Functional near infrared spectroscopy detects cortical activation changes concurrent with memory loss in postmenopausal women with Type II Diabetes.

Older adults with Type II Diabetes Mellitus (DM) experience mild cognitive impairment, specifically in the domain of recall/working memory. No consistent causative structural cortical deficits have been identified in persons with DM (PwDM). Memory deficits may be exacerbated in older adult females, who are at the highest risk of cardiovascular decline due to DM. The focus of the current study was to evaluate functional cortical hemodynamic activity during memory tasks in postmenopausal PwDM. Functional Near Infrared Spectroscopy (fNIRS) was used to monitor oxyhemoglobin (HbO) and deoxyhemoglobin (HbR) during memory-based tasks in a cross-sectional sample of postmenopausal women with DM. Twenty-one community-dwelling DM females (age = 65 ± 6 years) and twenty-one age- and sex-matched healthy controls (age = 66 ± 6 years) were evaluated. Working memory performance (via N-back) was evaluated while study participants donned cortical fNIRS. Health state, metabolic data, and menopausal status data were also collected. Deficits in working memory accuracy were found in the DM group as compared to controls. Differences in HbO responses emerged in the DM group. The DM group exhibited altered PFC activity magnitudes and increased functional cortical activity across ROIs compared to controls. HbO and HbR responses were not associated with worsened health state measures. These data indicate a shift in cortical activity patterns with memory deficits in postmenopausal PwDM. This DM-specific shift of HbO is a novel finding that is unlikely to be detected by fMRI. This underscores the value of using non-MRI-based neuroimaging techniques to evaluate cortical hemodynamic function to detect early mild cognitive impairment.

Dependence and reduced motor function in heart failure: future directions for well-being.

While patients with heart failure experience a wide range of symptoms, evidence is mounting that patients with heart failure suffer from reduced functional independence. Given that the number of patients with heart failure is rising and considering the adverse outcomes of reduced functional independence, understanding the underlying mechanisms of reduced functionality in patients with heart failure is of increasing importance. Yet, little information exists on how heart failure negatively affects functional independence, including motor function. This article summarizes reports of reduced independence and highlights its significant adverse outcomes in the patients with heart failure. Finally, this article discusses potential causes of reduced independence based on existing reports of impaired central and peripheral nervous systems in the patients with heart failure. Overall, the article provides a solid foundation for future studies investigating motor impairments in patients with heart failure. Such studies may lead to advances in treatment and prevention of reduced independence associated with heart failure, which ultimately contribute to the well-being of patients with heart failure.

Fear of Falling: Significant Barrier in Fall Prevention Approaches.

Fear of falling is a critical component in fall prevention approaches; however, it is often overlooked in the majority of fall prevention exercises. Alternative fall prevention approaches that take fear of falling into account are necessary. This article discusses fall prevention activities that are feasible for individuals with limited mobility who have an increased fear of falling. Health care providers should consider the degree to which a patient has a fear of falling and recommend activities that fit most to their patient's comfort level.

Sex-based differences and aging in tactile function loss in persons with type 2 diabetes.

BACKGROUND: Recent evidence of significant sex-based differences in the presentation of Type 2 Diabetes Mellitus (DM) and its complications has been found in humans, which may contribute to sex-based differences in reduced functionality and quality of life. Some functionality, such as tactile function of the hands, has significant direct impact on quality of life. The purpose of the current study was to explore the impact of DM and sex on tactile function, with consideration of variability in health state measures. RESEARCH DESIGN AND METHODS: A case-control single time point observational study from 2012-2020 in an ethnically diverse population-based community setting. The sample consists of 132 adult individuals: 70 independent community dwelling persons with DM (PwDM) and 62 age- and sex-matched controls (42 males and 90 females in total). The Semmes-Weinstein monofilament test was used to evaluate tactile sensation of the hands. RESULTS: Tactile sensation thresholds were adversely impacted by sex, age, degree of handedness, high A1c, diagnosis of DM, and neuropathy. Overall, strongly right-handed older adult males with poorly controlled DM and neuropathy possessed the poorest tactile discrimination thresholds. When self-identified minority status was included in a secondary analysis, DM diagnosis was no longer significant; negative impacts of age, neuropathy, degree of handedness, and high A1c remained significant. CONCLUSIONS: The data indicate significant impacts of male sex, age, degree of handedness, self-identified minority status, and metabolic health on the development of poor tactile sensation. This combination of modifiable and non-modifiable factors are important considerations in the monitoring and treatment of DM complications.

Effects of aging on rapid grip force responses during bimanual manipulation of an active object.

Rapid grip force responses to unexpected pulling loads on the fingertips are deteriorated in older adults due to, in part, age-related declines in somatosensory function. Such reports are limited to one-hand conditions despite the higher frequency of using two hands together in daily living activities of older adults. Unexpected perturbations during bimanual movements elicit goal-oriented and cortically-meditated bilateral rapid motor responses. Since aging is associated with declined somatosensory and cognitive functions, we hypothesized that bilateral rapid motor responses differ between young and older adults, such that older adults exert stronger grip forces following perturbation and the unperturbed hand is more involved in stabilizing the object in older adults. We tested our hypothesis by comparing the rapid grip force responses of both hands in young and older adults. A total of 13 right-handed young individuals (24.2 ± 4.0 years old, 5 men) and 13 right-handed older individuals (68.7 ± 7.1 years old, 5 men) were recruited. Tactile detection threshold, fingertip friction, and the rapid grip force responses of both hands triggered by unpredicted pulling loads during grip-lift movements were assessed. Older adults had higher tactile detection thresholds and lower fingertip friction compared to young adults. Regardless of age, rapid motor responses were found in both the perturbed (right) hand and the indirectly perturbed (left) hand at 73 ms and 135 ms after the perturbation, respectively, while magnitudes of the responses depended on perturbation magnitudes. Higher values in maximum grip force and maximum grip force rate were found in older adults as compared to young adults. In older adults, the indirectly perturbed (left) hand was more involved in stabilizing the object as compared to young healthy adults. The current study suggests that age-related changes in the peripheral and central nervous systems contribute to the greater involvement of the indirectly perturbed hand in older adults.