37 research outputs found
Exercise interventions for visual processing and functional mobility in dementia and mild cognitive impairment
No full textVisual processing deficits are seen early onset dementia and can impact other cognitive functions and mobility, leading to increased dependency and fall risk. While exercise interventions might be beneficial to address these issues, the optimal exercise-based approach for improving cognitive functions and mobility in this population remains unclear.This thesis aimed to investigate the effects of technology-integrated motor-cognitive dual- task exercise on visual processing, functional mobility, and balance in people with dementia (PwD) and cognitive impairment. A systematic overview of exercise studies (Chapter 2) showed that multicomponent and multitasking exercises combining cognitive and physical activities were most effective for improving independence and visuomotor skills in PwD. Observational studies investigated interest in technology use among older adults using data from the Cognitive Function and Ageing Studies (CFAS-II, Chapter 3) and identified early visual processing impairments as a sensitive predictor of future dementia risk using the EPIC-Norfolk cohort (Chapter 4). The CFAS-II study showed that older people, females and those with less access to technologies were less willing to use assistive technologies, while the EPIC-Norfolk cohort showed potential screening of future dementia development using a visual processing test.Two experimental studies investigated the effects of dual-task exergame technologies and combined cognitive-physical exercises. An 8-week home-based exergame intervention in 50 older adults demonstrated variable effects on cognitive or fall risk-related outcomes depending on the cognitive or physical domain trained (Chapter 5). A pilot study with 24 participants found that combined eye movement and resistance band exercises improved visual sensitivity and visuospatial working memory in both cognitively intact and impaired older adults (Chapter 6).These findings suggest that technology-integrated dual-task exercises combining visual processing and physical components may be effective in improving visual-cognitive functions and mobility in older adults with cognitive impairment. However, the optimal exercise type, intensity, and duration require further investigation through well-designed clinical trials. This research contributes to the literature supporting multimodal, technology- based interventions for maintaining cognitive and physical function in older adults. Future studies should examine long-term effects on fall risk and activities of daily living in larger, more diverse populations of people with varying levels of cognitive impairment.</p
Detecting dementia using linguistic analysis: Terry Pratchett's Discworld tells a more personal story
No full textDementia, characterised by cognitive decline, significantly impacts language abilities. While the risk of dementia increases with age, it often manifests years before clinical diagnosis. Identifying early warning signs is crucial for timely intervention. Previous research has demonstrated that changes in language, such as reduced vocabulary diversity and simpler sentence structures, may be observed in individuals with dementia. This study investigates the potential of linguistic analysis to detect early signs of cognitive decline by examining the writing of Sir Terry Pratchett, a renowned author diagnosed with Posterior Cortical Atrophy (PCA), a form of dementia caused by Alzheimer’s disease. This study analysed 33 Discworld novels by Terry Pratchett, comparing linguistic features (e.g., vocabulary size, lexical diversity, word class distribution) before and after a potential turning point identified through analysis of adjective type-token ratios (TTR). A significant decrease in lexical diversity (TTR) was observed for nouns and adjectives in later works. Total word count increased, while lexical diversity decreased, suggesting a shift towards simpler language. This shift coincided with a decrease in adjective TTR below a defined threshold, occurring approximately ten years before Pratchett's formal diagnosis. These findings suggest that subtle changes in linguistic patterns, such as decreased lexical diversity, may precede clinical diagnosis of dementia by a considerable margin. This research highlights the potential of linguistic analysis as a valuable tool for early detection of cognitive decline. Further research is needed to validate these findings in larger cohorts and explore the specific linguistic markers associated with different types of dementia
Detecting dementia using lexical analysis: Terry Pratchett’s Discworld tells a more personal story
No full textBackground/Objectives: Dementia, characterised by cognitive decline, significantly impacts language abilities. While the risk of dementia increases with age, it often manifests years before clinical diagnosis. Identifying early warning signs is crucial for timely intervention. Previous research has demonstrated that changes in language, such as reduced vocabulary diversity and simpler sentence structures, may be observed in individuals with dementia. This study investigates the potential of linguistic analysis to detect early signs of cognitive decline by examining the writing of Sir Terry Pratchett, a renowned author diagnosed with Posterior Cortical Atrophy (PCA), typically a form of dementia caused by Alzheimer’s disease.Methods: This study analysed 33 Discworld novels by Terry Pratchett, comparing linguistic features before and after a potential turning point identified through analysis of adjective type-token ratios (TTR).Results: A significant decrease in lexical diversity (TTR) was observed for nouns and adjectives in later works. Total wordcount increased, while lexical diversity decreased, suggesting a shift towards simpler language. This shift coincided with a decrease in adjective TTR below a defined threshold, occurring approximately ten years before Pratchett’s formal diagnosis.Conclusions: These findings suggest that subtle changes in linguistic patterns, such as decreased lexical diversity, may precede clinical diagnosis of dementia by a considerable margin. This research highlights the potential of linguistic analysis as a valuable tool for early detection of cognitive decline. Further research is needed to validate these findings in larger cohorts and explore the specific linguistic markers associated with different types of dementia.</p
