesian network meta-analyses will be conducted utilizing STATA 15.0 and ADDIS 1.16.8. Evidence quality will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS Results from this study will be published in peer-reviewed journals or conference reports. DISCUSSION In this study, we aim to comparatively assess the efficacy of various non-pharmacological treatments for BPSD. Findings from this review will help clinicians to make evidence-based treatment decisions. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022352095].
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Affiliation(s)
- Ya-Qin Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zi-Han Yin
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xin-Yue Zhang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zheng-Hong Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Man-Ze Xia
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lai-Xi Ji
- The 3rd Teaching Hospital, Shanxi University of Chinese Medicine, Jinzhong, China
| | - Fan-Rong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Fossati C, Torre G, Vasta S, Giombini A, Quaranta F, Papalia R, Pigozzi F. Physical Exercise and Mental Health: The Routes of a Reciprocal Relation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312364. [PMID: 34886090 PMCID: PMC8656946 DOI: 10.3390/ijerph182312364] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 01/18/2023]
Abstract
Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field.
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Affiliation(s)
- Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Guglielmo Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
- Correspondence:
| | - Sebastiano Vasta
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Arrigo Giombini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Federico Quaranta
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
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Zhou T, Qu J, Sun H, Xue M, Shen Y, Liu Y. Research Trends and Hotspots on Montessori Intervention in Patients With Dementia From 2000 to 2021: A Bibliometric Analysis. Front Psychiatry 2021; 12:737270. [PMID: 34566730 PMCID: PMC8458692 DOI: 10.3389/fpsyt.2021.737270] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with dementia experience a variety of neuropsychiatric symptoms and behavioral disturbances. The Montessori method is a type of non-pharmacological intervention to care for people with dementia. However, there are few bibliometric studies on the application of Montessori methods. We aimed to analyze the hotspots and trends of research on the application of Montessori methods to the care of dementia patients. Methods: Microsoft Office Excel, Co-Occurrence 9.9, and CiteSpace were used to analyze the articles on Montessori intervention in patients with dementia from 2000 to 2021 in China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, Web of Science core collection database, PubMed, and Scopus. Results: A total of 23 Chinese language publications and 113 English language publications were included. The number of English language publications was on the rise, while the number of Chinese language publications was low. There are many issuing institutions which published articles in this field, mostly concentrated in universities. English language publication sources were more than Chinese language publication sources. The hot research topic in Chinese language publications and English language publications was the care of agitated behavior of dementia patients based on the Montessori method. The psychological problems of dementia patients are likely to become a hot issue of concern for scholars in Chinese. There will be a lot of research focusing on dementia patients and their family caregivers in this field. Conclusion: The bibliometric and visualization analysis helps us understand the current research status and hotspots of Montessori intervention in dementia patients in Chinese language publications and English language publications.
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Affiliation(s)
- Ting Zhou
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Jiling Qu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Huiping Sun
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Mengxin Xue
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Yijing Shen
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Yongbing Liu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
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