Las percepciones de olvidos recurrentes o episodios de distracción en la vida diaria se denominan quejas subjetivas de memoria (QSM). Su naturaleza se ha estudiado ampliamente en adultos mayores, pero su importancia y relación con el rendimiento neurocognitivo no se han abordado por completo en adultos más jóvenes. Se han sugerido algunos rasgos psicológicos como posibles moderadores de la asociación entre el rendimiento de la memoria objetiva y subjetiva. El primer objetivo de este estudio fue analizar la correspondencia entre la percepción objetiva y subjetiva de los fallos de memoria en jóvenes. En segundo lugar, estudiamos si el rasgo psicológico del neuroticismo podría estar influyendo en esta relación. Para ello, medimos QSM, diferentes dominios cognitivos (memoria episódica y de trabajo y funciones ejecutivas) y neuroticismo en 80 hombres y mujeres jóvenes. Los resultados mostraron que solo la memoria episódica inmediata estaba estadísticamente relacionada con los QSM. Curiosamente, las relaciones negativas entre el rendimiento de la memoria objetiva y subjetiva solo aparecieron en participantes con mayor neuroticismo. Por lo tanto, las quejas de memoria reportadas por los jóvenes podrían reflejar un peor rendimiento de la memoria episódica inmediata, mientras que el neuroticismo jugaría un papel principal en la asociación entre los déficits de memoria y las QSM. Este estudio proporciona datos que pueden ayudar a comprender mejor las QSM en los jóvenes.(AU)
Perceptions of recurrent forgetfulness or episodes of distraction in daily life are referred to as subjective memory complaints (SMCs). Their nature has been extensively studied in older adults, but their significance and relationship with neurocognitive performance have not been fully ad-dressed in younger adults. Some psychological traits have been suggested as possible moderators of the association between objective and subjective memory performance. The first aim of this study was to analyze the corre-spondence between the objective and subjective perception of memory failures in young people. Second, we studied whether the psychological trait of neuroticism could be influencing this relationship. Todo this, we measured SMCs, different cognitive domains (episodic and working memory and executive functions), and neuroticism in 80 young men and women. Results showed that only immediate episodic memory was statisti-cally related to SMCs. Interestingly, the negative relationships between ob-jective and subjective memory performance only appeared in participants with higher neuroticism. Thus, memory complaints reported by young people could reflect poorer immediate episodic memory performance, whereas neuroticism would play a main role in the association between memory deficits and SMCs. This study provides data that can help to bet-ter understand SMCs in young people.(AU)
Humans , Male , Female , Aged , Neuroticism , Memory, Episodic , Cognition , Neurocognitive Disorders , Memory
Introducción: La doble tarea es una intervención no farmacológica en personas con condiciones neurodegenerativas, utilizada en la enfermedad de Parkinson (EP), principalmente para favorecer el desempeño motor. El objetivo de esta revisión es reunir la evidencia actual sobre cómo el entrenamiento de doble tarea afecta a los procesos cognitivos en personas que presenten EP. Material y métodos. Se desarrolló una revisión sistemática, aplicando las directrices de PRISMA, incluyendo artículos obtenidos en las bases de datos de PubMed, Web of Science, Science Direct y Springer Link. La calidad metodológica se evaluó mediante PEDro y ROBINS-I. Resultados: Doce artículos cumplieron con los criterios de inclusión y exclusión: nueve de ellos corresponden a ensayos controlados aleatorizados y los tres restantes fueron estudios no aleatorizados. Se identificaron mejoras en la atención y las funciones ejecutivas, aunque la diversidad en enfoques y duración dificulta llegar a conclusiones definitivas. Conclusiones: Es crucial expandir la investigación, estandarizando los programas de intervención. Del mismo modo, es importante llevar a cabo estudios longitudinales y controlados aleatorizados en muestras representativas que permitan llegar a conclusiones aplicables a otros contextos.(AU)
