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Late life deterioration of functional status is associated with adverse health outcomes and increased cost of care. This trial was conducted to determine whether dance-based intervention could reverse functional decline among nursing home (NH) residents. A total of 189 residents of seven NHs in the Czech Republic were randomly assigned to intervention and control groups. More detailed data were collected in a subsample of 52 participants. Intervention consisted of 3-month dance-based exercise. Functional status was assessed by the get-up-and-go test, basic activities of daily living (ADL), instrumental activities of daily living (IADL), and senior fitness tests (SFTs). Participants in the control group experienced a significant decline in get-up-and-go test, IADL, and in four of the six SFTs. The intervention proved to be effective in preventing this deterioration and improved chair stand test and chair sit-and-reach test. The findings indicate that a relatively simple dance-based exercise can slow down deterioration of functional status in NH residents.
- Klíčová slova
- dance, functional decline, nursing homes, older adults, prevention,
- MeSH
- činnosti denního života * MeSH
- cvičení fyziologie MeSH
- domovy pro seniory MeSH
- geriatrické hodnocení MeSH
- lidé MeSH
- lineární modely MeSH
- motorické dovednosti fyziologie MeSH
- pečovatelské domovy MeSH
- psychomotorický výkon fyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- terapie tancem metody MeSH
- úrazy pádem prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: The number of older people with cognitive impairment is increasing worldwide. Impaired lung function might be associated with cognitive decline in older age; however, results from large longitudinal studies are lacking. In this study, we examined the longitudinal associations between pulmonary function and the trajectories of cognitive decline using prospective population-based SHARE data from 14 countries. METHODS: The analytic sample included N = 32,049 older adults (Mean age at baseline = 64.76 years). The dependent variable was cognitive performance, measured repeatedly across six waves in three domains: verbal fluency, memory, and numeracy. The main predictor of interest was peak expiratory flow (PEF). The data were analyzed in a multilevel accelerated longitudinal design, with models adjusted for a variety of covariates. RESULTS: A lower PEF score was associated with lower cognitive performance for each domain as well as a lower global cognitive score. These associations remained statistically significant after adjusting for all covariates Q4 vs Q1 verbal fluency: unstandardized coefficient B = -3.15; numeracy: B = -0.52; memory: B = -0.64; global cognitive score B = -2.65, all p < .001). However, the PEF score was not found to be associated with the rate of decline for either of the cognitive outcomes. CONCLUSIONS: In this large multi-national longitudinal study, the PEF score was independently associated with lower levels of cognitive functions, but it did not predict a future decline. The results suggest that pre-existing differences in lung functions are responsible for variability in cognitive functions and that these differences remained stable across aging.
- Klíčová slova
- Cognitive decline, Cross-cultural, Longitudinal, Peak expiratory flow, Pulmonary function,
- MeSH
- kognice MeSH
- kognitivní dysfunkce * epidemiologie MeSH
- lidé MeSH
- longitudinální studie MeSH
- plíce MeSH
- prospektivní studie MeSH
- senioři MeSH
- stárnutí * psychologie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Our study aimed at exploring structural and functional differences in the brain during higher cognitive processing between middle-aged hypertensive patients and controls matched for sex, age and years of education. METHODS: Two groups of 20 patients took part in MRI examinations. This article reports the results of functional MRI during a Stroop color interference task and structural evaluations based on a modified Fazekas scale. RESULTS: No intergroup differences were found in regards to the severity of white matter lesions (Mann-Whitney U test = 150.5, P > 0.1), nor from the task performance in the scanner (t(35) = 0.2, P > 0.1). However, brain activation patterns between patients and controls varied. Hypertensive patients involved significantly more cerebral areas during the processing, regardless of the task difficulty. Differences were found in 26 diverse regions of both primary and associative cortices (with a peak voxel located in the cuneus, Z = 6.94, P < 0.05 family-wise error corrected at voxel level). CONCLUSION: Our findings provide an insight into the brain mechanisms related to essential hypertension and suggest a functional reorganization (neuroplasticity) early in the course of the disease.
- MeSH
- dospělí MeSH
- hypertenze komplikace patofyziologie MeSH
- kognitivní dysfunkce diagnostické zobrazování etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- mozek diagnostické zobrazování patologie patofyziologie MeSH
- neuropsychologické testy MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Brain dynamics and the associations with spatial navigation in individuals with subjective cognitive decline (SCD) remain unknown. In this study, a hidden Markov model (HMM) was inferred from resting-state functional magnetic resonance imaging data in a cohort of 80 SCD and 77 normal control (NC) participants. By HMM, 12 states with distinct brain activity were identified. The SCD group showed increased fractional occupancy in the states with less activated ventral default mode, posterior salience, and visuospatial networks, while decreased fractional occupancy in the state with general network activation. The SCD group also showed decreased probabilities of transition into and out of the state with general network activation, suggesting an inability to dynamically upregulate and downregulate brain network activity. Significant correlations between brain dynamics and spatial navigation were observed. The combined features of spatial navigation and brain dynamics showed an area under the curve of 0.854 in distinguishing between SCD and NC. The findings may provide exploratory evidence of the reconfiguration of brain network dynamics underlying spatial deficits in SCD.
