Neuropsychiatric Symptoms are Related to Blood-biomarkers in Major Neurocognitive Disorders.

BACKGROUND: Neuropsychiatric symptoms (NPS) are highly prevalent among individuals with major neurocognitive disorders (MNCD). OBJECTIVE: Here, we characterized blood biomarkers (metabolic, inflammatory, neurotrophic profiles and total antioxidant), body composition, physical fitness and quality of life (QoL) in individuals with MNCD according to NPS. METHODS: The sample comprised 34 older adults (71.4% women; 74.06±6.03 yrs, with MNCD diagnosis) categorized according to 50th percentile [Low (≤12) or High (≥13)] for NPS (Neuropsychiatric Inventory Questionnaire). Sociodemographic, clinical data, body composition, anthropometric, cognitive assessment (ADAS-Cog), physical fitness (Senior Fitness Test), QoL (QoL-Alzheimer's Disease scale) were evaluated, and blood samples were collected for biochemical analysis. RESULTS: Low compared to high NPS group showed higher levels of IL-6, IGF-1and neurotrophic zscore (composite of IGF-1, VEGF-1, BDNF). Additionally, low compared to high NPS group have higher QoL, aerobic fitness and upper body and lower body strength. CONCLUSION: The severity of NPS seems to be related to modified neurotrophic and inflammatory outcomes, lower physical fitness, and poor QoL. Strategies to counteract NPS development may preserve the physical and mental health of individuals with MNCD.

Urinary Hydration Biomarkers and Water Sources in Older Adults with Neurocognitive Disorder.

The risk of dehydration in older adults with neurocognitive disorder (NCD) is controversial. The purpose of this study was to assess hydration status, its determinants, and water intake sources in older adults with NCD. A sample of 30 participants (≥60 years) was included. Sociodemographic, clinical data and one 24-h urine sample were collected. Urinary osmolality, sodium, potassium, volume, and creatinine were quantified. Inadequate hydration status corresponded to urine osmolality > 500 mOsm/Kg, or a negative Free Water Reserve (FWR). Two 24-h food recalls were used to assess dietary intake and water sources. The adequacy of total water intake (TWI) was estimated according to EFSA. The contribution of food and beverages to TWI was calculated, and their associations with the urinary osmolality median were tested. Of the total number of participants, 30% were classified as having inadequate hydration status, with no differences between sexes. Regarding TWI, 68.4% of women and 77.8% of men did not reach the reference values. Water (23%), followed by soup (17%), contributed the most to TWI, while vegetables (2%) and alcoholic/other beverages (3%) contributed the least. According to the median urinary osmolality, there was no significant difference in sociodemographic/clinical characteristics. It is critical not to overlook hydration in this vulnerable population.

Physical activity and physical fitness according to loneliness levels in adults 50+ / Caraterização da atividade física e aptidão física de acordo com os níveis de solidão em adultos 50+

Loneliness is a perception of dissatisfaction that seems to be the result of a lack of significant re-lationships, with multiple potential causal factors. The current body of research is not conclusive in relation to the link between loneliness and physical activity (PA) and physical fitness (PF) in adults and seniors. The aim of this cross-sectional study is to characterize PA and PF according to levels of loneliness (Social Isolation versus Affinities). The 62 Portuguese individuals (64.68 ± 6.85 years; 68% women) were assessed for loneliness (University of California Los Angeles 16-item Loneliness Scale - UCLA-16). and classified in Social Isolation or Affinities, i.e., presence of significant social rela-tionships. PA was estimated using a questionnaire (International PA Questionnaire - Short Version - IPAQ-SV ) and PF was evaluated using the Senior Fitness Test (upper and lower body strength, upper and lower body flexibility, cardiorespiratory fitness, agility and dynamic balance). Descriptive statistics were used. The comparison between groups was performed using parametric (t-test, AN-COVA adjusted to sex and chi-square) and non-parametric tests (Mann-Whitney). The prevalence of social isolation was 53%. The individuals of the Affinities group spent more minutes per day on moderate and vigorous physical activity (MVPA) than the individuals of the Social Isolation group (0.00 [0.00 ­ 12.86] versus 11.43 [0.00 ­ 17.14] minutes, respectively; p = 0.041). After adjusting for sex, the differences were no longer significant. Loneliness groups were not different in relation to PF. PA appears to contribute to a better mental profile in adults and seniors. The results should be confirmed through studies with larger samples

