Inhibitory control mediates the association between body mass index and math performance in children: A cross-sectional study.

BACKGROUND: Overweight and obesity affect more than 18% of children and adolescents in the world. Obesity-related associations with brain morphology might be associated with reduced efficiency of inhibitory control. This association highlights a possible mechanism by which obesity impacts intelligence and academic achievement. Prior work indicates a mediating effect of inhibitory control on the relationship between body mass index (BMI) and intelligence and academic achievement. However, although obesity is associated with impaired math performance, we do not know whether inhibitory control also mediates the relationship between BMI and math performance. This study tests the hypothesis that inhibitory control statistically mediates the relationship between BMI and math performance. METHODS: 161 children (9 to 13 years old, 80 female) participated in the present study. We evaluated BMI; math performance, in a test composed of 20 arithmetic equations of the type x = (a × b) - c; and inhibitory control through the Flanker test. We carried out Spearman correlation tests, hierarchical multiple linear regression, and tested the confidence of the model where inhibitory control statistically mediates the indirect association between BMI and math performance. Mediation analysis in this cross-sectional study aimed to improve understanding of indirect relationships and offer insights into possible causal connections. RESULTS: Better math performance and lower BMI were associated with greater accuracy on the inhibitory control test and greater accuracy on the inhibitory control test was associated with better performance on math test. We found an indirect association between higher BMI in children and impairments in math performance, that was mediated by inhibitory control (a: -0.008, p = 0.025; b: 7.10, p = 0.0004; c: 0.05, p = 0.592; c': 0.11, p = 0.238; Indirect Effect: -0.0599, 95% CI: -0.13, -0.005). CONCLUSIONS: An indirect association between higher body mass indices in children and impairments in math performance was detected, through the impact that BMI has on inhibitory control.

Unexpected cognitive similarities between older adults and young people: Scores variability and cognitive performances.

BACKGROUND: Increased interindividual variability in cognitive performance during aging has been proposed as an indicator of cognitive reserve. OBJECTIVE: To determine if interindividual variability performance in episodic memory (PAL), working memory (SWM), reaction time (RTI), and sustained attention (RVP) could differentiate clusters of differential cognitive performance in healthy young and older adults and search for cognitive tests that most contribute to these differential performances. METHODS: We employed hierarchical cluster and canonical discriminant function analyses of cognitive scores using the Cambridge Neuropsychological Test Automated Battery (CANTAB) to identify cognitive variability in older and young adults using the coefficient of variability of cognitive performances between and within groups. We also analyzed potential influences of age, education, and physical activity. RESULTS: Cluster analysis distinguished groups with differential cognitive performance and correlation analysis revealed coefficient of variability and cognitive performance associations. The greater the coefficient of variability the poorer was cognitive performance in RTI but not in PAL and SWM. Older adults showed diverse trajectories of cognitive decline, and better education or higher percentage of physically active individuals exhibited better cognitive performance in both older and young adults. CONCLUSION: PAL and SWM are the most sensitive tests to investigate the wide age range encompassing older and young adults. In older adults' intragroup analysis PAL showed greater discriminatory capacity, indicating its potential for clinical applications late in life. Our data underscore the importance of studying variability as a tool for early detection of subtle cognitive declines and for interpreting results that deviate from normality.

Risk Polymorphisms of FNDC5, BDNF, and NTRK2 and Poor Education Interact and Aggravate Age-Related Cognitive Decline.

Cognitive abilities tend to decline with aging, with variation between individuals, and many studies seek to identify genetic biomarkers that more accurately anticipate risks related to pathological aging. We investigated the influence of BDNF, NTRK2, and FNDC5 single nucleotide polymorphisms (SNPs) on the cognitive performance of young and older adults with contrasting educational backgrounds. We addressed three questions: (1) Is education associated with reduced age-related cognitive decline? (2) Does the presence of SNPs explain the variation in cognitive performance observed late in life? (3) Is education differentially associated with cognition based on the presence of BDNF, NTRK2, or FNDC5 polymorphisms? We measured the cognitive functions of young and older participants, with lower and higher education, using specific and sensitive tests of the Cambridge Automated Neuropsychological Test Assessment Battery. A three-way ANOVA revealed that SNPs were associated with differential performances in executive functions, episodic memory, sustained attention, mental and motor response speed, and visual recognition memory and that higher educational levels improved the affected cognitive functions. The results revealed that distinct SNPs affect cognition late in life differentially, suggesting their utility as potential biomarkers and emphasizing the importance of cognitive stimulation that advanced education early in life provides.

