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Lui E, Venkatraman VK, Finch S, Chua M, Li TQ, Sutton BP, Steward CE, Moffat B, Cyarto EV, Ellis KA, Rowe CC, Masters CL, Lautenschlager NT, Desmond PM. 3T sodium-MRI as predictor of neurocognition in nondemented older adults: a cross sectional study. Brain Commun 2024; 6:fcae307. [PMID: 39318783 PMCID: PMC11420980 DOI: 10.1093/braincomms/fcae307] [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: 12/05/2023] [Revised: 06/13/2024] [Accepted: 09/10/2024] [Indexed: 09/26/2024] Open
Abstract
Dementia is a burgeoning global problem. Novel magnetic resonance imaging (MRI) metrics beyond volumetry may bring new insight and aid clinical trial evaluation of interventions early in the Alzheimer's disease course to complement existing imaging and clinical metrics. To determine whether: (i) normalized regional sodium-MRI values (Na-SI) are better predictors of neurocognitive status than volumetry (ii) cerebral amyloid PET status improves modelling. Nondemented older adult (>60 years) volunteers of known Alzheimer's Disease Assessment Scale (ADAS-Cog11), Mini-Mental State Examination (MMSE) and Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neurocognitive test scores, ApolipoproteinE (APOE) e4 +/- cerebral amyloid PET status were prospectively recruited for 3T sodium-MRI brain scans. Left and right hippocampal, entorhinal and precuneus volumes and Na-SI (using the proportional intensity scaling normalization method with field inhomogeneity and partial volume corrections) were obtained after segmentation and co-registration of 3D-T1-weighted proton images. Descriptive statistics, correlation and best-subset regression analyses were performed. In our 76 nondemented participants (mean(standard deviation) age 75(5) years; woman 47(62%); cognitively unimpaired 54/76(71%), mildly cognitively impaired 22/76(29%)), left hippocampal Na-SI, not volume, was preferentially in the best models for predicting MMSE (Odds Ratio (OR) = 0.19(Confidence Interval (CI) = 0.07,0.53), P-value = 0.001) and ADAS-Cog11 (Beta(B) = 1.2(CI = 0.28,2.1), P-value = 0.01) scores. In the entorhinal analysis, right entorhinal Na-SI, not volume, was preferentially selected in the best model for predicting ADAS-Cog11 (B = 0.94(CI = 0.11,1.8), P-value = 0.03). While right entorhinal Na-SI and volume were both selected for MMSE modelling (Na-SI OR = 0.23(CI = 0.09,0.6), P-value = 0.003; volume OR = 2.6(CI = 1.0,6.6), P-value = 0.04), independently, Na-SI explained more of the variance (Na-SI R 2 = 10.3; volume R 2 = 7.5). No imaging variable was selected in the best CERAD models. Adding cerebral amyloid status improved model fit (Akaike Information Criterion increased 2.0 for all models, P-value < 0.001-0.045). Regional Na-SI were more predictive of MMSE and ADAS-Cog11 scores in our nondemented older adult cohort than volume, hippocampal more robust than entorhinal region of interest. Positive amyloid status slightly further improved model fit.
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Affiliation(s)
- Elaine Lui
- Department of Radiology, The University of Melbourne, Parkville, 3050 Victoria, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, 3050 Victoria, Australia
| | - Vijay K Venkatraman
- Department of Radiology, The University of Melbourne, Parkville, 3050 Victoria, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, 3050 Victoria, Australia
| | - Sue Finch
- Statistical Consulting Centre, University of Melbourne, Parkville, 3010 Victoria, Australia
| | - Michelle Chua
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, 3050 Victoria, Australia
| | - Tie-Qiang Li
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Bradley P Sutton
- Beckman Institute for Advance Science and Technology, University of Illinois at Urbana Champaign, Champaign, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Christopher E Steward
- Department of Radiology, The University of Melbourne, Parkville, 3050 Victoria, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, 3050 Victoria, Australia
| | - Bradford Moffat
- Department of Radiology, The University of Melbourne, Parkville, 3050 Victoria, Australia
| | - Elizabeth V Cyarto
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, 3010 Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, 3010 Victoria, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, 3084 Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, 3052 Victoria, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, 3052 Victoria, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, 3010 Victoria, Australia
- Royal Melbourne Hospital Mental Health Service, Royal Melbourne Hospital, Parkville, Melbourne, 3052 Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, The University of Melbourne, Parkville, 3050 Victoria, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, 3050 Victoria, Australia
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Hotz I, Mildner S, Stampfer-Kountchev M, Slamik B, Blättner C, Türtscher E, Kübler F, Höfer C, Panzl J, Rücker M, Brenneis C, Seebacher B. Robot-assisted gait training in patients with various neurological diseases: A mixed methods feasibility study. PLoS One 2024; 19:e0307434. [PMID: 39190743 DOI: 10.1371/journal.pone.0307434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 07/01/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Walking impairment represents a relevant symptom in patients with neurological diseases often compromising social participation. Currently, mixed methods studies on robot-assisted gait training (RAGT) in patients with rare neurological diseases are lacking. This study aimed to explore the feasibility, acceptability, goal attainment and preliminary effects of RAGT in patients with common and rare neurological diseases and understand the intervention context and process. METHODS A mixed-methods feasibility study was conducted at an Austrian rehabilitation centre. Twenty-eight inpatients after stroke in the subacute and chronic phases, with multiple sclerosis, Parkinson's disease, spinal cord injury, spinocerebellar ataxia, acute/chronic inflammatory demyelinating polyneuropathy and motor neuron disease were included. Patients received RAGT for 45 minutes, 4x/week, for 4 weeks. Baseline and post-intervention assessments included gait parameters, walking and balance, and questionnaires. Semi-structured observations were conducted twice during the intervention period and analysed using thematic analysis. Descriptive statistics within the respective disease groups and calculation of effect sizes for the total sample were performed. Triangulation was employed to develop a deeper understanding of the research topic. RESULTS Data from 26 patients (mean age 61.6 years [standard deviation 13.2]) were analysed. RAGT was highly accepted by patients and feasible, indicated by recruitment, retention, and adherence rates of 84.8% (95% confidence interval, CI 0.7-0.9), 92.2% (95% CI 0.7-1.0) and 94.0% (95% CI 91.4-96.2), respectively. Goal attainment was high, and only mild adverse events occurred. Improvements in walking speed (10-Metre Walk Test, effect size r = 0.876), walking distance (6-Minute Walk Test, r = 0.877), functional mobility (Timed Up and Go, r = 0.875), gait distance (r = 0.829) and number of steps (r = 0.834) were observed. Four themes were identified: familiarising with RAGT; enjoyment and acceptance through a trusting therapeutic relationship; actively interacting; and minimising dissatisfaction. DISCUSSION Sufficiently powered randomised controlled trials are needed to validate our results. TRIAL REGISTRATION German Clinical Trials Register, DRKS00027887.
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Affiliation(s)
- Isabella Hotz
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Sarah Mildner
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | | | - Bianca Slamik
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Christoph Blättner
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Elisabeth Türtscher
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Franziska Kübler
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Clemens Höfer
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Johanna Panzl
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Michael Rücker
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Christian Brenneis
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institute of Interdisciplinary Rehabilitation Research, Münster, Austria
| | - Barbara Seebacher
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institute of Interdisciplinary Rehabilitation Research, Münster, Austria
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Hu J, Huang B, Chen K. The impact of physical exercise on neuroinflammation mechanism in Alzheimer's disease. Front Aging Neurosci 2024; 16:1444716. [PMID: 39233828 PMCID: PMC11371602 DOI: 10.3389/fnagi.2024.1444716] [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: 06/21/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Introduction Alzheimer's disease (AD), a major cause of dementia globally, imposes significant societal and personal costs. This review explores the efficacy of physical exercise as a non-pharmacological intervention to mitigate the impacts of AD. Methods This review draws on recent studies that investigate the effects of physical exercise on neuroinflammation and neuronal enhancement in individuals with AD. Results Consistent physical exercise alters neuroinflammatory pathways, enhances cognitive functions, and bolsters brain health among AD patients. It favorably influences the activation states of microglia and astrocytes, fortifies the integrity of the blood-brain barrier, and attenuates gut inflammation associated with AD. These changes are associated with substantial improvements in cognitive performance and brain health indicators. Discussion The findings underscore the potential of integrating physical exercise into comprehensive AD management strategies. Emphasizing the necessity for further research, this review advocates for the refinement of exercise regimens to maximize their enduring benefits in decelerating the progression of AD.
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Affiliation(s)
- Junhui Hu
- School of Physical Education, West Anhui University, Lu'an, China
| | - Baiqing Huang
- School of Physical Education, Yunnan Minzu University, Kunming, China
| | - Kang Chen
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin, China
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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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Petrosyan H, Leonardi C, Thakral A, Roth J, Russoniello N, Goldin Y, Parikh S. Barriers and factors associated with adherence to a home exercise program of adults with musculoskeletal pain. J Back Musculoskelet Rehabil 2024; 37:473-485. [PMID: 38108342 DOI: 10.3233/bmr-230178] [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] [Indexed: 12/19/2023]
Abstract
BACKGROUND Home exercise programs (HEPs) are cost-effective and efficacious treatments for musculoskeletal pain conditions. Although HEPs are an important part of the continuum of care, non-adherence limits their effectiveness. OBJECTIVE The objective of this study was to examine adherence and specific barriers to clinician-prescribed HEPs in adults with musculoskeletal pain. METHODS A cross-sectional study was conducted with a total of 300 patients presenting to an outpatient pain clinic in an academic medical center. Participants' self-reported information, including HEP completion frequency and barriers, was collected through a survey. RESULTS The participants' mean age was 54.1 ± 15.8 years (females = 133 (65.5%)). Of 203 participants, 99 (48.8%) adhered to HEP, 56 (27.6%) partially adhered, and 48 (23.6%) did not adhere. One hundred eighty-seven (92.1%) participants reported receiving adequate instructions, and 175 (86.2%) reported receiving instructional materials. Age and "sufficient instructions" were found to be significant determinants of adherence (p< 0.05), while gender and handouts were not (p> 0.05). Pain in more than one body part was significantly (p< 0.05) associated with motivational barriers for non-adherence. CONCLUSION Age and participants' perception of sufficient instructions were significant factors for non-adherence. These results emphasize the importance of therapist-provided instructions to overcome barriers to adherence.
