Effectiveness of Simultaneous Combined Intervention for Enhancing Cognitive Function in Patients with Moderate Alzheimer's Disease.

Background: The evidence supporting the effectiveness of combined interventions in Alzheimer's disease (AD) patients remains inconclusive. Objective: The aim of this study was to evaluate the mid- and long-term effectiveness of physical training, alone or combined with cognitive games, on cognitive performance in patients with moderate AD. Methods: Seventy-nine AD patients (≈73% females, age of ≈70±1 years) were randomly divided into three groups: aerobic-based training (AT-group, n = 27), aerobic-based training plus cognitive games (ACT-group, n = 25), and a control group engaged in reading (CG, n = 26), two sessions per week. Cognitive performance was evaluated at the start, 4th week (W4), end of the 8th week (W8), and after a 4-week detraining period (W12), using problem-solving (Tower-of-Hanoi), selective attention (Stroop-test), and working memory (Digit-Span-test) assessments. Stress levels and quality of life were also evaluated.Results:: Aerobic and combined training induced a positive effect on all cognitive functions tested at W4 (except problem-solving) and W8 (all p < 0.001) with greater improvements in working-memory and problem-solving in ACT-group (p < 0.05). Depression levels also decreased significantly, and quality of life improved at W8 (p < 0.001) in both groups. After 4 weeks of detraining, the beneficial effect of AT and ACT was still observed. The CG did not show any significant improvements at all time points.Conclusions:: Physical and cognitive interventions appear effective for improving cognitive-functions, quality-of-life, and reducing depression in AD patients. Combined training emerges as a more effective strategy to mitigate AD progression. Further research is necessary to validate these results and explore their potential for preventing early cognitive decline.

Does acute aerobic exercise enhance selective attention, working memory, and problem-solving abilities in Alzheimer's patients? A sex-based comparative study.

Introduction: The present study aimed to evaluate the effect of acute aerobic exercise on certain cognitive functions known to be affected by Alzheimer's disease (AD), with a particular emphasis on sex differences. Methods: A total of 53 patients, with a mean age of 70.54 ± 0.88 years and moderate AD, voluntarily participated in the study. Participants were randomly assigned to two groups: the experimental group (EG), which participated in a 20-min moderate-intensity cycling session (60% of the individual maximum target heart rate recorded at the end of the 6-min walk test); and the control group (CG), which participated in a 20-min reading activity. Cognitive abilities were assessed before and after the physical exercise or reading session using the Stroop test for selective attention, the forward and backward digit span test for working memory, and the Tower of Hanoi task for problem-solving abilities. Results: At baseline, both groups had comparable cognitive performance (p > 0.05 in all tests). Regardless of sex, aerobic acute exercise improved attention in the Stroop test (p < 0.001), enhanced memory performance in both forward (p < 0.001) and backward (p < 0.001) conditions, and reduced the time required to solve the problem in the Tower of Hanoi task (p < 0.001). No significant differences were observed in the number of movements. In contrast, the CG did not significantly improve after the reading session for any of the cognitive tasks (p > 0.05). Consequently, the EG recorded greater performance improvements than the CG in most cognitive tasks tested (p < 0.0001) after the intervention session. Discussion: These findings demonstrate that, irrespective to sex, a single aerobic exercise session on an ergocycle can improve cognitive function in patients with moderate AD. The results suggest that acute aerobic exercise enhances cognitive function similarly in both female and male patients, indicating promising directions for inclusive therapeutic strategies.

Mid-Term and Long-Lasting Psycho-Cognitive Benefits of Bidomain Training Intervention in Elderly Individuals with Mild Cognitive Impairment.