Introduction: Dual-tasking is a non-pharmacological intervention in people with neurodegenerative conditions, and is used in Parkinsons disease (PD), primarily to enhance motor performance. The aim of this review is to compile the current evidence on how dual-task training affects cognitive processes in people with PD. Material and methods: A systematic review was undertaken, applying PRISMA guidelines, which included articles obtained from the PubMed, Web of Science, Science Direct and Springer Link databases. Methodological quality was assessed using PEDro and ROBINS-I. Results: Twelve articles met the inclusion and exclusion criteria: nine of them were randomized controlled trials, and the remaining three were non-randomized studies. Improvements in attention and executive functions were identified, although the diversity of approaches and duration means that reaching definitive conclusions is difficult. Conclusions: Increased research and standardized intervention programmes are essential. Longitudinal and randomized controlled studies in representative samples which provide conclusions that are applicable to other contexts are also important.(AU)
Humans , Male , Female , Cognition , Parkinson Disease , Neurology , Nervous System Diseases
To maintain current cognitive function and access greater cognitive reserves, nonpharmacological interventions may be a viable alternative for older adults with or without cognitive impairment. This study aimed to compare different nonpharmacological interventions for enhancing global cognition, including mind-body exercise, physical exercise, non-invasive brain stimulation, cognitive training intervention (CTI), acutherapy (ACU), meditation, and music therapy, by applying a network meta-analysis (NMA). Sixty-one randomized controlled trials evaluating the efficacy of interventions on global cognition in older adults with or without mild cognitive decline were selected. An NMA was conducted to compare the efficacy of different nonpharmacological interventions. The NMA revealed that mind-body exercise (standardized mean difference, 1.384; 95% confidence interval, 0.777-1.992); ACU (1.283; 0.478-2.088); meditation (0.910; 0.097-1.724); non-invasive brain stimulation (1.242; 0.254-2.230); CTI (1.269; 0.736-1.802); and physical exercise (0.977; 0.212-1.742), showed positive effects compared to passive controls. There were no significant differences between the efficacies of other interventions. Nonpharmacological interventions may potentially enhance and maintain global cognition through various pathways, such as memorizing movements and enhancing brain plasticity by reducing stress in the older adult population. Additional studies are needed to clarify the impact of other variables, including intervention methods or psychological variables.
Cognitive Dysfunction , Meditation , Humans , Aged , Network Meta-Analysis , Randomized Controlled Trials as Topic , Cognitive Dysfunction/therapy , Cognitive Dysfunction/psychology , Cognition/physiology , Exercise Therapy
BACKGROUND: Hypertension and chronic kidney disease (CKD) pose significant public health challenges, sharing intertwined pathophysiological mechanisms. Prediabetes is recognized as a precursor to diabetes and is often accompanied by cardiovascular comorbidities such as hypertension, elevating the risk of pre-frailty and frailty. Albuminuria is a hallmark of organ damage in hypertension amplifying the risk of pre-frailty, frailty, and cognitive decline in older adults. We explored the association between albuminuria and cognitive impairment in frail older adults with prediabetes and CKD, assessing cognitive levels based on estimated glomerular filtration rate (eGFR). METHODS: We conducted a study involving consecutive frail older patients with hypertension recruited from March 2021 to March 2023 at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, followed up after three months. Inclusion criteria comprised age over 65 years, prior diagnosis of hypertension without secondary causes, prediabetes, frailty status, Montreal Cognitive Assessment (MoCA) score < 26, and CKD with eGFR > 15 ml/min. RESULTS: 237 patients completed the study. We examined the association between albuminuria and MoCA Score, revealing a significant inverse correlation (r: 0.8846; p < 0.0001). Subsequently, we compared MoCA Score based on eGFR, observing a significant difference (p < 0.0001). These findings were further supported by a multivariable regression analysis, with albuminuria as the dependent variable. CONCLUSIONS: Our study represents the pioneering effort to establish a significant correlation between albuminuria and eGFR with cognitive function in frail hypertensive older adults afflicted with prediabetes and CKD.
