An 18-month multimodal intervention trial for preventing dementia: J-MINT PRIME Tamba.

BACKGROUND: The number of people with dementia is increasing in Japan, and establishing evidence for preventing dementia is necessary. METHODS: This study was a randomized controlled trial in cognitively normal community-dwelling older adults aged 65 to 85 with diabetes and/or hypertension. Participants were randomly assigned in a 1:1 ratio. The intervention group underwent 90 min of group-based weekly physical exercise, cognitive training, nutritional counseling, and vascular risk management for 18 months. The primary endpoint was the change in a cognitive composite score calculated by averaging the z-scores of seven neuropsychological tests from baseline to 18 months. RESULTS: We randomly assigned 203 participants to two groups, and 178 (87.7%) completed the 18-month follow-up. There was a significant group difference in the cognitive composite score change at 18 months (mean difference 0.16, 95% confidence interval: 0.04 to 0.27; p = 0.009). DISCUSSION: An 18-month multimodal intervention for older adults at risk of dementia could improve their cognitive function. The trial was registered in the Clinical Trial Registration System (UMIN000041938). HIGHLIGHTS: Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT) PRIME Tamba was a randomized controlled trial to prevent dementia. We provided a multifactorial intervention based on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial methodology. The primary outcome, the cognitive composite score, improved with our intervention. Executive function/processing speed and memory improved in the intervention group. Intervention adherence was high, and no serious adverse events occurred.

Application value of dexmedetomidine in anesthesia for elderly patients undergoing radical colon cancer surgery.

BACKGROUND: Colon cancer presents a substantial risk to the well-being of elderly people worldwide. With advancements in medical technology, surgical treatment has become the primary approach for managing colon cancer patients. However, due to age-related physiological changes, especially a decline in cognitive function, older patients are more susceptible to the effects of surgery and anesthesia, increasing the relative risk of postoperative cognitive dysfunction (POCD). Therefore, in the surgical treatment of elderly patients with colon cancer, it is of paramount importance to select an appropriate anesthetic approach to reduce the occurrence of POCD, protect brain function, and improve surgical success rates. AIM: To explore the value of dexmedetomidine (Dex) in anesthesia for elderly patients undergoing radical colon cancer surgery. METHODS: One hundred and seventeen patients with colon cancer who underwent elective surgery under general anesthesia were selected and divided into two groups: A and B. Group A received Dex before anesthesia induction, and B group received an equivalent amount of normal saline. Changes in the mini-mental state examination, regional cerebral oxygen saturation (rSO2), bispectral index, glucose uptake rate (GluER), lactate production rate (LacPR), serum S100ß and neuron-specific enolase (NSE), POCD, and adverse anesthesia reactions were compared between the two groups. RESULTS: Surgical duration, duration of anesthesia, and intraoperative blood loss were comparable between the two groups (P > 0.05). The overall dosage of anesthetic drugs used in group A, including propofol and remifentanil, was significantly lower than that used in group B (P < 0.05). Group A exhibited higher rSO2 values at the time of endotracheal intubation, 30 min after the start of surgery, and immediately after extubation, higher GluER values and lower LacPR values at the time of endotracheal intubation, 30 min after the start of surgery, immediately after extubation, and 5 min after extubation (P < 0.05). Group A exhibited lower levels of serum S100ß and NSE 24 h postoperatively and a lower incidence of cognitive dysfunction on the 1st and 5th postoperative days (P < 0.05). CONCLUSION: The use of Dex in elderly patients undergoing radical colon cancer surgery helps maintain rSO2 Levels and reduce cerebral metabolic levels and the incidence of anesthesia- and surgery-induced cognitive dysfunction.

Social Support, Coping Strategies, Depression, Anxiety, and Cognitive Function Among People With Type 2 Diabetes Mellitus: A Path Analysis.

OBJECTIVE: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method. METHODS: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function. RESULTS: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety. CONCLUSION: Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Prediction of cognitive impairment among Medicare beneficiaries using a machine learning approach.

