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1.
Fisioterapia (Madr., Ed. impr.) ; 42(1): 33-38, ene.-feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-187813

RESUMO

Antecedentes y objetivo: Los programas de ejercicio físico grupales para el adulto mayor son ofrecidos usualmente por los servicios de salud comunitaria, los cuales pueden generar diferentes estímulos en la capacidad física y cognitiva de la población. El objetivo del estudio fue comparar el desempeño en actividades de simple y de doble tarea, equilibrio postural y funciones cognitivas en adultas mayores que participan de diferentes modalidades de ejercicios grupales. Materiales y métodos: Fueron evaluadas 41 adultas mayores pertenecientes a 3 programas de ejercicio (G1=grupo de caminata, G2=grupo de entrenamiento funcional y G3=grupo de danza). Para determinar el nivel de actividad física fue utilizado el International Physical Activity Questionnaire adaptado, para el equilibrio se utilizó el test de apoyo unipodal, para evaluación cognitiva el miniexamen del estado mental y para la evaluación del desempeño en actividades de tarea simple y doble fue contabilizado el número de repeticiones realizando actividades motoras y cognitivas durante 30seg. Para el análisis estadístico, ANOVA de un factor y Kruskal-Wallis fueron utilizadas para la comparación de las variables. El coeficiente de Spearman se utilizó para evaluar la correlación entre las variables. Resultados: Los grupos no fueron diferentes en edad ni índice de masa corporal (IMC), G1 (n=13; edad=62,5±2,9 años; IMC=28,49±6,4kg/m2), G2 (n=13; edad: 64,2±5,9 años; IMC=26,6±4,2kg/m2) y G3 (n=15; edad=66,6±6,05 años; IMC=29,4±8,4kg/m2); p>0,05. El G2 presentó un mayor número de repeticiones de la tarea simple, doble motora y doble motora-cognitiva comparado con el G1 y G3 (p<0,004). Fueron encontradas correlaciones entre la tarea simple, doble motora y doble motora-cognitiva (0,56>r<0,80; p<0,05). Conclusión: Las adultas mayores que practican entrenamiento funcional tienen mejor rendimiento en tareas motoras-cognitivas en comparación con a aquellas que practican danza y caminata


Background and objective: Physical exercise programmes for groups of older people are usually offered by community health services, which can generate different stimulus in the physical and cognitive capacity in this population. The objective of this study was to compare the performance of simple and dual task activities, postural balance and cognitive functions in older adults who took part in different types of group exercises. Materials and methods: A total of 41 older women took part in 3 exercise programmes were evaluated (G1=walking group, G2=functional training group, and G3=dancing group). To determine the level of physical activity the International Physical Activity Questionnaire. Balance was assessed using the unipedal stance test, the cognitive capacity was tested using the mini mental status examination, and the performing of the simple/dual tasks was assessed according to the number of repetitions made during cognitive and motor activities for 30seconds For the statistical analysis, One-way ANOVA and Kruskal-Wallis were used to compare the variables. The Spearman coefficient was used to evaluate the correlation between the variables. Results: There were no differences in age and body mass index (BMI) between the groups, G1 (n=13; age=62.5±2.9 years; BMI=28.49±6.4Kg/m2), G2 (n=13; age: 64.2±5 years; BMI=26.6±4.2Kg/m2), and G3 (n=15; age=66.6±6.05 years; BMI=29.4±8.4Kg/m2), P>.05. G2 showed a better performance in simple, dual motor, and dual motor-cognitive tasks compared to G1 and G3 (P>.004). Correlations were observed between simple, dual motor, and dual motor-cognitive tasks (0.56>r<0.80; P>.05). Conclusion: Older women who practice functional training have better performance in cognitive-motor tasks compared to those who dance and walk


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cognição/fisiologia , Equilíbrio Postural/fisiologia , Exercício Físico/fisiologia , Desempenho Psicomotor/fisiologia , Modalidades de Fisioterapia , Disfunção Cognitiva/reabilitação , Análise de Variância , Índice de Massa Corporal , Envelhecimento/fisiologia , Estudos Transversais , Inquéritos e Questionários , Antropometria , Caminhada , Teste de Caminhada/métodos , Terapia através da Dança
2.
Medicina (B Aires) ; 80(1): 54-68, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32044742

