scholarly journals Development of a healthy lifestyle index within a multidomain intervention aimed at prevention of cognitive impairment and dementia, and its association with cognition: Results from the FINGER trial

2021 ◽  
Vol 17 (S10) ◽  
Author(s):  
Mariagnese Barbera ◽  
Jenni Lehtisalo ◽  
Heta Rissanen ◽  
Roosamari Hannukkala ◽  
Tiia Ngandu ◽  
...  
2019 ◽  
pp. 52-58
Author(s):  
A. N. Bogolepova

The prevalence of dementia increases progressively, which actualizes the issue of prevention. Primary prevention of dementia involves preventing the transformation of mild cognitive impairment (MCI) into dementia, secondary prevention involves the early detection and early treatment of dementia, and tertiary prevention involves slowing down the progression of dementia. Current studies pay much attention to the correction of modifiable risk factors due to lifestyle, as primary prevention. Physical activity is a very important component of a healthy lifestyle, which is aimed at preventing the development of cognitive decline. The mechanisms of the positive effect of physical activity on cognitive functions are associated with decreased risk of cardiovascular disease, increased cerebral perfusion and cerebral blood flow, changes in neurogenesis and neuronal plasticity. Nutrition strategies focus on dieting, among which the Mediterranean diet has produced hopeful results. Sleep normalization is also considered a very important aspect of the prevention of cognitive impairment, because sleep disturbances provoke the development of cardiovascular pathology and affect the amyloid metabolism. However, along with combating risk factors, more and more attention is now being paid to the possibilities of drug treatments to prevent dementia. The experimental studies confirmed the neuroprotective effect of Akatinol (memantine). The clinical studies proved the efficacy of Akatinol in the treatment of Alzheimer’s disease and vascular dementia and showed the disease-modifying effect.


2018 ◽  
Vol 62 (2) ◽  
pp. 649-663 ◽  
Author(s):  
Mariagnese Barbera ◽  
Francesca Mangialasche ◽  
Susan Jongstra ◽  
Juliette Guillemont ◽  
Tiia Ngandu ◽  
...  

2021 ◽  
Vol 9 (8) ◽  
pp. 1-280
Author(s):  
Emma Reynish ◽  
Simona Hapca ◽  
Rebecca Walesby ◽  
Angela Pusram ◽  
Feifei Bu ◽  
...  

Background Cognitive impairment is common in older people admitted to hospital, but previous research has focused on single conditions. Objective This project sits in phase 0/1 of the Medical Research Council Framework for the Development and Evaluation of Complex Interventions. It aims to develop an understanding of current health-care outcomes. This will be used in the future development of a multidomain intervention for people with confusion (dementia and cognitive impairment) in general hospitals. The research was conducted from January 2015 to June 2018 and used data from people admitted between 2012 and 2013. Design For the review of outcomes, the systematic review identified peer-reviewed quantitative epidemiology measuring prevalence and associations with outcomes. Screening for duplication and relevance was followed by full-text review, quality assessment and a narrative review (141 papers). A survey sought opinion on the key outcomes for people with dementia and/or confusion and their carers in the acute hospital (n = 78). For the analysis of outcomes including cost, the prospective cohort study was in a medical admissions unit in an acute hospital in one Scottish health board covering 10% of the Scottish population. The participants (n = 6724) were older people (aged ≥ 65 years) with or without a cognitive spectrum disorder who were admitted as medical emergencies between January 2012 and December 2013 and who underwent a structured nurse assessment. ‘Cognitive spectrum disorder’ was defined as any combination of delirium, known dementia or an Abbreviated Mental Test score of < 8 out of 10 points. The main outcome measures were living at home 30 days after discharge, mortality within 2 years of admission, length of stay, re-admission within 2 years of admission and cost. Data sources Scottish Morbidity Records 01 was linked to the Older Persons Routine Acute Assessment data set. Results In the systematic review, methodological heterogeneity, especially concerning diagnostic criteria, means that there is significant overlap in conditions of patients presenting to general hospitals with confusion. Patients and their families expect that patients are discharged in the same or a better condition than they were in on admission or, failing that, that they have a satisfactory experience of their admission. Cognitive spectrum disorders were present in more than one-third of patients aged ≥ 65 years, and in over half of those aged ≥ 85 years. Outcomes were worse in those patients with cognitive spectrum disorders than in those without: length of stay 25.0 vs. 11.8 days, 30-day mortality 13.6% vs. 9.0%, 1-year mortality 40.0% vs. 26.0%, 1-year mortality or re-admission 62.4% vs. 51.5%, respectively (all p < 0.01). There was relatively little difference by cognitive spectrum disorder type; for example, the presence of any cognitive spectrum disorder was associated with an increased mortality over the entire period of follow-up, but with different temporal patterns depending on the type of cognitive spectrum disorder. The cost of admission was higher for those with cognitive spectrum disorders, but the average daily cost was lower. Limitations A lack of diagnosis and/or standardisation of diagnosis for dementia and/or delirium was a limitation for the systematic review, the quantitative study and the economic study. The economic study was limited to in-hospital costs as data for social or informal care costs were unavailable. The survey was conducted online, limiting its reach to older carers and those people with cognitive spectrum disorders. Conclusions Cognitive spectrum disorders are common in older inpatients and are associated with considerably worse health-care outcomes, with significant overlap between individual cognitive spectrum disorders. This suggests the need for health-care systems to systematically identify and develop care pathways for older people with cognitive spectrum disorders, and avoid focusing on only condition-specific pathways. Future work Development and evaluation of a multidomain intervention for the management of patients with cognitive spectrum disorders in hospital. Study registration This study is registered as PROSPERO CRD42015024492. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 8. See the NIHR Journals Library website for further project information.


2020 ◽  
Vol 4 (4) ◽  
pp. 267
Author(s):  
Ismail Samhani ◽  
Norhidayah Badya ◽  
Mohammed Faruque Reza ◽  
Nordin Simbak

The elderly population rising rapidly in Malaysia and contributes to the increasing number of cognitive problems including mild cognitive impairment (MCI). However, due to limited information regarding this problem which may progress towards severe neurologic degeneration, this problem rarely diagnosed and left untreated. Hence, the use of electroencephalography (EEG) biomarker is seen to be important with the spectral power, coherence and synchronization between the both halves of brain explain the pathophysiology underlined. This method is becoming popular for its capabilities in quantifying changes in brain electrical activity and provide early signs of brain impairment. This paper reviews the incidence of mild cognitive impairment in elderly as an early cognitive deterioration signal. It continues with the role of quantitative EEG analysis in providing the physiological meaning of their brain. This paper also provides the information about neurochemical changes which associated with MCI. In addition, this paper proposes an idea of study towards examining physiology, neurochemicals, diet and lifestyles to promote healthy lifestyle in elderly.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 267-270


2017 ◽  
Vol 86 (7-8) ◽  
Author(s):  
Klavdija Ovčar ◽  
Jure Potočnik ◽  
Martin Rakuša

In the developed world, five to ten percent of people older than 65 years have dementia. One fifth of dementia etiologies are due to vascular brain lesions (VaD – vascular dementia). A milder form is called vascular cognitive impairment (VCI). The main clinical criteria for VaD are: 1. cognitive decline verified with standardized cognitive test/scale, 2. evidence of the associated vascular brain lesion, 3. excluded reversible causes of cognitive decline. The main risk factors for VaD are age, atherosclerosis, diabetes and hypertension. They play a key role in pathogenesis of the cognitive impairment. Depending on the damaged brain region, different cognitive domains may be affected with or without other neurological signs. These diversities in the clinical picture challenge the correct diagnosis. Unique feature of VaD is its progression, which can be stopped, if patients receive an appropriate treatment.The treatment of VCI and VaD symptoms is similar to that in Alzheimer’s disease. More importantly, VCI may be slowed down or even stopped with proper secondary stroke prevention and good rehabilitation. The most efficient is primary stroke prevention with healthy lifestyle and treatment of acquired risk factors.


2018 ◽  
Vol 12 (4) ◽  
pp. 291-294 ◽  
Author(s):  
Stacey L. Gorniak ◽  
Craig A. Johnson

Cognitive impairment, particularly coupled with advanced age, is becoming an increasing concern for both clinicians and caregivers. Nonadherence is a common problem in individuals with cognitive impairment, leading to concerns regarding patient autonomy. The development and use of innovative strategies to overcome nonadherence is important to increase the likelihood of engagement in healthy lifestyle behaviors.


PLoS Medicine ◽  
2021 ◽  
Vol 18 (6) ◽  
pp. e1003597
Author(s):  
Xurui Jin ◽  
Wanying He ◽  
Yan Zhang ◽  
Enying Gong ◽  
Zhangming Niu ◽  
...  

