Effect of agility ladder training with a cognitive task (dual task) on physical and cognitive functions: a randomized study.

Introduction: Agility training (AT) is used to improve neuromuscular performance and dynamic balance, which are crucial for the physical function of older adults. Activities of daily living, which decrease with age, involve tasks that simultaneously require motor, and cognitive abilities and can be considered dual tasks. Methods: This study investigates a training program's physical and cognitive effects using an agility ladder on healthy older adults. This program consisted of 30-min sessions twice per week and lasted for 14 weeks. The physical training included four different sequences with progressive difficulty levels, while the cognitive training (CT) included different verbal fluency (VF) tasks for each physical task. Sixteen participants (mean age of 66.9 ± 5.0 years) were allocated to two groups: AT alone (AT) and dual-task training (AT combined with CT [AT + CT]). Assessments were performed before and after 14 weeks of interventions using physical functional tests (e.g., Illinois agility test, five times sit-to-stand test, timed up and go [TUG], and one-leg stand) and cognitive tests (cognitive TUG, verbal fluency, attention, and scenery picture memory test). Results: After this period, both groups had significant differences in physical performance, muscle power, agility, static and dynamic balance, and short-term memory, whereas only the AT + CT group improved phonological verbal fluency, executive function (TUG combined with a cognitive task), attention (trail-making test-B), and short-term memory (scenery picture memory test). Conclusion: Indicating that only the group that received direct cognitive training had better enhanced cognitive function. Clinical trial registration: www.ClinicalTrials.gov, identifier: RBR-7t7gnjk.

Whole-brain DTI parameters associated with tau protein and hippocampal volume in Alzheimer's disease.

The causes of the neurodegenerative processes in Alzheimer's disease (AD) are not completely known. Recent studies have shown that white matter (WM) damage could be more severe and widespread than whole-brain cortical atrophy and that such damage may appear even before the damage to the gray matter (GM). In AD, Amyloid-beta (Aß42 ) and tau proteins could directly affect WM, spreading across brain networks. Since hippocampal atrophy is common in the early phase of disease, it is reasonable to expect that hippocampal volume (HV) might be also related to WM integrity. Our study aimed to evaluate the integrity of the whole-brain WM, through diffusion tensor imaging (DTI) parameters, in mild AD and amnestic mild cognitive impairment (aMCI) due to AD (with Aß42 alteration in cerebrospinal fluid [CSF]) in relation to controls; and possible correlations between those measures and the CSF levels of Aß42 , phosphorylated tau protein (p-Tau) and total tau (t-Tau). We found a widespread WM alteration in the groups, and we also observed correlations between p-Tau and t-Tau with tracts directly linked to mesial temporal lobe (MTL) structures (fornix and hippocampal cingulum). However, linear regressions showed that the HV better explained the variation found in the DTI measures (with weak to moderate effect sizes, explaining from 9% to 31%) than did CSF proteins. In conclusion, we found widespread alterations in WM integrity, particularly in regions commonly affected by the disease in our group of early-stage disease and patients with Alzheimer's disease. Nonetheless, in the statistical models, the HV better predicted the integrity of the MTL tracts than the biomarkers in CSF.

Resistance Training Combined With Cognitive Training Increases Brain Derived Neurotrophic Factor and Improves Cognitive Function in Healthy Older Adults.

Background: The present study compared the effects of a traditional resistance training (TRT) and resistance training combined with cognitive task (RT + CT) on body composition, physical performance, cognitive function, and plasma brain-derived neurotrophic factor (BNDF) levels in older adults. Methods: Thirty community-dwelling older adults were randomized into TRT (70.0 ± 8.1; 25% men) and RT + CT (66.3 ± 4.6; 31% men). Exercise groups performed a similar resistance training (RT) program, twice a week over 16 weeks. Cognitive Training involved performing verbal fluency simultaneously with RT. Exercise sessions (eight resistance exercises) were performed 2-3 sets, 8-15 repetitions at 60%-70% of 1-repetition maximum (1RM). Body composition, physical function, cognitive performance, and BDNF levels were assessed before and after intervention period. Results: The physical performance was similarly improved in response to both TRT and RT + CT (p = 0.001). However, exclusive improvements on cognitive function (p < 0.001) and BDNF levels (p = 0.001) were observed only after RT + CT. Conclusion: The RT program associated with a cognitive task, improved physical and cognitive performance in healthy older adults.

Palmitate Is Increased in the Cerebrospinal Fluid of Humans with Obesity and Induces Memory Impairment in Mice via Pro-inflammatory TNF-α.

Obesity has been associated with cognitive decline, atrophy of brain regions related to learning and memory, and higher risk of developing dementia. However, the molecular mechanisms underlying these neurological alterations are still largely unknown. Here, we investigate the effects of palmitate, a saturated fatty acid present at high amounts in fat-rich diets, in the brain. Palmitate is increased in the cerebrospinal fluid (CSF) of overweight and obese patients with amnestic mild cognitive impairment. In mice, intracerebroventricular infusion of palmitate impairs synaptic plasticity and memory. Palmitate induces astroglial and microglial activation in the mouse hippocampus, and its deleterious impact is mediated by microglia-derived tumor necrosis factor alpha (TNF-α) signaling. Our results establish that obesity is associated with increases in CSF palmitate. By defining a pro-inflammatory mechanism by which abnormal levels of palmitate in the brain impair memory, the results further suggest that anti-inflammatory strategies may attenuate memory impairment in obesity.