RESUMO

It is estimated that two thirds of people who have suffered a stroke have sequels that condition their quality of life. The rehabilitation of the stroke is a complex process, which requires the multidisciplinary approach of specialized professionals (doctors, kinesiologists, nurses, occupational therapists, phonoaudiologists, neuropsychologists and nutritionists). Currently, the practices carried out are a consequence of the combination of evidence and consensus, most of them through international stroke rehabilitation guides. The objective of this review is to adjust the international recommendations on stroke rehabilitation to what is applied to daily practice, in order to unify the criteria of the recommendations and to reduce the variability of the practices carried out. This work is a review of the literature on stroke rehabilitation guides developed in the last 10 years. Each section was supervised by different professionals specialized in these areas. We analyze the time and organization necessary to develop rehabilitation, recommendations for motor, cognitive and visual rehabilitation, the management of dysphagia and nutrition, the approach of comorbidities (venous thrombosis, skin ulcers, pain, psychiatric disorders and osteoporosis) and the necessary tasks to favor the return to the activities of daily life.


Assuntos
Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Adulto , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/reabilitação , Humanos , Assistência Centrada no Paciente/métodos , Fatores de Risco
3.
Phys Ther ; 100(3): 523-542, 2020 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-32065236

RESUMO

BACKGROUND: Cancer-related cognitive impairment (CRCI), often called "chemo-brain" or "chemo-fog," is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI. PURPOSE: The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI. DATA SOURCES: Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE. STUDY SELECTION: Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures. DATA EXTRACTION: Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials. DATA SYNTHESIS: Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24-1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41-1.47). LIMITATIONS: Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses. CONCLUSIONS: Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.


Assuntos
Disfunção Cognitiva/reabilitação , Exercício Físico , Neoplasias/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto , Neoplasias da Mama/terapia , Exercícios Respiratórios , Cognição , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Qigong , Treinamento de Resistência , Autorrelato , Ioga
4.
J Stroke Cerebrovasc Dis ; 29(2): 104513, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31784380

RESUMO

BACKGROUND AND PURPOSE: Slowed Information Processing Speed (IPS) is a commonly reported cognitive deficit following stroke, affecting up to 50% to 70 % of stroke survivors. IPS has a major influence on poststroke cognitive dysfunction, affecting quality of life and increasing dependence on others. Few studies have examined predictors of slow IPS after stroke, and there is a paucity of data in terms of long-term prevalence. This study examined baseline predictors associated with long-term slow IPS in a population-based stroke incidence cohort, 4 years after stroke onset. METHODS: Adults with stroke (n = 133, m = 71.1 ± 13.5 years) completed the Symbol Digit Modalities Test (SDMT) at 4 years poststroke. Baseline predictors were obtained within 2 weeks of the acute event. Multivariate regression linear and logistic models were used to identify baseline predictors (reported as OR with 95%CI) and prevalence of impaired IPS at 4-years. RESULTS: 51% of people with stroke had low scores on the SDMT as indicated by a score of -1.0 SD to -2.5 SD (ranging from low to very low respectively). There were significant associations between slow IPS at 4-years after controlling for age and education level and the following baseline factors: older age (>75 years) (OR 3.03, 95% CI .9-9.3,P = .05), previous stroke (OR 2.74, 95% CI 1.0-7.4,P = .05), high cholesterol (OR 2.72, 95% CI 1.3-5.4,p = .01), hypertension (OR 1.82, 95% CI 0.9-3.6,p = .05), and presence of coronary artery disease (OR 3.35, 95% CI 1.6-9.6,P = .01), or arrhythmia (OR 4.40, 95% CI 1.5-12.4,P = .01). CONCLUSIONS: Even after 4-years poststroke, slowed IPS is highly prevalent, with comorbid vascular risk factors significantly contributing to persistent impaired IPS. Early identification of adults who are at higher risk of deficits in IPS is vital to targeting the timely delivery of cognitive rehabilitation interventions, improving overall outcomes.


