scholarly journals Aerobic Fitness and Cognition Changes After Exercise Training in Alzheimer's Disease

2017 ◽  
Vol 6 (2) ◽  
pp. 22-28
Author(s):  
Dereck L. Salisbury ◽  
Fang Yu
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Linear Regression ◽  
Exercise Training ◽  
Aerobic Fitness ◽  
Repeated Measures ◽  
The United States ◽  
Community Dwelling ◽  
The Relationship

Background: Alzheimer's disease (AD) currently affects 5.4 million Americans and is the sixth leading cause of death in the United States. The mechanism of exercise-induced brain adaptations are not fully understood, but enhanced aerobic fitness has been postulated as an essential physiological mechanism and is beginning to be studied. The purpose of this analysis was to examine the relationship between changes in aerobic fitness and cognition following 6 months of aerobic exercise training in older adults with AD. Methods: Twenty-seven community-dwelling older adults with mild to moderate AD completed a 6-month, 3 times per week, moderate-vigorous intensity cycling exercise program in 2 identical studies using a single-group repeated-measures designs. AD symptoms were measured with the AD Assessment Scale–cognitive subscale (ADAS-cog), while aerobic fitness was assessed by the intermittent shuttle walk test (ISWT) at baseline and 6 months. Pearson's correlation coefficient tests and linear regression were used to assess the relationship between changes in aerobic fitness and cognition. Results: Adjusted for age, the 6-month change in ISWT distance had an inverse relationship with the 6-month change in ADAS-Cog (r = −0.49; P = .01), indicating that enhanced aerobic fitness was associated with improved cognitive changes. Linear regression was statistically significant when adjusted by age (F([2,14] =5.33, P =.01, R2 = .31). Conclusion: Enhanced aerobic fitness may attenuate cognitive decline in persons with mild to moderate AD.

Recruitment and Screening Methods in Alzheimer’s Disease Research: The FIT-AD Trial

2021 ◽  
Author(s):  
Susan Greimel ◽  
Jean F Wyman ◽  
Lin Zhang ◽  
Fang Yu
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Exercise Intervention ◽  
Community Outreach ◽  
Community Dwelling ◽  
Single Site ◽  
Recruitment Strategy ◽  
Screening Methods ◽  
Screening Process

Abstract Background Recruiting older adults with Alzheimer’s disease (AD) dementia into clinical trials is challenging requiring multiple approaches. We describe recruitment and screening processes and results from the FIT-AD Trial, a single site, pilot randomized controlled trial testing the effects of a 6-month aerobic exercise intervention on cognition and hippocampal volume in community-dwelling older adults with mild-to moderate AD dementia. Methods Ten recruitment strategies and a four-step screening process were used to ensure a homogenous sample and exercise safety. The initial target sample was 90 participants over 48 months which was increased to 96 to allow those in the screening process to enroll if qualified. A tertiary analysis of recruitment and screening rates, recruitment yields and costs, and demographic characteristics of participants was conducted. Results During the 48-month recruiting period, 396 potential participants responded to recruitment efforts, 301 individuals were reached and 103 were tentatively qualified. Of these, 67 (69.8%) participants completed the optional magnetic resonance (MRI) imaging and seven were excluded due to abnormal MRI findings. As a result, we enrolled 96 participants with a 2.92 screen ratio, 2.14 recruitment rate, and 31.9% recruitment yield. Referrals (28.1%) and Alzheimer’s Association events/services (21.9%) yielded over 49% of the enrolled participants. Total recruitment cost was $ 38,246 or $ 398 per randomized participant. Conclusions A multi-prong approach involving extensive community outreach was essential in recruiting older adults with AD dementia into a single-site trial. For every randomized participant, three individuals needed to be screened. Referrals were the most cost-effective recruitment strategy.

scholarly journals Communicating 5-Year Risk of Alzheimer’s Disease Dementia: Development and Evaluation of Materials that Incorporate Multiple Genetic and Biomarker Research Results

2020 ◽  
pp. 1-14
Author(s):  
Jessica Mozersky ◽  
Sarah Hartz ◽  
Erin Linnenbringer ◽  
Lillie Levin ◽  
Marissa Streitz ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Absolute Risk ◽  
Brain Mri ◽  
Community Dwelling ◽  
Educational Materials ◽  
Research Results ◽  
Material Development ◽  
Biomarker Research