Physical exercise as treatment for adults with type 2 diabetes: a rapid review.

Background: Type 2 diabetes mellitus (T2DM) is a leading cause of disability-adjusted life years (DALY). Physical exercise is an effective non-pharmacological intervention to promote glycaemic control in T2DM. However, the optimal exercise parameters for glycemic control in individuals with T2DM remain unclear. Objective: This study aimed to analyze the relationship between physical training variables - frequency, intensity, type, duration, volume, and progression - and glycemic control in individuals with T2DM. Methods: A rapid systematic literature review was conducted on PubMed and LILACS databases. The PICOT strategy was employed to define the inclusion criteria. Eligible studies had to assess the impact of exercise parameters (frequency, intensity, type, duration, volume, and progression) on glycemic control indicators, primarily glycosylated hemoglobin (HbA1c). Randomized and non-randomized clinical trials were included in the review. The methodological quality of each study was assessed using the PEDro scale (PROSPERO - CRD 42021262614). Results: Out of 1188 papers initially identified, 18 reports met the inclusion criteria and were included in the analysis. A total of 1,228 participants with T2DM (1086 in exercise groups) were included in the selected studies. Among these studies, 16 (88.9%) were RCTs and 2 (11.1%) were nRCTs. The age of participants ranged from 43.1 and 68.9 years, and the average intervention duration was 16.8 weeks. Data on adherence to the intervention, adverse events, detailed intervention protocol, and its impacts on glycaemic control, lipid profile, blood pressure, anthropometric measures, medication, body composition, and physical fitness are reported. Conclusion: The evidence supports the safety and effectiveness of physical exercises as non-pharmacological interventions for glycemic control. Aerobic, resistance and combined training interventions were associated with reductions in HbA1c and fasting glucose. The diversity of the physical exercise intervention protocols investigated in the studies included in this review is an important limitation to generalizing evidence-based practice. The call for action is mandatory to implement large-scale education programs on the prevention of diabetes and public health policies aimed to include well-planned and supervised exercise programs as an essential part of the primary prevention of type 2 diabetes. Systematic Review Registration: PROSPERO, identifier (CRD42021262614).

Pilates and Cognitive Stimulation in Dual Task an Intervention Protocol to Improve Functional Abilities and Minimize the Rate of Age-Related Cognitive Decline in Postmenopausal Women.

It is already known the effectiveness of Pilates training on cognitive and functional abilities. It is also known that dual-task exercise and cognitive stimuli improve cognition and functional capacity. However, no previous report combined cognitive stimuli and Pilates in dual task and measured its effects on the cognitive and physical performances of postmenopausal women. OBJECTIVE: To apply an interventional dual-task (PILATES-COG) protocol and to evaluate its influence on memory, language, and functional physical performances on healthy, community-dwelling postmenopausal older women. METHODS: 47 women with amenorrhea for at least 12 months participated in this study. Those allocated on the PILATES-COG group underwent a 12-week, twice a week regimen of 50 min sessions of simultaneous mat Pilates exercise program and cognitive tasks. Cognitive and physical functional performance were assessed. Two-way mixed ANOVA was used for data analysis, and Bonferroni post hoc tests were used for within- and between-group comparisons. RESULTS: The PILATES-COG group showed significant improvement after the intervention in semantic verbal fluency (p < 0.001; ηρ² = 0.268), phonological verbal fluency (p < 0.019; ηρ² = 0.143), immediate memory (p < 0.001; ηρ² = 0.258), evocation memory (p < 0.001 ηρ² = 0.282), lower-limb muscle strength (p < 0.001; ηρ² = 0.447), balance (p < 0.001; ηρ² = 0.398), and dual-ask cost (p < 0.05; ηρ² = 0.111) assessments on healthy, community-dwelling postmenopausal older women. CONCLUSION: This is the first report of a feasible and effective approach using Pilates and cognitive stimulation in dual task for the reduction of age-related cognitive decline and the improvement of physical functional performance in healthy postmenopausal women.

