Effects of a dual intervention (motor and virtual reality-based cognitive) on cognition in patients with mild cognitive impairment: a single-blind, randomized controlled trial.

BACKGROUND: The increase in cases of mild cognitive impairment (MCI) underlines the urgency of finding effective methods to slow its progression. Given the limited effectiveness of current pharmacological options to prevent or treat the early stages of this deterioration, non-pharmacological alternatives are especially relevant. OBJECTIVE: To assess the effectiveness of a cognitive-motor intervention based on immersive virtual reality (VR) that simulates an activity of daily living (ADL) on cognitive functions and its impact on depression and the ability to perform such activities in patients with MCI. METHODS: Thirty-four older adults (men, women) with MCI were randomized to the experimental group (n = 17; 75.41 ± 5.76) or control (n = 17; 77.35 ± 6.75) group. Both groups received motor training, through aerobic, balance and resistance activities in group. Subsequently, the experimental group received cognitive training based on VR, while the control group received traditional cognitive training. Cognitive functions, depression, and the ability to perform activities of daily living (ADLs) were assessed using the Spanish versions of the Montreal Cognitive Assessment (MoCA-S), the Short Geriatric Depression Scale (SGDS-S), and the of Instrumental Activities of Daily Living (IADL-S) before and after 6-week intervention (a total of twelve 40-minutes sessions). RESULTS: Between groups comparison did not reveal significant differences in either cognitive function or geriatric depression. The intragroup effect of cognitive function and geriatric depression was significant in both groups (p < 0.001), with large effect sizes. There was no statistically significant improvement in any of the groups when evaluating their performance in ADLs (control, p = 0.28; experimental, p = 0.46) as expected. The completion rate in the experimental group was higher (82.35%) compared to the control group (70.59%). Likewise, participants in the experimental group reached a higher level of difficulty in the application and needed less time to complete the task at each level. CONCLUSIONS: The application of a dual intervention, through motor training prior to a cognitive task based on Immersive VR was shown to be a beneficial non-pharmacological strategy to improve cognitive functions and reduce depression in patients with MCI. Similarly, the control group benefited from such dual intervention with statistically significant improvements. TRIAL REGISTRATION: ClinicalTrials.gov NCT06313931; https://clinicaltrials.gov/study/NCT06313931 .

Effects of bottom-up versus top-down digital cognitive training in older adults: A randomized controlled trial.

INTRODUCTION: Impairments in bottom-up perceptual processing have been associated to the age-related cognitive decline. Digital cognitive training focusing on bottom-up and/or top-down processes have been studied as a tool to remediate age-related cognitive decline. However, the most effective training type and order of application remain unclear. METHODS: One hundred and fifteen older adults were randomly assigned to 40 h of bottom-up then top-down or top-down then bottom-up digital cognitive training or an active control group. We evaluated cognition at baseline, after 20 h and 40 h of training and at follow-up using a mixed-model analysis. RESULTS: Global cognition improved, for the top-down group, after 20 h of training (p = 0.04; d = 0.7) and for all three groups after 40 h. The improvement in global cognition remained five months after the bottom-up/ top-down training (p = 0.009; d = 4.0). There were also improvements in the recall cognitive domain, after 20 h of training, for the bottom-up group and, after 40 h, for all three groups. Gains were observed in verbal fluency after 40 h of training for both therapeutic groups. Processing speed was significantly slower, after 20 h of training, for the control and bottom-up groups and, after 40 h, only for the control group. Emotion recognition improved, after 20 h, for the control group as compared to the therapeutic groups. CONCLUSIONS: These results indicate that the bottom-up/top-down training has the most endurable effects, which reveals the importance of the order of application of the exercises for gains in cognition in older adults.

The effect of a cognitive training therapy based on stimulation of brain oscillations in patients with mild cognitive impairment in a Chilean sample: study protocol for a phase IIb, 2 × 3 mixed factorial, double-blind randomised controlled trial.