OBJECTIVE: Developing machine learning (ML) models to predict cognitive impairment among Medicare beneficiaries in the United States. METHODS: This retrospective study used the 2016-2019 Medicare Current Beneficiary Survey Cost and Use and Survey Public Use Files. Medicare beneficiaries aged 65 and older (n=4,965) with at least two consecutive years' data were included. Cognitive impairment was categorized into three stages: severe, moderate, and none based on self-reported data. Baseline year's demographic, socioeconomic factors, self-reported functional limitations, health status and comorbidities, number of concurrent medications, level of social engagement, behavioral variables, and satisfaction of medical care's quality were features assessed in ML algorithms to predict next years' cognitive function. ML models in six major categories were developed, tested, and compared (accuracy, AUC, and F1 score) using Python version 3.11. The importance of features was evaluated using the total reduction of the Gini. A subgroup analysis was conducted among beneficiaries who were 80 years and older. RESULTS: Approximately 11.1% of beneficiaries aged ≥ 65 had moderate or severe cognitive function impairment. Baseline cognitive function was the most significant predictor for next year's cognitive function impairment, followed by baseline IADL, level of social activities, ADL, general health status, income, age, education, region of residence, and body mass index. Beneficiaries 80 years and older had satisfaction of medical care's quality among the top 10 most significant predictors. CONCLUSIONS: Older adults' baseline cognitive function and IADL were top two predictors of cognitive function impairment. Clinicians should regularly screen and monitor older adults' cognitive and daily function.

Independent and joint role of inflammatory diet and physical activity with cognitive function in aging: Evidence from a population-based survey.

OBJECTIVE: This study aims to explore the independent and joint association of physical activity (PA) and inflammatory diet with cognitive function in aging. METHOD: Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) was used. 2249 NHANES participants with valid data represented a weighted population of 50.5 million American residents aged 60 and older. This study separately analyzed the independent associations of PA (measured by global physical activity questionnaire) and inflammatory diet (measured by energy-adjusted dietary inflammatory index from 24-h dietary recall), and their joints (inactive & pro-inflammatory as reference) with cognitive function (assessed by three cognitive tests), and considered an individual of different status and non-linear effect by sub-group and restricted cubic splines (RCS) analysis, respectively. All analysis was multivariable-adjusted and sample-weighted. RESULTS: The results showed that inflammatory diet was independently associated with lower cognitive function, with a 1.08, 1.29, 2.67, 0.56 lower score in the Registry for Alzheimer's Disease word list learning test (CERAD), the Animal Fluency Test (AFT), the Digit Symbol Substitution test (DSST), Z-scores, and 51 %, 62 %, 63 %, 93 % higher odds ratio (OR) of lower performance in CERAD, AFT, DSST, and p-MCI, respectively. PA was independently associated with higher cognitive function, with a 1.41, 3.37, and 0.52 higher score in AFT, DSST, Z-scores, and 28 %, 51 %, 41 % lower ORs of lower performance in CERAD and DSST and p-MCI, respectively. Active & Anti-inflammatory was always positively associated with cognitive function, with a 1.42, 2.69, 5.47, and 1.04 higher score for CERAD, AFT, DSST, and Z-score, a 58 %, 56 %, 74 %, 76 % lower ORs of lower performance in CERAT, AFT, DSST, and p-MCI, respectively, which elicited the maximum compared to other joints. CONCLUSION: Adhering to both active PA and anti-inflammatory diet is recommended for cognitive management in older adults. Sticking to either active PA or anti-inflammatory diet also shows potential cognitive benefits, with the diet possibly playing more vital role.

Association between geriatric nutritional risk index and cognitive function in older adults with/without chronic kidney disease.