Fisioterapia aquática em paciente com distrofia muscular de cinturas do tipo 2b: relato de caso / Aquatic Physical therapy in a patient with Limb-Girdle Muscular Dystrophy, type 2b: a case report

INTRODUÇÃO: A distrofia muscular de cinturas do tipo 2B (DMC2B) é uma doença neuromuscular, degenerativa, rara, hereditária, progressiva, com consequentes prejuízos progressivos na capacidade motora e funcional. OBJETIVO: descrever e analisar os efeitos da fisioterapia aquática sobre a funcionalidade, força muscular, amplitude de movimento e qualidade de vida de uma paciente com diagnóstico DMC2B atendida em projeto de extensão universitária. MÉTODOS: Paciente do sexo feminino, 32 anos, solteira, com diagnóstico genético de Distrofia Muscular de Cinturas do Tipo 2B, nível 3 da escala Vignos (modificada por Garder-Medwin e Walton). O relato de caso apresenta a reabilitação através da Fisioterapia Aquática (hidrocinesioterapia) e seus impactos sobre a força muscular, amplitude de movimento, capacidade funcional e qualidade de vida da paciente (CAAE No. 43505321.0.0000.0018). RESULTADOS: O protocolo de fisioterapia aquática, composto por 12 sessões, 60 min/2x/semana, resultou em melhoras na capacidade funcional global e aumento de 9,52% na avaliação da função motora distal, aumentos de 100% da força de preensão manual e aumento para o limite superior (grau 5) na escala MRC para várias das musculaturas testadas, além de ganho de ADM e melhora expressiva da Qualidade de Vida. CONCLUSÃO: A melhora funcional apresentada pela paciente sugere que a reabilitação funcional fundamentada na fisioterapia aquática, em intensidade leve a moderada, é uma opção terapêutica segura e eficaz para a melhora da força muscular, amplitude de movimento, capacidade funcional e qualidade de vida na DMC2B.

INTRODUCTION: Limb-Girdle Muscular Dystrophy, Type 2B (LGMD2B), is a rare, hereditary, progressive neuromuscular degenerative disease coursing with progressive impairments in motor and functional capacity. OBJECTIVE: To describe and analyze the effects of aquatic physical therapy on the functionality, muscle strength, range of motion, and quality of life of a patient diagnosed with LGMD2B attended on an outreach program. METHODS: A female patient, 32 years old, single, with genetic diagnosis of LGMD2B, level 5 at Vignos scale (modified by Garder-Medwin e Walton). The case reports the Aquatic Physical Therapy rehabilitation protocol (hydrokinesiotherapy) and its impacts on muscle strength, range of motion, functional capacity, and patient quality of life (CAAE No. 43505321.0.0000.0018). RESULTS: The aquatic physical therapy protocol, composed of 12 sessions, 60 minutes/2x/week, resulted in improvements in overall functional capacity and a 9.52% increase of distal motor function, 100% increase in handgrip strength, and increase up to the upper limit (grade 5) on the MRC scale for several of the muscles tested, in addition to increased range of motion and expressive improvement in Quality of Life. CONCLUSION: The patient' functional improvement suggests that water-based physical therapy rehabilitation, at mild to moderate exercise intensity, is a safe and effective therapeutic option for improvement muscle strength, range of motion, functional capacity, and quality of life in LGMD2B patients.

Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults.

BACKGROUND: It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults. METHODS: This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures. RESULTS: Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance. CONCLUSION: We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults. CLINICAL TRIAL REGISTRATION: Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.

Pilates for rehabilitation in patients with multiple sclerosis: A systematic review of effects on cognition, health-related physical fitness, general symptoms and quality of life.

OBJECTIVE: The aims of this systematic review is to analyze the effectiveness of Pilates intervention programs on cognitive function, health-related physical fitness, general symptoms, physical function, quality of life, and the impact Pilates can have on activities of daily living in Multiple Sclerosis (MS) patients. This review also aims to provide a synthesis of the most commonly used protocols regarding exercise parameters, such as periodicity and treatment duration. DATA SOURCES: Systematic review of the literature was carried out following the PRISMA guidelines (PROSPERO no. CRD42017070004). A literature search was undertaken for studies that investigated the effects of Pilates training on MS patients, using databases included PubMed, Medline, Scopus and the Physiotherapy Evidence Database (PEDro) up to May 2018. STUDY SELECTION: Three researchers independently reviewed the titles and abstract of each article to screen the papers in relation to the inclusion criteria. DATA EXTRACTION: Data were extracted by three researchers independently. The eligible articles were read in full and their levels of evidence were evaluated using the PEDro scale. DATA SYNTHESIS: Forty-two papers were found during the research phase. Duplicated (n = 23) or incomplete articles (n = 1) were excluded. Studies were also eliminated from the sample based on methodological approach (study design) quality assessment (n = 6). Twelve studies were ultimately selected and analyzed. CONCLUSIONS: The majority of the studies analyzed showed positive results after Pilates training intervention and concluded that Pilates intervention is safe and effective for the treatment of dysfunction of balance, strength, quality of life, cognition, physical performance, walking and posture parameters on MS patients. The articles investigated in this review provide a scientific basis to support Pilates as an option for rehabilitation programs for MS patients.

