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1.
BMJ Open ; 11(12): e046544, 2021 12 16.
Article in English | MEDLINE | ID: covidwho-1596818

ABSTRACT

INTRODUCTION: Mild cognitive impairment is one of the consequences of ageing, causing functional disability, a poor quality of life and an increased socioeconomic expenditure. Evidence shows that patients go through a long preclinical stage in which cognitive deficits appear subtly until they reach the threshold of dementia. Non-pharmacological interventions have been gaining ground as prevention of modifiable factors of cognitive decline such as obesity, diabetes, physical inactivity or social isolation. Along these lines, Information and Communication Technologies (ICTs) can be a tool for cognitive stimulation, cognitive training and cognitive rehabilitation. The main objective of the systematic review will be to review and analyse the use of ICTs for the improvement of cognitive functions in healthy older adult population aged 50 and over, for the prevention of cognitive impairment METHODS: A systematic review will be conducted including randomised clinical trials in adults without diseases or accidents associated with cognitive impairment, and whom have used ICTs for the improvement of cognitive functions between 2010 and 2020 in English or Spanish. The articles that report data on cognitive function by domain, for example, memory or executive functions, or by test will be included. The databases Medline (PubMed), CinahlPlus, Scopus, ISI WoS, CENTRAL and IEEE Xplore will be searched. Studies that meet the inclusion criteria will be analysed according to the Cochrane RoB2 tool for risk of bias assessment. ETHICS AND DISSEMINATION: Ethical approval is not necessary as this is a systematic review. The results will be published in scientific journals, as well as in specialised congresses on the subject of study.


Subject(s)
Cognitive Dysfunction , Quality of Life , Aged , Cognition/physiology , Cognitive Dysfunction/prevention & control , Cognitive Dysfunction/rehabilitation , Communication , Executive Function , Humans , Middle Aged , Systematic Reviews as Topic
2.
PLoS One ; 16(12): e0248446, 2021.
Article in English | MEDLINE | ID: covidwho-1571977

ABSTRACT

We examined the changes in cognitive function due to restrictions in daily life during the coronavirus disease 2019 (COVID-19) pandemic in community-dwelling older adults with mild cognitive decline. This was a retrospective, case-control study. The participants include 88 older adults with mild cognitive decline (mean age = 81.0 [standard deviation = 6.5] years) who participated in a class designed to help prevent cognitive decline. This class was suspended from early-March to end of May 2020 to prevent the spread of COVID-19, and resumed in June 2020. We collected demographic and cognitive function test data (Touch Panel-type Dementia Assessment Scale [TDAS]) before and after class suspension and questionnaire data on their lifestyle and thoughts during the suspension. Change in TDAS scores from before and after the suspension was used to divide the participants into decline (2 or more points worsening) and non-decline (all other participants) groups, with 16 (18.2%) and 72 (81.8%) participants in each group, respectively. A logistic regression model showed that the odds ratio (OR) for cognitive decline was lower in participants whose responses were "engaged in hobbies" (OR = 0.07, p = 0.015), "worked on a worksheet about cognitive training provided by the town hall" (OR = 0.19, p = 0.026), and "had conversations over the phone" (OR = 0.28, p = 0.0495). There was a significant improvement in TDAS scores after class was resumed (p < 0.01). A proactive approach to intellectual activities and social ties may be important for the prevention of cognitive decline during periods of restrictions due to COVID-19. We found that cognitive function test scores before class suspension significantly improved after resuming classes. We speculate that continued participation in this class led to positive behavioral changes in daily life during periods of restriction due to COVID-19.


Subject(s)
COVID-19/psychology , Cognitive Dysfunction/prevention & control , Independent Living/psychology , Aged , Aged, 80 and over , Case-Control Studies , Cognitive Dysfunction/virology , Humans , Japan , Life Style , Logistic Models , Neuropsychological Tests , Retrospective Studies , Surveys and Questionnaires
3.
J Intern Med ; 289(6): 807-830, 2021 06.
Article in English | MEDLINE | ID: covidwho-1447945

ABSTRACT

Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age-related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle-based intervention can prevent cognitive and functional decline amongst at-risk older adults from the general population. Within the World-Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self-management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.