Background: This study investigated whether combining simultaneous physical and cognitive training yields superior cognitive outcomes compared with aerobic training alone in individuals with mild cognitive impairment (MCI) and whether these benefits persist after four weeks of detraining. Methods: Forty-four people with MCI (11 males and 33 females) aged 65 to 75 years were randomly assigned to an 8-week, twice-weekly program of either aerobic training (AT group, n = 15), aerobic training combined with cognitive games (ACT group, n = 15), or simply reading for controls (CG group, n = 14). Selective attention (Stroop), problem-solving (Hanoi Tower), and working memory (Digit Span) tasks were used to assess cognitive performances at baseline, in the 4th (W4) and 8th weeks (W8) of training, and after 4 weeks of rest (W12). Results: Both training interventions induced beneficial effects on all tested cognitive performance at W4 (except for the number of moves in the Hanoi tower task) and W8 (all p <0.001), with the ACT group exhibiting a more pronounced positive impact than the AT group (p < 0.05). This advantage was specifically observed at W8 in tasks such as the Stroop and Tower of Hanoi (% gain ≈40% vs. ≈30% for ACT and AT, respectively) and the digit span test (% gain ≈13% vs. ≈10% for ACT and AT, respectively). These cognitive improvements in both groups, with the greater ones in ACT, persisted even after four weeks of detraining, as evidenced by the absence of a significant difference between W8 and W12 (p > 0.05). Concerning neuropsychological assessments, comparable beneficial effects were recorded following both training regimens (all p < 0.05 from pre- to post-intervention). The control group did not show any significant improvement in most of the cognitive tasks. Conclusions: The greater mid-term and long-lasting effects of combined simultaneous physical-cognitive training underscores its potential as a cost-effective intervention for the prevention and management of cognitive decline. While these results are valuable in guiding optimal physical and mental activity recommendations for adults with MCI, further neurophysiological-based studies are essential to offer robust support and deepen our understanding of the mechanisms underlying these promising findings.

Exploring stress response's role in executive function impairments among adults with early adverse childhood experiences.

Adverse childhood experiences (ACEs) are recognised as precursors to numerous physical and mental health challenges. However, research on their impact on inhibitory control and working memory, particularly among healthy young adults, remains limited. The role played by the stress response as a moderator in these effects is likewise underexplored. Our study addresses this gap by examining cognitive impairments in non-clinical adults with early childhood trauma, specifically trauma before the age of 13 years, and by assessing the influence of the stress response on these effects. A total of 15 participants with early ACEs were compared with a control group (n = 18) using the Corsi Block Tapping Test (CBTT) and Stroop Word Colour Test (SCWT). Results showed that participants with early ACEs exhibited lower scores on the SCWT but not the CBTT. The stress response emerged as a potential factor in the relationship between early ACEs and cognitive performance. The implications of these findings are then discussed in relation to the existing literature.

Sleep and psychological factors are associated with meeting discharge criteria to return to sport following ACL reconstruction in athletes.

This study aimed to determine if sleep quality and psychological factors were associated with time to meet the discharge criteria to return to sport (RTS) following anterior cruciate ligament reconstruction (ACL-R) among athletes. A cohort-study design included 89 athletes following ACL-R. Each participant completed a battery of questionnaires at 6 different time points: within 3 days of injury occurrence and at post-surgery (1.5 m, 3 m, 4.5 m, 6 m and when discharge criteria were met). Assessment included sleep quality and quantity, symptoms of depression, anxiety, stress, psychological readiness to RTS and fear of re-injury. The primary outcome was the time needed to meet all discharge criteria to RTS. Sleep parameters and psychological factors were not associated with time to meet the discharge criteria to RTS. However, athletes that had lower scores of anxiety (OR 1.2 (95% CI 1.0, 1.3) and insomnia (OR 1.2 (95% CI 1.0, 1.3) at baseline were more likely to meet the RTS discharge criteria. Athletes with better sleep quality at 3m, 4.5m and 6m were more likely to meet the RTS discharge criteria OR 1.3 (95% CI 1.1, 1.7), 2.0 (95% CI 1.1-3.4) and 1.4 (95% CI 1.0, 1.9) respectively. Sleep quality and psychological factors were not associated with time to meet the discharge criteria to RTS but impacted whether athletes adhered and completed their rehabilitation program or not. Monitoring sleep quality and psychological factors of athletes before and following ACL-R surgery is important to identify athletes who could have difficulties in adhering to and completing their rehabilitation program to RTS.

