Comparison of cognitive functioning of elders with late-life depression and patients with and without a history of depressive episodes: a cross-sectional study.

Nowadays there are numerous studies on the occurrence of cognitive dysfunction in late-life depression (LLD). The role of executive dysfunctions in the psychopathology of depression is particularly emphasized and needs further examination. The aim was to assess cognitive functions and their relation to depressive symptoms in elders with LLD, previously depressed, and patients without the history of depressive episodes. The study consisted of 824 older adults who underwent a neuropsychological evaluation (97 currently depressed, 114 previously depressed and 613 patients without the history of depressive episodes). LLD patients performed poorer in ACE-III and AVLT and poorer in TMT-B than those previously depressed and never depressed. The LLD group also performed significantly poorer than the previously depressed on Digit Span Forward. Results of a multiple regression analysis indicated that performance on measures of executive functioning was associated with depression severity in LLD (ß =.227, P =.024). The results of this study suggest that executive functions are the most impaired in the elderly with LLD. Furthermore, there is a relationship between executive dysfunction and the severity of depression in LLD. Executive dysfunction appears to be the core neurocognitive deficit in LLD.

Executive functions and working memory in motor control: Does the type of MCI matter?

The purpose of this study was to evaluate the association between functional mobility performance and executive functions in older adults with the amnestic (aMCI) and nonamnestic (naMCI) type of mild cognitive impairment (MCI), as well as in a control group. A cross-sectional study was conducted among 800 older adults (147 with MCI) who participated in a longitudinal study consisting in an interdisciplinary geriatric assessment and rehabilitation program in Kraków. Motor performance was measured with the Timed Up and Go test (TUG), while standard neuropsychological tests were used to assess different cognitive domains. Analysis of the entire sample showed that almost all cognitive domains and the presence of MCI are associated with functional mobility. Executive functions, letter fluency, and working memory were associated with TUG in the MCI group. The MCI type was not a significant moderator of the relationship between cognitive and motor performance. In group analyses, various cognitive predictors for TUG in the aMCI group, naMCI, and control group were demonstrated. Our results suggest that executive functions and working memory in aMCI and letter fluency in naMCI are independently associated with functional mobility performance. Executive functions are important for gait control in MCI.

[Clinical and demographic predictors of mild cognitive impairment - cross-sectional study].

OBJECTIVE: Introduction: Cognitive limitations are a serious health and social problem, which concerns elderly people. Effective prevention and treatment of cognitive dysfunction is one of the challenges of modern medicine. There is not enough consistent data in the literature to indicate to indicate the relationship between various clinical and demographic factors with cognitive functioning in different age ranges. The aim: To analyze clinical and demographic predictors of mild cognitive impairment by age group. PATIENTS AND METHODS: Material and methods: The analysis included 817 participants (669 with normal cognitive function and 148 people with MCI). The evaluation of the level of depressive symptoms was measured by the Short Form Geriatric Depression Scale. All participants were screened for cognitive functioning using the Mini-Mental State Examination and Addenbrooke's Cognitive Examination-III. Different cognitive domains were evaluated with different neuropsychological tools: the Rey Auditory Verbal Learning test, Clock Drawing test, Verbal Fluency test, Digit Span Test and Trail Making test. RESULTS: Results: It has been shown that independently associated with MCI ware age (OR = 1.09, 95% CI: 1.05-1.13) and level of education (OR = 0.75, 95% CI: 0.69-0.81). Depending on the age, it turned out that in the younger MCI group, age, education and depression were significant, and the age and level of education were significant in the older MCI group. CONCLUSION: Conclusions: The identification of cognitive dysfunctions is an important element of the diagnostic and therapeutic process.

Global cognitive functioning and physical mobility in older adults with and without mild cognitive impairment: evidence and implications.