Frailty , Hypertension , Prediabetic State , Renal Insufficiency, Chronic , Humans , Aged , Frail Elderly/psychology , Frailty/diagnosis , Frailty/epidemiology , Prediabetic State/diagnosis , Prediabetic State/epidemiology , Prediabetic State/complications , Albuminuria/diagnosis , Albuminuria/epidemiology , Albuminuria/complications , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/complications , Hypertension/diagnosis , Hypertension/epidemiology , Hypertension/complications , Glomerular Filtration Rate/physiology , Cognition
A systematic review was conducted to determine the trends in devices and parameters used for brain photobiomodulation (PBM). The revised studies included clinical and cadaveric approaches, in which light stimuli were applied to the head and/or neck. PubMed, Scopus, Web of Science and Google Scholar databases were used for the systematic search. A total of 2133 records were screened, from which 97 were included in this review. The parameters that were extracted and analysed in each article were the device design, actuation area, actuation site, wavelength, mode of operation, power density, energy density, power output, energy per session and treatment time. To organize device information, 11 categories of devices were defined, according to their characteristics. The most used category of devices was laser handpieces, which relate to 21% of all devices, while 28% of the devices were not described. Studies for cognitive function and physiological characterisation are the most well defined ones and with more tangible results. There is a lack of consistency when reporting PBM studies, with several articles under defining the stimulation protocol, and a wide variety of parameters used for the same health conditions (e.g., Alzheimer's or Parkinson's disease) resulting in positive outcomes. Standardization for the report of these studies is warranted, as well as sham-controlled comparative studies to determine which parameters have the greatest effect on PBM treatments for different neurological conditions.
Low-Level Light Therapy , Humans , Low-Level Light Therapy/methods , Brain , Cognition , Lasers
INTRODUCTION: Responsive caregiving (RC) leads to positive outcomes in children, including secure attachment with caregivers, emotional regulation, positive social interactions and cognitive development. Through our scoping review, we aim to summarise the practices and outcomes of RC in diverse caregiver and child populations from 0 to 8 years. METHODS AND ANALYSIS: We will use the Arksey and O'Malley framework and the Joanna Briggs Institute methodology for scoping reviews. We shall present our findings as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping review. Only peer-reviewed, English-language articles from 1982 to 2022 will be included from PubMed, Web of Science, APA PsychInfo, APA PsycArticles, SocINDEX and Google Scholar databases. Reference lists of included articles will also be screened. The search strategy will be developed for each database, and search results will be imported into Rayyan. Screening will be done in two phases: (1) titles and abstracts will be screened by two authors and conflicts will be resolved by mutual discussion between both or by consulting with a senior author; and (2) full-texts of shortlisted studies from the first phase will then be screened using the same inclusion/exclusion criteria. A data extraction form will be developed to collate relevant information from the final list of included articles. This form will be pilot tested on the first 10 papers and iteratively refined prior to data extraction from the remaining articles. Results will be presented in figures, tables and a narrative summary. ETHICS AND DISSEMINATION: No ethics approval needed as the review shall only use already published data. We shall publish the review in an open-access, peer-reviewed journal and disseminate through newsletters, social media pages, and presentations to relevant audiences.
Emotional Regulation , Mental Health , Child , Humans , Academies and Institutes , Cognition , Databases, Factual , Research Design , Review Literature as Topic
Decision Support Systems (DSS) are tools designed to help operators make effective choices in workplace environments where discernment and critical thinking are required for effective performance. Path planning in military operations and general logistics both require individuals to make complex and time-sensitive decisions. However, these decisions can be complex and involve the synthesis of numerous tradeoffs for various paths with dynamically changing conditions. Intelligence collection can vary in difficulty, specifically in terms of the disparity between locations of interest and timing restrictions for when and how information can be collected. Furthermore, plans may need to be changed adaptively mid-operation, as new collection requirements appear, increasing task difficulty. We tested participants in a path planning decision-making exercise with scenarios of varying difficulty in a series of two experiments. In the first experiment, each map displayed two paths simultaneously, relating to two possible routes for the two available trucks. Participants selected the optimal path plan, representing the best solution across multiple routes. In the second experiment, each map displayed a single path, and participants selected the best two paths sequentially. In the first experiment, utilizing the DSS was predictive of adoption of more heuristic decision strategies, and that strategic approach yielded more optimal route selection. In the second experiment, there was a direct effect of the DSS on increased decision performance and a decrease in perceived task workload.