Associations between cardiorespiratory fitness, physical activity, intraindividual variability in behavior, and cingulate cortex in younger adults.

BACKGROUND: Higher levels of cardiorespiratory fitness (CRF) and greater amounts of physical activity have been associated with lower intraindividual variability (IIV) in executive function in children and older adults. In the present study, we examined whether CRF, measured as maximal oxygen uptake (VO2max), and daily volume of moderate-to-vigorous intensity physical activity (MVPA) were associated with IIV of reaction time during performance of the incongruent condition of the Stroop task in younger adults. Further, we examined whether the thickness of the cingulate cortex was associated with regulating variability in reaction time performance in the context of CRF or physical activity. METHODS: CRF (measured as VO2max), accelerometry-measured MVPA, Stroop performance, and thickness of the rostral anterior cingulate cortex (rACC) derived from magnetic resonance imaging data were collected in 48 younger adults (age = 24.58 ± 4.95 years, mean ± SD). Multiple regression was used to test associations between IIV during the Stroop task and CRF, MVPA, and rACC thickness. Mediation was tested using maximum likelihood estimation with bootstrapping. RESULTS: Consistent with our predictions, higher VO2max was associated with greater rACC thickness for the right hemisphere and greater daily amounts of MVPA were associated with greater rACC thickness for both the left and right hemispheres. Greater thickness of the right rACC was associated with lower IIV for the incongruent condition of the Stroop task. CRF and MVPA were not directly associated with IIV. However, we did find that IIV and both CRF and MVPA were indirectly associated via the thickness of the right rACC. CONCLUSION: These results indicate that higher CRF and greater daily volume of MVPA may be associated with lower IIV during the Stroop task via structural integrity of the rACC. Randomized controlled trials of MVPA would provide crucial information about the causal relations between these variables.

A proposed correction in the weighted method to score the Ishihara test.

OBJECTIVE: Ishihara test is a color vision test, whose results consider that all plates of the test have the same weighting. Rodriguez-Carmona et al. (Aviat Space Environ Med 83:19-29, 2012) proposed an equation to quantify the Ishihara test results (severity index), which took an account the rate of hits from the different plates of the test considering the performance of trichromat or colorblind population. We proposed a correction in Rodiguez-Carmona's equation for the severity index. We evaluated 60 normal trichromats and 107 subjects with congenital color deficiency. We calculated three indexes to quantify the results of each subject: a non-weighted index, a weighted index similar to the Rodriguez-Carmona et al., and a weighted index modified which combined the hit frequency for each plate in a trichromat population and of the error reading frequency for each plate in color-blind populations. RESULTS: Compared to the non-weighted evaluation, the weighted index was reduced by 22.95%, 32.92%, and 35.38% from trichromats, protan and deutan groups, respectively. Receiver Operating Characteristics (ROC) analysis showed perfect performance of the classifier for all metrics to measure the Ishihara test results. The proposal correction changed significantly the value of the index, but the overall benefits were small.

Water-based exercise and resistance training improve cognition in older adults / Hidroginástica e treinamento resistido melhoram a cognição de idosos / Hidrogimnasia y entrenamiento resistido mejoran la cognición de personas de la tercera edad

ABSTRACT Introduction: Physical exercise has been associated with maintenance of physical abilities and the reduction of age-related cognitive decline, and is considered both a low-cost primary prevention strategy and a non-pharmacological treatment of cognitive dysfunction in older people. However, the contribution of each type of physical exercise to the cognitive health of the elderly population has not yet been fully investigated. Objective: This study investigated the possible influences of water-based and resistance training exercises on the cognitive performance of healthy older adults in automated tests, and investigated which test(s) would be the most effective indicator of differences in aging cognitive performance. Methods: Three groups of community-dwelling healthy older adults: water-based exercise group, resistance training group and sedentary group, were assessed using an automated set of neuropsychological tests (CANTAB) and tests to assess functional exercise capacity. Results were compared by one-way analysis of variance (ANOVA) and Pearson linear correlation. Results: The water-based exercise group had the best functional exercise capacity scores and the best performance in the reaction time evaluation (response and movement latencies). The resistance training group had less movement latency than the sedentary group. Functional mobility was positively correlated with response and movement latency. Conclusions: Taken together our findings show that physical exercise contributes to the preservation of cognitive function in healthy older adults and that water-based exercise has better results than resistance training in terms of reaction time. Moreover, the changes related to reaction time function were detected before the changes in working memory functions, sustained attention and learning in the sedentary participants, suggesting that this variable could be an early sensitive indicator of subtle cognitive changes associated with aging. Level of Evidence II; Retrospective study.