A solidão é uma percepção de insatisfação que parece resultar da carência de relacionamentos significativos, sendo múltiplos os seus potenciais fatores causais. A atual evidência não é robusta no que diz respeito à associação da solidão com a atividade física (AF) e aptidão física (ApF) em adultos 50+. O objetivo deste estudo transversal é caracterizar a AF e ApF de acordo com a solidão. Os 62 indivíduos portugueses (64,68 ± 6,85 anos; 68% mulheres) foram avaliados para solidão (Escala de Solidão de 16 itens da Universidade da Califórnia em Los Angeles - UCLA-16) e classificados como Isolamento Social ou Afinidades, i.e., presença de relações socias significativas. A AF foi estimada por questionário (Questionário Internacional de AF - Versão Curta - IPAQ-SV ) e a ApF medida pela bateria Senior Fitness Test (força de membros superiores e inferiores, flexibilidade de membros superiores e membros inferiores, aptidão cardiorrespiratória e agilidade e equilíbrio dinâmico. Foram utilizadas estatísticas descritivas. A comparação entre grupos foi realizada através de testes paramétricos (teste-t, ANCOVA ajustada ao sexo e qui-quadrado) e não paramétricos (Mann-Whitney). A prevalência de isolamento social foi de 53%. O grupo Afinidades apresentou mais AF moderada a vigorosa comparativamente ao grupo Isolamento Social (11,43 [0,00 ­ 17,14] vs (0,00 [0,00 ­ 12,86], respetivamente; p = 0,041). Após ajuste para o sexo, as diferenças deixaram de ser significativas. Os grupos de solidão não foram diferentes relativamente à ApF. A AF parece contribuir para um melhor perfil mental de adultos e idosos, contudo, os resultados devem ser confirmados em estudos com amostras maiores

"Body & Brain": effects of a multicomponent exercise intervention on physical and cognitive function of adults with dementia - study protocol for a quasi-experimental controlled trial.

BACKGROUND: Dementia is a leading cause of death and disability that was declared as one of the greatest health and social care challenges of the twenty-first century. Regular physical activity and exercise have been proposed as a non-pharmacological strategy in disease prevention and management. Multicomponent Training (MT) combines aerobic, strength, balance and postural exercises and might be an effective training to improve both functional capacity and cognitive function in individuals with dementia (IwD). Nevertheless, data on the effects of MT in IwD are still limited and the extent to which IwD can retain improvements after an exercise intervention still needs to be elucidated. The aim of "Body & Brain" study is to investigate the effects of a 6-month MT intervention and 3-month detraining on the physical and cognitive function of IwD. Additionally, we aim to explore the impact of this intervention on psychosocial factors and physiologic markers related to dementia. METHODS: This study is a quasi-experimental controlled trial using a parallel-group design. The study sample consists of community-dwelling individuals aged ≥60 years who are clinically diagnosed with dementia or major neurocognitive disorder. Participants will be either allocated into the intervention group or the control group. The intervention group will participate in MT biweekly exercise sessions, whereas the control group will receive monthly sessions regarding physical activity and health-related topics for 6 months. The main outcomes will be physical function as measured by the Short Physical Performance Battery (SPPB) and cognitive function evaluated using the Alzheimer Disease Assessment Scale - Cognitive (ADAS-Cog) at baseline, after 6-months and 3-months after the end of intervention. Secondary outcomes will be body composition, physical fitness, daily functionality, quality of life, neuropsychiatric symptoms and caregiver's burden. Cardiovascular, inflammatory and neurotrophic blood-based biomarkers, and arterial stiffness will also be evaluated in subsamples. DISCUSSION: If our hypothesis is correct, this project will provide evidence regarding the efficacy of MT training in improving physical and cognitive function and give insights about its impact on novel molecular biomarkers related to dementia. This project may also contribute to provide guidelines on exercise prescription for IwD. TRIAL REGISTRATION: ClinicalTrials.gov - identifier number NCT04095962 ; retrospectively registered on 19 September 2019.