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Affiliation(s)
- Hayk Petrosyan
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Christopher Leonardi
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Aakash Thakral
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Jason Roth
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Nicholas Russoniello
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Yelena Goldin
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Sagar Parikh
- International Spine Pain and Performance Center, Washington, DC, USA
- Center for Interventional Pain and Spine, Wilmington, DE, USA
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Andrade-Guerrero J, Rodríguez-Arellano P, Barron-Leon N, Orta-Salazar E, Ledesma-Alonso C, Díaz-Cintra S, Soto-Rojas LO. Advancing Alzheimer's Therapeutics: Exploring the Impact of Physical Exercise in Animal Models and Patients. Cells 2023; 12:2531. [PMID: 37947609 PMCID: PMC10648553 DOI: 10.3390/cells12212531] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
Alzheimer's disease (AD) is the main neurodegenerative disorder characterized by several pathophysiological features, including the misfolding of the tau protein and the amyloid beta (Aβ) peptide, neuroinflammation, oxidative stress, synaptic dysfunction, metabolic alterations, and cognitive impairment. These mechanisms collectively contribute to neurodegeneration, necessitating the exploration of therapeutic approaches with multiple targets. Physical exercise has emerged as a promising non-pharmacological intervention for AD, with demonstrated effects on promoting neurogenesis, activating neurotrophic factors, reducing Aβ aggregates, minimizing the formation of neurofibrillary tangles (NFTs), dampening inflammatory processes, mitigating oxidative stress, and improving the functionality of the neurovascular unit (NVU). Overall, the neuroprotective effects of exercise are not singular, but are multi-targets. Numerous studies have investigated physical exercise's potential in both AD patients and animal models, employing various exercise protocols to elucidate the underlying neurobiological mechanisms and effects. The objective of this review is to analyze the neurological therapeutic effects of these exercise protocols in animal models and compare them with studies conducted in AD patients. By translating findings from different approaches, this review aims to identify opportune, specific, and personalized therapeutic windows, thus advancing research on the use of physical exercise with AD patients.
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Affiliation(s)
- Jesús Andrade-Guerrero
- Laboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico;
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Paola Rodríguez-Arellano
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Nayeli Barron-Leon
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Erika Orta-Salazar
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Carlos Ledesma-Alonso
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Sofía Díaz-Cintra
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Luis O. Soto-Rojas
- Laboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico;
- Red MEDICI, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico
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David S, Hohenfeld C, Haberl L, Pahl J, Costa AS, Kilders A, Hildebrand F, Schulz JB, Reetz K, Haeger A. Physical activity monitoring in Alzheimer's disease during sport interventions: a multi-methodological perspective. Front Neurol 2023; 14:1195694. [PMID: 37808485 PMCID: PMC10557074 DOI: 10.3389/fneur.2023.1195694] [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: 03/28/2023] [Accepted: 08/23/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Assessment methods for physical activity and fitness are of upmost importance due to the possible beneficial effect of physical conditioning on neurodegenerative diseases. The implementation of these methods can be challenging when examining elderly or cognitively impaired participants. In the presented study, we compared three different assessment methods for physical activity from the Dementia-MOVE trial, a 6-months intervention study on physical activity in Alzheimer's disease. The aim was to determine the comparability of physical activity assessments in elderly participants with cognitive impairment due to Alzheimer's disease. Material or methods 38 participants (mean age 70 ± 7 years) with early-stage Alzheimer's disease (mean MoCA 18.84 ± 4.87) were assessed with (1) fitness trackers for an average of 12 (± 6) days, (2) a written diary on daily activities and (3) a questionnaire on physical activity at three intervention timepoints. For comparison purposes, we present a transformation and harmonization method of the physical assessment output parameters: Metabolic equivalent of task (MET) scores, activity intensity minutes, calorie expenditure and moderate-to-vigorous physical activity (MVPA) scores were derived from all three modalities. The resulting parameters were compared for absolute differences, correlation, and their influence by possible mediating factors such as cognitive state and markers from cerebrospinal fluid. Results Participants showed high acceptance and compliance to all three assessment methods. MET scores and MVPA from fitness trackers and diaries showed high overlap, whilst results from the questionnaire suggest that participants tended to overestimate their physical activity in the long-term retrospective assessment. All activity parameters were independent of the tested Alzheimer's disease parameters, showing that not only fitness trackers, but also diaries can be successfully applied for physical activity assessment in a sample affected by early-stage Alzheimer's disease. Discussion Our results show that fitness trackers and physical activity diaries have the highest robustness, leading to a highly comparable estimation of physical activity in people with Alzheimer's disease. As assessed parameters, it is recommendable to focus on MET, MVPA and on accelerometric sensor data such as step count, and less on activity calories and different activity intensities which are dependent on different variables and point to a lower reliability.