RESUMO Introdução: A prática de exercícios físicos tem sido associada à manutenção das habilidades físicas e redução do declínio cognitivo durante o envelhecimento, sendo considerada uma estratégia de prevenção primária de baixo custo, assim como tratamento não-farmacológico da disfunção cognitiva em idosos. Entretanto, a contribuição das diferentes modalidades de exercícios físicos sobre a saúde cognitiva da população idosa carece de investigação. Objetivo: O presente estudo investigou as possíveis influências da hidroginástica e musculação no desempenho cognitivo dos adultos idosos saudáveis em testes automatizados e qual(is) teste(s) seria o indicador mais sensível das diferenças de desempenho cognitivo. Métodos: Três grupos de idosos saudáveis, residentes na comunidade, praticantes de hidroginástica, musculação ou sedentários foram avaliados através de uma bateria automatizada de testes neuropsicológicos (CANTAB) e testes para avaliação da capacidade funcional ao exercício. Os resultados foram comparados através da análise de variância de 1 critério (ANOVA) e da correlação linear de Pearson. Resultados: O grupo de hidroginástica apresentou melhor capacidade funcional ao exercício e melhor desempenho na avaliação do tempo de reação (latências de resposta e de movimento). Os praticantes de musculação apresentaram menor latência de movimento do que os sedentários. A mobilidade funcional foi positivamente correlacionada às latências de resposta e de movimento. Conclusão: Considerados em conjunto, nossos resultados indicam que o exercício físico contribui para a preservação da função cognitiva em idosos saudáveis e que a hidroginástica apresenta melhores resultados do que a musculação em relação ao tempo de reação. Além disso, as mudanças relacionadas à função tempo de reação foram detectadas antes das mudanças nas funções de memória de trabalho, atenção sustentada e aprendizado nos participantes sedentários, sugerindo que essa variável pode ser um indicador sensível e precoce de sutis mudanças cognitivas associadas ao envelhecimento. Nível de Evidência II; Estudo retrospectivo.

RESUMEN Introducción: La práctica de ejercicios físicos ha sido asociada al mantenimiento de las habilidades físicas y reducción de la disminución cognitiva durante el envejecimiento, siendo considerada una estrategia de prevención primaria de bajo costo, así como tratamiento no farmacológico de la disfunción cognitiva en personas de la tercera edad. Entretanto, la contribución de las diferentes modalidades de ejercicios físicos sobre la salud cognitiva de la población de la tercera edad carece de investigación. Objetivo: El presente estudio investigó las posibles influencias de la hidrogimnasia y musculación en el desempeño cognitivo de los adultos de la tercera edad saludables en tests automatizados y qué test(s) sería el indicador más sensible de las diferencias de desempeño cognitivo. Métodos: Tres grupos de personas de la tercera edad saludables, residentes en la comunidad, practicantes de hidrogimnasia, musculación o sedentarios fueron evaluados a través de una batería automatizada de tests neuropsicológicos (CANTAB) y tests para evaluación de la capacidad funcional para el ejercicio. Los resultados fueron comparados a través del análisis de variancia de 1 criterio (ANOVA) y de la correlación lineal de Pearson. Resultados: El grupo de hidrogimnasia presentó mejor capacidad funcional para el ejercicio y mejor desempeño en la evaluación del tiempo de reacción (latencias de respuesta y de movimiento). Los practicantes de musculación presentaron menor latencia de movimiento que los sedentarios. La movilidad funcional fue positivamente correlacionada a las latencias de respuesta y de movimiento. Conclusión: Considerados en conjunto, nuestros resultados indican que el ejercicio físico contribuye para la preservación de la función cognitiva en personas de la tercera edad saludables y que la hidrogimnasia presenta mejores resultados que la musculación con relación al tiempo de reacción. Además, los cambios relacionados a la función tiempo de reacción fueron detectados antes que los cambios em las funciones de memoria de trabajo, atención sustentada y aprendizaje en los participantes sedentarios, sugiriendo que esa variable puede ser un indicador sensible y precoz de sutiles cambios cognitivos asociados al envejecimiento. Nivel de Evidencia II; Estudio retrospectivo.

