Dynamic reciprocal relationships between cognitive and functional declines along the Alzheimer’s disease continuum in the prospective COGICARE study

Abstract Background Thoroughly understanding the temporal associations between cognitive and functional dimensions along the dementia process is fundamental to define preventive measures likely to delay the disease’s onset. This work aimed to finely describe the trajectories of cognitive and functional declines, and assess their dynamic bidirectional relationships among subjects at different stages of the dementia process. Methods We leveraged extensive repeated data of cognition and functional dependency from the French prospective COGICARE study, designed to better characterize the natural history of cognitive and functional declines around dementia diagnosis. Cognition was measured by the Mini-Mental State Examination, the Isaacs Set Test for verbal fluency, the Benton Visual Retention Test for visuo-spatial memory, and Trail Making Test Part B for executive functioning. Functional dependency was measured by basic and instrumental activities of daily living. The study included 102 cognitively normal, 123 mildly cognitively impaired, and 72 dementia cases with a median of 5 repeated visits over up to 57 months. We used a dynamic causal model which addresses the two essential issues in temporal associations assessment: focusing on intra-individual change and accounting for time. Results Better cognitive abilities were associated with lower subsequent decline of the functional level among the three clinical stages with an intensification over time but no reciprocity of the association whatever the clinical status. Conclusion This work confirms that the progressive functional dependency could be induced by cognitive impairment. Subjects identified as early as possible with clinically significant cognitive impairments could benefit from preventive measures before the deterioration of activities of daily living and the appearance of dementia clinical signs.

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The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting

BMC Veterinary Research ◽

10.1186/s12917-020-02715-7 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

A. Meier ◽

J. McGree ◽

R. Klee ◽

J. Preuß ◽

D. Reiche ◽

...

Keyword(s):

Best Practice ◽

Clinical Status ◽

Clinical Signs ◽

Scoring Method ◽

Pain Medications ◽

Exponential Decay Model ◽

History Of ◽

Consistent Method ◽

Foot Disease ◽

New Treatments

Abstract Background Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a ‘normal’ pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, using two different scoring methods. Eighty horses and ponies with suspected HAL were enrolled in a study conducted at 16 veterinary practices across Germany. The severity of laminitis was assessed by independent veterinarians using both the traditional Obel method and a modified Obel method developed by Meier and colleagues. Assessments were made on the day of diagnosis (d 0), then on days 4, 9, 14, 25 and 42 during the intervention period. Pain medications were withheld for 24 h prior to clinical examination in all cases. Results Time to marked improvement from laminitis varied between individuals, but was difficult to monitor accurately using the Obel method, with the median grade being 2/4 on days 0 and 4, then 0/4 from d 9 onwards. More subtle changes could be identified using the Meier method, however, and the median scores were seen to follow the form of an exponential decay model in most horses, improving from 8/12 on d 0, to 0/12 on d 25. Within this composite scoring method, considerable variation was observed in the rate of improvement of individual clinical signs, with the average time taken for each sign to reach a median score of 0 ranging from 4 days (foot lift and weight shifting) to 25 days (gait when turned in a circle) across all 80 horses. Conclusions The Meier method provides a reliable and consistent method for monitoring the clinical status of horses with HAL, and despite the variability, the pattern of improvement described here should provide a useful benchmark against which individual cases and new treatments can be assessed.

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Cardio-metabolic and socio-demographic risk factors associated with dependency in basic and instrumental activities of daily living among older Iranian adults: Bushehr elderly health program

BMC Geriatrics ◽

10.1186/s12877-021-02124-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kazem Khalagi ◽

Akram Ansarifar ◽

Noushin Fahimfar ◽

Mahnaz Sanjari ◽

Safoora Gharibzdeh ◽

...

Keyword(s):

Physical Activity ◽

Activities Of Daily Living ◽

Daily Living ◽

Education Level ◽

Lower Education Level ◽

History Of ◽

Elderly Health ◽

Lower Education ◽

Demographic Risk ◽

Demographic Risk Factors

Abstract Background Iran’s population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. Methods The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. Results Mean (Standard Deviation) of the participants’ age was 69.3 (6.4) years (range: 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.3 (1.9–2.9)), having a lower education level, a history of diabetes mellitus (OR: 1.4 (1.2–1.7)) and past smoking (OR: 1.3 (1.0–1.6)), and no physical activity (OR: 1.5 (1.2–1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.4 (1.9–3.0)), having a lower education level, no physical activity (OR: 2.2 (1.6–2.9)) and daily intake of calories (OR: 0.99 (0.99–0.99)) were associated with dependency in BADL. Conclusion Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake.

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Polyneuropathy relates to impairment in daily activities, worse gait, and fall-related injuries

Neurology ◽

10.1212/wnl.0000000000004067 ◽

2017 ◽

Vol 89 (1) ◽

pp. 76-83 ◽

Cited By ~ 14

Author(s):

Rens Hanewinckel ◽

Judith Drenthen ◽

Vincentius J.A. Verlinden ◽

Sirwan K.L. Darweesh ◽

Jos N. van der Geest ◽

...

