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Roman de Mettelinge T, Calders P, Cambier D. The Effects of Aerobic Exercise in Patients with Early-Onset Dementia: A Scoping Review. Dement Geriatr Cogn Disord 2021; 50:9-16. [PMID: 33957623 DOI: 10.1159/000516231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/30/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early-onset dementia (EOD) defines all dementia related conditions with an onset before the age of 65 years. EOD places a large and distressing psychological, emotional and financial burden on the individuals themselves and their caregivers. For various reasons, diagnostic and treatment strategies for EOD are very challenging. There is a general agreement that not only the human body but also the mind benefits from physical activity and/or exercise. Especially aerobic exercise has shown to have favorable effects on cognitive functions in healthy older adults, as well as in patients with MCI and dementia. However, there are major differences in age, physical fitness level and clinical presentation between EOD and late-onset dementia. Therefore, one cannot just assume that the same type and intensity of exercise will lead to similar effects in the former population. By conducting this scoping review, the authors aimed to identify the evidence on the effectiveness of aerobic exercise on physical and mental health outcomes in individuals with EOD, display gaps in this context, and formulate related directions for future research. SUMMARY There are a number of reasons to assume that aerobic exercise might be extremely valuable within individuals with EOD. However, this scoping review led to the surprising and striking finding that not a single study so far has investigated the effects of physical exercise on cognition, physical performance and feelings of well-being and quality of life in EOD. Although nowadays the disease is increasingly recognized, coping and (non-pharmacological) treatment strategies for EOD are virtually non-existent. Key Messages: Exercise intervention studies in EOD are lacking. With this scoping review the authors hope to inspire researchers in the field for related directions for future research. The potential beneficial effects of aerobic exercise in individuals with EOD should be explored and assessed extensively. Secondarily, decent guidelines for non-pharmacological treatment and coping strategies should be developed, with the aim of supporting people with EOD and their caregivers.
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Affiliation(s)
- Tine Roman de Mettelinge
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dirk Cambier
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Hartman SJ, Weiner LS, Natarajan L, Sears DD, Palmer BW, Parker B, Ahles T, Irwin ML, Au K. A randomized trial of physical activity for cognitive functioning in breast cancer survivors: Rationale and study design of I Can! Improving Cognition After Cancer. Contemp Clin Trials 2021; 102:106289. [PMID: 33503496 PMCID: PMC8009833 DOI: 10.1016/j.cct.2021.106289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/11/2020] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Difficulties with cognition are extremely common among breast cancer survivors and can significantly impact quality of life, daily functioning, and ability to return to work. One promising intervention is increasing physical activity, as it has been effective in improving cognition in non-cancer populations. Few physical activity intervention trials with cognition outcomes have included cancer survivors. This project builds upon our previous work indicating that increased physical activity can improve objectively measured processing speed and self-reported cognition among breast cancer survivors. METHODS The I Can! study will examine whether a physical activity intervention improves cognition among 250 post-treatment breast cancer survivors (Stages I-III, <5 years post-treatment) who are reporting cognitive difficulties. This 2-arm randomized controlled trial comparing a 6-month physical activity intervention (Exercise Group) to a health & wellness attention-comparison condition (Health & Wellness Group) will examine intervention effects on cognition (at 3 and 6 months) and maintenance of effects at 12 months. The primary aim is to investigate the impact of exercise on objectively measured processing speed and self-reported cognition. Secondary aims are to investigate maintenance of cognitive changes and examine candidate biological mechanisms and psychological mediators. CONCLUSION The I Can! study will contribute to the scientific, public health, and survivorship intervention literature by providing new information on the impact of physical activity for cognitive impairment in breast cancer survivors. Findings from this study will inform guidelines for physical activity to improve the lives of millions of breast cancer survivors.
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Affiliation(s)
- Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA.