- Klíčová slova
- Brain dynamics, Hidden Markov model, Spatial navigation, Subjective cognitive decline,
- MeSH
- kognitivní dysfunkce * psychologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mapování mozku metody MeSH
- mozek fyziologie MeSH
- pravděpodobnost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Patients with Alzheimer's disease (AD) related dementia and mild cognitive impairment experience difficulties with spatial navigation (SN). However, SN has rarely been investigated in individuals with subjective cognitive decline (SCD), a preclinical stage with elevated progression rate to symptomatic AD. In this study, 30 SCD subjects and 30 controls underwent cognitive scale (CS) evaluation, a 2D computerized SN test, and resting-state functional magnetic resonance imaging scanning. Two SN brain networks (ego-network and allo-network), each with 10 selected spherical regions, were defined. We calculated the average network functional connectivity (FC) and region-to-region FC within the two networks and evaluated correlations with SN performance. Compared with the controls, the SCD group performed worse in the SN test and showed decreased FC between the right retrosplenial and right prefrontal cortices in the ego-network, and between the right retrosplenial cortex and right hippocampus in the allo-network. The logistic regression model based on SN and FC measures revealed a high area under the curve of .880 in differentiating SCD individuals from controls. These results suggest that SN network disconnection contributes to spatial deficits in SCD, and SN and FC measures could benefit the preclinical detection of subjects with incipient AD dementia.
- Klíčová slova
- Allocentric, Egocentric, Functional connectivity, Spatial navigation, Subjective cognitive decline,
- MeSH
- Alzheimerova nemoc * diagnostické zobrazování MeSH
- ego MeSH
- kognitivní dysfunkce * diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozek MeSH
- zmatenost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
We sought to describe the cognitive profile of patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) using a comprehensive neuropsychological battery. Based on age and education correlated norms, we aimed to compare performance in each measured cognitive domain: executive functions (EFs), verbal memory (VM), non-verbal memory (nVM), visuoconstructional abilities (VA) and attention/psychomotor speed (A/PS). Patients diagnosed with iNPH underwent comprehensive neuropsychological evaluation before shunting. Their performance was compared to the age and education correlated norms. Correlation of different cognitive domains in iNPH profile was performed. A total of 53 iNPH patients (73.21 ± 5.48 years) were included in the study. All of the measured cognitive domains were significantly damaged. The most affected domains were EFs and VM (p<0.001 and p<0.001, respectively). A/PS domain was affected milder than EFs and VM (p<0.001). The least affected domains were nVM (p<0.001) and VA (p<0.001). Patients with iNPH are affected in all cognitive domains and the cognitive decline is uneven across these domains. The impairment of memory was shown to depend on the presented material. VM was shown to be much more severely affected than nVM and along with VM, EFs were shown to be the most affected. A/PS speed was shown to be less affected than VM and EFs and the least affected domains were nVM and VA.
- Klíčová slova
- Cognitive decline, executive functions, Neuropsychology, Normal pressure hydrocephalus,
- MeSH
- exekutivní funkce MeSH
- kognice MeSH
- kognitivní dysfunkce * MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- normotenzní hydrocefalus * diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Cognitive decline is a key characteristic of Huntington's disease (HD). This study aimed to investigate the diagnostic accuracy of a cognitive battery with six tests used by most HD research centers to assess cognitive impairment in HD. METHOD: In total, 106 HD patients in different disease stages with more (HD-CD, N = 30) and less cognitive impairments (HD-NC, N = 70) and 100 healthy controls (NC) were matched by age, sex, and education and were examined using a standardized protocol including cognitive, motor, and functional assessments. RESULTS: One-way between-groups analysis of variance showed that controls performed significantly better than HD patients and that HD-NC significantly outperformed HD-CD patients in all cognitive tests (NC > HD-NC > HD-CD), with all Games-Howell post-hoc tests p < .001. Analyses using area under the receiver-operating characteristic curve (AUC) disclosed the diagnostic accuracy of all tests included in the battery to discriminate between NC and HD patients with AUC ranging from 0.809 to 0.862 (all p < .001) and between HD-CD and HD-NC patients with AUC ranging from 0.833 to 0.899 (all p < .001). In both analysis, Stroop Color Naming Test showed the highest discriminative potential. Additional analyses showed that cognitive deficits in all domains progressed with disease duration. Moreover, cognitive performance correlated with the severity of motor and functional impairment (all p < .001) and with the Disease Burden Score regardless of disease duration and age. CONCLUSION: Our results indicate that the cognitive battery is a suitable tool for assessing cognitive impairment in HD.