BACKGROUND: The ageing population has increased the prevalence of disabling and high-cost diseases, such as dementia and mild cognitive impairment (MCI). The latter can be considered a prodromal phase of some dementias and a critical stage for interventions to postpone the impairment of functionality. Working memory (WM) is a pivotal cognitive function, representing the fundamental element of executive functions. This project proposes an intervention protocol to enhance WM in these users, combining cognitive training with transcranial electrical stimulation of alternating current (tACS). This technique has been suggested to enhance the neuronal plasticity needed for cognitive processes involving oscillatory patterns. WM stands to benefit significantly from this approach, given its well-defined electrophysiological oscillations. Therefore, tACS could potentially boost WM in patients with neurodegenerative diseases. METHODS: This study is a phase IIb randomised, double-blind clinical trial with a 3-month follow-up period. The study participants will be 62 participants diagnosed with MCI, aged over 60, from Valparaíso, Chile. Participants will receive an intervention combining twelve cognitive training sessions with tACS. Participants will receive either tACS or placebo stimulation in eight out of twelve training sessions. Sessions will occur twice weekly over 6 weeks. The primary outcomes will be electroencephalographic measurements through the prefrontal theta oscillatory activity, while the secondary effects will be cognitive assessments of WM. The participants will be evaluated before, immediately after, and 3 months after the end of the intervention. DISCUSSION: The outcomes of this trial will add empirical evidence about the benefits and feasibility of an intervention that combines cognitive training with non-invasive brain stimulation. The objective is to contribute tools for optimal cognitive treatment in patients with MCI. To enhance WM capacity, postpone the impairment of functionality, and obtain a better quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05291208. Registered on 28 February 2022. ISRCTN87597719 retrospectively registered on 15 September 2023.

Effects of a physical exercise or motor activity protocol on cognitive function, lipid profile, and BDNF levels in older adults with mild cognitive impairment.

This study analyzed the effects of a physical exercise program compared to the complexity of the motor task on the cognitive function, brain-derived neurotrophic factor (BDNF) levels, and lipid profile of older adults with mild cognitive impairment (MCI). Twenty-seven participants were randomized into three intervention groups: Physical Exercise (PE), Motor Task (MT), and Physical Exercise associated with Motor Task (PE + MT). Six months of intervention twice a week resulted in improvements in cognitive function, total cholesterol (TC), and LDL cholesterol (LDL-C) in the PE (p < 0.05). In the PE + MT, in addition to improved cognitive capacity, there was also a reduction in non-HDL cholesterol (NHDL-C) and LDL cholesterol (LDL-C) levels (p < 0.05), while in the MT, the values of TC, NHDL-C, and LDL-C decreased as a result of the intervention. BDNF levels were not affected by the interventions. In conclusion, PE alone or combined with MT is effective in promoting improvements in overall cognitive function and lipid profile in older adults with MCI; and BDNF seems not to be a sensitive marker for people with mild cognitive impairment.

If deprivation worsens dementia outcomes, stimulation should improve them.

It is still not known what causes Alzheimer's Disease (AD). In this period of uncertainty, an emerging literature on risk factors suggests that the concept of "stimulation" is a useful pragmatic tool both before and after diagnosis to improve cognitive health. Before diagnosis of AD, stimulation of the brain through education, exercise, and social stimulation provides fortification against later cognitive decline. After diagnosis, specific electrical stimulation of brain circuits may protect cognitive function, and non-specific stimulation through different kinds of environmental enrichment may help to compensate for cognitive decline. Pragmatic guidelines are offered here to maximise enabling stimulation (physical, cognitive, and social activity) and minimise disabling stimulation across the lifetime (e.g. stress, pollution, and poor diet). However, much deeper structural changes in society are needed to struggle against socioeconomic and environmental deprivation and the inaccessibility of education for women across the globe.