Cognition , Decision Making , Humans , Male , Adult , Female , Cognition/physiology , Intelligence/physiology , Young Adult , Decision Support Techniques , Task Performance and Analysis
Increasingly complex and unpredictable personnel and operational demands require Special Operations Forces (SOF) members and their families to remain flexible, adaptive, and resilient within ever-changing circumstances. To mitigate the impact of these stressors on psychological health and fitness, researchers and educators at the Uniformed Services University of the Health Sciences (USUHS) developed Special Operations Cognitive Agility Training (SOCAT), a cognitive performance optimization program supported by the United States Special Operations Command (USSOCOM) Preservation of the Force and Family (POTFF). The goal of SOCAT is to enhance cognitive agility, defined as the ability to deliberately adapt cognitive processing strategies in accordance with dynamic shifts in situational and environmental demands, in order to facilitate decision making and adapt to change. Overall, SOCAT emphasizes optimal cognitive performance across different contexts - as well as across various stages of the military lifecycle - to serve as a buffer against biopsychosocial vulnerabilities, environmental and social stressors, military operational demands, and behavioral health problems, including suicide. This paper reviews foundational research behind SOCAT, mechanisms through which SOCAT is anticipated to build psychological resilience, and describes the process of developing and tailoring SOCAT for active duty SOF members and spouses. Limitations and future directions, including an ongoing, randomized controlled program evaluation, are discussed.
Military Personnel , Humans , Military Personnel/psychology , Military Personnel/education , Spouses/psychology , Spouses/education , Resilience, Psychological , Cognition/physiology
A growing body of work has found that a mismatch between early and recent life stress, more than a cumulative influence of stress, contributes to detrimental stress-related health outcomes. To date, however, no work has examined how such a mismatch might relate to stress-related cognitive outcomes. We addressed this gap in the current study by assessing participants' (N = 154, Mage = 18.7, 104 female) early and recent life stress using the same inventory, and subsequently assessing their inhibitory control in a hybrid stop-signal/flanker task. Surprisingly, we found that a greater degree of stressor mismatch was associated with better response inhibition (i.e. smaller stop-signal reaction time) across a number of analytic approaches. Cognitive inhibition (i.e. the flanker interference effect) was not associated with stressor mismatch. These results thus show that a greater degree of mismatch between early and recent life stress is related to response inhibition in the same way as acute stress affects response inhibition, suggesting that response inhibition may be an important cognitive process for navigating both acute stress and general environmental conditions that do not match the conditions in which expected stress occurrence was established.
Cognition , Inhibition, Psychological , Reaction Time , Stress, Psychological , Humans , Female , Stress, Psychological/psychology , Male , Adolescent , Young Adult , Adult , Executive Function/physiology
INTRODUCTION: Although limited, recent research suggests that contact sport participation might have an adverse long-term effect on brain health. Further work is required to determine whether this includes an increased risk of neurodegenerative disease and/or subsequent changes in cognition and behaviour. The Advanced BiomaRker, Advanced Imaging and Neurocognitive Health Study will prospectively examine the neurological, psychiatric, psychological and general health of retired elite-level rugby union and association football/soccer players. METHODS AND ANALYSIS: 400 retired athletes will be recruited (200 rugby union and 200 association football players, male and female). Athletes will undergo a detailed clinical assessment, advanced neuroimaging, blood testing for a range of brain health outcomes and neuropsychological assessment longitudinally. Follow-up assessments will be completed at 2 and 4 years after baseline visit. 60 healthy volunteers will be recruited and undergo an aligned assessment protocol including advanced neuroimaging, blood testing and neuropsychological assessment. We will describe the previous exposure to head injuries across the cohort and investigate relationships between biomarkers of brain injury and clinical outcomes including cognitive performance, clinical diagnoses and psychiatric symptom burden. ETHICS AND DISSEMINATION: Relevant ethical approvals have been granted by the Camberwell St Giles Research Ethics Committee (Ref: 17/LO/2066). The study findings will be disseminated through manuscripts in clinical/academic journals, presentations at professional conferences and through participant and stakeholder communications.