Background Apolipoprotein E (APOE) ε4 is the single most important genetic risk factor for cognitive impairment and Alzheimer disease (AD), while lifestyle factors such as smoking, drinking, diet, and physical activity also have impact on cognition. The goal of the study is to investigate whether the association between lifestyle and cognition varies by APOE genotype among the oldest old. Methods and findings We used the cross-sectional data including 6,160 oldest old (aged 80 years old or older) from the genetic substudy of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) which is a national wide cohort study that began in 1998 with follow-up surveys every 2–3 years. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score less than 18. Healthy lifestyle profile was classified into 3 groups by a composite measure including smoking, alcohol consumption, dietary pattern, physical activity, and body weight. APOE genotype was categorized as APOE ε4 carriers versus noncarriers. We examined the associations of cognitive impairment with lifestyle profile and APOE genotype using multivariable logistic regressions, controlling for age, sex, education, marital status, residence, disability, and numbers of chronic conditions. The mean age of our study sample was 90.1 (standard deviation [SD], 7.2) years (range 80–113); 57.6% were women, and 17.5% were APOE ε4 carriers. The mean MMSE score was 21.4 (SD: 9.2), and 25.0% had cognitive impairment. Compared with those with an unhealthy lifestyle, participants with intermediate and healthy lifestyle profiles were associated with 28% (95% confidence interval [CI]: 16%–38%, P < 0.001) and 55% (95% CI: 44%–64%, P < 0.001) lower adjusted odds of cognitive impairment. Carrying the APOE ε4 allele was associated with 17% higher odds (95% CI: 1%–31%, P = 0.042) of being cognitively impaired in the adjusted model. The association between lifestyle profiles and cognitive function did not vary significantly by APOE ε4 genotype (noncarriers: 0.47 [0.37–0.60] healthy versus unhealthy; carriers: 0.33 [0.18–0.58], P for interaction = 0.30). The main limitation was the lifestyle measurements were self-reported and were nonspecific. Generalizability of the findings is another limitation because the study sample was from the oldest old in China, with unique characteristics such as low body weight compared to populations in high-income countries. Conclusions In this study, we observed that healthier lifestyle was associated with better cognitive function among the oldest old regardless of APOE genotype. Our findings may inform the cognitive outlook for those oldest old with high genetic risk of cognitive impairment.


Author(s):  
Juan Miguel Fernández Campoy

Abstract.SPORT AND PHYSICAL ACTIVITY AS A MEANS FOR REDUCING LEVELS OF COGNITIVE DECLINE IN THE ELDERLY.Thanks to scientific knowledge, developed societies begin to assume that the population is growing significantly, which makes copper paramount importance in order to guarantee high levels of quality of life, articulation and implementation of a wide range of activities and programs that enable them to reduce their levels of cognitive impairment. It is in this context that the programs and activities of sport and physical activity are presented as outstanding instruments to ensure that older acquire and adopt efficient sports routines and healthy habits that will enable them to reduce their levels of cognitive decline and improve the quality of lifetime. From this situation, with this empirical study, we try to ascertain whether there is empirical evidence to affirm categorically that the combination of exercise and healthy lifestyle helps reduce levels of cognitive impairment in old age and therefore, to increase their quality of life. For this we used a descriptive methodology characterized by the use of qualitative instruments, such as the analysis of the main scientific studies on the subject, preceded the present. Although the data collected are not entirely decisive, it does shows that those elderly who manage to maintain significant levels of physical activity and sport and, moreover, are able to adopt healthy lifestyles will be able to maintain adequate health balance and, Consequently, a higher quality of life. interesting results are presented for future studies and research in this area continue to deepen. the desirability of the biggest sporting routines and adopt healthy lifestyles as a great strategy to ensure adequate health balance that enables them to increase their levels of perceived quality of life.Keywords: Health balance, cognitive impairment, elderly, programs and physical activities and sports, healthy lifestyle, quality of life.Resumen.Merced al conocimiento científico, las sociedades desarrolladas comienzan a asumir que la población mayor está creciendo de manera significativa, lo que hace que cobre una importancia capital, a fin de garantizarles altos niveles de calidad de vida, la articulación e implementación de una amplio abanico de actividades y programas que les posibiliten reducir sus niveles de deterioro cognitivo. Es precisamente en este contexto donde los programas y actividades de actividad física y deportiva se presentan como destacados instrumentos para garantizar que los mayores adquieran y adopten eficientes rutinas deportivas y hábitos de vida saludable que les posibiliten reducir sus niveles de deterioro cognitivo e incrementar su calidad de vida. A partir de esta situación, con el presente estudio empírico, se intenta comprobar si existen evidencias empíricas que permitan afirmar, con rotundidad, que la combinación de ejercicio físico y de hábitos de vida saludable contribuye a reducir los niveles de deterioro cognitivo durante la vejez y, por tanto, a incrementar su calidad de vida. Para ello se ha utilizado una metodología descriptiva caracterizada por el empleo de instrumentos de corte cualitativo, como son el análisis de los principales estudios científicos que, sobre la temática, han precedido al presente. Aunque los datos recopilados no son totalmente determinantes, sí que se aprecia que aquellos mayores que logran mantener importantes niveles de actividad física y deportiva y que, además, son capaces de adoptar hábitos de vida saludable van a conseguir mantener un adecuado equilibrio sanitario y, en consecuencia, una mayor calidad de vida. Se presentan resultados interesantes para futuros estudios e investigaciones que continúen profundizando en este ámbito. Se percibe la conveniencia de que los mayores adopten rutinas deportivas y hábitos de vida saludable como una gran estrategia para garantizarles un adecuado equilibrio sanitario que les posibilite incrementar sus niveles de calidad de vida.Palabras clave: Equilibrio sanitario, deterioro cognitivo, personas mayores, programas y actividades físicas y deportivas, hábitos de vida saludable, calidad de vida.


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