- Klíčová slova
- Cognitive impairment, Diagnostic accuracy, Huntington’s disease, Neuropsychological test battery, Unified Huntington’s Disease Rating Scale,
- MeSH
- Huntingtonova nemoc * komplikace diagnóza MeSH
- kognice MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- osobní újma zaviněná nemocí MeSH
- tělesná a funkční výkonnost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Examine cognitive changes over time among nursing home residents and develop a risk model for identifying predictors of cognitive decline. DESIGN: Using secondary analysis design with Minimum Data Set data, cognitive status was based on the Cognitive Performance Scale (CPS). SETTING AND PARTICIPANTS: Baseline and 7 quarterly follow-up analyses of US and Canadian interRAI data (N = 1,257,832) were completed. METHODS: Logistic regression analyses identified predictors of decline to form the CogRisk-NH scale. RESULTS: At baseline, about 15% of residents were cognitively intact (CPS = 0), and 11.2% borderline intact (CPS = 1). The remaining more intact, with mild impairment (CPS = 2), included 15.0%. Approximately 59% residents fell into CPS categories 3 to 6 (moderate to severe impairment). Over time, increasing proportions of residents declined: 17.1% at 6 months, 21.6% at 9 months, and 34.0% at 21 months. Baseline CPS score was a strong predictor of decline. Categories 0 to 2 had 3-month decline rates in midteens, and categories 3 to 5 had an average decline rate about 9%. Consequently, a 2-submodel construction was employed-one for CPS categories 0 to 2 and the other for categories 3 to 5. Both models were integrated into a 6-category risk scale (CogRisk-NH). CogRisk-NH scale score distribution had 15.9% in category 1, 26.84% in category 2, and 36.7% in category 3. Three higher-risk categories (ie, 4-6) represented 20.6% of residents. Mean decline rates at the 3-month assessment ranged from 4.4% to 28.3%. Over time, differentiation among risk categories continued: 6.9% to 38.4.% at 6 months, 11.0% to 51.0% at 1 year, and 16.2% to 61.4% at 21 months, providing internal validation of the prediction model. CONCLUSIONS AND IMPLICATIONS: Cognitive decline rates were higher among residents in less-impaired CPS categories. CogRisk-NH scale differentiates those with low likelihood of decline from those with moderate likelihood and, finally, much higher likelihood of decline. Knowledge of resident risk for cognitive decline enables allocation of resources targeting amenable factors and potential interventions to mitigate continuing decline.
- Klíčová slova
- CPS, Cognitive Performance Scale, cognitive decline, cognitive impairment, dementia, interRAI, long term care facilities, nursing homes, older adults,
- MeSH
- kognice MeSH
- kognitivní dysfunkce * diagnóza MeSH
- lidé MeSH
- pečovatelské domovy * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Kanada MeSH
BACKGROUND: Currently, there is a significant increase in the number of older generation groups, which may result in serious economic and social issues. Therefore, there is a need to prolong the active life of these older individuals, especially by focusing on modifying lifestyle factors such as healthy nutrition. In fact, recent research has shown that, for example, nuts are an important part of people's healthy diet because they have appeared to be neuroprotective compounds which might maintain or in some cases even improve people's cognitive functions. OBJECTIVE: The purpose of this review study is to explore the role of the nut nutrition in the maintenance and delay of cognitive decline among older individuals. RESULTS: The findings indicate that the nut consumption may contribute to the delay of cognitive decline in aging. However, this nut diet is just one component of the multi-nutrient dietary intervention for health aging. CONCLUSION: More longitudinal controlled randomized studies have to be performed in this field to prove the efficacy of the nut nutrition for the delay of cognitive decline.
- Klíčová slova
- Nuts, aging, cognitive decline, intervention, multi-nutrient diet, quality of life.,
- MeSH
- dieta * MeSH
- kognitivní dysfunkce prevence a kontrola MeSH
- lidé MeSH
- management nemoci * MeSH
- ořechy * metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
The aim was to investigate the pattern and rate of cognitive decline across distinctive trajectories of depressive symptoms in older adults. In this prospective multinational cohort study on 69,066 participants (on average 64 years at baseline, 55% women), assessments of cognitive functions (immediate recall, delayed recall, verbal fluency) and depressive symptoms (EURO-D scale) were conducted at 2-year intervals. The trajectories of depressive symptoms were obtained using latent growth mixture modelling, cognitive decline was assessed using smoothing splines and linear mixed effects models. Four distinct trajectories of depressive symptoms were identified: constantly low (n = 49,660), constantly high (n = 2999), increasing (n = 6828) and decreasing (n = 9579). Individuals with increasing and constantly high depressive symptoms showed linear cognitive decline, while those with constantly low and decreasing depressive symptoms had fluctuating cognition. Participants with increasing depressive symptoms had the fastest decline, while those with decreasing symptoms were spared from decline in cognition. This study suggests that the pattern as well as the rate of cognitive decline co-occurs with specific patterns of changes in depressive symptoms over time. The most pronounced cognitive decline is present in individuals, in whom depressive symptoms increase late in life. Unique mechanisms of cognitive decline may exist for subgroups of the population, and are associated with the trajectory of depressive symptoms.
- MeSH
- deprese patofyziologie psychologie MeSH
- depresivní poruchy patofyziologie MeSH
- kognice fyziologie MeSH
- kognitivní dysfunkce patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH