scholarly journals 324 - Twelve-month progress of online intervention to prevent cognitive decline: Maintain Your Brain

2020 ◽  
Vol 32 (S1) ◽  
pp. 82-82

Authors:Henry Brodaty, Megan Heffernan, Gavin Andrews, Kaarin Anstey, Maria Fiatarone Singh, Louisa Jorm, Nicola Lautenschlager, Anthony Maeder, John McNeill, Perminder Sachdev, Michael Valenzuela, Maintain Your Brain Collaborative Team.Abstract:In the absence of disease modifying interventions for Alzheimer’s disease (AD) and other dementias there is an increased interest in dementia prevention. An issue for population-based lifestyle preventative approaches is scalability. An internet-based multicomponent Maintain Your Brain (MYB) randomised trial is currently underway.Invitations to participate in Maintain Your Brain were emailed or mailed to people aged 55-77 years from the 45 and Up study, a population-based cohort study of one in ten people aged 45 years and older (n = 267,000). To be enrolled into the study participants were required to have risk factors that made them eligible for at least one of the available modules. Modules were designed to address physical inactivity and health risks associated with inactivity (Physical Activity), adherence to a Mediterranean-type diet and health risks associated with poor nutrition (Nutrition), cognitive activity (Brain Training) and mental wellbeing (Peace of Mind).During recruitment 96,418 invitations were sent and 14,064 (14%) provided consent. Of those who completed baseline over 90% were eligible for at least two modules of the intervention. Overall, 6,236 (44%) were enrolled resulting in an overall recruitment rate of 6%, or 50% of those eligible at screening. The final sample was 64% female with a mean age of 64.9yrs (SD = 5.8, range 55-77 yrs) and mean years of education of 12.9yrs (SD = 3.0, range 2-22 yrs).Recruitment rates in MYB were comparable to other clinical trials targeting older people and who included online recruitment strategies. This is promising for the willingness of participants to engage with trials that use online rather than traditional in-person methods. Although the baseline withdrawal number (3%) remained stable after randomisation (4%), a further 25% of participants did not attempt any activities. These rates continued at the annual assessments when 4% withdrew, 31% completed no follow-up activities, 14% partially completed and 55% completed all.Online lifestyle interventions have capacity to reach broad segments of the 55-77 year old population, the majority of whom may benefit from support activities shown to be effective in reducing risk of cognitive decline and ultimately delay onset of dementia. The challenge with this new approach is encouraging continued engagement with the program over time.

2021 ◽  
pp. 1-9
Author(s):  
Giulia Grande ◽  
Jing Wu ◽  
Petter L.S. Ljungman ◽  
Massimo Stafoggia ◽  
Tom Bellander ◽  
...  

Background: A growing but contrasting evidence relates air pollution to cognitive decline. The role of cerebrovascular diseases in amplifying this risk is unclear. Objectives: 1) Investigate the association between long-term exposure to air pollution and cognitive decline; 2) Test whether cerebrovascular diseases amplify this association. Methods: We examined 2,253 participants of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). One major air pollutant (particulate matter ≤2.5μm, PM2.5) was assessed yearly from 1990, using dispersion models for outdoor levels at residential addresses. The speed of cognitive decline (Mini-Mental State Examination, MMSE) was estimated as the rate of MMSE decline (linear mixed models) and further dichotomized into the upper (25%fastest cognitive decline), versus the three lower quartiles. The cognitive scores were used to calculate the odds of fast cognitive decline per levels of PM2.5 using regression models and considering linear and restricted cubic splines of 10 years exposure before the baseline. The potential modifier effect of cerebrovascular diseases was tested by adding an interaction term in the model. Results: We observed an inverted U-shape relationship between PM2.5 and cognitive decline. The multi-adjusted piecewise regression model showed an increased OR of fast cognitive decline of 81%(95%CI = 1.2–3.2) per interquartile range difference up to mean PM2.5 level (8.6μg/m3) for individuals older than 80. Above such level we observed no further risk increase (OR = 0.89;95%CI = 0.74–1.06). The presence of cerebrovascular diseases further increased such risk by 6%. Conclusion: Low to mean PM2.5 levels were associated with higher risk of accelerated cognitive decline. Cerebrovascular diseases further amplified such risk.


2017 ◽  
Vol 13 (7) ◽  
pp. P238
Author(s):  
Mozhu Ding ◽  
Laura Fratiglioni ◽  
Kristina Johnell ◽  
Alessandra Marengoni ◽  
Petter Ljungman ◽  
...  

2021 ◽  
pp. jnnp-2020-324992
Author(s):  
Emmet Costello ◽  
James Rooney ◽  
Marta Pinto-Grau ◽  
Tom Burke ◽  
Marwa Elamin ◽  
...  