Athletes , Biomarkers , Football , Neuroimaging , Neuropsychological Tests , Humans , Prospective Studies , Biomarkers/blood , Male , Football/injuries , Neuroimaging/methods , Female , Athletes/psychology , Retirement , Cognition , Research Design , Brain/diagnostic imaging , Soccer/injuries
BACKGROUND: The Square Stepping Exercise (SSE) is an exercise training program that integrates physical exercise and cognitive elements and can be conducted in a group setting. The potential of SSE in delaying cognitive decline in older adults is promising. However, the coronavirus pandemic has made it more difficult for older adults worldwide to exercise together in person. To address this issue, this study conducted a wholistic evaluation of the effects of a center-based hybrid SSE trial on cognitive, physical, psychological, and group functioning in sedentary older adults. METHODS: A total of 93 older adults (19 men, 74 women) participated in the study. Fifty-eight participants (9 men, 49 women) completed center-based hybrid SSE sessions over 12 weeks under coronavirus pandemic circumstances, whereas other 35 participants in the control group maintained their current level of daily activities. Cognitive functions focused on executive functions assessed by the Stroop Color-Word Test (inhibition) and the Trail Marking Test (TMT) (set-shifting). Psychological and group functioning were assessed by the Subjective Vitality Scale and the Physical Activity Group Environment Questionnaire. Physical function was evaluated by measuring gait speeds. A repeated ANOVA was conducted on the measured variables separately for the intervention and control groups to focus on the change of participant's performance over data collection points. RESULTS: Outcomes of the Stroop Color-Word Test and the TMT revealed that the hybrid SSE was highly effective in improving executive function. Stroop performance (correct trials) was significantly improved in the incongruent condition, as well as both TMT-A and -B over the intervention period in the intervention group. The hybrid SSE was also beneficial to improve physical (gait speed at usual pace and at the maximum pace) as well as psychological functioning (subjective vitality). Furthermore, SSE participants reported increased engagement with the SSE task, social communication, and increased bonding and closeness with their group members through the hybrid SSE. CONCLUSIONS: In this study, hybrid SSE was found to be effective in enhancing cognitive, physical, psychological, and group functioning in sedentary older adults. The findings of this study are crucial to provide older adults with a safer and efficient option to exercise.
COVID-19 , Cognition , Sedentary Behavior , Humans , Male , Female , Aged , Cognition/physiology , COVID-19/psychology , COVID-19/epidemiology , Exercise Therapy/methods , Exercise/physiology , Exercise/psychology , Cognitive Dysfunction/psychology , Cognitive Dysfunction/therapy , Aged, 80 and over , Executive Function/physiology , Middle Aged
BACKGROUND: Evidence remains limited and inconsistent for assessing cognitive function in Chinese older adults (CFCOA) and inequalities in cognitive function in Chinese older adults (ICFCOA) and exploring their influencing factors and gender differences. This study aimed to identify influencing factors and inequality in CFCOA to empirically explore the existence and sources of gender differences in such inequality and analyse their heterogeneous effects. METHODS: Based on data from the China Health and Retirement Longitudinal Study (CHARLS) for three periods from 2011 to 2015, recentered influence function unconditional quantile regression (RIF-UQR) and recentered influence function ordinary least squares (RIF-OLS) regression were applied to assess influencing factors of CFCOA, while grouped treatment effect estimation, Oaxaca-Blinder decomposition, and propensity score matching (PSM) methods were conducted to identify gender differences in ICFCOA and influencing factors, respectively. RESULTS: The results showed heterogeneous effects of gender, age, low BMI, subjective health, smoking, education, social interactions, physical activity, and household registration on CFCOA. Additionally, on average, ICFCOA was about 19.2-36.0% higher among elderly females than among elderly males, mainly due to differences in characteristic effects and coefficient effects of factors such as marital status and education. CONCLUSIONS: Different factors have heterogeneous and gender-differenced effects on CFCOA and ICFCOA, while the formation and exacerbation of ICFCOA were allied to marital status and education. Considering the severe ageing and the increasing incidence of cognitive decline, there is an urgent need for the government and society to adopt a comprehensive approach to practically work for promoting CFCOA and reducing ICFCOA.