Assuntos
Encéfalo/fisiopatologia , Cognição , Disfunção Cognitiva/reabilitação , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
5.
Adv Gerontol ; 32(4): 664-667, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31800198

RESUMO

The article presents the results of the analysis of the needs of long-lived people with disabilities in medical and social care, reflects the problems that arise in this contingent of persons when it is necessary to address the issues of medical and social rehabilitation. A medical and social examination of 238 long-lived patients undergoing inpatient treatment in a geriatric medical organization was carried out. The most frequent deviations from the norm in laboratory and instrumental methods of research are revealed. Screening of «Age is no obstacle¼, which revealed the presence of cognitive disorders and depression in a significant number of investigated and their dependence on others. Emphasized the importance of participation of bodies of social protection of the population in solving the problems of the aged.


Assuntos
Pessoas com Deficiência , Problemas Sociais , Idoso , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/reabilitação , Depressão/epidemiologia , Depressão/reabilitação , Pessoas com Deficiência/estatística & dados numéricos , Humanos , Problemas Sociais/estatística & dados numéricos
6.
Clin Interv Aging ; 14: 1705-1717, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31686796

RESUMO

Purpose: As an intermediate prodromal stage of dementia, mild cognitive impairment (MCI) causes functional, emotional, and social challenges for both of the person with MCI (PwMCI) and their family caregiver. However, major attention has only been placed on the PwMCI's for cognitive training. This study evaluated a more comprehensive intervention, which integrated both strength-based and empowerment approaches, to address their complex needs in a dyadic fashion. Patients and methods: This randomized controlled trial allocated 103 MCI patient-caregiver dyads to receive a 14-week dyadic strength-based empowerment program (D-StEP-MCI, n=52) or usual care (n=51). The D-StEP-MCI program consisted of group-based session to the PwMCI, home-based dyadic sessions, and telephone follow-up, with the activities supported the care dyads to navigate their own strengths and resources for integration, together with the trained skills, to optimize role and social engagement in everyday life. Dyadic health outcomes in terms of subjective and objective cognitive function, and neuro-psychiatric symptoms of PwMCI, stress in symptom management of their family caregivers, and depression of the dyads were evaluated at baseline, after the D-StEP-MCI and at 3 months thereafter. Results: By using general estimating equation, the D-StEP-MCI significantly improved the cognitive function, subjective memory, and mood status of the PwMCI, and the positive changes were maintained at the 3-month endpoints. It also has significantly positive effects on caregivers' stress in symptom management and level of depression. Conclusion: Our findings showed the health benefit of combining strength-based and empowerment approach in supporting the disease adaptation of PwMCI and caregiver in a dyadic fashion. This study also supports the use of a social interaction approach to optimize the everyday engagement of the PwMCI.


Assuntos
Cuidadores/educação , Disfunção Cognitiva/reabilitação , Afeto , Idoso , Cuidadores/psicologia , Cognição , Disfunção Cognitiva/psicologia , Emoções , Feminino , Humanos , Relações Interpessoais , Masculino , Memória , Pessoa de Meia-Idade
7.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 27(Special Issue): 699-703, 2019 Aug.
Artigo em Russo | MEDLINE | ID: mdl-31747164

RESUMO

The article introduces a complex program of neurocognitive rehabilitation into the system of dementia prevention in patients with mild cognitive impairment syndrome. It took about a year to prepare and form a complex program of neurocognitive rehabilitation (the Program). The researchers have also developed clear algorithms of the specialized medical rehabilitation unit Memory Clinic. The conducted study has proved the effectiveness of cognitive functions improvement in patients with mild cognitive impairment after participation in the Program in Memory Clinic. The authors, Professor Kostyuk, and Research Institute for Healthcare Organization and Medical Management have prepared Medical Rehabilitation Guidelines for Elderly Patients with Early Signs of Cognitive Deficits (Structural and Functional Model). The guidelines serve as a tool for practice distribution and transforming them into a project Memory Clinic.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Demência , Idoso , Transtornos Cognitivos/reabilitação , Disfunção Cognitiva/reabilitação , Demência/reabilitação , Humanos , Memória , Testes Neuropsicológicos
8.
Artigo em Russo | MEDLINE | ID: mdl-31626165