Transcultural Pilot Study of the Efficacy of Reminiscence Therapy for Mexican and Spanish Older Adults with Different Levels of Cognitive Decline.

The main objective for this study is to analyze the impact of a positive reminiscence therapy program (REMPOS) in cognitive functioning and depressive symptomatology for older adults in different vital situations (healthy aging, mild cognitive impairment, and Alzheimer's disease).This is a transcultural comparative study (older people from Spain and Mexico). A randomized design with pre-posttest measurement and twelve groups was formulated, during a period of six months of intervention (3 in Mexico and 3 in Spain). The design had: 6 experimental groups with REMPOS intervention (3 in Mexico and 3 in Spain) during a period of six months and 6 control groups that received cognitive stimulation.While a key aspect of this study is the cross-cultural differences, an important part is to determine whether each experimental group had similar results in terms of the change in magnitude between the pre and post analysis. In general, intervention significantly improved cognitive function and decreased depressive symptoms.These findings provide further evidence about the efficacy of the REMPOS therapy between different types of aging and both geographical and cultural contexts (Spain and Mexico).

Effects of a cognitive stimulation program on physical and cognitive dimensions in community-dwelling faller older adults with cognitive impairment: study protocol.

BACKGROUND: Cognitive functioning is an important dimension among the elderly. Cognitive maintenance is vital for aging due to its association with autonomy and independence. Considering the importance of preventive programs in older adults' health, this study aims to share an intervention protocol of a falls prevention program for community-dwelling faller older adults with cognitive impairment. METHODS: This is the protocol of an experimental and longitudinal study, consisting of cognitive stimulation associated with physical exercise in a 16-week fall prevention program. For cognitive intervention, the APG Cognitive Training Protocol will be used. Participants will be assessed pre-and post-intervention and will be randomly allocated to experimental or control groups. The screening protocol is composed of the TUG, FES-I, LAWTON & BRODY, ACE-R, GAI and fall survey instruments, focusing on the assessment of balance and mobility, fear of falling, performance on IADL, cognitive and anxiety tracking, respectively. DISCUSSION: This study can determine the long-term effects of multimodal cognitive training, providing evidence for its replication in the provision of care for the elderly. The objective is to promote improvements in the cognitive performance, mobility and balance of the elderly, with a focus on reducing the number of falls, fractures, hospitalizations and institutionalization, serving as an alternative to interrupt the cycle of falls. TRIAL REGISTRATION: The research was approved by the Research Ethics Committee with Human Beings at the Federal University of São Carlos, CAAE: 3654240.9.0000.5504 and Brazilian Registry of Clinical Trials (REBEC) RBR-3t85fd, registered on the 25th of September, 2020.

Association between motivation and engagement with changes in cognition and symptoms after digital cognitive training in schizophrenia.

BACKGROUND: Digital cognitive training can remediate cognitive deficits present in schizophrenia. However, limited motivation and engagement may impact adherence to training. Therefore, identifying factors that may enhance (facilitators) or decrease (barriers) engagement in digital cognitive training and possibly modulate its effects are of great clinical relevance. METHODS: We measured cognition, symptom severity, motivation (semi-structured interview), and engagement (adapted Utrecht Work Engagement Scale - UWES) of 27 patients with schizophrenia after a 40-h digital cognitive training. The interview transcript quotes were coded and categorized into facilitators and barriers. Thereafter, we tested the association of motivation and engagement with changes in cognition and symptoms after training. RESULTS: The facilitator 'good performance' and the barrier 'difficult exercise' were associated with larger gains in attention (p = 0.03) and reasoning and problem solving (p = 0.02), respectively. 'Poor performance' was associated with smaller gains in global cognition (p < 0.01), attention (p = 0.03), and working memory (p = 0.02). The facilitator 'welcoming setting' was associated with larger reductions in the negative (p = 0.01) and total (p = 0.01) symptoms measured by the Positive and Negative Syndrome Scale. The UWES engagement scale was associated with different facilitators and barriers that emerged from the interview, an indication of consistency among both qualitative and quantitative assessments. DISCUSSION: Using a mixed quantitative and qualitative research design, we showed associations between motivation and engagement and the response to digital cognitive training in schizophrenia. Facilitators and barriers were associated with engagement, gains in cognition, and reduced symptoms after the intervention, providing insights on how to increase engagement in the digital cognitive training delivered to subjects with schizophrenia.