Keyword(s):

Logistic Regression ◽

Linear Regression ◽

Activities Of Daily Living ◽

Daily Living ◽

Health Assessment ◽

Population Based ◽

Daily Activities ◽

Instrumental Activities ◽

Gait Parameters ◽

History Of

Objective:To extensively investigate the association of chronic polyneuropathy with basic and instrumental activities of daily living (BADL and IADL), falls, and gait.Methods:A total of 1,445 participants of the population-based Rotterdam Study (mean age 71 years, 54% women) underwent a polyneuropathy screening involving a symptom questionnaire, neurologic examination, and nerve conduction studies. Screening yielded 4 groups: no, possible, probable, and definite polyneuropathy. Participants were interviewed about BADL (Stanford Health Assessment questionnaire), IADL (Instrumental Activities of Daily Living scale), and frequency of falling in the previous year. In a random subset of 977 participants, gait was assessed with an electronic walkway. Associations of polyneuropathy with BADL and IADL were analyzed continuously with linear regression and dichotomously with logistic regression. History of falling was evaluated with logistic regression, and gait changes were evaluated with linear regression.Results:Participants with definite polyneuropathy had more difficulty in performing BADL and IADL than participants without polyneuropathy. Polyneuropathy related to worse scores of all BADL components (especially walking) and 3 IADL components (housekeeping, traveling, and shopping). Participants with definite polyneuropathy were more likely to fall, and these falls more often resulted in injury. Participants with polyneuropathy had worse gait parameters on the walkway, including lower walking speed and cadence, and more errors in tandem walking.Conclusions:Chronic polyneuropathy strongly associates with impairment in the ability to perform daily activities and relates to worse gait and an increased history of falling.

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Activities of Daily Living in Children with Hemiparesis: Influence of Cognitive Abilities and Motor Competence

Neuropediatrics ◽

10.1055/s-0034-1382824 ◽

2014 ◽

Vol 45 (06) ◽

pp. 341-345 ◽

Cited By ~ 4

Author(s):

Markus Rauchenzauner ◽

Martin Staudt ◽

Steffen Berweck ◽

Caroline Adler

Keyword(s):

Activities Of Daily Living ◽

Cognitive Abilities ◽

Daily Living ◽

Motor Competence

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Asylum-seeking children with severe loss of activities of daily living: clinical signs and course during rehabilitation

Acta Paediatrica ◽

10.1111/j.1651-2227.2009.01499.x ◽

2009 ◽

Vol 98 (12) ◽

pp. 1977-1981 ◽

Cited By ~ 14

Author(s):

B Aronsson ◽

C Wiberg ◽

P Sandstedt ◽

A Hjern

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Clinical Signs ◽

Severe Loss

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The Story of Equine Atypical Myopathy: A Review from the Beginning to a Possible End

ISRN Veterinary Science ◽

10.5402/2012/281018 ◽

2012 ◽

Vol 2012 ◽

pp. 1-14 ◽

Cited By ~ 11

Author(s):

Dominique-Marie Votion

Keyword(s):

Dehydrogenase Deficiency ◽

Preventive Measures ◽

Clinical Signs ◽

Pathological Process ◽

Scientific Data ◽

Practical Support ◽

Main Emphasis ◽

History Of ◽

Treatment Plans ◽

Great Step

Atypical myopathy (AM) is a frequently fatal seasonal pasture myopathy that emerges in Europe. Outbreaks are of an acute and unexpected nature and practitioners should be prepared to handle these critically ill patients. This review retraces the history of AM and describes results of epidemiological investigations that were conducted to raise hypotheses concerning the etiology of this devastating disease as well as to be able to suggest potential preventive measures. Also, clinical studies have contributed to a better definition and recognition of the syndrome, whereas elucidation of the pathological process, identified as a multiple acyl-CoA dehydrogenase deficiency (MADD), was a great step forward improving medical management of AM and guiding the search for the etiological agent towards toxins that reproduce the identified defect. Treatment plans can be extrapolated from the described clinical signs and metabolic problems, but they remain limited to supportive care until the causative agent has been identified with certainty. Since treatment is still unsuccessful in the majority of cases, the main emphasis is currently still on prevention. This paper aims at being a practical support for equine clinicians dealing with AM and is based on discussion and comparison of the currently available scientific data.

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23. ZOE-50 and ZOE-70 Placebo Groups Data Shows that Burden of Pain Associated with Herpes Zoster Interferes with Activities of Daily Living

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.225 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S135-S135

Author(s):

Eliazar Sabater Cabrera ◽

Desmond Curran ◽

Sean Matthews ◽

Céline Boutry ◽

Nicolas Lecrenier ◽

...