| | - Lauren S Weiner
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Dorothy D Sears
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA; Department of Medicine, UC San Diego, La Jolla, CA, USA; College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Barton W Palmer
- Department of Psychiatry, UC San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Barbara Parker
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA; Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Tim Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Kaylene Au
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
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Metcalfe A, Jones B, Mayer J, Gage H, Oyebode J, Boucault S, Aloui S, Schwertel U, Böhm M, Tezenas du Montcel S, Lebbah S, De Mendonça A, De Vugt M, Graff C, Jansen S, Hergueta T, Dubois B, Kurz A. Online information and support for carers of people with young-onset dementia: A multi-site randomised controlled pilot study. Int J Geriatr Psychiatry 2019; 34:1455-1464. [PMID: 31111516 DOI: 10.1002/gps.5154] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/04/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The European RHAPSODY project sought to develop and test an online information and support programme for caregivers of individuals diagnosed with young onset dementia. The objectives were to assess user acceptability and satisfaction with the programme and to test outcome measures for a larger effectiveness study. DESIGN A pilot randomised controlled trial in England, France, and Germany was conducted with 61 caregivers for adults with young onset Alzheimer's disease or frontotemporal degeneration. Evaluations at baseline, week 6, and week 12 assessed user acceptability and satisfaction. Use of the programme was measured from online back-end data. Qualitative feedback on user experiences was collected via semi-structured interviews. Measures of caregiver well-being (self-efficacy, stress, burden, frequency of patient symptoms, and caregiver reactions) were explored for use in a subsequent trial. RESULTS Participants logged in online on average once a week over a 6-week period, consulting approximately 31% of programme content. Seventy percent of participants described the programme as useful and easy to use. Eighty-five percent expressed intent to use the resource in the future. Reductions in reported levels of stress and caregivers' negative reactions to memory symptoms were observed following use of the programme. CONCLUSIONS Results indicated that the RHAPSODY programme was acceptable and useful to caregivers. The programme may be complementary to existing services in responding to the specific needs of families affected by young onset dementia. Distribution of the programme is underway in England, France, Germany, and Portugal.
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Affiliation(s)
- Anna Metcalfe
- Hôpital de la Pitié-Salpêtrière, Sorbonne University, Assistance Publique - Hôpitaux de Paris AP-HP, Paris, France
| | - Bridget Jones
- Surrey Health Economics Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK
| | - Johannes Mayer
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Heather Gage
- Surrey Health Economics Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK
| | - Jan Oyebode
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Sarah Boucault
- Hôpital de la Pitié-Salpêtrière, Sorbonne University, Assistance Publique - Hôpitaux de Paris AP-HP, Paris, France
| | - Sabrina Aloui
- Hôpital de la Pitié-Salpêtrière, Sorbonne University, Assistance Publique - Hôpitaux de Paris AP-HP, Paris, France
| | - Uta Schwertel
- IMC, Information Multimedia Communication AG, Saarbrücken, Germany
| | - Markus Böhm
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sophie Tezenas du Montcel
- Sorbonne Universités, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Said Lebbah
- Hôpital de la Pitié-Salpêtrière, Sorbonne University, Assistance Publique - Hôpitaux de Paris AP-HP, Paris, France
| | | | - Marjolein De Vugt
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Caroline Graff
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Bioclinicum J10:20, Solna, Sweden.,Karolinska University Hospital, Theme Aging, Unit for Hereditary Dementias, Solna, Sweden
| | | | - Thierry Hergueta
- Hôpital de la Pitié-Salpêtrière, Sorbonne University, Assistance Publique - Hôpitaux de Paris AP-HP, Paris, France.,Laboratoire de Psychopathologie et Processus de Santé, Institut de Psychologie Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Bruno Dubois
- Hôpital de la Pitié-Salpêtrière, Sorbonne University, Assistance Publique - Hôpitaux de Paris AP-HP, Paris, France
| | - Alexander Kurz
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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RHAPSODY - Internet-based support for caregivers of people with young onset dementia: program design and methods of a pilot study. Int Psychogeriatr 2016; 28:2091-2099. [PMID: 27572272 DOI: 10.1017/s1041610216001186] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Young Onset Dementia (YOD), defined by first symptoms of cognitive or behavioral decline occurring before the age of 65 years, is relatively rare compared to dementia of later onset, but it is associated with diagnostic difficulty and heavy burden on affected individuals and their informal carers. Existing health and social care structures rarely meet the needs of YOD patients. Internet-based interventions are a novel format of delivering health-related education, counseling, and support to this vulnerable yet underserved group. METHODS The RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young) project is a European initiative to improve care for people with YOD by providing an internet-based information and skill-building program for family carers. The e-learning program focuses on managing problem behaviors, dealing with role change, obtaining support, and looking after oneself. It will be evaluated in a pilot study in three countries using a randomized unblinded design with a wait-list control group. Participants will be informal carers of people with dementia in Alzheimer's disease or behavioral-variant Frontotemporal degeneration with an onset before the age of 65 years. The primary outcome will be caregiving self-efficacy after 6 weeks of program use. As secondary outcomes, caregivers' stress and burden, carer health-related quality of life, caring-related knowledge, patient problem behaviors, and user satisfaction will be assessed. Program utilization will be monitored and a health-economic evaluation will also be performed. CONCLUSIONS The RHAPSODY project will add to the evidence on the potential and limitations of a conveniently accessible, user-friendly, and comprehensive internet-based intervention as an alternative for traditional forms of counseling and support in healthcare, aiming to optimize care and support for people with YOD and their informal caregivers.