Cognition , Humans , Male , Female , Aged , China/epidemiology , Cognition/physiology , Longitudinal Studies , Sex Factors , Cohort Studies , Middle Aged , Aged, 80 and over , Health Status Disparities , Socioeconomic Factors , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/psychology , East Asian People
BACKGROUND: Plasma neurofilament light chain (NfL) is a promising biomarker of neurodegeneration with potential clinical utility in monitoring the progression of neurodegenerative diseases. However, the cross-sectional associations of plasma NfL with measures of cognition and brain have been inconsistent in community-dwelling populations. METHODS: We examined these associations in a large community-dwelling sample of early old age men (N = 969, mean age = 67.57 years, range = 61-73 years), who are either cognitively unimpaired (CU) or with mild cognitive impairment (MCI). Specifically, we investigated five cognitive domains (executive function, episodic memory, verbal fluency, processing speed, visual-spatial ability), as well as neuroimaging measures of gray and white matter. RESULTS: After adjusting for age, health status, and young adult general cognitive ability, plasma NfL level was only significantly associated with processing speed and white matter hyperintensity (WMH) volume, but not with other cognitive or neuroimaging measures. The association with processing speed was driven by individuals with MCI, as it was not detected in CU individuals. CONCLUSIONS: These results suggest that in early old age men without dementia, plasma NfL does not appear to be sensitive to cross-sectional individual differences in most domains of cognition or neuroimaging measures of gray and white matter. The revealed plasma NfL associations were limited to WMH for all participants and processing speed only within the MCI cohort. Importantly, considering cognitive status in community-based samples will better inform the interpretation of the relationships of plasma NfL with cognition and brain and may help resolve mixed findings in the literature.
Biomarkers , Cognition , Cognitive Dysfunction , Independent Living , Neurofilament Proteins , Neuroimaging , Neuropsychological Tests , Humans , Male , Neurofilament Proteins/blood , Aged , Middle Aged , Cross-Sectional Studies , Cognitive Dysfunction/blood , Cognitive Dysfunction/diagnostic imaging , Neuroimaging/methods , Cognition/physiology , Biomarkers/blood , Magnetic Resonance Imaging , Brain/diagnostic imaging , White Matter/diagnostic imaging , White Matter/pathology , Aging/blood
AIM: To describe patients' with chronic obstructive pulmonary disease (COPD) experiences of group-based self-management education with a digital website. DESIGN: A qualitative approach with a phenomenologicalmethod. Patients participating in an earlier study, with self-experience of COPD as a special competence, were involved as research partners at the design of this study. METHODS: Eleven individual and two group interviews with five participants in each group were conducted. RESULTS: Group-based self-management education with a digital website supports learning. Sharing experiences with others in similar situations creates security and reduces the feeling of being alone. Based on questions and discussion in the group, and through self-reflection, general information is transformed into useful knowledge and understanding of one's own situation. COPD information on the website provides an opportunity to gain knowledge continuously based on needs that contributes to learning. This research has demonstrated that adapting learning activities to individual learning styles increases sustainability of learning. Sharing experiences reduces feelings of loneliness. It is therefore important to create spaces for sharing experiences and in-depth reflection that support learning over time.