Background: Cognitively normal (CN) older adults participating in Alzheimer’s disease (AD) research increasingly ask for their research results—including genetic and neuroimaging findings—to understand their risk of developing AD dementia. AD research results are typically not returned for multiple reasons, including possible psychosocial harms of knowing one is at risk of a highly feared and untreatable disease. Objective: We developed materials that convey information about 5-year absolute risk of developing AD dementia based on research results. Methods: 20 CN older adults who received a research brain MRI result were interviewed regarding their wishes for research results to inform material development (Pilot 1). Following material development, 17 CN older adults evaluated the materials for clarity and acceptability (Pilot 2). All participants were community-dwelling older adults participating in longitudinal studies of aging at a single site. Results: Participants want information on their risk of developing AD dementia to better understand their own health, satisfy curiosity, inform family, and future planning. Some articulated concerns, but the majority wanted to know their risk despite the limitations of information. Participants found the educational materials and results report clear and acceptable, and the majority would want to know their research results after reviewing them. Conclusion: These materials will be used in a clinical study examining the psychosocial and cognitive effects of offering research results to a cohort of CN older adults. Future AD research may incorporate the return of complex risk information to CN older adults, and materials are needed to communicate this information.

Relevance of urban green space for physical activity and health-related quality of life in older adults

2018 ◽  
Vol 19 (3) ◽  
pp. 158-166 ◽  
Author(s):  
Evi Petersen ◽  
Gerhard Schoen ◽  
Gunnar Liedtke ◽  
Astrid Zech
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Older Adults ◽  
Linear Regression ◽  
Community Dwelling ◽  
Content Type ◽  
Related Quality ◽  
Community Dwelling Older Adults ◽  
The Relationship

Purpose Urban green space (UGS) shows to be a sustainable resource stimulating physical activity, health and quality of life in the general population. With regard to an aging European population, the purpose of this paper is to investigate the relationship between UGS, physical activity and health-related quality of life (HRQoL) in community-dwelling older adults. Design/methodology/approach Cross-sectional survey data were provided by a sample from Hamburg (Germany), consisting of 272 adults aged⩾65 years. Respondents answered questions regarding HRQoL (Short Form 12), physical activity (German-PAQ-50+) and exposure to UGS. The authors applied a linear regression to analyse the relationship between weekly duration of exposure to UGS and physical activity. While controlling for confounding factors, the authors used a multivariate linear regression model to detect effects on HRQoL. Findings A significant effect (adjusted R2: 4.3 per cent; p-value⩽0.001) was found for weekly duration of exposure to UGS and weekly physical activity. Multiple linear regression showed significant positive effects of weekly duration of exposure to UGS (p=0.010) and weekly time of physical activity (p=0.017) on HRQoL. Age, sex and feeling of satisfaction were identified as relevant confounding factors. Research limitations/implications Future research should continue to explore the indicators that mediate an increase of physical activity and HRQoL in the heterogeneous age band of older adults. Practical implications Findings suggest that community-dwelling older adults are likely to benefit from higher amounts of time in UGS since it is positively associated with both physical activity and HRQoL. Therefore, urban planners should explicitly consider the demands of community-dwelling older adults towards UGS. Originality/value This study is one of the first to examine the relationship between UGS, physical activity and HRQoL in older adults.

scholarly journals Dementia Care in Diverse Older Adults in the U.S. Deep South and the Rest of the United States

2021 ◽  
pp. 1-13
Author(s):  
Maria Pisu ◽  
Roy C. Martin ◽  
Liang Shan ◽  
Giovanna Pilonieta ◽  
Richard E. Kennedy ◽  
...  
Keyword(s):  
United States ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Drug Use ◽  
Ethnic Groups ◽  
The United States ◽  
Deep South ◽  
Racial Ethnic ◽  
The U.S

Background: Use of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer’s disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it. Objective: To examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS. Methods: We obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013–2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS. Results: Across racial/ethnic groups, 33%–43% in DS and 43%–50% in non-DS used specialists; 47%–55% in DS and 41%–48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor “Availability of Medical Resources” were associated with specialist use; Alzheimer’s disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes. Conclusion: We did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.