Cognitive and structural cerebral changes in amnestic mild cognitive impairment due to Alzheimer's disease after multicomponent training.

Introduction: Information about how physical exercise affects patients with amnestic mild cognitive impairment (aMCI) due to Alzheimer's disease (AD) is still missing. This study evaluated the impact of multicomponent exercise training on cognition and brain structure in aMCI subjects with cerebral spinal fluid positive AD biomarkers. Methods: Forty aMCI subjects were divided in training (multicomponent exercise thrice a week for 6 months) and nontraining groups. Assessments included cardiorespiratory fitness, neurocognitive tests, and a structural magnetic resonance imaging using 3.0 T scanner. FreeSurfer software analyzed hippocampal volume and cortical thickness. Results: The training group showed increased volume in both hippocampi and better performance in episodic memory test after 6 months. In contrast, the nontraining group declined in functional activities, recognition, and cardiorespiratory fitness for the same period. Discussion: Multicomponent exercise seems to improve hippocampal volume and episodic memory, and maintains VO2max in aMCI due to AD.

Relation between aerobic fitness and brain structures in amnestic mild cognitive impairment elderly.

Mild cognitive impairment (aMCI) is a clinical condition, with high risk to develop Alzheimer's disease. Physical exercise may have positive effect on cognition and brain structure in older adults. However, it is still under research whether these influences are true on aMCI subjects with low Ab_42 and high total tau in cerebrospinal fluid (CSF), which is considered a biomarker for AD. Therefore, we aimed to investigate a possible relation between aerobic fitness (AF) and gray matter (GM) volume and AF and white matter (WM) integrity in aMCI with a CSF biomarker. Twenty-two participants with aMCI acquired the images on a 3.0-T MRI. AF was assessed by a graded exercise test on a treadmill. Voxel-based morphometry and tract-based spatial statistic methods were used to analyze the GM volume and WM microstructural integrity, respectively. We correlated AF and GM volume and WM integrity in aMCI (p < 0.05, FWE corrected, cluster with at least five voxels). There was a positive relation between AF and GM volume mostly in frontal superior cortex. In WM integrity, AF was positively correlated with fractional anisotropy and negatively correlated with mean diffusivity and radial diffusivity, all in the same tracts that interconnect frontal, temporal, parietal, and occipital areas (longitudinal fasciculus, fronto-occipital fasciculus, and corpus callosum). These results suggest that aerobic fitness may have a positive influence on protection of brain even in aMCI CSF biomarker, a high-risk population to convert to AD.

Effects of Square-Stepping Exercise on balance and depressive symptoms in older adults / Efeitos do Square-Stepping Exercise (SSE) no equilíbrio e sintomas depressivos de idosos / Efectos del Square-Stepping Exercise (SSE) en equilibrio y síntomas depresivos en adultos mayores

The aim of this study was analyze the effects of Square-Stepping Exercise (SSE) on depressive symptoms, balance and functional mobility in older adults. Participants were distributed into two groups: Trained Group (TG), who performed a 16-week intervention with SSE and Control Group (CG), who performed only evaluations. The Berg Balance Scale and Time Up and Go Test (TUG) constituted the evaluation protocol to verify balance and functional mobility. Geriatric Depression Scale-short form (GDS-15) was applied for measure depressive symptoms. Evaluations were realized pre and post 16-week. Significant improvements were observed in the TG with the maintenance of GDS-15 scores and on the time to perform the TUG test which reflects better functional mobility than the CG. This could lead to conclude that the SSE is an important tool for improve balance, prevent falls and decrease depression symptoms...

"Efeitos do Square-Stepping Exercise (SSE) no equilíbrio e sintomas depressivos de idosos." O objetivo desse estudo foi analisar os efeitos do Square-Stepping Exercise (SSE) nos sintomas depressivos, equilíbrio e mobilidade funcional de idosos. Os participantes foram distribuídos em dois grupos: Grupo Treinamento (TG), que realizou 16 semanas de intervenção com o SSE e Grupo Controle (CG), que penas respondeu as avaliações. A Escala de Equilíbrio de Berg e o Time Up and Go Test (TUG) constituíram o protocolo de avaliação, e verificaram o equilíbrio e a mobilidade funcional. A Escala Geriátrica de Depressão curta (GDS-15) foi aplicada para mensurar os sintomas depressivos. Avaliações Foram realizadas pré e após 16 semanas. Resultados significativos foram observados no TG, como a manutenção do escore da GDS-15 e melhora do tempo para realizar o TUG, o que reflete em uma mobilidade funcional melhor que no CG. Podemos concluir que o SSE é uma importante ferramenta para promover equilíbrio, prevenir que das e diminuir os sintomas depressivos...