Subject(s)
Cognitive Dysfunction , Dementia , Aged , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/prevention & control , Dementia/epidemiology , Dementia/prevention & control , Humans , Life Style , Randomized Controlled Trials as Topic , Risk Factors , Risk Reduction Behavior
4.
J Prev Alzheimers Dis ; 7(4): 294-298, 2020.
Article in English | MEDLINE | ID: covidwho-1389817

ABSTRACT

Individuals experiencing brain aging, cognitive decline, and dementia are currently confronted with several more complex challenges due to the current Sars-Cov-2 pandemic as compared to younger and cognitively healthy people. During the first six months of the pandemic, we are experiencing critical issues related to the management of mild cognitive impairment (MCI) and dementia. The evolving, highly contagious global viral spread has created a pressure test of unprecedented proportions for the existing brain health care infrastructure and related services for management, diagnosis, treatment, and prevention. Social distancing and lock-down measures are catalyzing and accelerating a technological paradigm shift, away from a traditional model of brain healthcare focused on late symptomatic disease stages and towards optimized preventive strategies to slow brain aging and increase resilience at preclinical asymptomatic stages. Digital technologies transform global healthcare for accessible equality of opportunities in order to generate better outcomes for brain aging aligned with the paradigm of preventive medicine.


Subject(s)
Alzheimer Disease/prevention & control , Cognitive Dysfunction/prevention & control , Coronavirus Infections , Interpersonal Relations , Pandemics , Pneumonia, Viral , Social Isolation/psychology , Aged , Aged, 80 and over , Aging , Alzheimer Disease/psychology , Betacoronavirus , COVID-19 , Cognitive Dysfunction/psychology , Disease Progression , Humans , Male , Quarantine/psychology , Risk Factors , SARS-CoV-2 , Technology
5.
Int J Environ Res Public Health ; 18(15)2021 08 03.
Article in English | MEDLINE | ID: covidwho-1341671

ABSTRACT

BACKGROUND: Mild cognitive impairment (MCI) is a stage preceding dementia, and early intervention is critical. This study investigated whether multi-domain cognitive training programs, especially robot-assisted training, conducted 12 times, twice a week for 6 weeks can improve cognitive function and depression decline in community-dwelling older adults with mild cognitive impairment (MCI). METHODS: A randomized controlled trial was conducted with 135 volunteers without cognitive impairment aged 60 years old or older. Participants were first randomized into two groups. One group consisted of 90 participants who would receive cognitive training and 45 who would not receive any training (NI). The cognitive training group was randomly divided into two groups, 45 who received traditional cognitive training (TCT) and 45 who received robot-assisted cognitive training (RACT). The training for both groups consisted of a daily 60 min session, twice a week for six weeks. RESULTS: RACT participants had significantly greater post-intervention improvement in cognitive function (t = 4.707, p < 0.001), memory (t = -2.282, p = 0.007), executive function (t = 4.610, p < 0.001), and depression (t = -3.307, p = 0.004). TCT participants had greater post-intervention improvement in memory (t = -6.671, p < 0.001) and executive function (t = 5.393, p < 0.001). CONCLUSIONS: A 6-week robot-assisted, multi-domain cognitive training program can improve the efficiency of global cognitive function and depression during cognitive tasks in older adults with MCI, which is associated with improvements in memory and executive function.


Subject(s)
COVID-19 , Cognitive Dysfunction , Robotics , Aged , Cognition , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/prevention & control , Humans , Independent Living , Middle Aged , Pandemics , SARS-CoV-2
6.
Plant J ; 107(5): 1299-1319, 2021 09.
Article in English | MEDLINE | ID: covidwho-1282039

ABSTRACT

Caffeoylquinic acids (CQAs) are specialized plant metabolites we encounter in our daily life. Humans consume CQAs in mg-to-gram quantities through dietary consumption of plant products. CQAs are considered beneficial for human health, mainly due to their anti-inflammatory and antioxidant properties. Recently, new biosynthetic pathways via a peroxidase-type p-coumaric acid 3-hydroxylase enzyme were discovered. More recently, a new GDSL lipase-like enzyme able to transform monoCQAs into diCQA was identified in Ipomoea batatas. CQAs were recently linked to memory improvement; they seem to be strong indirect antioxidants via Nrf2 activation. However, there is a prevalent confusion in the designation and nomenclature of different CQA isomers. Such inconsistencies are critical and complicate bioactivity assessment since different isomers differ in bioactivity and potency. A detailed explanation regarding the origin of such confusion is provided, and a recommendation to unify nomenclature is suggested. Furthermore, for studies on CQA bioactivity, plant-based laboratory animal diets contain CQAs, which makes it difficult to include proper control groups for comparison. Therefore, a synthetic diet free of CQAs is advised to avoid interferences since some CQAs may produce bioactivity even at nanomolar levels. Biotransformation of CQAs by gut microbiota, the discovery of new enzymatic biosynthetic and metabolic pathways, dietary assessment, and assessment of biological properties with potential for drug development are areas of active, ongoing research. This review is focused on the chemistry, biosynthesis, occurrence, analytical challenges, and bioactivity recently reported for mono-, di-, tri-, and tetraCQAs.