BACKGROUND: Cognitive impairment is highly prevalent among patients with chronic kidney disease, who face an increased risk of cognitive decline. The aim of this study was to investigate the relationship between the Geriatric Nutritional Risk Index (GNRI) and cognitive function in older individuals, both with and without chronic kidney disease (CKD). METHODS: In this study, we analyzed data from 2728 participants in the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Cognitive function was measured using the Consortium to Establish a Registry for the Alzheimer's Disease Word Learning subtest (CERAD W-L), the animal fluency test (AFT), the digit symbol substitution test (DSST), and the global cognitive z-score. The GNRI, representing whole-body nutritional status, was calculated based on serum albumin, body weight, and ideal body weight. We employed weighted multiple linear regression analyses and subgroup analyses to assess the independent association of GNRI with cognitive function in CKD and non-CKD populations. Smoothing techniques were used to fit curves, and interaction tests were used to assess the robustness and specificity of the findings. RESULTS: Our analyses revealed a significant positive association between higher GNRI levels and cognitive function in the older US population (for global z-score: ß = 0.01; 95% confidence interval [CI] = 0.00, 0.01). This association remained consistent across various subgroup analyses, including those for different gender groups, age groups, smoking statuses, diabetes statuses, hypertension statuses, individuals with a BMI below 25, individuals who consumed alcohol, and non-Hispanic white individuals. Smoothed curve-fitting analyses indicated that the GNRI was linearly related to cognitive function. No statistically significant interactions were detected among these variables. CONCLUSION: Our findings emphasize the positive association between GNRI and cognitive health in individuals with or without CKD, especially when combined with other risk factors. Consequently, enhancing the nutritional status of the elderly may serve as a viable strategy to thwart the onset of cognitive decline.

Association of obesity indicators with cognitive function among US adults aged 60 years and older: Results from NHANES.

BACKGROUND: Midlife obesity is a significant risk factor for Alzheimer's disease, but the effects of obesity on cognitive function, either detrimental or beneficial, are controversial among older individuals. This study aims to assess this associations of body mass index (BMI) or waist circumference (WC) with cognitive function among United States older individuals. METHODS: A cross-sectional research study was conducted utilizing data from the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). Initially, the study compared differences in cognitive function among the normal weight, overweight, and obese groups. Subsequently, we examined the relationships between BMI or WC and cognitive function using multivariate linear regression. Finally, structural equation models were constructed to assess the relationships among body shape, lifestyle, and cognitive function pathways. RESULTS: The study included 2254 individuals. Obese subjects had lower scores in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word list learning tasks (CERAD-WL) (χ2 = 7.804, p = .020) and digit symbol substitution test (χ2 = 8.869, p = .012). The regression analysis showed that WC was negatively connected with the CERAD-WL score after adjusting for confounding factors (ß = -.029, p = .045). Moreover, WC had a mediating effect on the path from lifestyle to cognition (CERAD-WL). However, there was no difference in the CERAD delayed recall score and the animal fluency test between the obese and the other groups. CONCLUSIONS: Obese older adults exhibited impaired cognitive abilities in terms of learning and working memory performance. The impact of lifestyle on cognition was mediated by obesity-related anthropometric indices. Sleep, physical activity, and diet influenced the degree of obesity, which subsequently determined cognitive function. Prioritizing weight management in elderly people is crucial for safeguarding cognitive function.

Comparative effectiveness of open and closed skill exercises on cognitive function in young adults: a fNIRS study.

While it is widely acknowledged that exercise has positive effects on cognitive function, the specific impacts of different types of exercises, particularly open and closed skill exercises, on cognitive impairment continue to be a debated topic. In this study, we used fNIRS and cognitive psychology tasks to investigate the effects of different types of exercises on cognitive function and brain activity in young adults. We conducted an observational study to assess the cognitive function of participants who had engaged in these exercises for a long period. Additionally, we examined the effects of open skill exercise (badminton) and closed skill exercise (calisthenics) on localized blood flow in the prefrontal lobe of the brain using an experimental research method. Specifically, during the Stroop task, the badminton group exhibited significantly higher △HbO2 in channel 18, corresponding to the dorsolateral prefrontal cortex, compared to the calisthenics group (F = 4.485, P < 0.05, η2 = 0.074). In the 2-back task, the calisthenics group showed significantly higher △HbO2 in channel 17, corresponding to the frontopolar area, dorsolateral prefrontal cortex and inferior prefrontal gyrus, than the badminton group (F = 8.842, P < 0.01, η2 = 0.136). Our findings reveal that open skill exercises are more effective in enhancing cognitive inhibition, thereby increasing attention capacity, self-regulation, and flexibility in response to environmental changes. Conversely, closed skill exercises demonstrate greater efficacy in improving working memory within cognitive functions, showcasing an enhanced capacity for information processing and storage. These data indicate that while both open and closed skill exercises are beneficial for cognitive function, they exhibit significant distinctions in some aspects.

The effect of super brain yoga on the cognitive function of hemodialysis patients.