RESUMO

AIM: Diabetes mellitus (DM) type 2 leads to the progression of cognitive impairment. The authors compared different types of cognitive rehabilitation in patients with type 2 diabetes. MATERIAL AND METHODS: One hundred and twenty patients with type 2 diabetes were examined and randomized into 4 groups: the computerized training group, the exercise therapy group, the akatinol memantine group and the control group. The duration of rehabilitation was 6 months. All patients underwent general clinical examination and neuropsychological testing. RESULTS AND CONCLUSION: All patients had impaired cognitive functions, especially in visual-constructive skills, speech, abstraction, and memory. Treatment with akatinol memantine was most effective compared to computerized training and exercise therapy. With the exception of the control group, all groups, in particular the exercise therapy group, showed the improvement in carbohydrate metabolism.


Assuntos
Disfunção Cognitiva , Diabetes Mellitus Tipo 2 , Terapia por Exercício , Terapia Assistida por Computador , Cognição , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/reabilitação , Disfunção Cognitiva/terapia , Diabetes Mellitus Tipo 2/complicações , Humanos , Memantina/uso terapêutico , Testes Neuropsicológicos , Reabilitação/métodos
10.
Trials ; 20(1): 478, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382998

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) is defined as an intermediate stage between normal aging and Alzheimer's disease (AD), and early and easily available interventions to delay the progress of MCI to AD are necessary. Feasible complementary and alternative therapies such as electroacupuncture (EA), exercise, and cognitive training have shown some beneficial effects on MCI and AD. Here we report the protocol for a randomized controlled trial of the efficacy and safety of EA combined with computer-based cognitive rehabilitation (EA-CCR) for the treatment of MCI. METHODS: The study will be a prospective, outcome assessor-blinded, parallel-arm, single-center (DongShin University Gwangju Korean Medicine Hospital, Republic of Korea), pilot randomized controlled clinical trial with a 1:1 allocation ratio. Participants with MCI will be randomized to a computer-based cognitive rehabilitation (CCR) or an EA-CCR group (n = 18 each). The CCR group will receive RehaCom cognitive rehabilitation once (30 min) a day, 3 days per week (excluding Saturday and Sunday) for 8 weeks. The EA-CCR group will receive EA at Baihui (GV20), Sishencong (EX-HN1), Fengchi (GB20), and Shenting (GV24) in addition to RehaCom cognitive rehabilitation once (EA:30 min, CCR:30 min) a day, 3 days per week (excluding Saturday and Sunday) for 8 weeks. The primary outcome will be an improvement in cognitive function assessed using the Korean version of the Alzheimer's Disease Assessment Scale-cognitive subscale. Scores for the Korean version of the Montreal Cognitive Assessment scale, Center for Epidemiological Studies Depression Scale, Korean Activities of Daily Living scale, Korean Instrumental Activities of Daily Living scale, and European Quality of Life Five Dimension Five Level Scale will be recorded as secondary outcome measures. All scores will be recorded at baseline (before intervention), 8 weeks after the first intervention (i.e., at the end of the intervention), and 12 weeks after completion of the intervention. DISCUSSION: The study is expected to provide preliminary evidence regarding the efficacy, safety, and usefulness of EA-CCR for the treatment of MCI. TRIAL REGISTRATION: Korea Clinical Information Service, cris.nih.go.kr, KCT0003415 . Registered on 4 January 2019. Retrospectively registered, http://cris.nih.go.kr .


Assuntos
Disfunção Cognitiva/reabilitação , Eletroacupuntura/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/terapia , Computadores , Eletroacupuntura/efeitos adversos , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Projetos de Pesquisa
11.
J Stroke Cerebrovasc Dis ; 28(10): 104299, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31371141

RESUMO

Cognitive dysfunction is the most common nonphysical impairment in the stroke survivors. This impairment has a negative impact on patients' quality of life affects their daily living activities. Both pharmacological and nonpharmacological interventions are employed to improve cognitive impairment. Recently, nonpharmacological interventions have attracted great attention. Cognitive rehabilitation is considered as a therapeutic strategy to improve and maintain cognitive skills in patients with stroke. Enriched environment (EE), as a cognitive rehabilitation strategy, has been shown to facilitate physical, cognitive, as well as social abilities. Moreover, EE has been shown to increase endogenous growth factors. Growth factors have pivotal role in neurogenesis, synaptogenesis, as well as brain remodeling through neuron development, differentiation, and survival. In addition, administration of exogenous growth factors prevents cognitive dysfunction. Here, we review preclinical and clinical evidence of cognitive rehabilitation and role of growth factors in treating poststroke cognitive impairment.