Acute Exercise and Cognitive Function in Alzheimer's Disease.

BACKGROUND: Many studies have shown the impact of acute aerobic exercises (AAE) on cognition in healthy adults or at a pre-dementia stage. Few studies, however, have explored the positive effects of AAE in moderate Alzheimer's disease (ADM) patients. OBJECTIVE: Evaluating the effect of AAE on cognitive functions in ADM patients. METHODS: Overall, 79 (age: 69.62±0.99) ADM patients were recruited. Participants were divided into three groups according to the task: aerobic exercises done alone or combined with cognitive games presented on a screen, and a control group who performed a reading task. The aerobic exercise protocol consisted of a 20-min cycling exercise of moderate intensity, corresponding to 60%of the individual target maximal heart rate recorded in a 6-minute walking test. The participants' cognition was monitored before and after the intervention using the Tower of Hanoi, Digit Span, and Stroop tasks. RESULTS: After the exercise, the participants' attention in both the physical and combined groups improved for the Stroop, the forward and backward Digit Span tasks, as well as the time taken to solve the Tower of Hanoi, although no significant differences were found in the number of moves taken in the latter. By contrast, the control group did not show any significant improvement for most of the cognitive tasks after the reading session. CONCLUSION: Current evidence suggests that AAE may help to improve cognitive functions in ADM patients. This improvement is enhanced when the exercise is combined with cognitive games. Safe and progressive types of exercises should be promoted among ADM patients.

Resilience after a neurological pathology: What impact on the cognitive abilities of patients with brain damage?

The aim of this study is to examine resilience in patients with traumatic brain injury and patients who suffered from stroke. As traumatic brain injury and stroke both have a recovery potential, we investigate cognitive recovery in this context. Given the involvement of resilience in physiological recovery and positive emotions in enhancing cognitive capacities, we hypothesised that resilience could be related to cognitive abilities and recovery following traumatic brain injury and stroke. Our results show the same degree of resilience and cognitive capacities in our participants in two separate assessments. An improvement in cognitive abilities was observed, as was a correlation between these abilities and resilience. In other words, the greater the resilience, the higher the patient's cognitive performances. Resilience appears to influence cognitive abilities in participants with brain damage and also be involved in recovery.

Inter-relationship between sleep quality, insomnia and sleep disorders in professional soccer players.

OBJECTIVE: Insufficient sleep duration and quality has negative effects on athletic performance, injury susceptibility and athlete development. This study aimed to assess the sleep characteristics of professional Qatar Stars League (QSL) soccer players. METHODS: In a cross-sectional study, QSL players (n=111; 23.7±4.8 years) completed three questionnaires to screen sleep disorders: (1) Pittsburgh Sleep Quality Index (PSQI), (2) Insomnia Severity Index (ISI) and (3) Epworth Sleepiness Scale (ESS). Poor sleep quality was defined as PSQI≥5, excessive daytime sleepiness was defined by ESS>8 and insomnia was defined as ISI≥11. RESULTS: The prevalence of poor sleep quality (PSQI≥5) was 68.5%, with subthreshold insomnia (ISI≥11) 27.0% and daytime sleepiness 22.5% (ESS>8). Sleep quality was positively associated with insomnia (r=0.42, p<0.001) and daytime sleepiness (r=0.23, p=0.018). Age, anthropometry, body composition and ethnicity were not associated with any of the reported sleep quality parameters. CONCLUSION: The prevalence of poor sleep quality (68.5%) reported should concern practitioners. Increasing awareness of the importance of sleep relative to athletic performance, recovery, injury and illness appears prudent. Further, regular qualitative/quantitative sleep monitoring may help target subsequent evidence-informed interventions to improve sleep in those demonstrating undesirable sleep traits.

Traumatic brain injury and stroke: does recovery differ?