Pulmonary Disease, Chronic Obstructive , Self-Management , Humans , Pulmonary Disease, Chronic Obstructive/therapy , Learning , Cognition
SIGNIFICANT: Chunk memory is one of the essential cognitive functions for high-expertise (HE) player to make efficient decisions. However, it remains unknown how the neural mechanisms of chunk memory processes mediate or alter chess players' performance when facing different opponents. AIM: This study aimed at inspecting the significant brain networks associated with chunk memory, which would vary between club players and novices. APPROACH: Functional networks and topological features of 20 club players (HE) and 20 novice players (LE) were compared at different levels of difficulty by means of functional near-infrared spectroscopy. RESULTS: Behavioral performance indicated that the club player group was unaffected by differences in difficulty. Furthermore, the club player group demonstrated functional connectivity among the dorsolateral prefrontal cortex, the frontopolar cortex, the supramarginal gyrus, and the subcentral gyrus, as well as higher clustering coefficients and lower path lengths in the high-difficulty task. CONCLUSIONS: The club player group illustrated significant frontal-parietal functional connectivity patterns and topological characteristics, suggesting enhanced chunking processes for improved chess performance.
Brain , Cognition , Brain/diagnostic imaging , Memory , Brain Mapping , Head , Magnetic Resonance Imaging
INTRODUCTION: With increasing life expectancy of older adult population, maintaining independence and well-being in later years is of paramount importance. This study aims to investigate the impact of three distinct interventions: cognitive training, resistance training and a combination of both, compared with an inactive control group, on cognitive performance, mobility and quality of life in adults aged ≥65 years. METHODS AND ANALYSIS: This trial will investigate healthy older adults aged ≥65 years living independently without cognitive impairments. Participants will be randomly assigned to one of four groups: (1) cognitive training, (2) resistance training, (3) combined cognitive and resistance training, and (4) control group (n=136 participants with 34 participants per group). The interventions will be conducted over 12 weeks. The cognitive training group will receive group-based activities for 45-60 min two times a week. The resistance training group exercises will target six muscle groups and the combined group will integrate cognitive tasks into the resistance training sessions. Primary outcomes are: Short Physical Performance Battery, Sit-to-Stand Test, Montreal Cognitive Assessment, Trail Making Test and Stroop Test combined with gait on a treadmill (dual task). Life satisfaction will be measured by the Satisfaction With Life Scale. Secondary outcomes encompass hand grip strength and the Functional Independence Measure. ETHICS AND DISSEMINATION: Ethical approval was provided by the local Ethics Committee at the University of Hamburg (no. 2023_009). Informed consent will be obtained from all study participants. The results of the study will be distributed for review and discussion in academic journals and conferences. TRIAL REGISTRATION NUMBER: DRKS00032587.
Resistance Training , Humans , Aged , Resistance Training/methods , Hand Strength , Quality of Life , Gait , Cognition , Exercise Therapy/methods , Randomized Controlled Trials as Topic
INTRODUCTION: Subjective cognitive decline means a decline in the subjective perception of self-cognitive function, which is likely to evolve into mild cognitive impairment and dementia. The number of elderly with subjective cognitive decline has increased, bringing huge burdens and challenges to caregivers and society. With the increase in research on art therapies, some of them have gradually been proven to be effective for cognitive function. Therefore, this study aims to summarise the evidence and identify the best art therapy for elderly with subjective cognitive decline. METHODS AND ANALYSIS: We will include published randomised controlled trials written in English and Chinese if the intervention is one of the art therapies and applied in people aged 60 and above with subjective cognitive decline. Eight electronic databases, including the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Elsevier, China BioMedical Literature Database, China National Knowledge Infrastructure, VIP Database and Wanfang Database, will be searched from January 2013 to December 2023. Art therapies will mainly include music therapy, reminiscence therapy, painting therapy, dance therapy, reading therapy, horticultural therapy, museum therapy, calligraphy therapy and so on. The outcome will be cognitive function. Study selection, data extraction and quality assessment will be performed by two reviewers. The risk of bias will be evaluated according to the Cochrane Collaboration's risk-of-bias tool, and the evidence quality will be assessed with the Grading of Recommendations Assessment, Development and Evaluation. Standard pairwise meta-analysis and Bayesian network meta-analysis will be conducted. The probabilities of each art therapy will be ranked based on the surface under the cumulative ranking curve. ETHICS AND DISSEMINATION: Ethical approval is not required for reviewing published studies. To provide important evidence for clinicians and guideline developers, the findings of this study will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42023443773.