BackgroundAmyotrophic lateral sclerosis (ALS) is often associated with cognitive and/or behavioural impairment. Cognitive reserve (CR) may play a protective role in offsetting cognitive impairment. This study examined the relationship between CR and longitudinal change in cognition in an Irish ALS cohort.MethodsLongitudinal neuropsychological assessment was carried out on 189 patients over 16 months using the Edinburgh cognitive and behavioural ALS screen (ECAS) and an additional battery of neuropsychological tests. CR was measured by combining education, occupation and physical activity data. Joint longitudinal and time-to-event models were fitted to investigate the associations between CR, performance at baseline and decline over time while controlling for non-random drop-out.ResultsCR was a significant predictor of baseline neuropsychological performance, with high CR patients performing better than those with medium or low CR. Better cognitive performance in high CR individuals was maintained longitudinally for ECAS, social cognition, executive functioning and confrontational naming. Patients displayed little cognitive decline over the course of the study, despite controlling for non-random drop-out.ConclusionsThese findings suggest that CR plays a role in the presentation of cognitive impairment at diagnosis but is not protective against cognitive decline. However, further research is needed to examine the interaction between CR and other objective correlates of cognitive impairment in ALS.


Author(s):  
H.M. Snyder ◽  
M.C. Carrillo

An estimated 47 million people worldwide are living with dementia in 2015 and this number is expected to triple by 2050. There is a clear urgency for therapies and / or interventions to slow, stop or prevent dementia. Amounting evidence suggests strategies to reduce risk of development dementia may be of growing import for reducing the number of individuals affected. The Alzheimer’s Association believes, from a population based perspective that: (1) Regular physical activity and management of cardiovascular risk factors (e.g. diabetes, obesity, smoking and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; (2) A healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline. The current evidence underscores the need to communicate to the broader population what the science indicates and to do so with diverse stakeholders and consistent messaging. There has never been a better time to define and distribute global messaging on public health for dementia.


2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Juha Puustinen ◽  
Janne Nurminen ◽  
Minna Löppönen ◽  
Tero Vahlberg ◽  
Raimo Isoaho ◽  
...  

2012 ◽  
Vol 2 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Juha Puustinen ◽  
Janne Nurminen ◽  
Tero Vahlberg ◽  
Alan Lyles ◽  
Raimo Isoaho ◽  
...  

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e52755 ◽  
Author(s):  
Hélène Amieva ◽  
Céline Meillon ◽  
Catherine Helmer ◽  
Pascale Barberger-Gateau ◽  
Jean François Dartigues

Neurology ◽  
2018 ◽  
Vol 91 (17) ◽  
pp. e1602-e1610 ◽  
Author(s):  
Pavla Cermakova ◽  
Tomas Formanek ◽  
Anna Kagstrom ◽  
Petr Winkler

ObjectivesWe aimed to investigate whether socioeconomic position (SEP) in childhood has an effect on the level of cognitive performance and the rate of cognitive decline in older adults.MethodsWe performed a prospective cohort study of individuals enrolled in a multicenter population-based study, SHARE (Survey of Health, Ageing and Retirement in Europe). Interviews were conducted in 6 waves at approximately 2-year intervals and included examinations of cognitive performance (memory, verbal fluency, delayed recall) and measurements of childhood SEP (participants' household characteristics at the age of 10 years). We estimated the associations of SEP with the level of cognitive performance using linear regression and the relation to the rate of cognitive decline with mixed-effects models.ResultsThis study included 20,244 participants from 16 European countries (median age at baseline 71 years, 54% women). Adverse childhood SEP was associated with a lower level of baseline cognitive performance. This association was attenuated after adjustment for clinical and social risk factors but remained statistically significant. Childhood SEP was not related to the rate of cognitive decline.ConclusionsVariation in childhood SEP helps to explain differences in cognitive performance between older people, but not the rate of decline from their previous level of cognition. Strategies to protect cognitive aging should be applied early in life.


Author(s):  
Ranjit Kumar Dehury ◽  
Rajeev Kumar

Mental wellbeing was the centerpiece of the Indian system of medicine. Many healthcare issues are resolved by the peace of mind and brain stimulating processes. Of late, Government of India adopted many systems of medicines that are complementary to the modern allopathic medicines and named it AYUSH system of medicine. In this Ayurveda, Yoga, Homoeopathy, Siddha, Unani, Swa-rigppa, and additional healing systems are represented. There is also a great need for psychological wellbeing due to the rapid increase in stressful life situations. The current modern medical care is not adequate to provide mental health services in the society. At the same time, many indigenous and AYUSH system have come into action and solve the problem the best way it possible. The chapter focuses on the role of AYUSH system in catering to mental wellbeing in India. The policies of the government of India are to promote mental health and wellbeing in society. The specialties of various systems of medicine in curing the mental health conditions have been elaborated.


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