"Efectos del Square-Stepping Exercise (SSE) en equilibrio y síntomas depresivos en adultos mayores." El objetivo de este estudio fue analizar los efectos del SSE (Square-Stepping Exercise) en los síntomas depresivos, equilibrio y movilidad funcional de ancianos. Los participantes fueron divididos en dos grupos: Grupo de Entrenamiento (TG), que celebró 16 semanas de intervención con SSE y Grupo Control (GC), que respondió evaluaciones plumas. El rango de equilibrio de Berg Balance de el Time Up nd Go Test (TUG) constituyeron el protocolo de evaluación, y se encontró el equilibrio y la movilidad funcional. La Escala de Depresión Geriátrica breve (GDS-15) se utilizó para medir los síntomas depresivos. Las evaluaciones se realizaron antes y después de 16 semanas. Los resultados significativos se observaron en TG, como el mantenimiento de la puntuación GDS-15 y la mejora de tiempo para realizar el TUG, que se refleja en una mejor movilidad funcional en CG. Podemos concluir que la ESS es una herramienta importante para promover el equilibrio, la prevención y disminución de los síntomas depresivos...

Differences and the relationship in default mode network intrinsic activity and functional connectivity in mild Alzheimer's disease and amnestic mild cognitive impairment.

There is evidence that the default mode network (DMN) functional connectivity is impaired in Alzheimer's disease (AD) and few studies also reported a decrease in DMN intrinsic activity, measured by the amplitude of low-frequency fluctuations (ALFFs). In this study, we analyzed the relationship between DMN intrinsic activity and functional connectivity, as well as their possible implications on cognition in patients with mild AD and amnestic mild cognitive impairment (aMCI) and healthy controls. In addition, we evaluated the differences both in connectivity and ALFF values between these groups. We recruited 29 controls, 20 aMCI, and 32 mild AD patients. To identify the DMN, functional connectivity was calculated by placing a seed in the posterior cingulate cortex (PCC). Within the DMN mask obtained, we calculated regional average ALFFs. Compared with controls, aMCI patients showed decreased ALFFs in the temporal region; compared with AD, aMCI showed higher values in the PCC but lower in the temporal area. The mild AD group had lower ALFFs in the PCC compared with controls. There was no difference between the connectivity in the aMCI group compared with the other groups, but AD patients showed decreased connectivity in the frontal, parietal, and PCC. Also, PCC ALFFs correlated to functional connectivity in nearly all subregions. Cognitive tests correlated to connectivity values but not to ALFFs. In conclusion, we found that DMN connectivity and ALFFs are correlated in these groups. Decreased PCC ALFFs disrupt the DMN functional organization, leading to cognitive problems in the AD spectrum.

Effects of square stepping exercise in patients with sequel of cerebrovascular accident / Efeitos do square stepping exercise em pacientes com sequelas de acidente vascular encefálico

Introduction Cerebral stroke is the interruption of blood flow to the brain and can be classified into hemorrhagic and ischemic. It may result in serious body balance and cognition complications. Kinesiotherapy is a privileged means of rehabilitation.Objective Verify the effects of Square Stepping Exercise (SSE) on cognitive functions, depressive symptoms and the body balance of cerebral stroke sequel patients.Methods Thirteen brain stroke sequel patients were divided into two groups: SSE (SSEG n = 8) and conventional physiotherapy group (PG, n = 5). The SSEG participated only of the SSE training protocol, while the PG participated of its physical therapy routine group, both for 4 months. They were evaluated using the Mini Mental State Examination (MMSE), the Brief Cognitive Screening Battery (BBRC), the Geriatric Depression Scale (GDS),Berg Balance Scale(BBS) and Timed Up and Go(TUG).Results The U Mann Whitney test showed no significant differences between groups. In intragroup analysis, the Wilcoxon test showed significant improvement in global cognitive status for PG (p < 0.042), and for SSEG there were positive results for verbal fluency (p < 0.04) and in TUG for number of steps (p < 0.04) and the time (p < 0.02).Conclusion The SSE seems to benefit dynamic balance, influencing gait agility, cognition related to verbal fluency and may have contributed to maintain other cognitive functions.

Introdução O Acidente vascular encefálico (AVE) é a interrupção do fluxo de sangue para o cérebro e pode ser classificado em hemorrágico e isquêmico, podendo resultar em graves complicações do equilíbrio corporal e cognição. A cinesioterapia constitui-se em meio privilegiado de reabilitação.Objetivo Verificar os efeitos do Square Stepping Exercise (SSE) nas funções cognitivas, nos sintomas depressivos e no equilíbrio de pacientes com sequelas de AVE.Métodos Treze pacientes com sequelas de AVE foram alocados em dois grupos: grupo SSE (GSSE n = 8) e grupo fisioterapia convencional (GF n = 5). O GSSE participou apenas do protocolo de treinamento do SSE, o GF participou apenas de sua rotina de fisioterapia realizada em grupo, ambos pelo período de 4 meses e avaliados por meio do Mini Exame do Estado Mental (MEEM), da Bateria Breve de Rastreio Cognitivo (BBRC), da Escala de Depressão Geriátrica (GDS), da Escala de Equilíbrio Funcional de Berg (EEFB) e do Timed Up and Go (TUG).Resultados O teste U Mann Whitney não apontou diferenças significantes intergrupos. Na análise intragrupo, o teste de Wilcoxon mostrou melhora significativa no GF (p < 0,042) no estado cognitivo global, e no GSSE quanto à fluência verbal (p < 0,04) e no TUG tanto para número de passos (p < 0,04) quanto para tempo o (p < 0,02).Conclusão O SSE parece beneficiar o equilíbrio dinâmico, fazendo com que os pacientes com sequela de AVE apresentem marcha mais ágil, a cognição no tocante à fluência verbal, bem como pode ter contribuído para a manutenção de outras funções cognitivas.

