Effects of Functional-Task Training on Older Adults With Alzheimer's Disease.

The aim of this study was to verify the effects of functional-task training on cognitive function, activities of daily living (ADL) performance, and functional fitness in community-dwelling older adults with diagnosis of Alzheimer's disease (AD). A total of 57 participants (22 functional-task training group [FTG], 21 social gathering group [SGG], 14 control group [CG]) were recruited. Participants in both intervention groups carried out three 1-hr sessions per week of a functional-task program and social gathering activities for 12 weeks. Significant improvements were observed in executive functions (TMT, t-test, p = .03) in the SGG and in upper limb strength (arm curl, t-test, p = .01) in the FTG. Functional-task training has no significant effect on cognitive function, ADL, and functional fitness among people with AD, although it may contribute to slowing down the process of deterioration this illness causes.

Effects of physical activity on the P300 component in elderly people: a systematic review.

The effects of physical activity on brain function can be assessed through event-related potentials (P300) that reflect cortical activities related to cognitive functions. P300 latency represents the information processing time; longer latencies represent slower processing. P300 amplitude is associated with the attentional system and working memory, with higher amplitudes representing more preserved functions. This systematic review summarizes the literature concerning the effects of physical activity and exercise on P300 in the elderly. Databases, including Web of Science, Scopus, PsycINFO, MEDLINE/PubMed, and Biological Abstracts, were searched for articles up to November 2015. Articles were considered for inclusion if they were studies of the elderly, assessed P300, and evaluated the influence of physical activity on P300 or the effect of physical exercise training on P300. Of the 1227 articles found, 14 investigations matched the inclusion criteria. Nine analyzed the influence of physical activity on P300 in the elderly, and five examined the effects of physical exercise on P300 in the elderly. The obtained results showed that physically active elderly people have shortened P300 latency and higher amplitude. Physical exercise, especially those involving aerobic or resistance training, seems to have marked beneficial effects on P300 in the elderly. Evidence shows that physical activity and physical exercise positively influence cortical activities related to cognitive functions, as indicated by P300, in elderly people.

Cerebellar cognitive affective syndrome in Machado Joseph disease: core clinical features.

The cerebellum is no longer considered a purely motor control device, and convincing evidence has demonstrated its relationship to cognitive and emotional neural circuits. The aims of the present study were to establish the core cognitive features in our patient population and to determine the presence of Cerebellar Cognitive Affective Syndrome (CCAS) in this group. We recruited 38 patients with spinocerebellar ataxia type 3 (SCA3) or Machado­Joseph disease (MJD)-SCA3/MJD and 31 controls. Data on disease status were recorded (disease duration, age, age at onset, ataxia severity, and CAG repeat length). The severity of cerebellar symptoms was measured using the International Cooperative Ataxia Rating Scale and the Scale for the Assessment and Rating of Ataxia. The neuropsychological assessment consisted of the Mini-Mental State Examination, Clock Drawing Test, Wechsler Adult Intelligence Scale, Rey­Osterrieth Complex Figure, Wisconsin Card Sorting Test, Stroop Color­Word Test, Trail-Making Test, Verbal Paired Associates, and verbal fluency tests. All subjects were also submitted to the Hamilton Anxiety Scale and Beck Depression Inventory. After controlling for multiple comparisons, spatial span, picture completion, symbol search, Stroop Color­Word Test, phonemic verbal fluency, and Trail-Making Tests A and B were significantly more impaired in patients with SCA3/MJD than in controls. Executive and visuospatial functions are impaired in patients with SCA3/MJD, consistent with the symptoms reported in the CCAS. We speculate on a possible role in visual cortical processing degeneration and executive dysfunction in our patients as a model to explain their main cognitive deficit.

Cognitive deficits in Machado-Joseph disease correlate with hypoperfusion of visual system areas.

Cognitive and olfactory impairments have previously been demonstrated in patients with spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph disease (MJD)-SCA3/MJD. We investigated changes in regional cerebral blood flow (rCBF) using single-photon emission computed tomography (SPECT) imaging in a cohort of Brazilian patients with SCA3/MJD. The aim of the present study was to evaluate the correlation among rCBF, cognitive deficits, and olfactory dysfunction in SCA3/MJD. Twenty-nine genetically confirmed SCA3/MJD patients and 25 control subjects were enrolled in the study. The severity of cerebellar symptoms was measured using the International Cooperative Ataxia Rating Scale and the Scale for the Assessment and Rating of Ataxia. Psychiatric symptoms were evaluated by the Hamilton Anxiety Scale and Beck Depression Inventory. The neuropsychological assessment consisted of Spatial Span, Symbol Search, Picture Completion, the Stroop Color Word Test, Trail Making Test (TMT), and Phonemic Verbal Fluency. Subjects were also submitted to odor identification evaluation using the 16-item Sniffin' Sticks. SPECT was performed using ethyl cysteine dimer labeled with technetium-99m. SCA3/MJD patients showed reduced brain perfusion in the cerebellum, temporal, limbic, and occipital lobes compared to control subjects (pFDR <0.001). A significant positive correlation was found between the Picture Completion test and perfusion of the left parahippocampal gyrus and basal ganglia in the patient group as well as a negative correlation between the TMT part A and bilateral thalamus perfusion. The visuospatial system is affected in patients with SCA3/MJD and may be responsible for the cognitive deficits seen in this disease.