Management of psychiatric and cognitive complications in Parkinson's disease.

Neuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson's disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.

Mal de desembarque / Mal de debarquement

Resumen El síndrome de mal de desembarque es un cuadro clínico de mareo y oscilaciones corporales persistente, descrito siglos atrás cuando los marineros llegaban a tierra después de navegar. Actualmente, se sabe que este cuadro clínico ocurre también al bajarse de cualquier medio de transporte, ya sea marítimo, aéreo o terrestre. Cuando el cuadro clínico tiene una duración de tres o más días, se denomina mal de desembarque persistente, y se asocia a cefalea y mayores niveles de ansiedad y síntomas depresivos. A continuación, presentamos el cuadro clínico de un paciente que consultó por mareo persistente posterior a un paseo en bote en el mar. Se discute diagnóstico y manejo terapéutico.

Abstract Mal de Debarquement is a clinical syndrome characterized by persistent self-motion dizziness and increased oscillatory body sway, that was described centuries ago after sailors landed in port. Nowadays, it is known that mal de debarquement could appear after any travel in a motion vehicle, including airplanes, ships and cars. When the duration of the symptoms lasts longer than three days, a persistent mal de debarquement is diagnosed, and it is associated with headache and higher levels of anxiety and depressive symptoms. Here, we present a clinical case of a persistent mal de debarquement that attended to the Otolaryngology clinics at the Clinical Hospital of the University of Chile after a boat trip in the sea. We discuss diagnosis and clinical management.

Disfunção cognitiva canina: tratamentos disponíveis / Canine cognitive dysfunction: Available treatments

A disfunção cognitiva canina (DCC) é uma enfermidade que causa alterações fisiológicas e comportamentais em cães idosos, e que apresenta uma fisiopatogenia semelhante à doença de Alzheimer (DA), que acomete seres humanos. Os sinais clínicos são representados pela sigla DISHA (desorientação, mudanças na interação com pessoas/animais, alterações no ciclo sono-vigília, falha no aprendizado/memória e nível de atividades alteradas). A principal forma de diagnóstico da doença é baseada em um questionário respondido pelo tutor, relacionado ao comportamento do animal. O tratamento é multimodal, consistindo basicamente em uso de fármacos, mudanças na alimentação, e enriquecimento ambiental e mental. Os fármacos utilizados são de diversas classes farmacológicas e agem diretamente em substâncias relacionadas com a fisiopatogenia da DCC, além de atenuarem alguns sinais clínicos da enfermidade. Essa ação dos fármacos é potencializada com a adição de alimentos específicos, enriquecimento do ambiente que o animal vive e estimulação mental, principalmente por meio de passeios. A união de todas essas modalidades de tratamento auxilia na melhoria do bem-estar do animal acometido. Como a disfunção não tem cura, o tratamento é longo e, muitas vezes, não é possível visualizar melhora evidente no animal. Dessa forma, alguns tutores acabam optando pela eutanásia. Apesar de ser frequente em cães idosos e haver uma ampla base literária acerca da DCC, não há um protocolo terapêutico específico. Sendo assim, há diversos tratamentos disponibilizados de forma isolada na literatura, fazendo com que os clínicos veterinários encontrem dificuldades para achar um compilado de informações em uma única fonte.