The subtleties of cognitive decline in multiple sclerosis: an exploratory study using hierarchichal cluster analysis of CANTAB results.

BACKGROUND: It is essential to investigate cognitive deficits in multiple sclerosis (MS) to develop evidence-based cognitive rehabilitation strategies. Here we refined cognitive decline assessment using the automated tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) and hierarchical cluster analysis. METHODS: We searched for groups of distinct cognitive profiles in 35 relapsing-remitting MS outpatients and 32 healthy controls. All individuals participated in an automated assessment (CANTAB) and in a pencil and paper general neuropsychological evaluation. RESULTS: Hierarchical cluster analysis of the CANTAB results revealed two distinct groups of patients based mainly on the Simple Reaction Time (RTI) and on the Mean Latency of Rapid Visual Processing (RVP). The general neuropsychological assessment did not show any statistically significant differences between the cluster groups. Compared to the healthy control group, all MS outpatients had lower scores for RTI, RVP, paired associate learning, and delayed matching to sample. We also analyzed the associations between CANTAB results and age, education, sex, pharmacological treatment, physical activity, employment status, and the Expanded Disability Status Scale (EDSS). Although limited by the small number of observations, our findings suggest a weak correlation between performance on the CANTAB and age, education, and EDSS scores. CONCLUSIONS: We suggest that the use of selected large-scale automated visuospatial tests from the CANTAB in combination with multivariate statistical analyses may reveal subtle and earlier changes in information processing speed and cognition. This may expand our ability to define the limits between normal and impaired cognition in patients with Multiple Sclerosis.

Psychophysical Evaluation of Congenital Colour Vision Deficiency: Discrimination between Protans and Deutans Using Mollon-Reffin's Ellipses and the Farnsworth-Munsell 100-Hue Test.

We have used the Farnsworth-Munsell 100-hue (FM 100) test and Mollon-Reffin (MR) test to evaluate the colour vision of 93 subjects, 30.4 ± 9.7 years old, who had red-green congenital colour vision deficiencies. All subjects lived in Belém (State of Pará, Brazil) and were selected by the State of Pará Traffic Department. Selection criteria comprised the absence of visual dysfunctions other than Daltonism and no history of systemic diseases that could impair the visual system performance. Results from colour vision deficient were compared with those from 127 normal trichromats, 29.3 ± 10.3 years old. For the MR test, measurements were taken around five points of the CIE 1976 colour space, along 20 directions irradiating from each point, in order to determine with high-resolution the corresponding colour discrimination ellipses (MacAdam ellipses). Three parameters were used to compare results obtained from different subjects: diameter of circle with same ellipse area, ratio between ellipse's long and short axes, and ellipse long axis angle. For the FM 100 test, the parameters were: logarithm of the total number of mistakes and positions of mistakes in the FM diagram. Data were also simultaneously analysed in two or three dimensions as well as by using multidimensional cluster analysis. For the MR test, Mollon-Reffin Ellipse #3 (u' = 0.225, v' = 0.415) discriminated more efficiently than the other four ellipses between protans and deutans once it provided larger angular difference in the colour space between protan and deutan confusion lines. The MR test was more sensitive than the FM 100 test. It separated individuals by dysfunctional groups with greater precision, provided a more sophisticated quantitative analysis, and its use is appropriate for a more refined evaluation of different phenotypes of red-green colour vision deficiencies.

Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up.