Effects of square-stepping exercise on cognitive functions of older people.

AIM: Cognitive functions can decline with age, and interventions focusing on stimulating them may have positive results. Previous studies have shown that square-stepping exercise (SSE) has a good influence on balance, but this exercise also seems to promote cognitive stimulation. Therefore, the purpose of the present study was to analyse the effect of 16 weeks of SSE on cognitive functions in non-demented community-dwelling older people. METHODS: This was a longitudinal, non-randomized study. Forty-one older adults (60 years and older) were recruited, and 21 participated in the SSE group (practised only SSE sequences) and 20 were in the control group (continued with their activities of daily living). Both groups were evaluated using the Mini-Mental State Examination, the Digit Span test, the Toulouse-Pierón Attention Test and the Modified Card Sorting Test. RESULTS: The SSE group showed a significant improvement in global cognitive status, concentrated attention and mental flexibility after 16 weeks of the SSE intervention. CONCLUSION: Evidence shows that SSE is a physical activity that positively influences cognitive functions in non-demented older people.

Effect of square-stepping exercise and basic exercises on functional fitness of older adults.

AIM: The aging process might reduce functional fitness, including balance, which can increase the risk of falls among older adults. Different types of intervention seem to benefit older adults, therefore the purpose of this study was to analyze the effect of a program using square-stepping exercises (SSE) sequences only on functional fitness in older adults. Furthermore, the possible effects were compared with a basic exercise program. METHODS: A total of 86 community-dwelling older adults (aged >60 years) were divided into four groups: one group practised only SSE sequences (n = 21), the second group practised basic physical exercises (n = 20), the third group practised both SSE sequences and physical exercises (n = 25); and the fourth group was the control group, which was evaluated in their functional fitness before and after the 16-week research period. RESULTS: Participants who practised basic physical exercises improved in agility and aerobic endurance, and SSE improved balance tests. CONCLUSIONS: SSE and basic exercise, practised together or alone, seem to have a good influence on the functional fitness of older adults. In addition, SSE training seems to be an effective new kind of activity for balance training.

Perfil lipídico de ratos com hipertireoidismo induzido: efeitos do exercício físico agudo / Lipid profile of rats with induced hyperthyroidism: effects of acute exercise

Este estudo teve como objetivo analisar o perfil lipídico de ratos Wistar com hipertireoidismo induzido em repouso e após exercício físico agudo. Foram utilizados 28 ratos machos Wistar, divididos em hipertireoidismo (H; induzido com tiroxina) e controle (C). Metade dos animais de cada grupo foi sacrificada em repouso. A outra metade foi submetida, imediatamente antes do sacrifício, à sessão única de exercício de natação, por 20 minutos (carga de 5% em relação ao peso corporal). Para as comparações entre os grupos utilizou-se Teste T de Student’s e ANOVA Two-Way, seguida de post-hoc de Newman-Keuls. O grupo H apresentou menor peso do tecido adiposo nas regiões mesentérica, retroperitoneal e subcutânea, comparado com o grupo C, o que reflete a perda de peso corporal neste grupo. Menores valores de colesterol total, LDL e HDL, na condição em repouso, foram observados no grupo H. Após o exercício agudo houve um incremento estatisticamente significativo de glicose em ambos os grupos, bem como, redução dos níveis de triglicerídeos no grupo C (p<0,05). As concentrações de lipídios totais nocoração foram menores em repouso para o grupo H quando comparado com o grupo C. Após sessão aguda de exercício físico essas concentrações se elevaram no grupo H (p<0,05). A droga utilizada induziu características de hipertireoidismo, associadas ao perfil lipídico, em ratos Wistar. O exercício físico agudo não alterou o perfil lipídico dos animais com hipertireoidismo experimental, exceto os lipídios totais do coração. A partir dos achados do presente estudo, trabalhos futuros poderão utilizar intensidade de exercício físico similar (5% do peso corporal) e analisar outros parâmetros metabólicos relacionados a essa patologia em ratos.

The aim of this study was to analyze the lipid profile of rats Wistar with hyperthyroidism at rest and after an acute exercise session. Twenty-eight male Wistar rats were divided into hyperthyroidism (H; induced with tiroxin), and control (C). Half of the animals of each group were sacrificed at rest. The other half was submitted, immediately before the sacrifice, to an a session of swimming exercise for 20 minutes. For the comparisons among the groups Student's t test and ANOVA Two-way test were used, following by post-hoc of Newman-Keuls. The H group presented lower adipose tissue weight of the mesenteric, retroperitoneal and subcutaneous areas compared with the group C, which reflects the loss of corporal weight observed in this group. Lower values of the total cholesterol, LDL and HDL were observed in the H group at rest condition. After exercise there was a glucose increment in both groups, and reduction of the triglycerides levels in the C group (p<0.05). The concentrations of total lipids in the heart were lower at rest for the H group compared with the C group. After the acute session of physical exercise those concentrations enhanced in the H group (p<0.05). The drug used was efficient in inducing characteristics of hyperthyroidism, associated to the lipid profile, in Wistar rats and that the acute session of exercise did not changed the lipid profile of the animals with experimental hyperthyroidism. This is important, because future studies may use similar intensity of physical exercise (5% body weight) and analyze other metabolic parameters associated with this pathology in rats.