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Lee YY, Wu CY, Teng CH, Hsu WC, Chang KC, Chen P. Evolving methods to combine cognitive and physical training for individuals with mild cognitive impairment: study protocol for a randomized controlled study. Trials 2016; 17:526. [PMID: 27793183 PMCID: PMC5084379 DOI: 10.1186/s13063-016-1650-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/08/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Nonpharmacologic interventions, such as cognitive training or physical exercise, are effective in improving cognitive functions for older adults with mild cognitive impairment (MCI). Some researchers have proposed that combining physical exercise with cognitive training may augment the benefits of cognition. However, strong evidence is lacking regarding whether a combined therapy is superior to a single type of training for older adults with MCI. Moreover, which combination approach - combining physical exercise with cognitive training sequentially or simultaneously - is more advantageous for cognitive improvement is not yet clear. This proposed study is designed to clarify these questions. METHODS/DESIGN This study is a single-blinded, multicenter, randomized controlled trial. Eighty individuals with MCI will be recruited and randomly assigned to cognitive training (COG), physical exercise training (PE), sequential training (SEQ), and dual-task training (DUAL) groups. The intervention programs will be 90 min/day, 2-3 days/week, for a total of 36 training sessions. The participants in the SEQ group will first perform 45 min of physical exercise followed by 45 min of cognitive training, whereas those in the DUAL group will perform physical exercise and cognitive training simultaneously. Participants will be assessed at baseline, after the intervention, and at 6-month follow-up. The primary cognitive outcome tests will include the Montreal Cognitive Assessment and the color-naming Stroop test. Other outcomes will include assessments that evaluate the cognitive, physical, and daily functions of older adults with MCI. DISCUSSION The results of this proposed study will provide important information regarding the feasibility and intervention effects of combining physical exercise and cognitive training for older individuals with MCI. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02512627 , registered on 20 July 2015.
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Affiliation(s)
- Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, 259 Wenhua 1st Rd, Taoyuan, 333, Taiwan. .,Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan. .,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
| | - Ching-Hung Teng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, 259 Wenhua 1st Rd, Taoyuan, 333, Taiwan
| | - Wen-Chuin Hsu
- Department of Neurology and Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ku-Chou Chang
- Division of Cerebrovascular Diseases, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Poyu Chen
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, 259 Wenhua 1st Rd, Taoyuan, 333, Taiwan
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Ibarria M, Alegret M, Valero S, Morera A, Guitart M, Cañabate P, Moreno M, Lara S, Diego S, Hernández J, Tantinyà N, Vera M, Hernández I, Becker JT, Ruíz A, Boada M, Tárraga L. Beneficial Effects of an Integrated Psychostimulation Program in Patients with Alzheimer's Disease. J Alzheimers Dis 2016; 50:559-66. [PMID: 26757182 PMCID: PMC4745126 DOI: 10.3233/jad-150455] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The existing pharmacological treatments for Alzheimer's disease (AD) can only slow the progression of symptoms or delay admission to long-term care facilities. The beneficial effects of non-drug treatments are poorly studied. OBJECTIVE To describe the effects of an Integrated Psychostimulation Program (IPP) in patients with mild-moderate AD treated with acetylcholinesterase inhibitors; and to identify factors related to greater benefit of the IPP. METHODS 206 patients (mean age = 75.9 years; MMSE = 19.6) were evaluated before starting the IPP and 3, 6, 9, and 12 months later. Measures included: Mini-Mental State Examination (MMSE), Cognitive Subscale of Alzheimer's Disease Assessment Scale (ADAS-Cog), Rapid Disability Rating Scale (RDRS-2), and Neuropsychiatric Inventory Questionnaire (NPI-Q). RESULTS Patients remained cognitively stable (MMSE/ADAS-Cog) for more than 6 months and significantly worsened at 9-month and 12-month follow-ups, without clinically significant functional changes (RDRS-2) or psychiatric symptoms(NPI-Q). The mean annual change on MMSE and ADAS-Cog were 2.06 and 3.56 points, respectively, lower than the annual decline demonstrated previously in similar patients (2.4 and 4.5, respectively). 42.7% of patients maintained or improved global cognitive scores between baseline and 12-month follow-up. The patients who maintained cognitive functions were older than those who did not (77.5 versus 74.7 years). CONCLUSIONS The IPP may be an effective treatment to maintain cognition, functionality, and psychiatric symptoms in AD patients pharmacologically treated, and older age seems to increase beneficial effects of IPP.
