RESUMO
BACKGROUND: Motoric Cognitive Risk (MCR) syndrome, which combines subjective memory complaint (SMC) and slower gait speed, is a newly-described predementia stage. Based on the involvement of vitamin D in the biology of both gait and cognition, we hypothesized that nondemented individuals with MCR would exhibit hypovitaminosis D more often compared to Cognitively Healthy Individuals (CHI). The objective of this cross-sectional analysis was to determine whether hypovitaminosis D was associated with MCR. METHODS: Participants without dementia from the GAIT (Gait and Alzheimer Interactions Tracking) cohort study were classified into MCR or Cognitively Healthy Individuals (CHI) groups. Hypovitaminosis D was defined as the lowest quartile of serum 25-hydroxyvitamin D (25OHD) concentration compared to the other three combined. Age, sex, body mass index (BMI), the Frontal Assessment Battery (FAB) score, the Mini-Mental Short Examination (MMSE) score, education level, use of psychoactive drugs, and the number of chronic diseases were used as covariates. RESULTS: Among 244 nondemented and nonMCInonMCR participants from the GAIT cohort (mean age 71.4 ± 3.7 years, 40.6% women), 66 participants were classified as MCR (36.9%) and 178 as CHI (63.1%). The lowest quartile of 25OHD concentration was directly associated with MCR (unadjusted OR = 2.85, p = 0.003) even after adjustment for studied potential confounders (fully adjusted OR = 2.61, p = 0.025). The BMI (adjusted OR = 6.65, p < 0.001), MMSE score (adjusted OR = 0.74, p = 0.009), FAB score (adjusted OR = 0.51, p < 0.001), number of chronic diseases (adjusted OR = 1.29, p = 0.043) and use of psychoactive drugs (adjusted OR = 2.55, p = 0.044) were also associated with MCR. CONCLUSIONS: Hypovitaminosis D was associated with MCR in older community-dwellers without dementia.
Assuntos
Doença de Alzheimer , Transtornos Cognitivos , Deficiência de Vitamina D , Humanos , Feminino , Idoso , Masculino , Estudos de Coortes , Transtornos Cognitivos/diagnóstico , Estudos Transversais , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/complicações , Fatores de Risco , Vitamina D , Cognição , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/complicações , VitaminasRESUMO
BACKGROUND: Falls are frequent and severe in older adults, especially among those with cognitive impairments due to altered motor control. Which brain areas are affected among fallers remains yet not elucidated. The objective of this cross-sectional analysis was to determine whether the history of falls correlated with focal brain volume reductions in older adults. METHODS: Participants from the MERE study (n = 208; mean, 71.9 ± 5.9 years; 43% female; 38% cognitively healthy, 41% with mild cognitive impairment and 21% with dementia) were asked about their history of falls over the preceding year and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, use of psychoactive drugs, cognitive status, and total intracranial volume were used as covariates. RESULTS: Fifty-eight participants (28%) reported history of falls. Fallers were older (P = 0.001), used more often psychoactive drugs (P = 0.008) and had more often dementia (P = 0.004) compared to non-fallers. After adjustment, we found correlations between the history of falls and brain subvolumes; fallers exhibiting larger gray matter subvolumes in striatum, principally in bilateral caudate nucleus, than non-fallers. By stratifying on cognitive status, these neuroanatomical correlates were retrieved only in participants with MCI or dementia. There were no correlations with the subvolumes of white matter. CONCLUSION: Older fallers had larger subvolumes in bilateral striatum than non-fallers, principally within the caudate nucleus. This suggests a possible brain adaptative mechanism of falls in people with neurocognitive decline.
RESUMO
Mulesing is a painful husbandry procedure commonly used to reduce the risk of breech strike in sheep. This study assessed the behavioural (over 6â¯h), cortisol, haptoglobin and haematology responses to surgical mulesing plus tail hot knife docking (mulesing); modulated by a buccal meloxicam formulation (Buccalgesic), a topical local anaesthetic wound dressing (Tri-Solfen) or both agents. 24 lambs were allocated to each of: 1) Placebo and sham handled (Sham); 2) Placebo and mulesing (Mules); 3) Buccalgesic and mulesing (Mulesâ¯+â¯B); 4) Tri-Solfen and mulesing (Mulesâ¯+â¯T); 5) Placebo, Tri-Solfen and mulesing (Mulesâ¯+â¯Tâ¯+â¯P); 6) Buccalgesic, Tri-Solfen and mulesing (Mulesâ¯+â¯Tâ¯+â¯B). Compared with Mules, Mulesâ¯+â¯T had a lower cortisol response (72.5⯱â¯8.7â¯nmol/L v 122.9⯱â¯8.7â¯nmol/L) at 30â¯min, reduced statue standing at 2â¯h (3.9% v 11.4%) and increased lying (20.9-25.0% v 7.3-12.5%). Mulesâ¯+â¯B had reduced cortisol response at 6â¯h (48.1⯱â¯8.5â¯nmol/L), reduced Neutrophil:Lymphocyte ratio at 6â¯h (Mulesâ¯+â¯B: 1.25; Mules: 2.44), reduced statue standing at 2â¯h and 4-6â¯h (4.1-8.3%), and increased lying at 5â¯h (27.4%). Mulesâ¯+â¯Bâ¯+â¯T had lower cortisol concentrations at 30â¯mins (86.51⯱â¯8.71â¯nmol/L), TWCC not significantly different from Sham at 6â¯h (9.07 vs 8.09) and 24â¯h (9.05 vs 8.38). Mulesâ¯+â¯Tâ¯+â¯B had significantly lower TWCC than Mules at 12â¯h (9.56 vs 11.05) and 24â¯h (9.05 vs 10.42). Mulesâ¯+â¯Tâ¯+â¯B did not.