Canine cognitive dysfunction (CCD) is a disease that causes physiological and behavioral changes in elderly dogs and presents a physiopathogeny similar to Alzheimer's disease (AD), which affects humans. Clinical signs are represented by the acronym DISHA (disorientation, changes in interaction with people/animals, changes in the sleep-wake cycle, learning/memory failure, and altered activity level). The main form of diagnosis of illness is based on a questionnaire answered by the tutor, related to the animal behavior. The treatment is multimodal, basically consisting of drug use, changes in the diet, and environmental and mental enrichment. The drugs used are of various pharmacological classes and act directly on substances related to the physiopathogeny of CCD, besides attenuating some clinical signs of the disease. This drug action is enhanced with the addition of specific foods, enrichment of the environment where the animal lives and mental stimulation, mainly through tours. The union of all these treatment modalities helps to improve the welfare of the affected animal. As the disease has no cure, the treatment is long and it is often not possible to visualize evident improvement in the animal. In this way, some tutors opt for euthanasia. Despite being frequent in elderly dogs and there is a broad literature on CCD, there is no specific therapeutic protocol. There are several treatments available in isolation in the literature, causing veterinary clinicians find it difficult to locate a compilation of information from a single source.

Gamepad: utilizando exergames para a promoção da saúde e inclusão social de pessoas com deficiência / Gamepad: use of exergames for promoting health and social inclusion of people with disabilities

O objetivo desse artigo é relatar os resultados de um programa de exercícios para indivíduos adultos com deficiências cognitivas e transtornos, utilizando diferentes exergames como ferramentas pedagógicas. A intervenção foi realizada com a participação de 26 indivíduos adultos com deficiências cognitivas e transtornos com idades entre 25 e 59 anos. A pesquisa de abordagem qualitativa, de cunho exploratória, a qual foram utilizados a entrevista semiestruturada e o diário de campo como instrumentos de pesquisa. Para interação com os exergames, foram utilizados os consoles Xbox 360 com Kinect, Xbox One com Kinect e Nintendo Wii U. As intervenções foram realizadas no Exergame Lab Brazil, na Escola Superior de Educação Física da UFPel, por um período de duas horas, uma vez por semana, totalizando 25 encontros. A utilização de Exergames tem grande potencial, tanto nos aspectos relacionados à viabilidade, por ser uma tecnologia de baixo custo e de fácil implementação, quanto nos resultados esperados. O Just Dance e o Kinect Sports foram os games que mais contribuíram nesta pesquisa. Os participantes da pesquisa ganharam independência e socialização, bem como melhoraram as habilidades específicas em cada game. Além disso, a possibilidade de utilização dos Exergames em casa também poderá auxiliar pais e responsáveis a melhorar aspectos da vida diária de adultos com deficiências cognitivas e transtornos.

The purpose of this article is to report the results of an exercise program for adults with cognitive disabilities and disorders using different exergames as pedagogical tools. The intervention was carried out with the participation of 26 individuals with cognitive disabilities and disorders aged between 25 and 59 years old. The exploratory, qualitative research used a semi-structured interview and a field diary as research instruments. The Xbox 360 with Kinect, Xbox One with Kinect and Nintendo Wii U consoles were used for the interactions with the exergames. The interventions were carried out at Exergame Lab Brazil, at the Physical Education School at UFPel, for a period of two hours, once a week, totaling 25 meetings. The use of Exergames presents great potential, both in relation to feasibility, since it is a low-cost, easy-to-implement technology, and in terms of expected results. Just Dance and Kinect Sports were the games that contributed most to this research. Research participants gained independence and socialization, as well as the improvement of specific skills in each game. In addition, the possibility of using Exergames at home can also help parents and guardians to improve aspects of the daily life of adults with cognitive disabilities and disorders.

Physical exercise as a non-pharmacological strategy for reducing behavioral and psychological symptoms in elderly with mild cognitive impairment and dementia: a systematic review of randomized clinical trials.

BACKGROUND: Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Non-pharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. OBJECTIVE: The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. METHODS: A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. RESULTS: Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. CONCLUSIONS: Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease.