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Affiliation(s)
- Shari David
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Christian Hohenfeld
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-11), Forschungszentrum Jülich GmbH, Jülich, Germany
- JARA-BRAIN Institute, Jülich, Germany
| | - Luisa Haberl
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Jennifer Pahl
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Ana S. Costa
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-11), Forschungszentrum Jülich GmbH, Jülich, Germany
- JARA-BRAIN Institute, Jülich, Germany
| | - Axel Kilders
- Department of Physiotherapy, RWTH Aachen University, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH Aachen University, Aachen, Germany
| | - Jörg B. Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-11), Forschungszentrum Jülich GmbH, Jülich, Germany
- JARA-BRAIN Institute, Jülich, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-11), Forschungszentrum Jülich GmbH, Jülich, Germany
- JARA-BRAIN Institute, Jülich, Germany
| | - Alexa Haeger
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-11), Forschungszentrum Jülich GmbH, Jülich, Germany
- JARA-BRAIN Institute, Jülich, Germany
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Tobe S, Ishiyama H, Nishiyama A, Miyazono K, Kimura H, Fueki K. Effects of Jaw-Opening Exercises with/without Pain for Temporomandibular Disorders: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16840. [PMID: 36554726 PMCID: PMC9779752 DOI: 10.3390/ijerph192416840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to evaluate the effects of jaw-opening exercises with and without pain on temporomandibular disorders (TMDs), specifically in relation to pain intensity and range-of-mouth opening in patients with TMDs. Participants were randomly assigned to either the jaw-opening exercise with pain (JE w/pain) or the jaw-opening exercise without pain (JE w/o pain) groups, and each exercise was performed for eight weeks. TMDs pain intensity was assessed using a 100-mm visual analog scale (VAS), and the range-of-mouth opening was evaluated at the baseline (T0), 2 weeks (T1), 4 weeks (T2), and 8 weeks (T3). Of the 61 participants, 57 (JE w/pain group, n = 30; JE w/o pain group, n = 27) were included in the analysis. The range-of-mouth opening and TMDs pain intensity improved from T1 to T3 in both groups. The JE w/pain group showed significant differences at T3 compared to T1 (pain-free unassisted mouth opening, p = 0.006; jaw-opening pain, p = 0.014; chewing pain, p = 0.018). In addition, the JE w/pain group showed significantly greater changes in the maximum unassisted mouth opening at T2 and T3 than the JE w/o pain group (T2, p < 0.001; T3, p = 0.003). Thus, jaw-opening exercises, until the occurrence of pain, may be effective in patients with TMDs.
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Affiliation(s)
- Shoko Tobe
- Department of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Hiroyuki Ishiyama
- Department of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Akira Nishiyama
- Department of General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Keisuke Miyazono
- Department of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Hiroko Kimura
- Department of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Kenji Fueki
- Department of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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Coley N, Giulioli C, Aisen PS, Vellas B, Andrieu S. Randomised controlled trials for the prevention of cognitive decline or dementia: A systematic review. Ageing Res Rev 2022; 82:101777. [PMID: 36336171 DOI: 10.1016/j.arr.2022.101777] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/02/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Dementia prevention research has progressed rapidly in recent years, with publication of several large lifestyle intervention trials, and renewed interest in pharmacological interventions, notably for individuals with Alzheimer's disease biomarkers, warranting an updated review of results and methodology. We identified 112 completed trials testing the efficacy of single-domain pharmacological (n = 33, 29%), nutritional (n = 27, 24%), physical activity (n = 18, 16%) and cognitive stimulation (n = 13, 12%), or multidomain (n = 22, 20%) interventions on incident dementia, or a relevant intermediate marker (e.g. cognitive function, biomarkers or dementia risk scores) in people without dementia. The earliest trials tested pharmacological interventions or nutritional supplements, but lifestyle interventions predominated in the last decade. In total, 21 (19%) trials demonstrated a clear beneficial effect on the pre-specified primary outcome (or all co-primary outcomes), but only two (10%) were large-scale (testing blood pressure lowering (Syst-Eur) or multidomain (FINGER) interventions on incident dementia and cognitive change in cognitive function, respectively). Of the 116 ongoing trials, 40% (n = 46) are testing multidomain interventions. Recent methodological shifts concern target populations, primary outcome measures, and intervention design, but study design remains constant (parallel group randomised controlled trial). Future trials may consider using adaptive trials or interventions, and more targeted approaches, since certain interventions may be more effective in certain subgroups of the population, and at specific times in the life-course. Efforts should also be made to increase the representativeness and diversity of prevention trial populations.
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Affiliation(s)
- Nicola Coley
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France.