INTRODUCTION: Co-occurrence of physical and cognitive dysfunctions contribute to functional decline and a gradual loss of independence. OBJECTIVES: The purpose of this study was to evaluate the association between global cognitive impairment and physical mobility in older adults with and without mild cognitive impairment (MCI). MATERIAL AND METHODS: A total of 800 older adults were recruited (653 with normal cognitive functioning and 147 participants with MCI). Motor performance was measured with the Timed Up and Go test (TUG) and the 6 Minute Walk Test (6MWT). Cognitive functions were evaluated using Mini- Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination (ACE-III). RESULTS: ACE-III scores were associated with the TUG test performance in older adults (with and without MCI), but not with 6MWT results. The overall score in ACE-III and its subscales, i.e. a) memory and fluency in the MCI group and in the total group, and b) fluency in the control group, were associated with TUG after adjusting for age, sex, body mass index, medication use, depressive symptoms, hypertension, coronary artery disease and diabetes. In the case of the 6MWT test results, only the ACE-III fluency subscale scores and not the overall ACE-III score were associated with them. CONCLUSIONS: Global cognitive function, verbal fluency and memory were independently associated with the TUG. ACE-III, being a more extensive testing tool than MMSE, made it possible to show the relationship between global cognition and motor skills.

Slow gait as a motor marker of mild cognitive impairment? the relationships between functional mobility and mild cognitive impairment.

The purpose of this study was to evaluate the association between functional mobility and mild cognitive impairment in older adults. A total of 800 older adults were recruited (653 controls and 147 subjects with MCI [88 subjects with aMCI and 59 subjects with naMCI]). Motor performance was measured with the Timed Up and Go test (TUG). The demographic factors associated with MCI were: age (OR = 1.05; 95% CI: 1.01-1.09) and the level of education (OR = 0.73; 95% CI: 0.68-0.79). An independent clinical factor associated with MCI was the TUG (OR = 1.14; 95% CI: 1.03-1.27). In the aMCI group, the relation between the TUG and cognitive status occurred (OR = 1.15; 95% CI: 1.02-1.31), whereas in the naMCI group this relationship was not observed. There is an association between cognitive dysfunction and impaired motor performance in older adults with MCI.

[The disorders of the musculoskeletal system in patients hospitalized in the geriatric ward].

OBJECTIVE: Introduction: In recent years the interest in the quality of life in old age has been rising, which no doubt is closely linked with the growing population of elderly people. The problems associated with declined functionality of the locomotor system, which naturally occur with age, contribute to increasing morbidity in elderly patients. It is known that lack of exercise can lead to increased aging and disability. Applying the Senior Fitness Test (SFT) allows to explore and assess the patient's mobility. The aim: To evaluate the functioning of the patients hospitalized in the geriatric ward and realize them using the method of the Senior Fitness Test (SFT). PATIENTS AND METHODS: Materials and methods: The study involved 60 elderly subjects, including 30 men and 30 women in four age groups: 75-79, 80-84, 85-89, 90-94. The research was carried out in the Department of Internal Medicine and Geriatrics at the University Hospital in Krakow. Within the group, the functional mobility of patients was assessed by Senior Fitness Test (SFT), that means that the upper-body and the lower-body strength, the upper-body and the lower-body flexibility, cardiovascular endurance and finally the patient's agility and balance were measured by individual tests. RESULTS: Results: In the study group in the assessment of functional capacity, patients usually have difficulties in getting up from a chair, lifting heavy objects, more bending, dressing, lifting hands, moving. The obtained results of all studies assessed activities are significantly deviateng from the correct results. None of the patients did not perform all tests in accordance with the standards laid down for the ages. CONCLUSION: Conclusions: We conclude that in the study population of hospitalized elderly functional ability presents a very unfavorable.

[Improvement of physical and functional fitness in patients hospitalized at a geriatric ward depending on the duration of kinesitherapy].