Subject(s)
Anti-Inflammatory Agents/chemistry , Antioxidants/chemistry , Cognitive Dysfunction/prevention & control , Neuroprotective Agents/chemistry , Phytochemicals/chemistry , Plants, Medicinal/chemistry , Quinic Acid/analogs & derivatives , Acyltransferases/genetics , Acyltransferases/metabolism , Animals , Anti-Inflammatory Agents/metabolism , Anti-Inflammatory Agents/pharmacology , Antioxidants/metabolism , Antioxidants/pharmacology , Biosynthetic Pathways , Brachypodium/enzymology , Dietary Supplements , Humans , Ipomoea batatas/enzymology , Mixed Function Oxygenases/genetics , Mixed Function Oxygenases/metabolism , Neuroprotective Agents/metabolism , Neuroprotective Agents/pharmacology , Phytochemicals/metabolism , Phytochemicals/pharmacology , Plant Proteins/genetics , Plant Proteins/metabolism , Quinic Acid/chemistry , Quinic Acid/metabolism , Quinic Acid/pharmacology , Terminology as Topic
7.
Dement Geriatr Cogn Disord ; 50(1): 85-95, 2021.
Article in English | MEDLINE | ID: covidwho-1268156

ABSTRACT

INTRODUCTION: It is well-known that cognitive function declines with age. In order to detect changes in cognitive function, cognitive tests should be performed repeatedly. Currently existing cognitive tests come in only a single version, so the subject is likely to remember the contents with repeated testing. And, under the outbreak of coronavirus disease 2019 (COVID-19), in-person assessment should be avoided. This study was performed to develop a new cognitive test (brain assessment, BA) that has 5 versions and can be performed on a personal computer (PC) through the Internet. MATERIALS AND METHODS: Five thousand subjects performed the online BA, which consisted of 5 subtests: number memory, word memory, mental rotation test, N-back test, and judgment test. We standardized the raw scores (cognitive scores, CSs) using mean and standard deviation, which were 50 and 10, respectively. Then, we calculated the mean CS for each sex and age, plotted the relationships between ages and mean CSs on figures, and calculated the formula of cognitive changes during normal aging. RESULTS: The CSs of all subtests decreased with aging. The regression coefficient was from -0.31 to -0.45. It is noteworthy that in most subtests, the CSs started to increase at 85 years of age. DISCUSSION: Our BA has 5 versions and can be done on a PC using the Internet. We tested the BA in a large number of subjects, and the standard values of CSs were measured in individuals up to 89 years of age. By performing this test repeatedly, subjects can evaluate the degree of their cognitive decline. If the rate of cognitive decline is greater than that predicted using the normalized formula, the subjects can undertake strategies to improve their control of lifestyle-related diseases or other habits of daily living. CONCLUSION: The BA can be easily taken online using a PC, and its scores linearly declined with normal aging. The BA will be useful for detecting longitudinal cognitive changes and comparing them to the pattern seen in normal aging.


Subject(s)
Aging/psychology , Cognition , Cognitive Dysfunction/diagnosis , Neuropsychological Tests , Adult , Aged , Aged, 80 and over , Cognitive Dysfunction/prevention & control , Female , Humans , Internet , Male , Middle Aged
8.
Int J Environ Res Public Health ; 18(2)2021 01 07.
Article in English | MEDLINE | ID: covidwho-1024574

ABSTRACT

Targeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60-77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.


Subject(s)
Cognitive Dysfunction/prevention & control , Life Style , Patient Selection , Aged , Female , Germany , Healthy Aging , Humans , Male , Middle Aged , Neuropsychological Tests
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