| | - Caroline Giulioli
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Bruno Vellas
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital, France
| | - Sandrine Andrieu
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
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10
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Newton RL, Beyl R, Hebert C, Harris M, Carter L, Gahan W, Carmichael O. A Physical Activity Intervention in Older African Americans: The PAACE Pilot Randomized Controlled Trial. Med Sci Sports Exerc 2022; 54:1625-1634. [PMID: 35522253 PMCID: PMC9488750 DOI: 10.1249/mss.0000000000002956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Older African Americans have low levels of physical activity, which increases the risk of aging-related health conditions. This study aimed to determine the effectiveness of, and satisfaction with, a community-engaged physical activity intervention targeting older African Americans. METHODS Fifty-six older African Americans were randomized to a successful aging group (SAG) or a physical activity group (PAG) for 12 wk. The PAG consisted of two weekly group exercise sessions and two to three home-based exercise sessions per week. The SAG consisted of weekly group educational sessions related to various aspects of healthy aging. Physical activity was measured by ActiGraph accelerometers and the Community Healthy Activities Model Program for Seniors Activities Questionnaire in both groups, and a Fitbit was continuously worn by PAG participants. RESULTS Group session attendance was 93% and 86% in the PAG and SAG, respectively. The increase in ActiGraph-derived steps per day (1085.3 ± 265.6 vs 34.7 ± 274.3; P = 0.008) and daily minutes of moderate-to-vigorous physical activity (MVPA; 6.2 ± 1.6 vs 0.3 ± 1.7; d = 0.68; P = 0.01), and self-reported Community Healthy Activities Model Program for Seniors Activities Questionnaire MVPA bouts (3.5 ± 0.77 vs 0.33 ± 0.79; P < 0.001) were significantly greater within the PAG than the SAG. ActiGraph-derived minutes of daily MVPA and steps as well as Fitbit-derived steps per day were significantly greater on days when PAG participants engaged in group sessions compared with days when they self-reported home-based exercise or no exercise ( P < 0.016). Participants in both study arms reported high levels of satisfaction (>4- on 5-point Likert scale). CONCLUSIONS The intervention increased physical activity, was well attended, and resulted in high satisfaction. Future studies should assess long-term sustainability in this population.
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11
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Ribarič S. Physical Exercise, a Potential Non-Pharmacological Intervention for Attenuating Neuroinflammation and Cognitive Decline in Alzheimer's Disease Patients. Int J Mol Sci 2022; 23:ijms23063245. [PMID: 35328666 PMCID: PMC8952567 DOI: 10.3390/ijms23063245] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
This narrative review summarises the evidence for considering physical exercise (PE) as a non-pharmacological intervention for delaying cognitive decline in patients with Alzheimer’s disease (AD) not only by improving cardiovascular fitness but also by attenuating neuroinflammation. Ageing is the most important risk factor for AD. A hallmark of the ageing process is a systemic low-grade chronic inflammation that also contributes to neuroinflammation. Neuroinflammation is associated with AD, Parkinson’s disease, late-onset epilepsy, amyotrophic lateral sclerosis and anxiety disorders. Pharmacological treatment of AD is currently limited to mitigating the symptoms and attenuating progression of the disease. AD animal model studies and human studies on patients with a clinical diagnosis of different stages of AD have concluded that PE attenuates cognitive decline not only by improving cardiovascular fitness but possibly also by attenuating neuroinflammation. Therefore, low-grade chronic inflammation and neuroinflammation should be considered potential modifiable risk factors for AD that can be attenuated by PE. This opens the possibility for personalised attenuation of neuroinflammation that could also have important health benefits for patients with other inflammation associated brain disorders (i.e., Parkinson’s disease, late-onset epilepsy, amyotrophic lateral sclerosis and anxiety disorders). In summary, life-long, regular, structured PE should be considered as a supplemental intervention for attenuating the progression of AD in human. Further studies in human are necessary to develop optimal, personalised protocols, adapted to the progression of AD and the individual’s mental and physical limitations, to take full advantage of the beneficial effects of PE that include improved cardiovascular fitness, attenuated systemic inflammation and neuroinflammation, stimulated brain Aβ peptides brain catabolism and brain clearance.
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Affiliation(s)
- Samo Ribarič
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
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12
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Sexton CE, Anstey KJ, Baldacci F, Barnum CJ, Barron AM, Blennow K, Brodaty H, Burnham S, Elahi FM, Götz J, Jeon YH, Koronyo-Hamaoui M, Landau SM, Lautenschlager NT, Laws SM, Lipnicki DM, Lu H, Masters CL, Moyle W, Nakamura A, Pasinetti GM, Rao N, Rowe C, Sachdev PS, Schofield PR, Sigurdsson EM, Smith K, Srikanth V, Szoeke C, Tansey MG, Whitmer R, Wilcock D, Wong TY, Bain LJ, Carrillo MC. Alzheimer's disease research progress in Australia: The Alzheimer's Association International Conference Satellite Symposium in Sydney. Alzheimers Dement 2022; 18:178-190. [PMID: 34058063 PMCID: PMC9396711 DOI: 10.1002/alz.12380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/03/2023]
Abstract
The Alzheimer's Association International Conference held its sixth Satellite Symposium in Sydney, Australia in 2019, highlighting the leadership of Australian researchers in advancing the understanding of and treatment developments for Alzheimer's disease (AD) and other dementias. This leadership includes the Australian Imaging, Biomarker, and Lifestyle Flagship Study of Ageing (AIBL), which has fueled the identification and development of many biomarkers and novel therapeutics. Two multimodal lifestyle intervention studies have been launched in Australia; and Australian researchers have played leadership roles in other global studies in diverse populations. Australian researchers have also played an instrumental role in efforts to understand mechanisms underlying vascular contributions to cognitive impairment and dementia; and through the Women's Healthy Aging Project have elucidated hormonal and other factors that contribute to the increased risk of AD in women. Alleviating the behavioral and psychological symptoms of dementia has also been a strong research and clinical focus in Australia.