Apathy, cognitive function and motor function in Alzheimers disease / Apatia, funções cognitivas e funcionalidade motora em idosos com doença de alzheimer

The aims of this study were to characterize the presence of apathy in patients with AD, determine the relationshipbetween apathy, motor function and cognitive function, and to verify differences among patients stratified by level of apathy inrelation to cognitive and motor abilities. Methods: A cross-sectional study was conducted of 37 patients with AD. The followingtests were used: MoCA, the Frontal Assessment Battery, Verbal Fluency, Clock Drawing Test, Andreotti & Okuma BatteryTests, Sit and Reach, Resistance of Upper Limbs - AAHPERD Battery Test, Sit and Lift Chair and the Apathy domain of theNeuropsychiatric Inventory. After verifying the normality of the data distribution, comparisons were made using Students t-testand the U Mann Whitney test; relationships were also assessed using Pearsons and Spearmans correlation coefficients. Allanalyses were considered to be statistically significant at a p-value of 0.05. Results: 46% of participants in this study showedmild symptoms of apathy. Significant and weak associations were found (p=0.04) between apathy and the attention domainon the MoCA and between apathy and the Walk Test. Analysis of differences in cognitive and motor functions according toparticipants level of apathy revealed no significant differences for any of the variables. Conclusion: Apathy was reflectedin attention and the Walk Test, suggesting these variables may be related to cognitive and functional decline in AD patients.

Os objetivos deste estudo compreendem: caracterizar a presença de apatia em pacientes com doença de Alzheimer(DA); verificar se há relação entre apatia, funções cognitivas e funcionalidade motora dos mesmos e analisar se há diferençasentre os pacientes, separados por nível de apatia, em relação às suas funções cognitivas e funcionalidade motora. Métodos:Trata-se de um estudo com delineamento transversal. Ao todo 37 pacientes com DA compuseram a amostra. Foramutilizados os seguintes testes: Mini-Exame de Estado Mental, Montreal Cognitive Assessment (MoCA), Bateria de AvaliaçãoFrontal, Teste de Fluência Verbal Semântica, Teste do Desenho do Relógio, Bateria de Testes de Andreotti & Okuma, Teste deSentar e Alcançar, Resistência de Membros Superiores da AAHPERD, Teste Sentar-se e Levantar-se da Cadeira e o domínioApatia do Inventário Neuropsiquiátrico. Após verificar a distribuição dos dados as comparações seguiram através dos testest student e U Mann Whitney e as relações, através das correlações de Pearson e Spearman. Todas as análises admitiramnível de significância de 5%. Resultados: 46% dos participantes deste estudo apresentam sintomatologia para apatia emnível leve. Foram verificadas relações significativas e fracas (p=0,04) entre apatia e o domínio atenção do MoCA e entreapatia e o Teste de Caminhar. Ao verificar a diferença nas funções cognitivas e funcionalidade motora segundo o nível deapatia dos participantes não foram encontradas diferenças significativas para nenhuma das variáveis analisadas. Conclusão:Apatia relaciona-se com a atenção e o Teste de Caminhar sugerindo que estas variáveis podem estar relacionadas com odeclínio cognitivo e funcional dos pacientes com esta patologia.

Effects of weight training on cognitive functions in elderly with Alzheimers disease / Efeitos do treinamento com pesos nas funções cognitivas de idosos com doença de alzheimer

Deterioration in cognitive functions is characteristic in Alzheimers disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life. Objective: To analyze weight training effects oncognitive functions in elderly with AD. Subjects: 34 elderly with AD were allocated into two groups: Training Group (TG)and Social Gathering Group (SGG). Methods: Global cognitive status was determined using the Mini-Mental State Exam.Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test.The protocols were performed three times a week, one hour per session. The weight training protocol consisted of threesets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the UMann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of0.05. Results: There were no significant differences associated to the effects of the practice of weight training on cognitionin AD patients. Conclusion: In this study, no improvement in cognitive functions was evident in elderly with AD who followeda low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs.