Physical exercise as a non-pharmacological strategy for reducing behavioral and psychological symptoms in elderly with mild cognitive impairment and dementia: a systematic review of randomized clinical trials / Exercício físico como estratégia não farmacológica para a redução de sintomas psicológicos e comportamentais em idosos com comprometimento cognitivo leve e demência: revisão sistemática de ensaios clínicos randomizados

ABSTRACT Background: Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Non-pharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. Objective: The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. Methods: A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. Results: Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. Conclusions: Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease.

RESUMO Antecedentes: Idosos com demência podem manifestar sintomas comportamentais e psicológicos durante o percurso da doença. Terapias não farmacológicas, como por exemplo a atividade física regular, são consideradas como uma das estratégias para manejar esses sintomas. Objetivo: O objetivo deste estudo é investigar se a participação em programas de exercício físico é efetiva na redução de sintomas comportamentais e neuropsiquiátricos de idosos com comprometimento cognitivo leve (CCL) e demência. Métodos: Foi realizada uma revisão da literatura nas bases de dados Medical Literature Analysis and Retrieval System Online — MEDLINE (PubMed), Scientific Electronic Library Online (SciELO), Web of Science, Scopus e SPORTDiscus de 2010 a 2020. Os estudos elegíveis foram: ensaios clínicos randomizados envolvendo idosos com CCL ou demência, que medissem como desfecho primário ou secundário a mudança nos sintomas neuropsiquiátricos e psicológicos. Os estudos tiveram grupo com apenas o exercício físico como intervenção em comparação a um grupo controle. Resultados: De 175 publicações identificadas na pesquisa inicial, apenas sete estudos atenderam aos critérios de elegibilidade. Quatro em sete estudos demonstraram efeitos positivos na redução dos sintomas comportamentais, enquanto os demais não fizeram diferenciação entre os ganhos conforme o tipo de protocolo. Conclusões: Exercícios aeróbicos e de fortalecimento muscular de intensidade moderada a vigorosa podem ter um benefício potencial no manejo dos sintomas psicológicos e comportamentais da demência. Esta revisão mostrou a necessidade de mais estudos de intervenção, buscando investigar como desfecho primário o efeito absoluto do exercício físico e seu impacto nos sintomas comportamentais e psicológicos de idosos com CCL e demência, principalmente nas fases iniciais da doença.

Efecto de una intervención no farmacológica multidimensional en un grupo de personas con deterioro cognitivo leve / Effects of a multidimensional intervention in older adults with mild cognitive impairment

BACKGROUND: Mild Cognitive Impairment (MCI) is defined as the intermediate stage between the cognitive changes associated with normal aging and dementia. People with MCI can benefit from the implementation of multidimensional non-pharmacological interventions. Aim: To determine the effect of a Multidimensional Intervention based on cognitive, physical, and social training (IMCFS) on the cognitive performance of a group of people with MCI. MATERIALS AND METHODS: Pre and post intervention measurements of cognitive and physical parameters were performed in 10 adults aged 76 ± 4 years with MCI, who participated in the IMCFS lasting three months. Results: A significant improvement was observed in global cognitive performance, anterograde memory, visuospatial memory and in associative learning after IMCFS implementation. No significant effects of the IMCFS on attention, executive functions, language, and viso-constructive skills were observed. CONCLUSIONS: Older adults with MCI benefit from the implementation of a multidimensional intervention, such as IMCFS, which is feasible to implement and integrate into the programs offered by the Chilean healthcare network.