The effects of polyunsaturated fatty acids in alcohol dependence treatment--a double-blind, placebo-controlled pilot study.

BACKGROUND: The lipid fraction of cell membranes consists of polyunsaturated fatty acids (PUFAS), and chronic alcohol use alters it, modifying its permeability, what might contribute for the dysfunctional metabolism observed in the central nervous system of alcohol dependent patients. Therefore, the supplementation of PUFAS can be an important adjuvant in alcoholism treatment. METHODS: This was a placebo controlled, double blind, randomized study where, 80 alcohol dependent patients, according to DSM-IV, were allocated in four groups with 20 patient each: 'PUFAS', 'Naltrexone', 'Naltrexone + PUFAS' and 'Placebo'. Those substances were administered for 90 days and scales were applied to assess patients craving (OCDS) and alcohol dependence severity (SADD) at baseline and after 90 days. PUFAS serum levels were assessed before and after treatment by high performance liquid chromatography assay. RESULTS: Forty-three patients completed the trial. There was a significant improvement over time on drinking days, SADD and OCDS scores in all groups (p < 0.001). The drinking days comparison between groups did not show statistical significant difference. The same effect was observed for compulsion (OCDS) and severity of dependence scale (SADD). The serum levels of PUFAS increased in all the supplemented groups after treatment, although not significantly. CONCLUSIONS: The oral supplementation of 2 g PUFAS for 3 months did not significantly differ from placebo in reducing the amount of alcohol ingestion, or OCDS and SADD scores in a group of alcohol dependent patient. TRIAL REGISTRATION: NCT01211769.

[Psychoneuroimmunological predictors for burden in older caregivers of patients with Alzheimer's disease]. / Los predictores psiconeuroinmunológicos de la sobrecarga de cuidado en ancianos cuidadores de pacientes con enfermedad de Alzheimer.

INTRODUCTION: The responsibility of giving care to patients with Alzheimer's disease (AD) may result in health changes in the older caregiver. It is important to explore the factors which influence the presence of care burden and to create strategies to face this condition. In this context, the aims of present study were to investigate the relationships between psychoneuroimmunological parameters and determine the predictors to burden in older caregivers of patients with AD. MATERIAL AND METHODS: A total of 30 AD older caregivers participating in the «Cognitive and Functional Kinesiotherapy Program in Elderly with Alzheimer's disease«(PRO-CDA)¼, de Rio Claro, SP-Brazil, were submitted to an assessment protocol to evaluate the psychoneuroimmunological parameters. A descriptive statistical analysis, Pearson correlation and multiple linear regressions were performed. RESULTS: The mean age of caregivers was 71.3 (±9.3), and predominantly are first-grade relatives. The caregiver burden was associated with depressive symptoms (r=0.60, P<.001), caregiver distress (r=0.68, P<.001), and neuropsychiatric disorders of AD patients (r=0.53, P<.001). The multiple regression analysis confirmed depressive symptoms and neuropsychiatric disturbances as predictors of caregiver burden. CONCLUSION: Caregiver burden is associated with, and influenced by parameters related to the caregiver psychological suffering and to characteristics inherent to AD. Thus, it is important to find strategies and implement non-pharmacological programs to provide support to older caregivers, and to assist in the treatment of patients with AD, in order to improve the integral health of this population.

Influence of blood viscosity to cerebral blood flow in older humans compared to young subjects.

OBJECTIVE: Since blood viscosity (BV) is one of the most important factors determining blood flow, this study aimed to investigate the possible correlation between increased blood viscosity and reduction of regional cerebral blood flow (rCBF) in healthy ageing. METHODS: Male subjects were distributed in two groups: "young", aged 20-30 (27 volunteers), or "elderly", aged 60-70 (50 volunteers). Whole blood viscosity was obtained with a Wells-Brookfield Cone/Plate Viscometer. Cerebral blood flow was analysed by means of single photon emission computed tomography (SPECT). RESULTS: The mean BV values were 3.28±0.43 mPa in the group of young volunteers and 4.33±0.73 mPa in the group of elderly volunteers (t=-6.9, p<0.0001). The elderly had a lower blood flow than the young in the following regions: bilateral parietal; temporal-parietal and temporal of the left hemisphere. Pearson's correlation between BV and rCBF showed a good inverse correlation when the BV was above 3.95±0.83 mPa. CONCLUSIONS: Our results point to a close relationship between the two parameters analysed, BV and rCBF. The impairment in rCBF observed in the elderly volunteers might be due to an increase in BV, among other factors. SIGNIFICANCE: These findings suggest interesting possibilities for the treatment/prevention of brain ageing.

Cognitive and olfactory deficits in Machado-Joseph disease: a dopamine transporter study.