We previously demonstrated the beneficial effects of a multisensory and cognitive stimulation program, consisting of 48 sessions, twice a week, to improve the cognition of elderly subjects living either in long-term care institutions (institutionalized - I) or in communities with their families (noninstitutionalized - NI). In the present study, we evaluated these subjects after the end of the intervention and compared the rate of age-related cognitive decline of those living in an enriched community environment (NI group, n=15, 74.1±3.9 years old) with those living in the impoverished environment of long-term care institutions (I group, n=20, 75.1±6.8 years old). Both groups participated fully in our stimulation program. Over 1 year, we conducted revaluations at five time points (2 months, 4 months, 6 months, 8 months, and 12 months) after the completion of the intervention. Both elderly groups were evaluated with the mini-mental state examination and selected language tests. Progressive cognitive decline was observed in both groups over the period. Indeed, it took only 4-6 months after the end of the stimulation program for significant reductions in language test scores to become apparent. However, earlier reductions in test scores were mainly associated with I group, and linguistic prosody test scores were significantly affected by institutionalization and time, two variables that interacted and reduced these scores. Moreover, I group reduced the Montréal cognitive assessment battery language tests scores 4 months before NI group. It remains to be investigated what mechanisms may explain the earlier and more intense language losses in institutionalized elderly.

CANTAB object recognition and language tests to detect aging cognitive decline: an exploratory comparative study.

OBJECTIVE: The recognition of the limits between normal and pathological aging is essential to start preventive actions. The aim of this paper is to compare the Cambridge Neuropsychological Test Automated Battery (CANTAB) and language tests to distinguish subtle differences in cognitive performances in two different age groups, namely young adults and elderly cognitively normal subjects. METHOD: We selected 29 young adults (29.9±1.06 years) and 31 older adults (74.1±1.15 years) matched by educational level (years of schooling). All subjects underwent a general assessment and a battery of neuropsychological tests, including the Mini Mental State Examination, visuospatial learning, and memory tasks from CANTAB and language tests. Cluster and discriminant analysis were applied to all neuropsychological test results to distinguish possible subgroups inside each age group. RESULTS: Significant differences in the performance of aged and young adults were detected in both language and visuospatial memory tests. Intragroup cluster and discriminant analysis revealed that CANTAB, as compared to language tests, was able to detect subtle but significant differences between the subjects. CONCLUSION: Based on these findings, we concluded that, as compared to language tests, large-scale application of automated visuospatial tests to assess learning and memory might increase our ability to discern the limits between normal and pathological aging.

Beneficial effects of multisensory and cognitive stimulation on age-related cognitive decline in long-term-care institutions.

The aim of the present report was to evaluate the effectiveness and impact of multisensory and cognitive stimulation on improving cognition in elderly persons living in long-term-care institutions (institutionalized [I]) or in communities with their families (noninstitutionalized [NI]). We compared neuropsychological performance using language and Mini-Mental State Examination (MMSE) test scores before and after 24 and 48 stimulation sessions. The two groups were matched by age and years of schooling. Small groups of ten or fewer volunteers underwent the stimulation program, twice a week, over 6 months (48 sessions in total). Sessions were based on language and memory exercises, as well as visual, olfactory, auditory, and ludic stimulation, including music, singing, and dance. Both groups were assessed at the beginning (before stimulation), in the middle (after 24 sessions), and at the end (after 48 sessions) of the stimulation program. Although the NI group showed higher performance in all tasks in all time windows compared with I subjects, both groups improved their performance after stimulation. In addition, the improvement was significantly higher in the I group than the NI group. Language tests seem to be more efficient than the MMSE to detect early changes in cognitive status. The results suggest the impoverished environment of long-term-care institutions may contribute to lower cognitive scores before stimulation and the higher improvement rate of this group after stimulation. In conclusion, language tests should be routinely adopted in the neuropsychological assessment of elderly subjects, and long-term-care institutions need to include regular sensorimotor, social, and cognitive stimulation as a public health policy for elderly persons.

Pilates method in personal autonomy, static balance and quality of life of elderly females.

OBJECTIVE: The aim of this study was to evaluate the effects of the Pilates method on the personal autonomy, static balance and quality of life in healthy elderly females. METHOD: Fifty-two elderly females were selected and submitted to evaluation protocols to assess functional autonomy (GDLAM), static balance (Tinetti) and quality of life (WHOQOL-OLD). The Pilates group (PG: n=27) participated in Pilates exercises twice weekly for eight weeks. Descriptive statistics were compiled using the Shapiro-Wilk test. The level of significance was considered to be p< or =0.05. RESULTS: The dependent Student-t test demonstrated significant post-test differences in the Pilates group in the following areas balance (Delta%=4.35%, p=0.0001) and General Index of GDLAM (Delta%=-13.35%, p=0.0001); the Wilcoxon test demonstrated significant post-test differences in the quality of life Index (Delta%=1.26%, p=0.0411). CONCLUSION: The Pilates method can offer significant improvement in personal autonomy, static balance and quality of life.