OBJECTIVE: Introduction: Physical and functional fitness plays the key role in an independent, quality life of patients. Primarily, it prevents deterioration of health and loss of independence. Our degree of physical fitness depends on us and determines our old age life. There has been lots of scientific research into physical and functional fitness and its role in disease prevention and maintaining independence. With physical and functional fitness, older people have the chance to maintain their functional independence and improve quality of life. The aim: To evaluate the effect of duration of kinesitherapy on the improvement of physical and functional fitness in patients hospitalized at a geriatric ward. PATIENTS AND METHODS: Material and methods: The study involved 40 randomly selected, old-age patients hospitalized at a geriatric ward. All the patients took part in the study two times - both before and after kinesitherapy. The study was carried out on the basis of selected elements of comprehensive geriatric assessment. ADL and IADL tests were used for each patient to assess both basic and complex aspects of life functions. To assess physical fitness, SPPB (Short Physical Performance Battery) tests were employed. RESULTS: Results: The results show that the longer of kinesitherapy process, the better improvement of functional and physical fitness. CONCLUSION: Conclusions: The test showed that patients who had underwent kinesitherapeutic intervention for more than four days at the ward had better results. To sum up, it can be concluded that quick implementation of kinesitherapy, thus making the kinesitherapy process longer, significantly improves patients' fitness.

Executive dysfunction in late-life depression. / Dysfunkcje wykonawcze w depresji wieku podeszlego.

OBJECTIVES: Nowadays there are numerous reports stressing the occurrence of cognitive functions disorders in late-life depression (LLD). More and more frequently the studies stress the role of executive dysfunctions in LLD. The purpose of the study was an evaluation of the components of executive functions in non-demented LLD patients, as well as an evaluation of the relation between the individual components of executive functions and the level of depressiveness. METHODS: The study included 87 persons with depression and 100 persons in the control group. For the purpose of a screening evaluation of cognitive functions the Mini-MentalState Examination (MMSE) was applied. For the evaluation of the level of executive functions efficiency the following were chosen: a) Trail Making Test (TMT), b) Verbal Fluency Tests (VFT) and c) go/no-go task (GNG). RESULTS: A significant difference was found in the levels of efficiency of all the components of executive functions in patients with late-life depression. The patients with depression demonstrated the slowest psychomotor speed and worse results in the tests evaluating cognitive flexibility, semantic fluency and inhibition. Statistically significant relation was observed between the higher result in GDS-SF (Geriatric Depression Scale-Short Form) and the worse performance in the GNG test. CONCLUSIONS: The patients with depression demonstrated a significant impairment of executive functions. A relation was found between the cognitive control disorder and the level of depressiveness. Executive dysfunctions can play an important role in the persistence of depressive symptoms. Identification of patients with depression and executive dysfunctions has significant therapeutic implications.

[The relationship between executive functions, physical and functional capability in people over 60 years old].

Introduction: Nowadays it is believed that cognitive decline may contribute to the formation of gait disturbance and increased risk of falls. Currently the importance of executive functions to maintain proper control of gait is emphasized. The aim of the study was to assess the relationship between the level of executive function, functional and physical capability in patients over 60 years of age. Materials and methods: The study included 300 patients (199 women and 101 men) aged 60-88 years. In order to screening for cognitive function Mini-Mental State Examination (MMSE) was used. The following researchers tools were used to conduct functional assessment: a) Short Physical Performance Battery (SPPB), b) Timed "Up and Go" (TUG) and c) Fast Walking Test. To assess executive fucntion Trail Making Test (TMT) was selected. Results: The relationship between the speed of information processing (part A, TMT), executive functions (Part B, TMT), level of functional and physical capability was observed. The strongest positive correlation was noted between the time of TUG test and TMT part B (r=0.32; p<0.01), and also between Fast Gait Test and TMT part A (r=0.27; p<0.01). It has been proven that the level of executive function is related to the level of functional capability (ß=0.18; p=0.001). It was found that 15% of variation in the level of the TUG test was explained by age, TMT- B, GDS and BMI. Conclusions: There is a relationship between level of executive functions, functional and physical capability in patients over 60 years of age. Cognitive processes play an important role in the control of motor functions therefore it is important to incorporate examination of cognitive functions in the early geriatric diagnosis.