Assuntos
Isquemia Encefálica/reabilitação , Encéfalo/efeitos dos fármacos , Cognição/efeitos dos fármacos , Terapia Cognitivo-Comportamental , Disfunção Cognitiva/reabilitação , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Animais , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Isquemia Encefálica/metabolismo , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/psicologia , Disfunção Cognitiva/metabolismo , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Plasticidade Neuronal/efeitos dos fármacos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/metabolismo , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Resultado do Tratamento
12.
Neuropsychology ; 33(6): 822-841, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31448949

RESUMO

OBJECTIVE: Cognitive training is an effective means of improving performance in a range of populations. Whether it may serve to facilitate cognitive recovery and longer-term outcomes in persons with alcohol use disorders (AUDs) is unclear. Here, we review historical and current literature and offer perspectives for model development and potential implementation. METHOD: We considered a large literature regarding the nature of alcohol-related compromise, early efforts to clarify the nature of recovery and current models and methods underlying cognitive training paradigms. We then constructed a narrative review demonstrating evolving frameworks and empirical data informing the critical review of cognitive training methods as a means of mitigating compromise and facilitating functional outcomes. RESULTS: Cognitive improvement with abstinence is generally noted, but training protocols may enhance performance and generalize benefit to untrained, but highly similar, tasks. Transfer of training to dissimilar tasks and functional outcomes is uncommonly reported. It is noteworthy that some work suggests that clinician ratings for participants are improved. Inconsistency in sample characteristics, training protocols, and outcome measures constrain general conclusions while suggesting opportunities for study and development. CONCLUSIONS: Cognitive training protocols have shown benefit in a variety of populations but have been examined infrequently in persons with AUDs. This overview indicates significant opportunity for cognitive improvement and recovery and thus a strong potential role for training protocols. However, supportive data are not robustly obtained. We suggest that one step in bridging this gap is the implementation of a conceptual framework incorporating contextual, behavioral, and neurobiological variables. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Alcoolismo/reabilitação , Disfunção Cognitiva/reabilitação , Remediação Cognitiva , Alcoolismo/psicologia , Disfunção Cognitiva/psicologia , Humanos , Resultado do Tratamento
13.
Clin Interv Aging ; 14: 1167-1175, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303750

RESUMO

Purpose: We assessed the effect of home-based cognitive intervention (HCI) on cognitive function along with brain metabolism by 18F-FDG PET in patients with amnestic MCI (aMCI). Patients and methods: Fifty-seven patients with aMCI from three hospitals were randomized (30 HCI, 27 control). For 12 weeks, subjects received HCI. Thirty-two subjects (15 HCI, 17 control) underwent brain 18-F-FDG-PET imaging at baseline and at 12 and 24 weeks. Results: The HCI group showed significant improvement in the scores of the Controlled Oral Word Association Test (COWAT) 12 and at 24 weeks. Significant brain metabolic changes by 18F-FDG PET were not observed. Conclusion: The current study suggests that HCI was effective in improving general cognition along with frontal executive function in patients with aMCI.


Assuntos
Cognição , Terapia Cognitivo-Comportamental/métodos , Disfunção Cognitiva/reabilitação , Idoso , Encéfalo/metabolismo , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/metabolismo , Função Executiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons/métodos , Resultado do Tratamento
14.
Geriatr Gerontol Int ; 19(9): 950-955, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31342655