Keyword(s):

Herpes Zoster ◽

Activities Of Daily Living ◽

Pain Score ◽

Daily Living ◽

Severe Pain ◽

Phase Iii ◽

Independent Contractor ◽

Significant Pain ◽

Increased Risk ◽

Clinically Significant

Abstract Background Adults ≥ 50 years of age (YOA) are at increased risk of herpes zoster (HZ), a condition which can cause long-term pain and discomfort. In this analysis, we assessed the burden of pain associated with HZ and its interference with activities of daily living (ADL) in patients ≥ 50 YOA. Methods ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) were phase III, observer-blind, placebo-controlled, 1:1 randomized studies in adults ≥ 50 YOA (ZOE-50) and ≥ 70 YOA (ZOE-70) who received 2 doses of the adjuvanted recombinant zoster vaccine or placebo, 2 months apart. To correctly evaluate HZ pain, the analysis was performed only on the placebo groups data of ZOE-50 (≥ 50 YOA) and pooled ZOE-50/70 (≥ 70 YOA pooled data) in the modified total vaccinated cohort (mTVC, primary population for efficacy analysis) HZ-confirmed cases. HZ pain and interference with ADL was assessed by the Zoster Brief Pain Inventory (ZBPI) instrument completed daily by patients for the first 28 days and then weekly until resolution. Time to resolution of clinically significant pain was analyzed using Kaplan Meier methods. We estimated the cumulative area under curve (AUC) of the ZBPI worst pain score and the ZBPI ADL score up to 182 days post-HZ rash onset. A high AUC reflects a higher severity/longer duration of pain. Results Overall, 254 patients ≥ 50 YOA and 284 patients ≥ 70 YOA were included in the mTVC HZ-confirmed cases for the ZOE-50 and ZOE-70 pooled analysis, respectively. In HZ patients ≥ 50 YOA, 94.6% reported any pain (ZBPI pain score > 0), 87.6% clinically significant pain (ZBPI pain score ≥ 3) and 65.1% severe pain (ZBPI pain score ≥ 7). Similarly, in HZ patients ≥ 70 YOA, 93.2% reported any pain, 90.9% clinically significant pain and 68.4% severe pain. It was estimated that 11.6% and 18.3% of patients aged ≥ 50 and ≥ 70 YOA, respectively, had clinically significant pain 3 months after the onset of HZ. The mean AUC at 182 days was 137.24 (≥ 50 YOA) and 190.68 (≥ 70 YOA), for the ZBPI worst pain score and 92.75 (≥ 50 YOA) and 130.89 (≥ 70 YOA), for the ZBPI ADL score. Conclusion Analysis of data provided by patients with confirmed HZ shows that the burden of HZ pain is high and is associated with interference on patients’ ADL. Funding GlaxoSmithKline Biologicals SA Acknowledgment M Maior/S Hulsmans provided medical writing/editorial support (Modis c/o GSK) Disclosures Eliazar Sabater Cabrera, MSc, GSK (Employee, Shareholder) Desmond Curran, PhD, The GSK group of companies (Employee, Shareholder) Sean Matthews, MSc, GSK (Independent Contractor) Céline Boutry, PhD, GSK (Employee) Nicolas Lecrenier, Ing, PhD, The GSK group of companies (Employee, Shareholder) Anthony L. Cunningham, F.A.H.M.S., MD, M.B.B.S., B. Med. Sci. (Hons), F.R.A.C.P., F.R.C.P.A., F.A.S.M., GSK group of companies (Grant/Research Support, Advisor or Review Panel member, Speaker’s Bureau)

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Awareness of cognitive abilities in the execution of activities of daily living after acquired brain injury: an evaluation protocol

BMJ Open ◽

10.1136/bmjopen-2020-037542 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037542

Author(s):

Jose Antonio Merchán-Baeza ◽

Maria Rodriguez-Bailon ◽

Giorgia Ricchetti ◽

Alba Navarro-Egido ◽

María Jesús Funes

Keyword(s):

Brain Injury ◽

Activities Of Daily Living ◽

Cognitive Abilities ◽

Cognitive Skills ◽

Daily Living ◽

Convergent Validity ◽

Acquired Brain Injury ◽

Scientific Publication ◽

Assessment Protocol ◽

Registration Number

IntroductionOne of the main limitations that can be observed after acquired brain injury (ABI) is the alteration of the awareness of the deficits that can occur in the cognitive skills necessary for performing activities of daily living (ADL). According to the Dynamic Comprehensive Model of Awareness (DCMA), consciousness is composed of offline component, which contains the information stored about characteristics of the tasks and stable beliefs about one’s own capabilities and online awareness, which is activated in the context of the performance of a specific task. The main objective of this project was to generate and validate a detailed cognitive assessment protocol within the context of ADL to evaluate the components of DCMA.Methods and analysisThe proposed protocol consists of two ecological tools: The Cog-Awareness ADL Scale to measure offline component and the Awareness ADL-task: Basic and Instrumental ADL performance-based test to measure online awareness. The aim is to identify the presence of cognitive deficits and anosognosia in patients with ABI within the context of everyday life activities. These two measures will be administered to a group of patients with ABI. In addition, these participants will complete another series of classic tests on anosognosia and cognitive functions in order to find the convergent validity of the two tests proposed in this protocol. The external validity of the Cog-Awareness ADL Scale and the relationships between awareness components within the same ADL domain will be also analysed.Ethics and disseminationThis study was approved by the Ethics Committee of Biomedical Research of Andalusia, on 13 January /2017 (Proceeding 1/2017). All participants are required to provide written informed consent. The findings from this will be disseminated via scientific publication.Trial registration numberNCT03712839.

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