Subjective Cognitive Decline and Antisaccade Latency: Exploring Early Markers of Dementia Risk
No full textBackground/Objectives: Subjective cognitive decline (SCD) is a common symptom experienced by individuals in the preclinical stage of dementia. However, traditional neuropsychological tests often fail to detect subtle cognitive changes associated with SCD. People with SCD may appear to have intact cognitive function (as measured by traditional tests), but they themselves subjectively feel that their cognition is becoming impaired. Methods: This preliminary study investigated the relationship between SCD and antisaccade performance as a potential early marker of dementia risk in a community-based sample of older adults (N = 17, mean age = 77.71 years). SCD was also explored by calculating the dissociation between objective and subjective memory performance, with SCD implied if there was a large dissociation between perceived memory performance but intact objective performance. Results: Participants with evidence of SCD exhibited significantly increased antisaccade latency compared to healthy controls, even when standard cognitive tests were normal. Antisaccade latency showed a significant correlation with self-reported cognitive complaints (r = 0.57, p = 0.018), while traditional cognitive measures did not. Conclusions: These compelling but preliminary findings suggest that antisaccade performance may be a more sensitive indicator of early cognitive decline than traditional cognitive measures, even in the preclinical stage of dementia. The results have implications for early dementia diagnosis, as antisaccade tasks could be incorporated into routine assessments to identify individuals at risk for dementia, potentially enabling earlier therapeutic intervention
Terry Pratchett’s novels may have held clues to his dementia a decade before diagnosis, our new study suggests
No full textDoes physical exercise improve the capacity for independent living in people with dementia or mild cognitive impairment: an overview of systematic reviews and meta-analyses
No full textObjective: To summarise existing systematic reviews which assessed the effects of physical exercise on activities of daily living, walking, balance and visual processing in people with dementia or mild cognitive impairment
Methods: In this overview of systematic reviews and meta-analyses, seven electronic databases were searched to identify eligible reviews published between January 2015 and April 2021.
Results: A total of 30 systematic reviews were identified and included in the overview. The most frequent type of exercise for the intervention group was multimodal exercises. Mind-body exercises, exergames, dance intervention and aerobic exercise were other exercise types. Most of the reviews reported that exercise is significantly effective for improving activities of daily living (SMD 95%CI, from 0.27 to 1.44), walking (SMD 95%CI, from 0.08 to 2.23), balance (SMD 95%CI, from 0.37 to 2.24) and visuospatial function (SMD 95%CI, from 0.16 to 0.51), which are among the most leading determinants of independent living in individuals with dementia or mild cognitive impairment.
Conclusion: Evidence has shown that exercise (especially multicomponent exercise programmes including cognitive, physical and multitasking exercises) with sufficient intensity improves the activities of daily living skills. Exercise also improves walking, balance and visual processing, which can provide a more independent life for people with dementia and mild cognitive impairment. Cognitively impaired people should therefore be encouraged to exercise regularly in order to be more independent. Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2019192.</p
Subjective cognitive decline and antisaccade latency: exploring early markers of dementia risk
No full textBackground/Objectives: Subjective cognitive decline (SCD) is a common symptom experienced by individuals in the preclinical stage of dementia. However, traditional neuropsychological tests often fail to detect subtle cognitive changes associated with SCD. People with SCD may appear to have intact cognitive function (as measured by traditional tests), but they themselves subjectively feel that their cognition is becoming impaired.Methods: This preliminary study investigated the relationship between SCD and antisaccade performance as a potential early marker of dementia risk in a community-based sample of older adults (N = 17, mean age = 77.71 years). SCD was also explored by calculating the dissociation between objective and subjective memory performance, with SCD implied if there was a large dissociation between perceived memory performance but intact objective performance.Results: Participants with evidence of SCD exhibited significantly increased antisaccade latency compared to healthy controls, even when standard cognitive tests were normal. Antisaccade latency showed a significant correlation with self-reported cognitive complaints (r = 0.57, p = 0.018), while traditional cognitive measures did not.Conclusions: These compelling but preliminary findings suggest that antisaccade performance may be a more sensitive indicator of early cognitive decline than traditional cognitive measures, even in the preclinical stage of dementia. The results have implications for early dementia diagnosis, as antisaccade tasks could be incorporated into routine assessments to identify individuals at risk for dementia, potentially enabling earlier therapeutic intervention.</p