A deterioração das funções cognitivas é característica na doença de Alzheimer (DA) e se relaciona com uma piorrealização das atividades de vida diária levando a uma pior qualidade de vida. Objetivo: Analisar os efeitos de um programade treinamento com pesos nas funções cognitivas de idosos com DA. Sujeitos: 34 idosos com DA foram alocados em dois grupos: Grupo Treinamento (GT) e Grupo de Convívio Social (GCS). Métodos: Para caracterização do perfil cognitivo global utilizou-se o Mini-Exame de Estado Mental. Para a mensuração das funções cognitivas foram utilizadas: Bateria Cognitiva Breve, Teste do Desenho do Relógio e teste de Fluência Verbal. Os protocolos oferecidos foram realizados três vezes na semana, durante uma hora. O protocolo de treinamento do GT consistiu em realizar três séries de 20 repetições para cada exercício, com dois minutos de intervalo entre séries e entre exercícios. As atividades propostas para o GCS não foram sistematizadas e tiveram por objetivo promover uma socialização dos pacientes. A análise estatística consistiu na utilização dos testes U Mann Whitney e Wilcoxon para comparação intra e entre grupos. Adotou-se nível de significância de 5% para todas as análises. Resultados: Não foram evidenciadas diferenças significativas relacionadas aos efeitos da prática do treinamento com pesos na cognição de idosos com DA. Conclusão: Neste estudo não houve melhora nas funções cognitivas em idosos com DA que realizaram um protocolo de exercícios resistidos de intensidade leve. Assim, estudos futuros poderiam verificar o efeito de exercícios mais intensos.

Efeitos de três modalidades de atividade física na capacidade funcional de idosos / Efectos de tres modalidades de actividad física en la capacidad funcional de adultos mayores / Effects of three methods of physical activity in functional ability of elderly

O objetivo do presente estudo foi analisar e comparar os efeitos de três modalidades de atividade física: atividade física geral, dança e musculação, na capacidade funcional de idosos. A amostra foi composta por 94 idosos com idade média de 64,06 ± 7,38 anos, que participavam do PROFIT. Para a avaliação foi utilizada a bateria de testes da AAHPERD, da qual se obtém os níveis de flexibilidade, coordenação, agilidade e equilíbrio dinâmico, resistência de força e resistência aeróbia geral, antes e após quatro meses de intervenção. Os resultados apontaram de uma maneira geral uma manutenção nos níveis dos componentes da capacidade funcional. Os participantes do grupo atividade física geral obtiveram melhora dos resultados nos componentes: resistência de força, agilidade e equilíbrio dinâmico. Pode-se concluir que a prática de atividade física regular e sistematizada, independentemente da modalidade, pode ter influência positiva no desempenho funcional de idosos, podendo preservar sua independência e autonomia.

The aim of this study was to analyze and compare the effects of three types of physical activity: general physical activity, dance and weight training, in functional capacity in elderly. The sample included 94 seniors with a mean age of 64.06 ± 7.38 years, who participated in PROFIT. For the evaluation we used the battery of test from AAHPERD, which checks the levels of flexibility, coordination, agility and dynamic balance, strength endurance and general endurance before and after four months of intervention. The results indicated a maintained in the levels of functional components. The participants general physical activity group had better results on the components: strength endurance, agility and dynamic balance. It can be concluded that the practice of regular physical activity and systematized, regardless of the type may have a positive influence on the functional performance of elderly and can preserve their independence and autonomy.

El objetivo de este estudio fue analizar y comparar los efectos de actividad física generalizada, danza y musculación en la capacidad funcional de adultos mayores. La muestra consistió en 94 adultos mayores con promedio de edad de 64,06 ± 7,38 años, participantes en el PROFIT. Para la evaluación se utilizó de la batería de testes de la AAHPERD, la cual se puede obtener los niveles de flexibilidad, coordinación, agilidad y equilibrio dinámico, resistencia de fuerza y resistencia general, antes y después de cuatro meses de intervención. Los resultados mostraron una manutención en los niveles de los componentes funcionales. Lo grupo de actividad física general tuvieron mejores resultados en la resistencia de fuerza, agilidad y equilibrio dinámico. Se conclui que la práctica de actividad física regular y sistematizada, independiente dela modalidad, puede tener una influencia positiva en el desempeño funcional de los adultos mayores y pueden preservar su independencia y autonomía.

Nível de atividade física, sono e qualidade de vida de pacientes com doença de Alzheimer / Level of physical activity, sleep and quality of life of patients with Alzheimer?s disease

A atividade física (AF) tem sido considerada um importante recurso não farmacológico, que pode proporcionar benefícios ao sono e à qualidade de vida de pacientes com Doença de Alzheimer (DA). O presente estudo teve por objetivo analisar a relação entre nível de atividade física, distúrbios do sono e qualidade de vida em pacientes com DA. Participaram deste estudo 30 pacientes com DA. Para mensurar nível de AF, sono e qualidade de vida foram utilizados, respectivamente: Questionário Baecke Modificado para Idosos, Mini Questionário do Sono e Escala de avaliação da qualidade de vida na Doença de Alzheimer ? respondida pelo paciente e cuidador. Para comparação do sono e da qualidade de vida, em função do nível da prática de AF, a amostra foi dividida em dois grupos (maior e menor nível de AF). Para verificar relações entre as variáveis e comparar os grupos foram empregados, respectivamente, os seguintes testes: correlação de Spearman e o teste de U de Mann Whitney. Foi admitido o nível de significância de 5% para as análises. Os pacientes apresentaram um baixo nível de AF e foi encontrada relação positiva, moderada e significativa (rho = 0,4; p = 0,01) entre nível de AF e qualidade de vida do cuidador. Concluímos, assim, que cuidadores de pacientes mais ativos possuem uma melhor qualidade de vida e não existe relação entre sono e qualidade de vida e nível de AF de pacientes com DA.