Aplicación piloto de un programa de reminiscencia positiva para personas mayores institucionalizadas / Pilot application of a positive reminiscence program for institutionalized older people

Resumen Los conocimientos actuales sobre la salud de las personas mayores permiten afirmar que es posible mejorar su calidad de vida, especialmente a través del uso de técnicas no farmacológicas de carácter preventivo. El objetivo de este artículo es presentar una aplicación piloto de un Programa de Reminiscencia Positiva (REMPOS) que en otros países como España y México han demostrado ser efectivo en personas mayores con deterioro cognitivo leve y en población normal institucionalizadas. La población fue de 60 personas mayores pertenecientes a un centro de Larga Estudia del Gran Concepción. La muestra estuvo constituida por 5 personas mayores que aceptaron participar y que cumplían los criterios de inclusión. Instrumentos: se usó el MOCA y Mini Mental para evaluar deterioro leve y normalidad. Procedimiento: se seleccionaron sesiones del REMPOS que podrían tener un sesgo transcultural. Resultados: se encontró que varias de las sesiones necesitaban cambios especialmente con relación a la presencia de analfabetismo funcional, limitación motora y sensorial (vista y oído) en las personas mayores. Se discute la adaptación del programa y las implicaciones derivadas de la institucionalización.

Current knowledge about the health of older people, allows us to affirm that it is possible to improve their quality of life, especially with preventive non-pharmacological techniques. The objective of this article is to present a pilot Application of a Positive Reminiscence Program (REMPOS) which in other countries such as Spain and Mexico have been shown to be effective in older people with mild cognitive impairment and in normal institutionalized populations. The population was 60 older adults belonging to a Long Study center of the Great Conception. The sample consisted of 5 older adults who agreed to participate and who met the inclusion criteria. Instruments MOCA and Mini Mental were used to assess mild impairment and normality. Procedure REMPOS sessions were selected that could have a cross-cultural bias. Results It was found that several of the sessions needed changes especially in relation to the presence of functional illiteracy, motor and sensory limitation (sight and hearing) in older people. Program adaptation and institutionalization are discussed.

IGF1 Gene Therapy Reversed Cognitive Deficits and Restored Hippocampal Alterations After Chronic Spinal Cord Injury.

The hippocampus is implicated in the generation of memory and learning, processes which involve extensive neuroplasticity. The generation of hippocampal adult-born neurons is particularly regulated by glial cells of the neurogenic niche and the surrounding microenvironment. Interestingly, recent evidence has shown that spinal cord injury (SCI) in rodents leads to hippocampal neuroinflammation, neurogenesis reduction, and cognitive impairments. In this scenario, the aim of this work was to evaluate whether an adenoviral vector expressing IGF1 could reverse hippocampal alterations and cognitive deficits after chronic SCI. SCI caused neurogenesis reduction and impairments of both recognition and working memories. We also found that SCI increased the number of hypertrophic arginase-1 negative microglia concomitant with the decrease of the number of ramified surveillance microglia in the hilus, molecular layer, and subgranular zone of the dentate gyrus. RAd-IGF1 treatment restored neurogenesis and improved recognition and working memory impairments. In addition, RAd-IGF1 gene therapy modulated differentially hippocampal regions. In the hilus and molecular layer, IGF1 gene therapy recovered the number of surveillance microglia coincident with a reduction of hypertrophic microglia cell number. However, in the neurogenic niche, IGF1 reduced the number of ramified microglia and increased the number of hypertrophic microglia, which as a whole expressed arginase-1. In summary, RAd-IGF1 gene therapy might surge as a new therapeutic strategy for patients with hippocampal microglial alterations and cognitive deficits such as those with spinal cord injury and other neurodegenerative diseases.

[Effects of a multidimensional intervention in older adults with mild cognitive impairment]. / Efecto de una intervención no farmacológica multidimensional en un grupo de personas con deterioro cognitivo leve.

