Psychosocial benefits of exercise for older adults with amnestic Mild Cognitive Impairment: Innovative practice

The aim of this study was to explore the perceived psychosocial benefits of a three-month exercise program for 10 older adults with amnestic Mild Cognitive Impairment, a condition in which memory loss is the main symptom. Qualitative data were collected by observation (research diary) and 20 semi-structured interviews with the participants (10) and their caregivers (10). The narratives showed remarkable psychosocial benefits, such as improved mood, motivation, autonomy, perceived competence, self-esteem, and social relationships. The results of this study should provide new insights into the importance of exercise for this population, and may help to design appropriate programs for them.

Does the diurnal cycle of cortisol explain the relationship between physical performance and cognitive function in older adults?

Background

Regular physical activity is a promising strategy to treat and prevent cognitive decline. The mechanisms that mediate these benefits are not fully clear but physical activity is thought to attenuate the harmful effects of chronic psychological stress and hypercortisolism on cognition. However, the circadian pattern of cortisol secretion is complex and it is not known which aspects are most closely associated with increased cognitive function and better physical performance. This is the first study to simultaneously measure cognitive function, the diurnal cycle of salivary cortisol and physical performance in older adults, without cognitive impairment (n = 30) and with amnestic Mild Cognitive Impairment (aMCI) (n = 30).

Results

Regression analysis showed that better cognitive function was associated with better physical performance. A greater variance in cortisol levels across the day from morning to evening was associated with better cognitive function and physical performance.

Conclusions

The results support the idea that a more dynamic cortisol secretion pattern is associated with better cognitive function and physical performance even in the presence of cognitive impairment, but our results could not confirm a mediating role in this relationship.

Linear and nonlinear heart rate dynamics in elderly inpatients. Relations with comorbidity and depression

BACKGROUND

Hospitalization processes are known to increase depressive symptoms arising among elderly population. Meanwhile, dysregulation of cardiac autonomic function has been suggested to link depression and cardiovascular mortality. In this context, analysis of heart rate variability (HRV) is emerging as a powerful mortality risk stratifier clinical tool. The purpose of the study was to examine the relationship among HRV, depression, and comorbidity risk among an elderly inpatient population.

MATERIAL AND METHODS

Twenty-six subjects (aged 78±9 years) were recruited from the Short-Term Stay Unit at the Hospital General de Alicante. Before joining a Physical Activity Program aimed to prevent functional impairment and after medical selection and written consent, inpatients were tested for heart rate variability, Yesavage Geriatric Depression Scale, and Charlson comorbidity index score.

RESULTS

Men compared to women showed a significantly larger CCI score. Short-term scaling exponent (α(1)), derived from detrended fluctuation analysis, showed a negative correlation with Charlson comorbidity index. Conversely, a positive correlation was found between sample entropy (SampEn) and Yesavage Scale.

CONCLUSIONS

On the one hand, fractal analysis of HRV confirms to be useful as a risk stratifier tool. On the other hand, SampEn is proposed to be reflecting a non-neurally generated complexity when accompanied with low values of α(1). Accordingly, in this regime, it would be indicative of a paradoxical gradual reduction in cardiac autonomic control, accentuated with the severity of depressive symptoms.