Detecting dementia using lexical analysis: Terry Pratchett's discworld tells a more personal story
No full textBackground/Objectives: Dementia, characterised by cognitive decline, significantly impacts language abilities. While the risk of dementia increases with age, it often manifests years before clinical diagnosis. Identifying early warning signs is crucial for timely intervention. Previous research has demonstrated that changes in language, such as reduced vocabulary diversity and simpler sentence structures, may be observed in individuals with dementia. This study investigates the potential of linguistic analysis to detect early signs of cognitive decline by examining the writing of Sir Terry Pratchett, a renowned author diagnosed with Posterior Cortical Atrophy (PCA), typically a form of dementia caused by Alzheimer’s disease. Methods: This study analysed 33 Discworld novels by Terry Pratchett, comparing linguistic features before and after a potential turning point identified through analysis of adjective type-token ratios (TTR). Results: A significant decrease in lexical diversity (TTR) was observed for nouns and adjectives in later works. Total wordcount increased, while lexical diversity decreased, suggesting a shift towards simpler language. This shift coincided with a decrease in adjective TTR below a defined threshold, occurring approximately ten years before Pratchett’s formal diagnosis. Conclusions: These findings suggest that subtle changes in linguistic patterns, such as decreased lexical diversity, may precede clinical diagnosis of dementia by a considerable margin. This research highlights the potential of linguistic analysis as a valuable tool for early detection of cognitive decline. Further research is needed to validate these findings in larger cohorts and explore the specific linguistic markers associated with different types of dementia
Alzheimer’s disease and (phyto)estrogen treatment: modification of effects by age, type of treatment and duration of use
No full textIntroduction
There is a continued debate on whether menopausal hormone therapy (MHT) protects women against Alzheimer’s disease (AD). It is also unclear whether phytoestrogen could be an alternative treatment for AD.
Objective
To investigate whether mixed study findings may be due to differences in age at initiation of MHT and duration of prescription of different types of MHT using meta-analyses.
Materials and methods
After a systematic literature search, meta-analyses were carried out using Cochrane Revman 5.4.1.software including data from large nationwide studies of registered medically diagnosed AD and prescribed MHT. These analyses were stratified for duration and type of treatment, by age at start of prescription of therapy. Insufficient quality data were available for phytoestrogen treatment and AD meta-analyses.
Results
A total of 912,157 women were included from five registries, of whom 278,495 had developed AD during follow-up. Meta-analyses suggested a small increased AD risk after 5-10 years prescription of combination MHT regardless of age, and over 10 years only in women younger than 60 years of age. No association was seen for estrogen alone for women younger than 60 years of age, but AD risk did increase for women over 60 years of age for up to 5 years of MHT prescriptions.
Discussion
Combination MHT should probably be prescribed for less than 5 years after menopause to reduce risk for AD, while estrogen alone should not be prescribed to women over 60. For phytoestrogen, small treatment trials suggested some benefit of tempe, fermented soy, which should be investigated further.</p
Alzheimer’s disease and (phyto)estrogen treatment: modification of effects by age, type of treatment and duration of use
No full textIntroduction
There is a continued debate on whether menopausal hormone therapy (MHT) protects women against Alzheimer’s disease (AD). It is also unclear whether phytoestrogen could be an alternative treatment for AD.
Objective
To investigate whether mixed study findings may be due to differences in age at initiation of MHT and duration of prescription of different types of MHT using meta-analyses.
Materials and methods
After a systematic literature search, meta-analyses were carried out using Cochrane Revman 5.4.1.software including data from large nationwide studies of registered medically diagnosed AD and prescribed MHT. These analyses were stratified for duration and type of treatment, by age at start of prescription of therapy. Insufficient quality data were available for phytoestrogen treatment and AD meta-analyses.
Results
A total of 912,157 women were included from five registries, of whom 278,495 had developed AD during follow-up. Meta-analyses suggested a small increased AD risk after 5-10 years prescription of combination MHT regardless of age, and over 10 years only in women younger than 60 years of age. No association was seen for estrogen alone for women younger than 60 years of age, but AD risk did increase for women over 60 years of age for up to 5 years of MHT prescriptions.
Discussion
Combination MHT should probably be prescribed for less than 5 years after menopause to reduce risk for AD, while estrogen alone should not be prescribed to women over 60. For phytoestrogen, small treatment trials suggested some benefit of tempe, fermented soy, which should be investigated further.</p