Physical activity (PA) has been considered an important non pharmacological feature that provides benefits on sleeping and quality of life of patients with Alzheimer?s disease (AD). The aim of this research was to analyze the relation of the level of PA; sleep disturbances and quality of life in pacients with AD. The study included 30 patients with PA. To measure PA level, sleeping and quality of life, it was used, respectively: Modified Baecke Questionnaire for the Elderly, Mini Sleep Questionnaire and Quality of life assessment scale on Alzheimer?s disease ? answered by the patients and their caregivers. For comparçliing of sleeping and quality of life, the sample was divided into two groups (higher and lower PA levels). In order to verify relations between the variables, and for the comparison both groups, it was used, respectively: Spearman correlation and U-Mann Whitney tests. It was admitted the level of significance at 5% for all analyzes. Patients had a low level of PA and it was only found relationship positive, moderated and significant (rho = 0,4; p = 0,01) between the level of PA and the caregiver?s quality of life. Thus, the caregivers of more active patients have a better quality of life and, there were no differences in sleep and quality of life when comparing the lowest and the highest level of PA groups of patients with AD.

Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI).

Mild cognitive impairment (MCI) can be a stage of pre-dementia. There is no consensus about pharmacological treatment for this population, so it is important to structure non-pharmacological interventions for increasing their cognitive reserve. We intended to analyze the effects of non-pharmacological interventions in the cognitive functions in older people with MC, in form of a systemic review. Data sources were the Web of Science, Biological Abstracts, Medline, Pub Med, EBSCHost, Scirus and Google Scholar. All studies were longitudinal trials, with MCI sample, aged>60 years, community-dwelling, and having cognitive functions as dependent variable. Seven studies, from 91 previously selected ones, were identified according to the inclusion criteria. Six studies used cognitive intervention, improving memory and one study used physical activity as intervention, improving executive functions. The results show evidence that physical activity and cognitive exercise may improve memory and executive functions in older people with MCI. But yet, more controlled studies are needed to establish a protocol of recommendations regarding the systemization of exercise, necessary to produce benefits in the cognitive functioning in older people with MCI.

Apathy, cognitive function and motor function in Alzheimer's disease.

The aims of this study were to characterize the presence of apathy in patients with AD, determine the relationship between apathy, motor function and cognitive function, and to verify differences among patients stratified by level of apathy in relation to cognitive and motor abilities. METHODS: A cross-sectional study was conducted of 37 patients with AD. The following tests were used: MoCA, the Frontal Assessment Battery, Verbal Fluency, Clock Drawing Test, Andreotti & Okuma Battery Tests, Sit and Reach, Resistance of Upper Limbs - AAHPERD Battery Test, Sit and Lift Chair and the Apathy domain of the Neuropsychiatric Inventory. After verifying the normality of the data distribution, comparisons were made using Student's t-test and the U Mann Whitney test; relationships were also assessed using Pearson's and Spearman's correlation coefficients. All analyses were considered to be statistically significant at a p-value of 0.05. RESULTS: 46% of participants in this study showed mild symptoms of apathy. Significant and weak associations were found (p=0.04) between apathy and the attention domain on the MoCA and between apathy and the Walk Test. Analysis of differences in cognitive and motor functions according to participants' level of apathy revealed no significant differences for any of the variables. CONCLUSION: Apathy was reflected in attention and the Walk Test, suggesting these variables may be related to cognitive and functional decline in AD patients.

Os objetivos deste estudo compreendem: caracterizar a presença de apatia em pacientes com doença de Alzheimer (DA); verificar se há relação entre apatia, funções cognitivas e funcionalidade motora dos mesmos e analisar se há diferenças entre os pacientes, separados por nível de apatia, em relação às suas funções cognitivas e funcionalidade motora. MÉTODOS: Trata-se de um estudo com delineamento transversal. Ao todo 37 pacientes com DA compuseram a amostra. Foram utilizados os seguintes testes: Mini-Exame de Estado Mental, Montreal Cognitive Assessment (MoCA), Bateria de Avaliação Frontal, Teste de Fluência Verbal Semântica, Teste do Desenho do Relógio, Bateria de Testes de Andreotti & Okuma, Teste de Sentar e Alcançar, Resistência de Membros Superiores da AAHPERD, Teste Sentar-se e Levantar-se da Cadeira e o domínio Apatia do Inventário Neuropsiquiátrico. Após verificar a distribuição dos dados as comparações seguiram através dos testes t student e U Mann Whitney e as relações, através das correlações de Pearson e Spearman. Todas as análises admitiram nível de significância de 5%. RESULTADOS: 46% dos participantes deste estudo apresentam sintomatologia para apatia em nível leve. Foram verificadas relações significativas e fracas (p=0,04) entre apatia e o domínio atenção do MoCA e entre apatia e o Teste de Caminhar. Ao verificar a diferença nas funções cognitivas e funcionalidade motora segundo o nível de apatia dos participantes não foram encontradas diferenças significativas para nenhuma das variáveis analisadas. CONCLUSÃO: Apatia relaciona-se com a atenção e o Teste de Caminhar sugerindo que estas variáveis podem estar relacionadas com o declínio cognitivo e funcional dos pacientes com esta patologia.