RESUMO

AIM: Building community social capital is important for socially inclusive societies, leading to dementia-friendly communities. However, quantitative evidence is currently lacking regarding the effectiveness of dementia-friendly communities, including the association with community social capital. The current study examined the ecological relationship between social capital and the proportion of people with cognitive decline. METHODS: Data were obtained from population-based, cross-sectional surveys (mail-in questionnaire survey and home-interview survey) of community-dwelling older adults aged ≥65 years, living in 17 district areas in Machida City, Tokyo, Japan. Social capital included social networks (neighborly ties) and social support (emotional support and instrumental support). Cognitive function was assessed using the Mini-Mental State Examination, Japanese version (with a cut-off of 23/24). The proportions of people with high social capital and cognitive decline (Mini-Mental State Examination, Japanese version ≤23) were calculated for residential districts and used in the analysis. RESULTS: The district-level social capital indicators were positively and moderately correlated with the proportion of people with cognitive decline. After adjusting for the aging rate, educational level and population density of the district, an ordinal logistic regression analysis showed that higher proportions of people with strong neighborly ties and people with strong instrumental support were significantly associated with a higher proportion of people with cognitive decline. This trend was stronger among women than men. CONCLUSIONS: People can continue to live in communities with high social capital, even if they are experiencing cognitive decline. Although this study was preliminary, it provided empirical evidence for the benefits of promoting dementia-friendly communities. Geriatr Gerontol Int 2019; 19: 950-955.


Assuntos
Disfunção Cognitiva , Vida Independente , Sistemas de Apoio Psicossocial , Capital Social , Meio Social , Idoso , Ambiente Construído/organização & administração , Ambiente Construído/normas , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/reabilitação , Estudos Transversais , Feminino , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Vida Independente/psicologia , Vida Independente/normas , Japão/epidemiologia , Masculino , Testes de Estado Mental e Demência
15.
Trials ; 20(1): 362, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208471

RESUMO

BACKGROUND: The benefit of physical exercise in ageing and particularly in frailty has been the aim of recent research. Moreover, physical activity in the elderly is associated with a decreased risk of mortality, of common chronic illnesses (i.e. cardiovascular disease or osteoarthritis) and of institutionalization as well as with a delay in functional decline. Additionally, very recent research has shown that, despite its limitations, physical exercise is associated with a reduced risk of dementia, Alzheimer disease or mild cognitive decline. Nevertheless, the effect of physical exercise as a systematic, structured and repetitive type of physical activity, in the reduction of risk of cognitive decline in the elderly, is not very clear. The purpose of this study aims to examine whether an innovative multicomponent exercise programme called VIVIFRAIL has benefits for functional and cognitive status among pre-frail/frail patients with mild cognitive impairment or dementia. METHODS/DESIGN: This study is a multicentre randomized clinical trial to be conducted in the outpatient geriatrics clinics of three tertiary hospitals in Spain. Altogether, 240 patients aged 75 years or older being capable of and willing to provide informed consent, with a Barthel Index ≥ 60 and mild cognitive impairment or mild dementia, pre-frail or frail and having someone to help to supervise them when conducting the exercises will be randomly assigned to the intervention or control group. Participants randomly assigned to the usual care group will receive normal outpatient care, including physical rehabilitation when needed. The VIVIFRAIL multicomponent exercise intervention programme consists of resistance training, gait re-training and balance training, which appear to be the best strategy for improving gait, balance and strength, as well as reducing the rate of falls in older individuals and consequently maintaining their functional capacity during ageing. The primary endpoint is the change in functional capacity, assessed with the Short Physical Performance Battery (1 point as clinically significant). Secondary endpoints are changes in cognitive and mood status, quality of life (EQ-5D), 6-m gait velocity and changes in gait parameters (i.e. gait velocity and gait variability) while performing a dual-task test (verbal and counting), handgrip, maximal strength and power of the lower limbs as well as Barthel Index of independence (5 points as clinically significant) at baseline and at the 1-month and 3-month follow-up. DISCUSSION: Frailty and cognitive impairment are two very common geriatric syndromes in elderly patients and are frequently related and overlapped. Functional decline and disability are major adverse outcomes of these conditions. Exercise is a potential intervention for both syndromes. If our hypothesis is correct, the relevance of this project is that the results can contribute to understanding that an individualized multicomponent exercise programme (VIVIFRAIL) for frail elderly patients with cognitive impairment is more effective in reducing functional and cognitive impairment than conventional care. Moreover, our study may be able to show that an innovative individualized multicomponent exercise prescription for these high-risk populations is plausible, having at least similar therapeutic effects to other pharmacological and medical prescriptions. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03657940 . Registered on 5 September 2018.