BACKGROUND: Traumatic brain injury and stroke often lead to cognitive, neurological and psychological disorders, which can result in many difficulties. Despite the existence of various disorders, improving cognitive capacities may be possible for these two pathologies. OBJECTIVES: The purpose of this study was to assess cognitive recovery in patients with traumatic brain injury and stroke and compare recovery between both groups. PARTICIPANTS AND METHODS: Forty-nine adults who had suffered from mild to severe traumatic brain injury and 42 from stroke were assessed third with a minimum of 2 months between assessments. The French version of the Barrow Neurological Institute Scale was used to examine cognitive abilities and included six subscales on language, memory, guidance, visual spatial functions, affectivity and attention. RESULTS: Cognitive performances were similar for the two groups at both assessments, with the exception of language performances, which were higher for participants with traumatic brain injury. An improvement was observed for several cognitive abilities, but no significant differences were found between traumatic brain injury and stroke groups. CONCLUSIONS: The findings of this study reveal the possibility of cognitive recovery after brain damage. No recovery differences were found for vascular and traumatic lesions.

Effect of Passive Hyperthermia on Working Memory Resources during Simple and Complex Cognitive Tasks.

The aim of this study was to verify the hypothesis that hyperthermia represents a cognitive load limiting available resources for executing concurrent cognitive tasks. Electroencephalographic activity (EEG: alpha and theta power) was obtained in 10 hyperthermic participants in HOT (50°C, 50% RH) conditions and in a normothermic state in CON (25°C, 50% RH) conditions in counterbalanced order. In each trial, EEG was measured over the frontal lobe prior to task engagement (PRE) in each condition and during simple (One Touch Stockings of Cambridge, OTS-4) and complex (OTS-6) cognitive tasks. Core (39.5 ± 0.5 vs. 36.9 ± 0.2°C) and mean skin (39.06 ± 0.3 vs. 31.6 ± 0.6°C) temperatures were significantly higher in HOT than CON (p < 0.005). Theta power significantly increased with task demand (p = 0.017, η2 = 0.36) and was significantly higher in HOT than CON (p = 0.041, η2 = 0.39). The difference between HOT and CON was large (η2 = 0.40) and significant (p = 0.036) PRE, large (η2 = 0.20) but not significant (p = 0.17) during OTS-4, and disappeared during OTS-6 (p = 0.87, η2 = 0.00). Those changes in theta power suggest that hyperthermia may act as an additional cognitive load. However, this load disappeared during OTS-6 together with an impaired performance, suggesting a potential saturation of the available resources.

Conditions for exercising residents' voting rights in long-term care residences: a prospective multicenter study.

To assess voting conditions in long-term care settings, we conducted a multicenter survey after the 2009 European elections in France. A questionnaire about voting procedures and European elections was proposed in 146 out of 884 randomized facilities. Sixty-four percent of facilities answered the questionnaire. Four percent of residents voted (national turnout: 40%), by proxy (58%) or at polling places (42%). Abstention related to procedural issues was reported in 32% of facilities. Sixty-seven percent of establishments had voting procedures, and 53% declared that they assessed residents' capacity to vote. Assistance was proposed to residents for voter registration, for proxy voting, and for voting at polling places, respectively, in 33%, 87%, and 80% of facilities. This survey suggests that residents may be disenfranchised and that more progress should be made to protect the voting rights of residents in long-term care facilities.

Cognitive decrements do not follow neuromuscular alterations during passive heat exposure.