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Affiliation(s)
| | - Kaarin J. Anstey
- University of New South Wales and Neuroscience Research, Sydney, NSW, Australia
| | - Filippo Baldacci
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | | | - Anna M. Barron
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Samantha Burnham
- CSIRO Health & Biosecurity, The Australian e-Health Research Centre, Parkville, VIC, Australia
| | - Fanny M. Elahi
- Memory and Aging Center, Weill Institute for NeurosciencesUniversity of California San Francisco, San Francisco, California, USA
| | - Jürgen Götz
- Clem Jones Centre for Ageing Dementia Research (CJCADR), Queensland Brain Institute (QBI), The University of Queensland, St Lucia Campus (Brisbane), Brisbane, QLD, Australia
| | - Yun-Hee Jeon
- The University of Sydney, Sydney, NSW, Australia
| | - Maya Koronyo-Hamaoui
- Departments of Neurosurgery and Biomedical Sciences, Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Susan M. Landau
- University of California Berkeley, Berkeley, California, USA
| | - Nicola T. Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- North Western Mental Health, Royal Melbourne Hospital, Melbourne, Australia
| | - Simon M. Laws
- Collaborative Genomics and Translation Group, Edith Cowan University, Joondalup, WA, Australia
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Griffith, QLD, Australia
| | - Akinori Nakamura
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Giulio Maria Pasinetti
- Department of Neurology, Icahn School of Medicine at Mount Sinai (ISSMS), New York, New York, USA
| | - Naren Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Christopher Rowe
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Department of Molecular Imaging, Austin Health, Melbourne, VIC, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney and School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - Einar M. Sigurdsson
- Departments of Neuroscience and Physiology, and Psychiatry, Neuroscience Institute, New York University Grossman School of Medicine, New York, New York, USA
| | - Kate Smith
- Centre for Aboriginal Medical and Dental Health, University of Western Australia, Crawley, WA, Australia
| | - Velandai Srikanth
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | | | - Malú G. Tansey
- Departments of Neuroscience and Neurology, Center for Translational Research in Neurodegenerative Disease, Normal Fixel Center for Neurological Diseases, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Rachel Whitmer
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Donna Wilcock
- Sanders-Brown Center on Aging and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Tien Y. Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Lisa J. Bain
- Independent Science Writer, Elverson, Pennsylvania, USA
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13
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Sinclair B, Steward C, Venkatraman V, Aljondi R, Cox KL, Ellis KA, Ames D, Masters CL, Phal PM, Sharman MJ, Cyarto EV, Lai MMY, Szoeke C, Lautenschlager NT, Desmond PM. Effects of a physical activity intervention on brain atrophy in older adults at risk of dementia: a randomized controlled trial. Brain Imaging Behav 2021; 15:2833-2842. [PMID: 34757564 DOI: 10.1007/s11682-021-00577-7] [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: 12/08/2020] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Abstract
Lack of physical activity is a risk factor for dementia, however, the utility of interventional physical activity programs as a protective measure against brain atrophy and cognitive decline is uncertain. Here we present the effect of a randomized controlled trial of a 24-month physical activity intervention on global and regional brain atrophy as characterized by longitudinal voxel-based morphometry with T1-weighted MRI images. The study sample consisted of 98 participants at risk of dementia, with mild cognitive impairment or subjective memory complaints, and having at least one vascular risk factor for dementia, randomized into an exercise group and a control group. Between 0 and 24 months, there was no significant difference detected between groups in the rate of change in global, or regional brain volumes.
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Affiliation(s)
- Benjamin Sinclair
- Department of Radiology, University of Melbourne, Melbourne, Australia. .,University of Melbourne, Melbourne, Australia. .,Department of Neuroscience, Monash University, Melbourne, Australia. .,Alfred Health, Melbourne, Australia.