Assuntos
Disfunção Cognitiva/reabilitação , Exercício Físico , Idoso Fragilizado , Ensaios Clínicos Controlados Aleatórios como Assunto , Idoso , Idoso de 80 Anos ou mais , Fragilidade , Marcha , Humanos , Equilíbrio Postural , Projetos de Pesquisa , Treinamento de Resistência
16.
BMJ ; 365: l4223, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221622

RESUMO

The studyClare L, Kudlicka A, Oyebode J R, et al. Goal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT. Health Technol Assess 2019;23:1-242.The trial was funded by the NIHR Health Technology Assessment Programme (project number11/15/04).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000767/goal-setting-in-early-stage-dementia-can-improve-function.


Assuntos
Disfunção Cognitiva/economia , Disfunção Cognitiva/reabilitação , Demência/psicologia , Atividades Cotidianas , Disfunção Cognitiva/psicologia , Análise Custo-Benefício , Demência/economia , Demência/epidemiologia , Demência/reabilitação , Objetivos , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Autoeficácia , Avaliação da Tecnologia Biomédica , Resultado do Tratamento , Reino Unido
17.
NeuroRehabilitation ; 44(3): 333-339, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31177239

RESUMO

BACKGROUND: The effects of traumatic brain injury (TBI) on return to work have been the focus of many clinical studies in recent years. Veterans with a history of TBI may be at increased risk of unemployment. OBJECTIVE: We sought to understand predictors of work outcomes for Veterans with a history of TBI who received evidence-based supported employment. METHODS: Fifty unemployed Veterans with a history of mild-to-moderate TBI and current neuropsychological impairment participated in a 12-month supported employment intervention. Demographic data and baseline assessments of neuropsychological impairment, functional capacity, and psychiatric and post-concussive symptom severity were investigated as predictors of work outcomes (job attainment, weeks worked, and wages earned). RESULTS: Bivariate analyses showed that lower disability ratings, more recent work history, more months worked in the past 5 years, lower PTSD symptom severity, worse verbal memory, and better cognitive flexibility were all associated with better work outcomes. In multivariate regression analyses, better cognitive flexibility and worse verbal memory performance predicted better work outcomes. CONCLUSIONS: Further research is needed to determine how treatment of cognitive impairments and psychiatric symptoms is related to return to work in Veterans with a history of TBI.


Assuntos
Lesões Encefálicas Traumáticas/psicologia , Lesões Encefálicas Traumáticas/reabilitação , Readaptação ao Emprego/psicologia , Readaptação ao Emprego/tendências , Veteranos/psicologia , Adulto , Lesões Encefálicas Traumáticas/diagnóstico , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/reabilitação , Feminino , Previsões , Humanos , Masculino , Síndrome Pós-Concussão/diagnóstico , Síndrome Pós-Concussão/psicologia , Síndrome Pós-Concussão/reabilitação , Distribuição Aleatória , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/reabilitação
18.
Support Care Cancer ; 27(9): 3253-3279, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31147780

RESUMO

PURPOSE: Individuals with non-central nervous system (CNS) cancers can experience cancer-related cognitive dysfunction (CRCD), negatively impacting daily functioning and quality of life. This systematic review examined cognitive rehabilitation programs aimed at improving cognitive function. METHODS: PsychInfo and PubMed were searched in February 2019. Eligible studies evaluated a cognitive rehabilitation program for adults with non-CNS cancers and included at least one objective cognitive measure. Across studies, we assessed methodological quality using relevant criteria based on published intervention-related review guidelines and examined findings from performance-based and self-reported outcome measures. RESULTS: 19 studies met inclusion criteria, totalling 1124 participants altogether. These studies included randomized controlled trials (n = 12), partial, quasi or non-randomized controlled trials (n = 3) and single-arm pilot studies (n = 4). All studies found improvements on at least one cognitive measure (performance-based or self-reported). By cognitive domain, objective improvements in memory were most commonly reported, followed by executive functions and processing speed. In terms of methodological quality, studies generally provided clear descriptions of participants and interventions. However, limitations included lack of standardized terminology for interventions, discrepancies in outcome measures, and incomplete statistical reporting. CONCLUSIONS: The available evidence supports clinical implementation of cognitive rehabilitation to improve CRCD, with further work in program development, dissemination, and feasibility recommended. We provide specific recommendations to facilitate future research and integration in this field.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Disfunção Cognitiva/reabilitação , Disfunção Cognitiva/terapia , Adulto , Cognição/fisiologia , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Neoplasias/patologia , Qualidade de Vida/psicologia
19.
Mult Scler Relat Disord ; 34: 103-111, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31254960