Introduction: Cognitive impairment is one of the most important end-stage consequences of renal disease. This study was conducted to investigate the effect of super brain yoga on the cognitive function of hemodialysis (HD) patients. Methods: This randomized clinical trial was conducted on 60 HD patients who were assigned to the control (n = 30) and intervention (n = 30) groups. In addition to undergoing their routine HD, subjects in the intervention group performed yoga exercises for one month, at least three days a week, once a day. Cognitive function score of the patients at baseline and after the study (one month later) was measured using the Mini-Mental State Examination (MMSE). Data were analyzed using SPSS version 20 using descriptive statistics, including mean and standard deviation, and inferential statistics, including independent t-test, paired t-test, and ANCOVA. Results: The mean score of cognitive function, urea, creatinine, and dialysis adequacy at baseline was 26.07 ± 3.72, 133.83 ± 34.19, 9.37 ± 2.55, and 1.22 ± 0.24 in the control group and28.97 ± 1.62, 174.17 ± 52.8, 13.38 ± 4.16, and 1.26 ± 0.22, in the intervention group, respectively. At the baseline, there was a significant difference between the two groups in terms of cognitive function, urea, creatinine (p-value = 0.001), but there was not in terms of dialysis adequacy (p-value = 0.974). Therefore, the analysis of covariance (ANCOVA) was used to adjust their effects. The mean score of these variables after the study was 25.77 ± 3.11, 146 ± 42.03, 9.7 ± 2.61, and 1.24 ± 0.24 in the control group and 29.17 ± 1.23, 156.03 ± 37.67, 12.27 ± 3.46, and 1.43 ± 0.19 in the intervention group, respectively. There was a significant difference in cognitive function between two the groups (p = 0.05). Conclusion: Super brain yoga exercises seem to play an effective role in improving the cognitive function of HD patients. Therefore, super brain yoga is recommended as a complementary therapy for HD patients in nursing.

LFHP-1c improves cognitive function after TBI in mice by reducing oxidative stress through the PGAM5-NRF2-KEAP1 ternary complex.

Traumatic brain injury (TBI) is a leading cause of disability and death. Thus, timely and effective secondary brain injury intervention is crucial, with potential to improve the prognosis of TBI. Oxidative stress contributes to post-traumatic secondary cognitive impairment, and the reduction of post-traumatic oxidative stress effectively enhances cognitive function. Phosphoglycerate-mutating enzyme 5 (PGAM5), a member of the phosphoglycerate transporter enzyme family, is upregulated in TBI and induces mitochondrial autophagy. This further exacerbates damage following TBI. The present study focused on the small molecule drug, LFHP-1c, which is a novel inhibitor of PGAM5. The present study used an in vivo mouse model incorporating a controlled cortical impact-induced TBI, to examine the impact of LFHP-1c on oxidative stress and cognitive function. The present study aimed to determine the impact of LFHP-1c on the PGAM5-Kelch-like ECH-associated protein 1 (KEAP1)- nuclear factor erythroid 2-related factor 2 (NRF2) ternary complex within the TBI context. Results of the present study indicated that LFHP-1c suppresses PGAM5 expression and inhibits the development of the PGAM5-KEAP1-NRF2 ternary complex, thereby promoting the release of NRF2 and KEAP1. This in turn promotes the entry of NRF2 into the nucleus following TBI, leading to increased expression of anti-oxidative stress downstream factors, such as heme oxygenase-1, glutathione peroxidase 1 and superoxide dismutase 1. In addition, LFHP-1c also released KEAP1, leading to mitochondrial Rho GTPase 2 degradation and reducing perinuclear aggregation of mitochondria in the cell, which reduced oxidative stress and ultimately improved cognitive function after TBI.

LncRNA 51A: A promising diagnostic biomarker for assessing cognitive decline in occupationally exposed aluminum workers.