Art Therapy , Cognitive Dysfunction , Aged , Humans , Network Meta-Analysis , Bayes Theorem , Cognition , Cognitive Dysfunction/therapy , Meta-Analysis as Topic
Individual sirolimus whole blood concentrations are highly variable, critically influenced by the concomitant use of cytochrome P450 (CYP) 3A inducers or inhibitors, and also modulated by food. Therapeutic drug monitoring is therefore recommended, especially at treatment start or in circumstances that can influence sirolimus exposure. In this case report, we highlight the challenge of achieving therapeutic sirolimus concentrations and present pragmatic solutions with regimen adaptions, pharmacokinetic enhancement (use of a drug-drug interaction), concentration monitoring, and subsequent modeling of population pharmacokinetics to support treatment decisions. In a 69-year-old female patient with allogeneic hematopoietic stem cell transplantation, tacrolimus concentrations were stable until she developed cerebral toxoplasmosis with tonic-clonic seizures. During treatment of this acute infection, tacrolimus concentrations dropped to subtherapeutic levels and remained largely unaffected by dose increases. Only the simultaneous administration of the CYP3A4 inhibitor fluconazole and a shortening of the sirolimus dosing intervals to a (non-approved) twice-daily administration led to successful control of the concentrations, which ultimately even made a dose reduction possible. This intervention resulted in an increase of sirolimus mean trough concentration to 5.85 ng/mL, i.e., into the desired target range. Additionally, a higher ratio of sirolimus trough levels/daily dose from 26.9 to 109 ng/mL/mg/kg/day was achieved with the initiation of fluconazole. Thus, this case report describes the use of clinical pharmacological concepts and pharmacokinetic modeling to optimize treatment strategies in an individual patient. This strategy could be generalized to other CYP inhibitors and other treatment regimens.
Fluconazole , Tacrolimus , Female , Humans , Aged , Cognition
This study examines the relationship between family socioeconomic status, parent-child activities, and young children's digital development. Using the Family SES questionnaire, the parent-child activities questionnaire, and the 5 to 6 year old children's number sense development scale as research instruments, 314 young children (M = 70.42, SD = 3.47). The results show that: (1) Family Socioeconomic Status can significantly positively predict the young children's number sense development; (2) Parent-child activities play a partial mediating role in the relationship between family socioeconomic status and the young children's number sense development. This study provides specific guidelines and recommendations for improving the young children's number sense development.
Cognition , Social Class , Humans , Child , Child, Preschool , Surveys and Questionnaires , Parent-Child Relations
Narratives can synchronize neural and physiological signals between individuals, but the relationship between these signals, and the underlying mechanism, is unclear. We hypothesized a top-down effect of cognition on arousal and predicted that auditory narratives will drive not only brain signals but also peripheral physiological signals. We find that auditory narratives entrained gaze variation, saccade initiation, pupil size, and heart rate. This is consistent with a top-down effect of cognition on autonomic function. We also hypothesized a bottom-up effect, whereby autonomic physiology affects arousal. Controlled breathing affected pupil size, and heart rate was entrained by controlled saccades. Additionally, fluctuations in heart rate preceded fluctuations of pupil size and brain signals. Gaze variation, pupil size, and heart rate were all associated with anterior-central brain signals. Together, these results suggest bidirectional causal effects between peripheral autonomic function and central brain circuits involved in the control of arousal.
Brain , Heart Rate , Humans , Brain/physiology , Female , Male , Heart Rate/physiology , Adult , Pupil/physiology , Young Adult , Arousal/physiology , Auditory Perception/physiology , Saccades/physiology , Cognition/physiology , Autonomic Nervous System/physiology , Acoustic Stimulation