RESUMO

BACKGROUND: Growing evidence supports the efficacy of restorative cognitive training in people with multiple sclerosis (PwMS), but the effects vary across individuals. Differences in treatment efficacy may be related to baseline individual differences. We investigated clinical characteristics and MRI variables to predict response to a previously validated approach to home-based restorative cognitive training. METHODS: In a single-arm repeated measures study, 51 PwMS completed a 12-week at-home restorative cognitive training program called BrainHQ, shown to be effective in a placebo-controlled clinical trial. Baseline demographic, clinical, neuropsychological, and brain MRI factors were captured and the effects of treatment were quantified with Symbol Digit Modalities Test (SDMT). Also measured were indices of treatment compliance. Regression modeling was employed to identify the factors associated with greatest SDMT improvement. RESULTS: As a group, patients improved significantly after training: mean SDMT improving from 49.6 ±â€¯14.7 to 52.6 ±â€¯15.6 (t = 3.91, p<0.001). Greater SDMT improvement correlated positively with treatment exposure (r = 0.38, p = 0.007). Increased post-rehabilitation improvement on SDMT was predicted by baseline relapsing-remitting course (ß=-0.34, p = 0.017), higher trait Conscientiousness-Orderliness (ß=0.29, p = 0.040), and higher baseline gray matter volume (GMV; ß=0.31, p = 0.030). CONCLUSION: The study was designed to explore the variables that predict favorable outcome in a home-based application of a validated restorative cognitive training program. We find good outcomes are most likely in patients with higher trait Conscientiousness-Orderliness, and relapsing-remitting course. The same was found for individuals with higher GMV. Future work in larger cohorts is needed to support these findings and to investigate the unique needs of individuals according to baseline factors.


Assuntos
Terapia Cognitivo-Comportamental , Esclerose Múltipla/psicologia , Esclerose Múltipla/reabilitação , Autocuidado , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/reabilitação , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico por imagem , Testes Neuropsicológicos , Tamanho do Órgão , Cooperação do Paciente , Personalidade , Qualidade de Vida , Resultado do Tratamento
20.
Neurol Sci ; 40(9): 1849-1854, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31055729

RESUMO

In this study, we aimed to determine the difference of motor reaction time and accuracy between the patients with moderate multiple sclerosis (MS) and healthy subjects and to determine whether a specified cognitive-motor training can improve the speed and accuracy of information processing in patients with MS. A total of 205 patients (30% males) and 276 age-/gender-matched healthy subjects (31% males) were included in the study. Furthermore, using a stratified randomization method, patients with MS were randomly assigned to one of two groups: active information processing training (AIPT) (n = 49) or post-control (n = 55). The AIPT group was asked to complete a computerized visual-manual training program and the post-control group asked to complete the same task without an increase in difficulty. Before and after the intervention phase, the simple, choice, and semantic reaction times and accuracies of all participants were evaluated using the VLS measurement battery. Our results demonstrated that the case and control group were significantly different in terms of the simple, choice, and semantic motor reaction times and accuracies. Compared with the pre-intervention phase, the AIPT and control group's performances in the post-intervention phase were considerably improved in simple, choice, and semantic motor reaction times and choice and semantic motor reaction accuracies. The results also showed that the AIPT group performed significantly better than the post-control group in terms of simple and choice motor reaction times. We showed the positive effects of training on the performance of patients with MS in motor reaction time and accuracy.


Assuntos
Disfunção Cognitiva/reabilitação , Remediação Cognitiva , Atividade Motora/fisiologia , Esclerose Múltipla/reabilitação , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Adulto , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Feminino , Humanos , Masculino , Esclerose Múltipla/complicações , Esclerose Múltipla/fisiopatologia , Reconhecimento Visual de Modelos/fisiologia , Terapia Assistida por Computador , Resultado do Tratamento
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