Effects of weight training on cognitive functions in elderly with Alzheimer's disease.

Deterioration in cognitive functions is characteristic in Alzheimer's disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life. OBJECTIVE: To analyze weight training effects on cognitive functions in elderly with AD. SUBJECTS: 34 elderly with AD were allocated into two groups: Training Group (TG) and Social Gathering Group (SGG). METHODS: Global cognitive status was determined using the Mini-Mental State Exam. Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test. The protocols were performed three times a week, one hour per session. The weight training protocol consisted of three sets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the U Mann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of 0.05. RESULTS: There were no significant differences associated to the effects of the practice of weight training on cognition in AD patients. CONCLUSION: In this study, no improvement in cognitive functions was evident in elderly with AD who followed a low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs.

A deterioração das funções cognitivas é característica na doença de Alzheimer (DA) e se relaciona com uma pior realização das atividades de vida diária levando a uma pior qualidade de vida. OBJETIVO: Analisar os efeitos de um programa de treinamento com pesos nas funções cognitivas de idosos com DA. SUJEITOS: 34 idosos com DA foram alocados em dois grupos: Grupo Treinamento (GT) e Grupo de Convívio Social (GCS). MÉTODOS: Para caracterização do perfil cognitivo global utilizou-se o Mini-Exame de Estado Mental. Para a mensuração das funções cognitivas foram utilizadas: Bateria Cognitiva Breve, Teste do Desenho do Relógio e teste de Fluência Verbal. Os protocolos oferecidos foram realizados três vezes na semana, durante uma hora. O protocolo de treinamento do GT consistiu em realizar três séries de 20 repetições para cada exercício, com dois minutos de intervalo entre séries e entre exercícios. As atividades propostas para o GCS não foram sistematizadas e tiveram por objetivo promover uma socialização dos pacientes. A análise estatística consistiu na utilização dos testes U Mann Whitney e Wilcoxon para comparação intra e entre grupos. Adotou-se nível de significância de 5% para todas as análises. RESULTADOS: Não foram evidenciadas diferenças significativas relacionadas aos efeitos da prática do treinamento com pesos na cognição de idosos com DA. CONCLUSÃO: Neste estudo não houve melhora nas funções cognitivas em idosos com DA que realizaram um protocolo de exercícios resistidos de intensidade leve. Assim, estudos futuros poderiam verificar o efeito de exercícios mais intensos.

Sintomas depressivos e prejuízo funcional de idosos de um Centro-Dia Geriátrico / Depressive symptoms and functional impairment of the elderly in a Geriatric Day Central

OBJETIVOS: Caracterizar idosos do Centro-Dia Geriátrico de Rio Claro (SP) de acordo com os sintomas depressivos e o prejuízo funcional e, ainda, verificar a relação entre sintomas depressivos e desempenho nas atividades instrumentais da vida diária. MÉTODOS: Estudo descritivo, transversal, do qual participaram 36 idosos. Os instrumentos utilizados foram: anamnese, Escala Geriátrica de Depressão e Questionário de Atividades Instrumentais de Pfeffer. A análise dos dados ocorreu por meio da estatística descritiva e dos testes U de Mann-Whi-t-ney e correlação de Spearman, com nível de significância de 5%. RESULTADOS: Houve maior presença de mulheres na amostra, que apresentou em média 77,02 anos de idade e 3,44 anos de estudo. A prevalência de sintomas depressivos e prejuízo funcional foi de 30,5% e 63,8%, respectivamente, sendo maior entre as mulheres. Não houve diferença significativa entre as variáveis analisadas em comparação aos gêneros e às faixas etárias. O teste de correlação de Spearman apresentou rho = 0,38 e p = 0,02, indicando correlação positiva, porém fraca, entre sintomas depressivos e prejuízo funcional. CONCLUSÃO: Conclui-se que há uma baixa relação entre as variáveis sintomas depressivos e prejuízo funcional, sendo necessários novos estudos para investigar outros fatores que podem estar relacionados a essas variáveis.

OBJECTIVES: To characterize the elderly in a Geriatric Day Center, of Rio Claro (SP), according to depressive symptoms and functional impairment and also verify the relationship between depressive symptoms and performance in instrumental activity of daily living. METHODS: Descriptive study, cross-sectional, which involved 36 elderly. The instruments used were: interview, Geriatric Depression Scale and Pfeffer's Instrumental Activities Questionnaire. Data were analyzed by descriptive statistics and by the U Mann-Whitney test and Spearman's correlation test, with a significance level of 5%. RESULTS: There was a greater presence of women in the sample, which showed a mean age of 77.02 years old and 3.44 years of study. The prevalence of depressive symptoms and functional impairment was 30.5% and 63.8%, respectively, being higher among women. There was no significant difference between the variables compared to the genders and age groups. The Spearman's correlation test showed a rho = 0.38, p = 0.02, indicating a positive correlation but weak correlation between depressive symptoms and functional impairment. CONCLUSION: We conclude that there is a low relationship between variables depressive symptoms and functional impairment, necessitating further studies to investigate other factors that may be related to these variables.