OBJECTIVE: To assess the diagnostic utility of lncRNA 51 A in detecting cognitive decline among aluminum-exposed workers occupationally. METHODS: 921 male workers from an aluminum manufacturing facility underwent cognitive assessments, measurement of plasma aluminum levels and quantification of lncRNA 51 A levels. Receiver Operating Characteristic (ROC) curves were constructed to assess the diagnostic potential of lncRNA 51 A. Bayesian network model was utilized to predict the likelihood of cognitive decline among the study population. RESULTS: Significant differences in lncRNA 51 A levels, plasma aluminum concentration and MMSE scores were observed between cognitive normal and decline groups. The lncRNA 51 A expression was negatively correlated with MMSE scores. The area under the curve (AUC) was 0.894, with 89.3 % sensitivity and 73.9 % specificity. The Bayesian network model indicated varying probabilities of cognitive decline based on lncRNA 51 A expression levels. CONCLUSION: Plasma lncRNA 51 A shows potential as an excellent biomarker for cognitive decline diagnosis in aluminum-exposed workers.

Odor identification dysfunction in late-life depression with suicidal ideation.

BACKGROUND: Suicide is more prevalent among older adults compared to younger individuals. Late-life depression (LLD) poses the highest risk for suicide. However, early recognition of suicidal ideation is challenging. Dysfunction in odor identification (OI), a characteristic of LLD, may hold potential for early identification of suicidal ideation. This study aims to compare OI between LLD patients with suicidal ideation (LLD-S) and LLD patients without suicidal ideation (LLD-NS), and examine its relationship with cognitive function. METHODS: A total of 262 LLD-NS patients, 63 LLD-S patients, and 316 healthy normal older adults (HOAs) underwent OI testing, standardized clinical interviews, and comprehensive neuropsychological assessments. RESULTS: (1) LLD-S patients exhibited lower OI scores and poorer cognitive performance (including global cognition, information processing speed, memory, language, executive function, and visuospatial ability) compared to LLD-NS patients and HOAs. (2) There were interactive effects between suicidal ideation and OI dysfunction, leading to lower scores in information processing speed and visuospatial ability. (3) OI dysfunction mediated the differences in cognition between the LLD-NS and LLD-S groups. LIMITATIONS: The present study was a cross-sectional design. CONCLUSIONS: LLD-S patients had worse odor identification than LLD-NS patients and HOAs, suggesting that OI testing could be a valuable approach for identifying suicidal ideation in LLD and screening for suicide risk. The presence of both OI impairment and suicidal ideation was associated with poorer cognitive performance in LLD.

Subjective cognitive decline and cognitive change among diverse middle-aged and older Hispanic/Latino adults: Results from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA).

INTRODUCTION: The potential utility of subjective cognitive decline (SCD) as an early risk marker of Alzheimer's disease and related dementias is under consideration. We examined associations between SCD and cognitive change among middle-aged and older Hispanic/Latino adults living in the United States. METHODS: The short-form Everyday Cognition Scale (ECog-12) was assessed to generate global, executive function, and memory-related SCD scores. We used survey generalized regressions to model the change in learning, memory, verbal fluency, executive function, and global cognitive performance over 7 years as a function of SCD (at Visit 2). RESULTS: The mean age was 56.37 ± 8.10 years at Visit 1 (n = 6225). Higher ECog-12 was associated with greater decline in global cognitive performance (ECog-12 global: B = -0.17, standard error [SE] = 0.02; ECog-12 executive: B = -0.15, SE = 0.02; ECog-12 memory: B = -0.14, SE = 0.02, p's < 0.001). DISCUSSION: These results support the link between subjective reports of cognitive decline and objectively measured 7-year cognitive decline in community-dwelling, middle-aged, and older Hispanic/Latino adults. HIGHLIGHTS: We found that nearly two-thirds of diverse middle-aged and older Hispanics/Latinos reported cognitive concerns in a large and representative population study. Self-reported subjective experiences of cognitive decline reflect objective cognitive decline in US Hispanics/Latinos. The relationship is stronger among men compared to women. The relationship between subjective and objective changes to memory are stronger in those with cognitive concerns, and remain even in cognitively healthy individuals.

Associations between sleep duration, depression status, and cognitive function among Chinese elderly: A community-based study.

