Uso de test dual en ancianos institucionalizados con diferentes niveles de deterioro cognitivo. Estudio transversal / Dual tasks in institutionalized seniors with different levels of cognitive impairment. Cross-sectional study

Resumen Introducción. El envejecimiento se ha relacionado con una mayor prevalencia de deterioro cognitivo. Las personas mayores con pérdida de funciones cognitivas presentan elevadas tasas de caídas. El desarrollo de las actividades de la vida diaria engloba dos o más tareas, siendo necesarios componentes cognitivos y motores. Objetivo. Analizar el rendimiento en pruebas sencillas y duales de sujetos en entorno residencial con diferentes grados de deterioro cognitivo. Materiales y métodos. Se realizó un estudio observacional de corte transversal en ancianos institucionalizados >65 años (n=80). Se evaluó el deterioro cognitivo con el Mini-Mental State Examination y se solicitó a los participantes realizar una tarea simple y dual en las pruebas Six-Minute Walk Test (6MWT) y Timed Up and Go (TUG). Resultados. Se distribuyeron los participantes en tres grupos. Se encontraron diferencias significativas entre los grupos con deterioro cognitivo y el grupo sin deterioro cognitivo para las pruebas 6MWT (p<0.05) y TUG (p<0.05), tanto en la tarea simple como en la tarea dual. Un peor rendimiento se asoció con una menor capacidad cognitiva. Conclusión. La severidad del deterioro cognitivo se encuentra relacionada con el desempeño en las tareas duales.

Abstract Introduction: Aging is linked to a higher prevalence of cognitive impairment. Seniors presenting with loss of cognitive functions have high fall rates. The development of activities of daily living encompasses two or more tasks that require cognitive and motor components. Objective: To analyze the performance in simple and dual tasks of subjects living in a residential environment with different degrees of cognitive impairment. Materials and methods: An observational cross-sectional study was performed in a population of institutionalized elderly >65 years (n=80). Cognitive impairment was assessed using the Mini-Mental State Examination and participants were asked to perform simple and dual tasks using the Six-Minute Walk Test (6MWT) and Timed Up and Go (TUG). Results: The participants were divided into three groups. Significant differences were found between the groups with cognitive impairment and the group without cognitive impairment in the 6MWT (p<0.05) and TUG (p<0.05) tests, both in simple task and dual tasks. Poorer performance was associated with lower cognitive capacity. Conclusion: The severity of cognitive impairment is correlated to performance in dual tasks.

Effects of a dance-based aquatic exercise program in obese postmenopausal women with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To evaluate the effects of a dance-based aquatic exercise program on functionality, cardiorespiratory capacity, postexercise heart rate, and fatigue in obese postmenopausal women with knee osteoarthritis. METHODS: A randomized controlled trial was performed. In all, 34 obese women diagnosed with knee osteoarthritis participated. Women were randomly allocated to an experimental group (n = 17) or a control group (n = 17). Participants in the experimental group were included in an 8-week dance-based aquatic exercise program conducted in community swimming pools. Those in the control group underwent a global aquatic exercise program. The primary outcome measure was functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were cardiorespiratory capacity evaluated with the 6-minute walk test, and postexercise heart rate and fatigue assessed using a visual analog scale. Variables were measured at baseline, after the intervention, and at 3-month follow-up. RESULTS: A between-group analysis showed significant postintervention differences in functionality (aggregate postintervention WOMAC score of 37.30 ±â€Š16.61 vs 41.83 ±â€Š13.69; P = 0.048) in favor of the experimental group. In addition, significant between-group differences were found after the 8 weeks in cardiorespiratory capacity, postexercise heart rate, and fatigue. Follow-up continued to show significant differences between groups in function (aggregate WOMAC score of 38.60 ±â€Š13.61 vs 42.60 ±â€Š9.05; P = 0.038), postexercise heart rate, and fatigue. CONCLUSIONS: An 8-week dance-based exercise program significantly improved function and cardiorespiratory capacity, and decreased postexercise heart rate and fatigue. Most of these improvements were maintained at 3-month follow-up in obese postmenopausal women.

Physical and Functional Impairment During and After Hospitalization in Subjects With Severe COPD Exacerbation.

BACKGROUND: COPD exacerbations are frequent events that have a negative impact on the lives of patients. The aims of this study were to analyze physical and functional impairment during hospital stay in subjects hospitalized due to COPD exacerbation and to assess the physical and functional impact of hospitalization at a 1-month follow-up in patients with severe COPD. METHODS: This was a prospective observational study on a sample of 52 subjects hospitalized due to COPD exacerbation. The assessments were performed at baseline, discharge, and 1-month follow-up. The outcome measures were dyspnea, muscle strength, functional capacity, and postural steadiness. RESULTS: Quadriceps strength [1.036 (P = .043) kg mean difference] and the one-leg stance test [1.04 (P = .02) and 0.73 (P = .032) s mean difference right and left leg] showed significant impairment during hospitalization. Dyspnea perception improved significantly (P = .004) during hospitalization. Additionally, strength in the upper and lower limbs [4.04 (P = .002) and 1.23 (P = .038) kg mean difference], functional capacity [3.0 number of steps mean difference (P = .032)], and the one-leg stance test [2.12 (P = .006) and 0.53 (P = .047) s mean difference right and left leg] showed significant impairment 1-month follow-up. CONCLUSIONS: Hospitalization due to COPD exacerbation leads to physical and functional impairment in patients; impairment is greater at 1-month follow-up. It would be interesting to conduct physical therapy interventions to prevent the impairment.

Cognitive impairment in COPD: a systematic review.

The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

Cognitive impairment in COPD: a systematic review / Cognitive impairment in COPD: a systematic review

The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

Os objetivos deste estudo foram caracterizar e esclarecer as relações entre os vários domínios cognitivos afetados em pacientes com DPOC e a doença em si, assim como determinar a prevalência de comprometimentos cognitivos em tais pacientes. Para tanto, foi realizada uma revisão sistemática utilizando as seguintes bases de dados: PubMed, Scopus e ScienceDirect. Os artigos incluídos forneciam informações sobre os comprometimentos cognitivos em pacientes com DPOC. A revisão dos achados de tais artigos mostrou uma relação significativa entre DPOC e comprometimento cognitivo. Os domínios cognitivos mais estudados são a memória e a atenção. Memória verbal e aprendizagem constituem o segundo domínio cognitivo mais comumente prejudicado em pacientes com DPOC. A prevalência de comprometimento da memória visuoespacial e da memória visual intermediária é 26,9% e 19.2%, respectivamente. Observamos que o comprometimento cognitivo está associado ao perfil de gravidade da DPOC e suas comorbidades. A revisão dos artigos demonstrou que há um comprometimento considerável dos domínios memória e atenção em pacientes com DPOC. Investigações futuras devem abordar os comprometimentos em diferentes domínios cognitivos em conformidade com o estágio da doença em pacientes com DPOC.