Quality of Life in Dementia Sufferers: The Role of Diet and Exercise.

BACKGROUND: Among the myriad of factors modulating quality of life assessments estimated in patients presenting a variety of cognitive impairments, the distinctive and critical influence of diet and exercise cannot be overestimated. OBJECTIVE: The objective of this study was to review the evidence to confirm the association between these health-endowering agents and cognitive performance in People With Dementia as well as providing a correlation between Mini Mental State Examination scores and available anthropometric data. METHODS: The authors tested the hypothesized correlation on a sample of subjects with instrumentally confirmed cognitive impairment using parameters as Body Mass Index and calf circumference. RESULTS: The results confirm the hypothesis and suggesting the possible use of anthropometric data in the process of objective evaluation of the patient with cognitive impairment that could also be used for forensic medicine.

Legal medical consideration of Alzheimer's disease patients' dysgraphia and cognitive dysfunction: a 6 month follow up.

BACKGROUND: The purpose of this study was to investigate the ability of Alzheimer's disease (AD) patients to express intentions and desires, and their decision-making capacity. This study examines the findings from a 6-month follow-up of our previous results in which 30 patients participated. MATERIALS AND METHODS: The patient's cognition was examined by conducting the tests of 14 questions and letter-writing ability over a period of 19 days, and it was repeated after 6 months. The difference between these two cognitive measures (PQ1 before-PQ2 before), tested previously and later the writing test, was designated DΔ before. The test was repeated after 6 months, and PQ1 after-PQ2 after was designated DΔ after. RESULTS: Several markedly strong relationships between dysgraphia and other measures of cognitive performance in AD patients were observed. The most aged patients (over 86 years), despite less frequency, maintain the cognitive capacity manifested in the graphic expressions. A document, written by an AD patient presents an honest expression of the patient's intention if that document is legible, clear, and comprehensive. CONCLUSION: The identification of impairment/deficits in writing and cognition during different phases of AD may facilitate the understanding of disease progression and identify the occasions during which the patient may be considered sufficiently lucid to make decisions.

Cognitive fluctuations in connection to dysgraphia: a comparison of Alzheimer's disease with dementia Lewy bodies.

BACKGROUND: The purpose of the present study was to examine the relationship between cognitive impairment and the performance of handwritten scripts presented as "letter-writing" to a close relative by patients with dementia Lewy bodies (DLB), as fluctuations of the symptoms phase, and in a matched group of patients with Alzheimer's disease (AD). The degree of writing disability and personal, spatial, and temporal orientation was compared in these two groups. DESIGN AND METHODS: Fourteen simple questions, designed in a form that could be utilized by any general practitioner in order to document the level of cognitive functioning of each patient, were presented to 30 AD patients and 26 DLB patients. The initial cognition test was designated PQ1. The patients were examined on tests of letter-writing ability. Directly after the letter-writing, the list of 14 questions presented in PQ1 was presented again in a repeated procedure that was designated PQ2. The difference between these two measures (PQ1 - PQ2) was designated DΔ. This test of letter-writing ability and cognitive performance was administered over 19 days. RESULTS: Several markedly strong relationships between dysgraphia and several measures of cognitive performance in AD patients and DLB patients were observed, but the deterioration of performance from PQ1 to PQ2 over all test days were markedly significant in AD patients and not significant in DLB patients. It is possible that in graphic expression even by patients diagnosed with moderate to relatively severe AD and DLB there remains some residual capacity for understanding and intention that may be expressed. Furthermore, the deterioration in performance and the differences noted in AD and DLB patients may be due to the different speed at which the process of the protein degradation occurs for functional modification of synapses. CONCLUSION: Our method can be used as part of neuropsychological tests to differentiate the diagnosis between AD and DLB.