BACKGROUND: The associations of sleep duration and depressive status on cognitive function among the elderly remain controversial. This study aimed to investigate the associative effects and mediating mechanisms between sleep duration and depressive status on cognitive function in elderly adults. METHODS: Participants were recruited from cross-sectional and cohort surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We identified thresholds for sleep duration and depression and used logistic regression to explore their independent and joint effects on cognitive impairment. Further, we analyze the mediating effects of depressive status on the association between sleep duration and cognitive function. RESULTS: Of 13840 elderly (median age: 84 years, female: 54.6 %), 2835 (20.5 %) had cognitive impairment. Compared with those who slept 6-8 h, the ORs (95%CIs) for those who slept < 6 h and > 8 h were 0.98 (0.85, 1.12) and 1.48 (1.32, 1.66). Compared with non-depressed, the OR (95%CI) for the depressed participants was 1.74 (1.53, 1.98). Compared with those with sleep 6-8 h and none-depression, those with sleep > 8 h and depression had the highest odds of cognitive impairment (OR = 2.40, 95%CI: 1.88-3.07). Additionally, Compared with those who slept 6-8 h, the associations between depression-mediated short and long sleep and cognitive impairment were 51.1 % and 6.5 %, respectively. LIMITATIONS: Cross-sectional studies require caution in the interpretation of causal associations. CONCLUSIONS: Long sleep and depression were independently and jointly associated with higher odds of cognitive impairment among the Chinese elderly, and short sleep increased the risk of cognitive impairment by promoting the prevalence of depression.

The association between 'weekend warrior', regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011-2014.

BACKGROUND: While previous studies have suggested that both 'Weekend Warrior' (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear. METHODS: Our study leveraged the NHANES 2011-2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health. RESULTS: Analysis revealed a positive correlation between PA time and CF across all participants (ß-depressive symptoms = 0.03, 95 % CI: 0.01-0.05; ß-non-depressive symptoms = 0.01, 95%CI: 0.00-0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (ß-WW = 0.22, 95 % CI: 0.05-0.39), similar to those engaging in RE (ß-RE = 0.15, 95 % CI: 0.09-0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (ß-RE = 0.15, 95 % CI: 0.04-0.25), with the WW showing less definitive results (ß-WW = 0.22, 95 % CI: -0.02-0.47). LIMITATION: The cross-sectional nature limits causal inferences. CONCLUSION: Our findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.

Association between cognitive performance and manual dexterity in patients with Parkinson's disease.

INTRODUCTION: Parkinson's disease (PD) is a progressive neurological condition resulting from the degeneration of dopaminergic neurons in the substantia nigra. Impaired manual dexterity and cognitive impairment are common symptoms and are often associated with recurrent adverse events in this population. OBJECTIVE: To verify the association between cognitive performance and manual dexterity in people with PD. METHODS: This is a cross-sectional observational study, with 29 participants, who underwent cognitive and manual dexterity assessments, and the following tools were used: Trail Making Test, box and block test (BBT), Learning Test of Rey and Nine Hole Peg Test. Descriptive statistics for clinical and demographic data were performed using mean and standard deviation, and data normality was assessed using the Shapiro-Wilk test. Spearman's nonparametric test was used to determine the correlation between variables. RESULTS: Our findings revealed significant associations between cognitive performance and manual dexterity. The nine-hole peg test positively correlated with TMT-Part A and Part B, establishing a relationship between manual dexterity and cognitive functions such as attention and mental flexibility. On the other hand, BBT showed an inverse relationship with TMT-Part B, indicating that longer time on this task was associated with lower manual dexterity. CONCLUSION: Fine manual dexterity had a significant correlation with visual search skills and motor speed, while gross motor dexterity had a negative correlation with cognitive skills. No significant results were demonstrated regarding the interaction between manual dexterity and memory.

Enhancing daily living and cognitive functions in traumatic brain injury patients through Orem's self-care theory.

