How non-drug interventions affect the quality of life of patients suffering from progressive cognitive decline and their main caregiver.

BACKGROUND: In the absence of cure for age-related neurodegenerative diseases, non-drug interventions (NDIs) represent useful options. Quality of life (QOL) is a multidimensional concept progressively affected by cognitive decline. How single or multiple NDIs impact QOL is unknown. RESULTS: We found no significant effect of multiple over single NDI on QOL. Socio-demographic variables influenced patients' (age, gender, caregivers' occupational status, management of patients' financial affairs) and caregivers' (gender, occupational status, patients' severity of cognitive decline) QOL. When dyads interrupted interventions after 6 months, their QOL was lower and caregivers' anxiety, depression and physical symptoms were higher at the end of the study. CONCLUSIONS: While the type and number of interventions do not appear to be critical, the continuity of adapted interventions in the long-term might be important for maintaining QOL of patients and caregivers. METHODS: This is a multicenter (7 Swiss Memory Clinics), quasi-experimental, one-year follow-up study including 148 subjects (mild cognitive impairment or mild dementia patients and their caregivers). Primary outcome was the effect of multiple vs single NDIs on QOL. Secondary outcome included NDIs effect on patients' cognitive impairment and functional autonomy, caregivers' burden, severity of patients' neuropsychiatric symptoms and dyads' anxiety and depression.

[Cognitive impairment and non-medical interventions: quality of life of patients and their caregivers]. / Troubles cognitifs et interventions non médicamenteuses†: qualité de vie des patients et de leurs proches.

In the absence of curative pharmaceutical treatment for evolving cognitive impairment, non-drug interventions are key components in patients' and caregivers' care. These interventions, when combined and adapted to the needs of the patient and the caregiver, allow for maintaining functional autonomy, decreasing caregiver burden and, possibly, slowing down cognitive decline. An on-going study in Suisse Romande (INDID-MCI-QOL) assesses the effect of the number and type of interventions conducted over a year on the evolution of physical, psychological and cognitive health in this population.

Les interventions non médicamenteuses sont des outils clés dans la prise en charge des patients atteints de troubles cognitifs évolutifs et de leurs proches aidants, en l'absence de traitement médicamenteux curatif. Ces interventions, lorsqu'elles sont combinées et adaptées aux besoins du patient et du proche aidant, permettent un meilleur maintien de l'autonomie, une diminution du sentiment de fardeau et pourraient même aider à ralentir le déclin cognitif. Une étude en cours en Suisse romande (INDID-MCI-QOL) évalue l'effet à un an du nombre et du type d'interventions non médicamenteuses effectuées sur l'évolution de la santé physique, cognitive et psychologique de cette population.

The impact of replacing sugar- by artificially-sweetened beverages on brain and behavioral responses to food viewing - An exploratory study.

Several studies indicate that the outcome of nutritional and lifestyle interventions can be linked to brain 'signatures' in terms of neural reactivity to food cues. However, 'dieting' is often considered in a rather broad sense, and no study so far investigated modulations in brain responses to food cues occurring over an intervention specifically aiming to reduce sugar intake. We studied neural activity and liking in response to visual food cues in 14 intensive consumers of sugar-sweetened beverages before and after a 3-month replacement period by artificially-sweetened equivalents. Each time, participants were presented with images of solid foods differing in fat content and taste quality while high-density electroencephalography was recorded. Contrary to our hypotheses, there was no significant weight loss over the intervention period and no changes were observed in food liking or in neural activity in regions subserving salience and reward attribution. However, neural activity in response to high-fat, sweet foods was significantly reduced from pre-to post-intervention in prefrontal regions often linked to impulse control. This decrease in activity was associated with weight loss failure, suggesting an impairment in individuals' ability to exert control and adjust their solid food intake over the intervention period. Our findings highlight the need to implement multidisciplinary approaches when aiming to help individuals lose body weight.