Cognitive and olfactory impairments have been demonstrated in patients with Machado-Joseph disease (MJD), and a possible relationship with dopaminergic dysfunction is implicated. However, there is still controversy regarding the pattern of striatal dopaminergic dysfunction in patients with MJD. In this study, we investigated whether these patients had different dopamine transporter (DAT) densities as compared to healthy subjects, and correlated these data with cognitive performance and sense of smell. Twenty-two MJD patients and 20 control subjects were enrolled. The neuropsychological assessment comprised the spatial span, symbol search, picture completion, stroop color word test, trail making test and phonemic verbal fluency test. The 16-item Sniffin' Sticks was used to evaluate odor identification. DAT imaging was performed using the SPECT radioligand [(99m)Tc]-TRODAT-1, alongside with Magnetic Resonance imaging. Patients with MJD showed significantly lower DAT density in the caudate (1.34 ± 0.27 versus 2.02 ± 0.50, p < 0.001), posterior putamen (0.81 ± 0.32 versus 1.32 ± 0.34, p < 0.001) and anterior putamen (1.10 ± 0.31 versus 1.85 ± 0.45, p < 0.001) compared with healthy controls. The putamen/caudate ratio was also significantly lower in patients compared with controls (0.73 ± 0.038 versus 0.85 ± 0.032, p = 0.027). Even though we had only two patients with parkinsonism, we detected striatal dopaminergic deficits in those patients. No significant correlations were detected between DAT density and cognitive performance or Sniffin' Sticks scores. The data suggests that striatal dopamine deficit is not involved in cognitive or sense of smell deficits. This finding raises the possibility of extra-striatal dopamine and other neurotransmitter system involvement or of cerebellum neurodegeneration exerting a direct influence on cognitive and sensorial information processing in MJD.

Los predictores psiconeuroinmunológicos de la sobrecarga de cuidado en ancianos cuidadores de pacientes con enfermedad de Alzheimer / Psychoneuroimmunological predictors for burden in older caregivers of patients with Alzheimer's disease

Introducción. La responsabilidad de cuidar de un paciente con enfermedad de Alzheimer (EA) puede generar alteraciones en la salud del anciano cuidador. Es importante investigar los factores que influyen en la presencia de sobrecarga para crear estrategias de enfrentamiento. En este contexto, los objetivos del presente estudio fueron investigar las relaciones entre parámetros psiconeuroinmunológicos y determinar los predictores de la sobrecarga de cuidado en ancianos cuidadores de pacientes con EA. Material y métodos. Un total de 30 cuidadores de pacientes con EA, participantes del Programa de Cinesioterapia Funcional e Cognitiva em Idosos com Doença de Alzheimer (PRO-CDA), de Rio Claro (SP, Brasil) fueron evaluados para estimar los parámetros psiconeuroinmunológicos. Se utilizó el análisis estadístico descriptivo, correlación de Pearson y regresión lineal múltiple. Resultados. Los cuidadores presentaron un promedio de edad de 71,3 (± 9,3) años, y la gran mayoría eran parientes de primer grado. La sobrecarga de cuidado se relacionó con los síntomas depresivos (r = 0,60; p < 0,001), desgaste del cuidador (r = 0,68; p < 0,001) y perturbaciones neuropsiquiátricas del paciente con EA (r = 0,53; p < 0,001). El análisis de regresión apuntó los síntomas depresivos y perturbaciones neuropsiquiátricas como predictores de la sobrecarga de cuidado. Conclusión. La sobrecarga de cuidado es asociada e influida por parámetros relacionados con el sufrimiento psíquico del cuidador y características inherentes a la EA. Así, es importante buscar estrategias e implementar programas de carácter no farmacológico para ofrecer soporte a los ancianos cuidadores, para que puedan auxiliar en el tratamiento del paciente con EA, buscando mejorar la salud holística de esta población (AU)

Introduction. The responsibility of giving care to patients with Alzheimer's disease (AD) may result in health changes in the older caregiver. It is important to explore the factors which influence the presence of care burden and to create strategies to face this condition. In this context, the aims of present study were to investigate the relationships between psychoneuroimmunological parameters and determine the predictors to burden in older caregivers of patients with AD. Material and methods. A total of 30 AD older caregivers participating in the «Cognitive and Functional Kinesiotherapy Program in Elderly with Alzheimer's disease«(PRO-CDA)», de Rio Claro, SP-Brazil, were submitted to an assessment protocol to evaluate the psychoneuroimmunological parameters. A descriptive statistical analysis, Pearson correlation and multiple linear regressions were performed. Results. The mean age of caregivers was 71.3 (± 9.3), and predominantly are first-grade relatives. The caregiver burden was associated with depressive symptoms (r = 0.60, P<.001), caregiver distress (r = 0.68, P<.001), and neuropsychiatric disorders of AD patients (r = 0.53, P<.001). The multiple regression analysis confirmed depressive symptoms and neuropsychiatric disturbances as predictors of caregiver burden. Conclusion. Caregiver burden is associated with, and influenced by parameters related to the caregiver psychological suffering and to characteristics inherent to AD. Thus, it is important to find strategies and implement non-pharmacological programs to provide support to older caregivers, and to assist in the treatment of patients with AD, in order to improve the integral health of this population (AU)