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Affiliation(s)
- Marta Ibarria
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Montserrat Alegret
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Sergi Valero
- Department of Psychiatry. Hospital Universitari Vall d’Hebron. Universitat Autònoma de Barcelona, Spain
- Hospital Universitari Vall d’Hebron -Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Spain
| | - Amèrica Morera
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
| | - Marina Guitart
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
| | - Pilar Cañabate
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Mariola Moreno
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Susana Lara
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
| | - Susana Diego
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Joan Hernández
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
| | - Natàlia Tantinyà
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
| | - Maribel Vera
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
| | - Isabel Hernández
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - James T. Becker
- Department of Psychiatry. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Agustín Ruíz
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Mercè Boada
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
| | - Lluís Tárraga
- Alzheimer Center Educational. Day Care Centers of Fundació ACE. Barcelona. Spain
- Memory Clinic of Fundació ACE. Institut Català de Neurociències Aplicades. Barcelona, Spain
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Abstract
BACKGROUND A substantial part of elderly persons with dementia show rest-activity rhythm disturbances. The rest-activity rhythm is important to study in people with early-onset dementia (EOD) for rest-activity rhythm disturbances are predictive of institutionalization, and caregivers of young patients suffer from high distress. OBJECTIVE The aim of this study was to study (1) whether EOD patients have more rest-activity rhythm disturbances compared with cognitively intact adults; and (2) which factors contribute to a disturbed rhythm. METHODS We included 61 patients with EOD [mean age 61.9 (4.9) y, 41 (67%) men] and 68 cognitively intact adults [mean age 61.6 (4.5) y, 28 (41%) men]. Rest-activity rhythm was assessed by actigraphy. RESULTS EOD patients tended to have higher intradaily variability [0.46 (0.16) and 0.39 (0.10), P=0.03]. EOD patients also lay for a longer time in bed [time in bed: 08:49 (0:51) h and 08:07 (0:47) h, P<0.001] and needed more time to fall asleep [sleep onset latency: 23 (22) min and 15 (15) min, P=0.02]. Disturbances in the rest-activity rhythm were predicted by a low level of physical activity, use of antidepressants and central nervous system neurological medications, and being male. CONCLUSIONS EOD patients showed more variability in the rest-activity rhythm compared with cognitively intact adults. The main predictor for rest-activity rhythm disturbances was a low level of physical activity.
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Boecker H, Drzezga A. A perspective on the future role of brain pet imaging in exercise science. Neuroimage 2015; 131:73-80. [PMID: 26477649 DOI: 10.1016/j.neuroimage.2015.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/08/2015] [Accepted: 10/08/2015] [Indexed: 12/20/2022] Open
Abstract
Positron Emission Tomography (PET) bears a unique potential for examining the effects of physical exercise (acute or chronic) within the central nervous system in vivo, including cerebral metabolism, neuroreceptor occupancy, and neurotransmission. However, application of Neuro-PET in human exercise science is as yet surprisingly sparse. To date the field has been dominated by non-invasive neuroelectrical techniques (EEG, MEG) and structural/functional magnetic resonance imaging (sMRI/fMRI). Despite PET having certain inherent disadvantages, in particular radiation exposure and high costs limiting applicability at large scale, certain research questions in human exercise science can exclusively be addressed with PET: The "metabolic trapping" properties of (18)F-FDG PET as the most commonly used PET-tracer allow examining the neuronal mechanisms underlying various forms of acute exercise in a rather unconstrained manner, i.e. under realistic training scenarios outside the scanner environment. Beyond acute effects, (18)F-FDG PET measurements under resting conditions have a strong prospective for unraveling the influence of regular physical activity on neuronal integrity and potentially neuroprotective mechanisms in vivo, which is of special interest for aging and dementia research. Quantification of cerebral glucose metabolism may allow determining the metabolic effects of exercise interventions in the entire human brain and relating the regional cerebral rate of glucose metabolism (rCMRglc) with behavioral, neuropsychological, and physiological measures. Apart from FDG-PET, particularly interesting applications comprise PET ligand studies that focus on dopaminergic and opioidergic neurotransmission, both key transmitter systems for exercise-related psychophysiological effects, including mood changes, reward processing, antinociception, and in its most extreme form 'exercise dependence'. PET ligand displacement approaches even allow quantifying specific endogenous neurotransmitter release under acute exercise interventions, to which modern PET/MR hybrid technology will be additionally fruitful. Experimental studies exploiting the unprecedented multimodal imaging capacities of PET/MR in human exercise sciences are as yet pending.