| | - Chris Steward
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Vijay Venkatraman
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Rowa Aljondi
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,College of Applied Medical Sciences, Department of Applied Radiologic Technology, University of Jeddah, Jeddah, Saudi Arabia
| | - Kay L Cox
- Medical School, University of Western Australia, Perth, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Colin L Masters
- The Florey Institute, University of Melbourne, Melbourne, Australia
| | - Pramit M Phal
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | | | - Elizabeth V Cyarto
- Bolton Clarke Research Institute, Brisbane, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle M Y Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Curtin Medical School, Curtin University, Perth, WA, Australia
| | | | - Nicola T Lautenschlager
- University of Melbourne, Melbourne, Australia.,Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
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14
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Cox KL, Clare L, Cyarto EV, Ellis KA, Etherton-Beer C, Southam J, Ames D, Flicker L, Almeida OP, LoGiudice D, Liew D, Vlaskovsky P, Lautenschlager NT. A Randomized Controlled Trial on the Effects of a 6-Month Home-Based Physical Activity Program with Individual Goal-Setting and Volunteer Mentors on Physical Activity, Adherence, and Physical Fitness in Inactive Older Adults at Risk of Cognitive Decline: The INDIGO Study. J Alzheimers Dis 2021; 84:207-226. [PMID: 34511499 DOI: 10.3233/jad-210479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Increasing physical activity (PA) in those who have memory concerns requires innovative approaches. OBJECTIVE To compare in this randomized controlled trial (RCT) the effects on PA, adherence, and fitness of two approaches to deliver a 6-month home-based PA program in older, inactive individuals at risk of cognitive decline. METHODS Individuals (n = 52) aged 60-85 years, inactive with mild cognitive impairment or subjective cognitive decline were recruited from the community and memory clinics. Randomization was to 6 months of 150 min/week moderate intensity PA with either: goal-setting with mentor support; or education and peer contact. A subset of participants (n = 36) continued for a further 6 months. PA, moderate and vigorous PA, and secondary outcomes, fitness, goal performance/satisfaction and self-efficacy were assessed at baseline, 6 and 12 months. Modelling of primary and secondary outcomes was conducted with linear mixed models. RESULTS Participants were mean age (±sd) 70.1 (6.4) years. Six-month retention was 88.5%(n = 46). No significant between-group differences were observed for PA or fitness. Post-hoc combined group data showed a significant, moderate-large effect size increase in PA with time. PA increased by a mean 1,662 (943, 2383) steps/day (95%CI) and 1,320 (603, 2037) steps/day at 6 and 12 months (p < 0.001). Median (quartiles Q1-Q3) 6 and 6-12 month combined group adherence was 88.9 (74.4-95.7)%and 84.6 (73.9-95.4)%respectively. CONCLUSION In this target group, no differences were detected between groups both intervention strategies were highly effective in increasing PA and fitness.
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Affiliation(s)
- Kay L Cox
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University ofExeter, UK
| | - Elizabeth V Cyarto
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Bolton Clarke Research Institute, Brisbane, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Qld, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Christopher Etherton-Beer
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Jenny Southam
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,St George's Hospital, Kew, Victoria, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Dina LoGiudice
- Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Philip Vlaskovsky
- Royal Perth Hospital Research Foundation Biostatistical Unit, Perth, Australia
| | - Nicola T Lautenschlager
- Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia.,Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,North Western Mental Health, Royal Melbourne Hospital, Melbourne, Australia
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15
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Jenkins E, Koirala B, Rodney T, Lee JW, Cotter VT, Szanton SL, Taylor JL. Home/community-based interventions to improve function in persons with mild cognitive impairment/early dementia. Geriatr Nurs 2021; 42:1109-1124. [PMID: 34280736 PMCID: PMC8578179 DOI: 10.1016/j.gerinurse.2021.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
Persons with mild cognitive impairment/early dementia have a possible 20-year trajectory of disability and dependence with little information on the effectiveness of interventions to improve function. This review investigates the literature of home/community-based interventions for physical and executive function in persons with mild cognitive impairment/early dementia. A 2007-2020 systematic literature search was conducted through PubMed, CINAHL Plus with Full Text and PsycINFO. Of the 1749 articles retrieved, 18 eligible studies were identified and consisted of three types of interventions: cognitive training-only (n = 7), multicomponent (n = 9), and physical activity-only (n = 2). Results showed that the interventions impacting function in persons with cognitive impairment incorporated a visual/written element, technology-based training, caregiver support, and modified duration/increased frequency of interventions. In studies improving function, participants simulated Instrumental Activities of Daily Living. They addressed cognitive function using both objective and subjective cognitive measures. We found gaps in the literature in incorporating race/ethnicity and appropriate socioeconomic status measures.
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Affiliation(s)
- Emerald Jenkins
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA.
| | - Binu Koirala
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Tamar Rodney
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Ji Won Lee
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Valerie T Cotter
- Johns Hopkins University School of Nursing, 929 N Wolfe St. Room 403, Baltimore, MD 21205 USA
| | - Sarah L Szanton
- Health Equity and Social Justice Endowed Professor, Director, Center on Innovative Care in Aging, Johns Hopkins School of Nursing, Joint Appointment with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, 525 North Wolfe Street #424, Baltimore, MD 21205 USA
| | - Janiece L Taylor
- Johns Hopkins University School of Nursing, 525 N. Wolfe St. Room 422, Baltimore, MD 21205 USA
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16
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de Menezes KKP, Ada L, Teixeira-Salmela LF, Scianni AA, Avelino PR, Faria CDCDM, Nascimento LR. Home-Based Interventions may Increase Recruitment, Adherence, and Measurement of outcomes in Clinical Trials of Stroke Rehabilitation. J Stroke Cerebrovasc Dis 2021; 30:106022. [PMID: 34364011 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/05/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the completion rates of a home-based randomized trial, which examined home-based high-intensity respiratory muscle training after stroke compared with sham intervention. MATERIALS AND METHODS Completion was examined in terms of recruitment (enrolment and retention), intervention (adherence and delivery of home-visits) and measurement (collection of outcomes). RESULTS Enrolment was 32% and retention was 97% at post-intervention and 84% at follow-up. Adherence to the intervention was high at 87%. Furthermore, 83% of planned home-visits were conducted and 100% of outcomes were collected from those attending measurement sessions. CONCLUSION This home-based randomized trial demonstrated high rates of enrolment, retention, adherence, delivery of home-visits, and collection of outcomes. Home-based interventions may help to improve completion rates of randomized trials.