BACKGROUND: Mild Cognitive Impairment (MCI) is defined as the intermediate stage between the cognitive changes associated with normal aging and dementia. People with MCI can benefit from the implementation of multidimensional non-pharmacological interventions. AIM: To determine the effect of a Multidimensional Intervention based on cognitive, physical, and social training (IMCFS) on the cognitive performance of a group of people with MCI. MATERIALS AND METHODS: Pre and post intervention measurements of cognitive and physical parameters were performed in 10 adults aged 76 ± 4 years with MCI, who participated in the IMCFS lasting three months. RESULTS: A significant improvement was observed in global cognitive performance, anterograde memory, visuospatial memory and in associative learning after IMCFS implementation. No significant effects of the IMCFS on attention, executive functions, language, and viso-constructive skills were observed. CONCLUSIONS: Older adults with MCI benefit from the implementation of a multidimensional intervention, such as IMCFS, which is feasible to implement and integrate into the programs offered by the Chilean healthcare network.

Modulatory action of environmental enrichment on hormonal and behavioral responses induced by chronic stress in rats: Hypothalamic renin-angiotensin system components.

Environmental enrichment (EE) has been studied as a protocol that can improve brain plasticity and may protect against negative insults such as chronic stress. The aim of this study was to evaluate the effects of EE on the hormonal and behavioral responses induced by chronic mild unpredictable stress (CMS) in rats, considering the involvement of the renin-angiotensin system. Male adult rats were divided into 4 groups: control, CMS, EE, and CMS + EE, and the experimental protocol lasted for 7 weeks. EE was performed during 7 weeks, 5 days per week, 2 h per day. CMS was applied during weeks 3, 4, and 5. After the CMS (week 6), depression-like behavior was evaluated by forced swimming and sucrose consumption tests, anxiety level was evaluated using the elevated plus-maze test, and memory was evaluated using the Y-maze test. On week 7, the animals were euthanized and basal plasma levels of corticosterone and catecholamines were determined. The hypothalamus was isolated and tissue levels of angiotensin peptides were evaluated. CMS increased plasma corticosterone, norepinephrine, and epinephrine basal concentrations, induced depression-like behaviors, impaired memory, and increased hypothalamic angiotensin I, II, and IV concentrations. EE decreased stress hormones secretion, depression-like behaviors, memory impairment, and hypothalamic angiotensin II induced by stress. Reductions of anxiety-like behavior and norepinephrine secretion were observed in both stressed and unstressed groups. The results indicated that EE seemed to protect adult rats against hormonal and behavioral CMS effects, and that the reduction of angiotensin II could contribute to these effects.

Knockdown of lncRNA TUG1 inhibits hippocampal neuronal apoptosis and participates in aerobic exercise-alleviated vascular cognitive impairment.

OBJECTIVES: Our previous study indicated that aerobic exercise relieves cognitive impairment in patients with vascular cognitive impairment (VCI) via regulating brain-derived neurotrophic factor (BDNF), but the mechanism is not yet clear. This study aimed to explore whether lncRNA taurine upregulated gene 1 (TUG1) participates in the process of VCI by regulating BDNF. METHODS: The expressions of TUG1 and BDNF in the serum of VCI patients were detected. The potential molecular mechanisms of TUG1 in regulating hippocampal neuronal apoptosis were explored in oxygen and glucose deprivation-induced (OGD-induced) hippocampal cell line HT22. The VCI mouse model was established, and TUG1 and BDNF were overexpressed via lentivirus injection. The cognitive impairment of mice was detected by the Morris water maze experiment after the aerobic exercise. RESULTS: The level of TUG1 was elevated in the serum of VCI patients compared with the control group. The knockdown of TUG1 in OGD-induced HT22 cells increased BDNF level and decreased cell apoptosis, and the downregulation of BDNF restored the decreased cell apoptosis. RNA immunoprecipitation and RNA pull-down assays showed that TUG1 could bind to BDNF protein. The aerobic exercise alleviated cognitive impairment and inhibited hippocampal apoptosis in VCI mice. Meanwhile, the overexpression of TUG1 reversed the therapeutic effects of aerobic exercise on cognitive impairment. CONCLUSIONS: The knockdown of TUG1 reduced hippocampal neuronal apoptosis and participates in the aerobic exercise-alleviated VCI, which was partly through regulating BDNF.