Outcome of a Targeted Nutritional Intervention Among Older Adults With Early-Stage Alzheimer’s Disease: The Nutrition Intervention Study

2016 ◽  
Vol 36 (7) ◽  
pp. 782-807 ◽  
Author(s):  
Bryna Shatenstein ◽  
Marie-Jeanne Kergoat ◽  
Isabelle Reid
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Intervention Program ◽  
Dietary Intervention ◽  
Early Stage ◽  
Intervention Group ◽  
Community Dwelling ◽  
Nutrition Intervention ◽  
Control Group

A 6-month dietary intervention program was designed for community-dwelling older adults with Alzheimer’s disease. Sixty-seven persons aged 70 years and above were recruited with their caregivers from six hospital memory and geriatric outpatient clinics, and allocated to intervention ( n = 34 dyads) or control group ( n = 33 dyads). Usual diet was assessed by a validated food frequency questionnaire and current diet by two nonconsecutive diet recalls or records corroborated by caregivers, at recruitment (T1) and exit from the study (T2). Intervention participants received targeted dietary recommendations; control participants received Canada’s Food Guide leaflets. The program was assessed using paired and independent t tests and nonparametric statistics. Fat intakes increased at T2 within intervention participants (54 ± 16 vs. 67 ± 23 g, p = .013), and there was a tendency for higher energy, protein, and calcium intakes at T2 within this group. Proportions with adequate protein intakes almost doubled from T1 to T2 in intervention group women ( p = .028) but decreased in female controls ( p = .030). Longer follow-up is necessary to determine persistence of benefits.

Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer’s Disease: A Pilot Study

2017 ◽  
Vol 59 (2) ◽  
pp. 565-574 ◽  
Author(s):  
Kalpana P. Padala ◽  
Prasad R. Padala ◽  
Shelly Y. Lensing ◽  
Richard A. Dennis ◽  
Melinda M. Bopp ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Pilot Study ◽  
Fear Of Falling ◽  
Exercise Program ◽  
Community Dwelling ◽  
Home Based ◽  
Community Dwelling Older Adults

scholarly journals Affective Neuropsychiatric Symptoms as Early Signs of Dementia Risk in Older Adults

2020 ◽  
Vol 77 (3) ◽  
pp. 1195-1207
Author(s):  
Jung Yun Jang ◽  
Jean K. Ho ◽  
Anna E. Blanken ◽  
Shubir Dutt ◽  
Daniel A. Nation ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Latent Class ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Dementia Risk ◽  
Increased Risk ◽  
Risk Of Progression

Background: Affective neuropsychiatric symptoms (aNPS: depression, anxiety, apathy, irritability) have been linked to increased dementia risk. However, less is known whether this association is independent of Alzheimer’s disease (AD) pathophysiology. Objective: To investigate the contribution of early aNPS to dementia risk in cognitively normal (CN) older adults and mild cognitive impairment (MCI) patients, with and without AD biomarker abnormality. Methods: Participants included 763 community-dwelling, stroke-free older adults identified as CN and 617 with MCI at baseline, drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Baseline assessments included a neuropsychological battery, the Neuropsychiatric Inventory (NPI), and apolipoprotein E ɛ4 (ApoE4) genotyping. A participant subset completed cerebrospinal fluid (CSF) AD biomarker assessment. Time to progression to dementia was measured based on months at follow-up when an individual was diagnosed with dementia, over the follow-up period of 48 months. Results: Latent class analysis identified 3 subgroups of older adults in CN and MCI, indicated by the baseline profiles of neuropsychiatric symptoms (NPS). Subgroups with higher aNPS were at increased risk of progression to dementia in both CN (HR = 3.65, 95% CI [1.80, 7.40]) and MCI (HR = 1.52, 95% CI [1.16, 2.00]; HR = 1.86 [1.05, 3.30]) groups, adjusting for age, sex, global cognition, and ApoE4, compared with their counterparts with minimal NPS. There was no difference between higher aNPS and minimal NPS subgroups in their CSF AD biomarker profiles. Conclusion: Findings suggest that aNPS may represent a neurobiological vulnerability that uniquely contribute to the dementia risk, independent of AD biomarker profiles.

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