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Affiliation(s)
| | - Louise Ada
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Aline Alvim Scianni
- NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Patrick Roberto Avelino
- NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Lucas Rodrigues Nascimento
- NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, ES 9043-900, Brazil.
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17
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Affiliation(s)
- Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, UK
| | - Edo Richard
- Department of Neurology, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands.,Department of Neurology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
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18
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Venkatraman VK, Steward CE, Cox KL, Ellis KA, Phal PM, Sharman MJ, Villemagne VL, Lai MMY, Cyarto EV, Ames D, Szoeke C, Rowe CC, Masters CL, Lautenschlager NT, Desmond PM. Baseline White Matter Is Associated With Physical Fitness Change in Preclinical Alzheimer's Disease. Front Aging Neurosci 2020; 12:115. [PMID: 32410984 PMCID: PMC7202286 DOI: 10.3389/fnagi.2020.00115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/06/2020] [Indexed: 11/13/2022] Open
Abstract
White matter (WM) microstructure is a sensitive marker to distinguish individuals at risk of Alzheimer's disease. The association of objective physical fitness (PF) measures and WM microstructure has not been explored and mixed results reported with physical activity (PA). Longitudinal studies of WM with PA and PF measures have had limited investigation. This study explored the relationship between objective PF measures over 24-months with "normal-appearing" WM microstructure. Data acquired on magnetic resonance imaging was used to measure "normal-appearing" WM microstructure at baseline and 24-months. Clinical variables such as cognitive and blood-based measures were collected longitudinally. Also, as part of the randomized controlled trial of a PA, extensive measures of PA and fitness were obtained over the 24 months. Bilateral corticospinal tracts (CST) and the corpus callosum showed a significant association between PF performance over 24-months and baseline WM microstructural measures. There was no significant longitudinal effect of the intervention or PF performance over 24-months. Baseline WM microstructural measures were significantly associated with PF performance over 24-months in this cohort of participants with vascular risk factors and at risk of Alzheimer's disease with distinctive patterns for each PF test.
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Affiliation(s)
- Vijay K Venkatraman
- Department of Medicine and Radiology, The University of Melbourne, Melbourne, VIC, Australia
| | - Christopher E Steward
- Department of Medicine and Radiology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Radiology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Kay L Cox
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Pramit M Phal
- Department of Medicine and Radiology, The University of Melbourne, Melbourne, VIC, Australia.,Epworth Medical Imaging, Richmond, VIC, Australia
| | - Matthew J Sharman
- School of Health Sciences, University of Tasmania, Launceston, TAS, Australia
| | - Victor L Villemagne
- Department of Medicine and Radiology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia
| | - Michelle M Y Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,South Metropolitan Health Service, Perth, WA, Australia.,Curtin Medical School, Curtin University, Perth, WA, Australia
| | | | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,National Ageing Research Institute, Melbourne, VIC, Australia.,St George's Hospital, Kew, VIC, Australia
| | - Cassandra Szoeke
- Department of Medicine and Radiology, The University of Melbourne, Melbourne, VIC, Australia.,Centre for Medical Research, Royal Melbourne Hospital, Melbourne, VIC, Australia.,Healthy Brain Initiative, Australian Catholic University, Melbourne, VIC, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, The University of Melbourne, Melbourne, VIC, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, VIC, Australia
| | - Patricia M Desmond
- Department of Medicine and Radiology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Radiology, Royal Melbourne Hospital, Melbourne, VIC, Australia
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19
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Lautenschlager NT, Cox KL, Ellis KA. Physical activity for cognitive health: what advice can we give to older adults with subjective cognitive decline and mild cognitive impairment? DIALOGUES IN CLINICAL NEUROSCIENCE 2020. [PMID: 31607781 PMCID: PMC6780362 DOI: 10.31887/dcns.2019.21.1/nlautenschlager] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are common conditions in older age and are associated with an increased risk of future cognitive decline and dementia. As there is currently no effective pharmacological treatment available for SCD and MCI, modifiable risk factors for cognitive decline and dementia have received increasing attention in the literature as a focus for clinical trials. Physical activity (PA) is one of the strongest protective lifestyle factors. This clinical review aims to highlight the accumulating evidence about the benefits of PA for SCD and MCI. Whilst there is agreement that at least 150 minutes of moderate aerobic PA per week in combination with additional resistance training is necessary to support brain health in people with SCD and MCI, future research is required to help inform specific advice on type of exercise, intensity, “dose” and effective strategies to encourage behavior change.
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Affiliation(s)
- Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia; North Western Mental Health, Melbourne Health, Melbourne, Australia; Division of Psychiatry and WA Centre for Health & Ageing, The University of Western Australia, Perth, Australia
| | - Kay L Cox
- Medical School, The University of Western Australia, Perth, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia ; The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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20
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Anstey KJ, Peters R. Dementia, Risk, Risk Reduction, and Translation into Practice: An International Research Network for Dementia Prevention (IRNDP) Special Issue. J Alzheimers Dis 2019; 70:S1-S3. [PMID: 31356212 PMCID: PMC6700648 DOI: 10.3233/jad-190506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Kaarin J. Anstey
- University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Ruth Peters
- University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
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