Introduction: This research seeks to investigate how early rehabilitation nursing, guided by Orem's self-care theory, affects cognitive function, neurological function, and daily living skills in individuals who have suffered a traumatic brain injury (TBI). Methods: A study was conducted with 108 patients with traumatic brain injury who were hospitalized at our facility from January 2021 to March 2023. Based on their admission dates, the participants were separated into a control group (n = 56) and an observation group (n = 52). The control group received standard nursing care, while the observation group received a combination of conventional treatment and nursing interventions based on Orem's self-care model. The research assessed alterations in the ability to perform daily tasks (Activities of Daily Living, ADL), neurological health (National Institutes of Health Stroke Scale, NIHSS; Glasgow Coma Scale, GCS), and cognitive abilities (Montreal Cognitive Assessment Scale, MoCA; Mini-Mental State Examination, MMSE) in both sets of participants prior to and following 4 and 8 weeks of nursing assistance. Results: Following the intervention, the group being observed showed notably increased ADL scores at 4 weeks (p < 0.001) and 8 weeks (p < 0.001) in comparison to the control group. At 4 weeks and 8 weeks after nursing, the observation group had significantly lower NIHSS scores compared to the control group (4 weeks after nursing, p = 0.03; 4 weeks after nursing, p < 0.001). GCS score comparison showed the similar results (4 weeks after nursing, p = 0.013; 4 weeks after nursing, p = 0.003). Moreover, the participants in the observation group had notably higher MoCA and MMSE scores in comparison with the control group 4 and 8 weeks after nursing (all p < 0.001). Conclusion: Orem's self-care theory improves patients' cognitive, neurological, and daily living functions of TBI patients during early rehabilitation nursing. This method helps enhance the level of care given by healthcare professionals, leading to more thorough and compassionate nursing care for patients.

Comparative analysis of nutritional status among institutionalised and community-dwelling elderly women and its association with mental health status and cognitive function.

Introduction: Population pyramids are significantly impacted by the global phenomena of ageing. It has been reported that depression and cognitive function have an impact on the nutritional status of older adults. Depression is the most common psychiatric problem in old age, and cognitive deterioration is frequently observed in this age group. Objective: This descriptive and comparative study set out to compare the cognitive abilities, nutritional health and depression status of older adults who lived in community settings and in assisted living facilities. Materials and Methods: A total of 250 older women (125 from institutionalised old age home and 125 from community) participated in a cross-sectional study (residing at Rajarhat, Newtown area). The lengthy version of the Mini Nutritional Assessment tool (MNA®) was used to evaluate the participants' nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination (MMSE), cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal-Wallis test, and Spearman's rho correlation coefficient were computed. Results: In the present study, it was observed that only 30.4% of the respondents who are community-dwelling elderly had normal MNA score, whereas 69.6% were at risk of malnutrition or already malnourished. Considering institutionalised elderly it was observed that only 7.2% were normal and 92.8% were malnourished/at risk of malnutrition. Statistically significant association was observed between nutritional status and mental health status (P = 0.00) as well as cognitive function (P = 0.00) among old age home residing elderly. Among the community-dwelling elderly mental health status has significant association with their nutritional status (P = 0.00) and cognitive function (P = 0.00) as well. Conclusions: Community-dwelling elderly were relatively healthy compared to old age home residents. Maintaining the nutritional, cognitive, and mental health of institutionalised and community-dwelling elderly women requires the implementation of physical and cognitive stimulation activities as well as interventions targeted at improving a healthy diet.

Effects of cognitively engaging physical activity interventions on executive function in children and adolescents: a systematic review and meta-analysis.

Background: This systematic review and meta-analysis aim to evaluate the effects of cognitively engaging Physical Activity (PA) interventions on Executive Function (EF) in children and adolescents. It examines how different intervention modalities, durations, frequencies, and session lengths influence these effects. Methods: We followed the PRISMA guidelines and searched PubMed, SPORTDiscus, Embase, and Web of Science for relevant studies. Studies were included if they were Randomized Controlled Trials (RCTs) focusing on PA with cognitive elements targeting EF in healthy children and adolescents. Data were extracted and effect sizes computed using Standardized Mean Differences (SMDs). Results: From an initial 1,635 articles, 23 studies with 2,857 participants were included. The overall effect of cognitively engaging PA on EF was significant (SMD = 0.32, 95% CI 0.14-0.51), with notable improvements in inhibitory control (SMD = 0.35) and working memory (SMD = 0.34). High heterogeneity was observed (I 2 = 91.1%). Moderator analyses revealed that interventions lasting more than 6 weeks, with sessions over 20 min and conducted more than twice a week, were particularly effective. Conclusion: Cognitively engaging PA interventions positively impact EF in children and adolescents, particularly in inhibitory control. Effective interventions are characterized by longer duration, higher frequency, and extended session lengths. These findings underscore the importance of integrating cognitive challenges within PA programs to enhance EF, warranting future research and practical applications in educational and developmental settings.