To investigate what triggers cognitive and neuromuscular alterations during passive heat exposure, eight volunteers performed simple (One Touch Stockings of Cambridge, OTS-4) and complex (OTS-6) cognitive tasks as well as neuromuscular testing (maximal isometric voluntary contractions of the thumb with electrical stimulation of the motor nerve and magnetic stimulation of the motor cortex). These tests were performed at the start (T1), after 1 h 30 min (T2), 3 h (T3) and 4 h 30 min (T4) of exposure in both hot (HOT) (Wet Bulb Globe Temperature [WBGT] = 38° ± 1.4°C) and neutral control (CON) (WBGT = 19° ± 0.3°C) environments. Environmental temperatures were adjusted during the HOT session to induce target core temperatures (T(core)) (T1 ∼ 37.3°; T2 ∼ 37.8°; T3 ∼ 38.3°; T4 ∼ 38.8°C). At T1 and T4 the OTS-6 was lower in HOT than in CON in response to the rapid increase in skin temperature and to hyperthermia, respectively. In HOT, the increase in T(core) limited force production capacity possibly via alterations occurring upstream the motor cortex (from T(core) ∼ 37.8°C) but also via a decrement in motor cortical excitability (from T(core) ∼ 38.3°C). These alterations in cortex excitability failed to explain the cognitive alterations that can originate from an additional cognitive load imposed by temperature variations.

Alterations in cognitive performance during passive hyperthermia are task dependent.

The objectives of this study were to (1) assess the effect of passive heating upon attention and memory task performance, and (2) evaluate the effectiveness of the application of cold packs to the head on preserving these functions. Using a counter-balance design 16 subjects underwent three trials: a control (CON, 20°C, 40% rH), hot (HOT, 50°C, 50% rH) and hot with the head kept cool (HHC). In each condition, three attention tests and two memory tests were performed. Mean core, forehead and tympanic temperatures were all significantly higher (p < 0.05) during HOT (38.6° ±0.1°, 39.6° ± 0.2° and 38.8°±0.1°C, respectively) and HHC (38° ± 0.2, 37.7° ± 0.3° and 37.7°C, respectively) than in CON (37.1° ± 0.6°, 33.3° ± 0.2° and 35.9° ± 0.3°C, respectively). Results indicate that there was impairment in working memory with heat exposure (p < 0.05) without alteration in attentional processes. The regular application of cold packs only prevented the detrimental effect of hyperthermia on short-term memory. Our results show that impairments in cognitive function with passive hyperthermia and the beneficial effect of head cooling are task dependent and suggests that exposure to a hot environment is a competing variable to the cognitive processes.

Reduced attention shift in response to auditory changes in subjects with tinnitus.

A current idea about the persistence of tinnitus is that fixation of this phantom auditory perception in the central auditory system may be influenced by attention to it. The present study investigated the mechanisms of involuntary attention and analysed performance in categorising sounds in tinnitus, simulated-tinnitus and control subjects. The sounds were presented in one ear and were preceded by presentation of frequent and deviant stimuli in the other ear. The results showed classical attention capture by deviant stimuli. In addition, the unilateral tinnitus subjects responded more accurately in the tinnitus ear than in the non-tinnitus ear. In contrast, the 'simulated-tinnitus' group showed no difference in the results between the ear where the tinnitus simulation was presented and the opposite ear. These findings suggest a difficulty in attention directing when the attention location coincides with the tinnitus ear and provides evidence for an attention focus on the tinnitus ear.

Processing emotional information in Alzheimer's disease: effects on memory performance and neurophysiological correlates.

BACKGROUND: There is some impairment of the ability of patients with Alzheimer's disease (AD) to perceive emotions, but this ability seems relatively preserved compared to the impairment of other cognitive domains. Few studies have focused on the link between emotional processing and other cognitive functions, such as memory or attention. OBJECTIVE: This study was designed to investigate whether the emotional content of a text can influence memory in patients affected by AD and whether this effect is related to attentional processes as measured by event-related potentials (ERP). METHODS: All subjects were administered neuropsychological tests and a logical memory test including emotional and nonemotional material. ERP were recorded during an attention task. RESULTS: AD patients had better immediate recall of sad and, to a lesser extent, happy stories than of neutral stories. This difference also affected multiple choice recognition and identification (immediate and delayed) of emotional content. The amplitude of both P300 and mismatch negativity was significantly decreased in the group as a whole. There was no correlation between P300 parameters and performance on the memory tasks, whatever their emotional content. CONCLUSIONS: The results show relatively preserved emotional processing in patients with AD and suggest that the emotional content of a context can influence memory performance. We found no evidence that this effect is mediated by attention as measured by ERP.