Preventive and Therapeutic Potential of Physical Exercise in Neurodegenerative Diseases.

Significance: The prevalence and incidence of age-related neurodegenerative diseases (NDDs) tend to increase along with the enhanced average of the world life expectancy. NDDs are a major cause of morbidity and disability, affecting the health care, social and economic systems with a significant impact. Critical Issues and Recent Advances: Despite the worldwide burden of NDDs and the ongoing research efforts to increase the underlying molecular mechanisms involved in NDD pathophysiologies, pharmacological therapies have been presenting merely narrow benefits. On the contrary, absent of detrimental side effects but growing merits, regular physical exercise (PE) has been considered a prone pleiotropic nonpharmacological alternative able to modulate brain structure and function, thereby stimulating a healthier and "fitness" neurological phenotype. Future Directions: This review summarizes the state of the art of some peripheral and central-related mechanisms that underlie the impact of PE on brain plasticity as well as its relevance for the prevention and/or treatment of NDDs. Nevertheless, further studies are needed to better clarify the molecular signaling pathways associated with muscle contractions-related myokines release and its plausible positive effects in the brain. In addition, particular focus of research should address the role of PE in the modulation of mitochondrial metabolism and oxidative stress in the context of NDDs.

Effects of a multicomponent exercise program in institutionalized elders with Alzheimer's disease.

This study examined the effect of a Multicomponent Training (MT) intervention on cognitive function, functional fitness and anthropometric variables in institutionalized patients with Alzheimer's disease (AD). Thirty-seven institutionalized elders (84.05 ± 5.58 years) clinically diagnosed with AD (mild and moderate stages) were divided into two groups: Experimental Group (EG, n = 19) and Control Group (CG, n = 18). The EG participated in a six-month supervised MT program (aerobic, muscular resistance, flexibility and postural exercises) of 45-55 minutes/session, twice/week. Cognitive function (MMSE), physical fitness (Senior Fitness Test) and anthropometric variables (Body Mass Index and Waist Circumference), were assessed before (M1), after three months (M2) and after six months (M3) of the experimental protocol. A two-way ANOVA, with repeated measures, revealed significant group and time interactions on cognitive function, chair stand, arm curl, 2-min step, 8-foot up-and-go (UG), chair sit-and-reach (CSR) and back scratch tests as well as waist circumference. Accordingly, for those variables a different response in each group was evident over the time, supported by a significantly better EG performance in chair stand, arm curl, 2-min step, UG, CSR and back scratch tests from M1 to M3, and a significant increase in MMSE from M1 to M2. The CG's performance decreased over time (M1 to M3) in chair stand, arm curl, 2-min step, UG, CSR, back scratch and MMSE. Results suggest that MT programs may be an important non-pharmacological strategy to improve physical and cognitive functions in institutionalized AD patients.

Feasibility and Impact of a Multicomponent Exercise Intervention in Patients With Alzheimer's Disease: A Pilot Study.

This quasi-experimental, nonrandomized study examined the feasibility and impact of a multicomponent (MT) intervention on 7 community-dwelling individuals diagnosed with probable Alzheimer's disease (AD) at mild to moderate stage. During 6 months, patients with AD and their caregivers were submitted to a biweekly exercise program, including muscle strengthening, aerobics, balance, and postural exercises. The following tests were used: Senior Fitness Test and Incremental Treadmill Test, Disability Assessment for Dementia Scale, Alzheimer Disease Assessment Scale-Cognitive, and Quality of Life-Alzheimer's. Attendance and retention mean rates were high (86% and 78%, respectively). No adverse events occurred. Results revealed a significant beneficial effect on cardiorespiratory fitness ( P = .028), upper ( P = .018) and lower ( P = .026) body muscle strength, agility ( P = .018), and ability to perform daily activities ( P = .018). Data suggest that a biweekly MT intervention is feasible to conduct in patients with AD. Findings also suggest a potential positive effect on mitigating cognitive decline and in positively influencing quality of life.