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Affiliation(s)
- Henning Boecker
- Functional Neuroimaging Group, Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany, German Center for Neurodegenerative Diseases (DZNE), Cologne, Germany.
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Hartman SJ, Natarajan L, Palmer BW, Parker B, Patterson RE, Sears DD. Impact of increasing physical activity on cognitive functioning in breast cancer survivors: Rationale and study design of Memory & Motion. Contemp Clin Trials 2015; 45:371-376. [PMID: 26427563 DOI: 10.1016/j.cct.2015.09.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/21/2015] [Accepted: 09/27/2015] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Many breast cancer survivors experience problems with cognitive functioning that can persist years after treatment. Increasing physical activity has been shown to improve cognitive functioning in healthy and cognitively impaired adults, but has not yet been tested in cancer survivors. The primary aim of this randomized controlled trial is to examine the effects of a 3-month physical activity intervention compared to a waitlist Control arm on neuropsychological outcomes and subjective cognitive concerns in breast cancer survivors. METHODS Eighty sedentary breast cancer survivors, self-reporting difficulties with cognition, will be randomized into an Exercise arm or Control arm. The Exercise arm includes an activity tracker (i.e., a Fitbit), phone calls, plus tailored and non-tailored email content. The Control arm will receive emails on women's health topics on the same schedule as the Exercise arm. Assessments conducted at baseline and 3 months include: neuropsychological testing, cognitive concerns and other aspects of quality of life, and 7 days of a hip-worn accelerometer. Participants will also provide fasting blood draws to assess brain-derived neurotropic factor, Insulin-like growth factor 1, insulin resistance, and C-reactive protein. Primary and secondary outcomes are changes in neuropsychological testing and cognitive concerns. Biomarkers will be examined to further understand the underlying relationship between physical activity and cognition. CONCLUSION The Memory & Motion study is designed to test whether increasing physical activity can improve cognitive functioning in breast cancer survivors. Results from this study could be used to guide development of interventions to improve cognitive functioning in breast cancer survivors.
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Affiliation(s)
- Sheri J Hartman
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA.
| | - Loki Natarajan
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Barton W Palmer
- Department of Psychiatry, UC San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Barbara Parker
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Ruth E Patterson
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Dorothy D Sears
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA; Department of Medicine, UC San Diego, La Jolla, CA, USA
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Pillai JA, Bonner-Jackson A. Review of information and communication technology devices for monitoring functional and cognitive decline in Alzheimer's disease clinical trials. JOURNAL OF HEALTHCARE ENGINEERING 2015; 6:71-83. [PMID: 25708378 DOI: 10.1260/2040-2295.6.1.71] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Detecting and monitoring early cognitive impairment in Alzheimer's disease (AD) is a significant need in the field of AD therapeutics. Successful AD clinical trial designs have to overcome challenges related to the subtle nature of early cognitive changes. Continuous unobtrusive assessments using Information and Communication Technology (ICT) devices to capture markers of intra-individual change over time to assess cognitive and functional disability therefore offers significant benefits. We review the literature and provide an overview on randomized clinical trials in AD that use intelligent systems to monitor functional decline, as well as strengths, weaknesses, and future directions for the use of ICTs in a new generation of AD clinical trials.
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Affiliation(s)
- Jagan A Pillai
- Department of Neurology and Lou Ruvo Center, Brain Health Cleveland Clinic, Cleveland, OH, USA
| | - Aaron Bonner-Jackson
- Department of Neurology and Lou Ruvo Center, Brain Health Cleveland Clinic, Cleveland, OH, USA
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Haywood C, Proietto J. Management of Obesity in Older People. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2013. [DOI: 10.1002/j.2055-2335.2013.tb00240.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Cilla Haywood
- Northern Health, Consultant Physician, Weight Control Clinic, Austin Health, Metabolic Disorders Unit, Department of Medicine; University of Melbourne
| | - Joe Proietto
- Metabolic Disorders Unit, Department of Medicine; University of Melbourne, Heidelberg Repatriation Hospital; Heidelberg Victoria
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12
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Robert PH, Konig A, Andrieu S, Bremond F, Chemin I, Chung PC, Dartigues JF, Dubois B, Feutren G, Guillemaud R, Kenisberg PA, Nave S, Vellas B, Verhey F, Yesavage J, Mallea P. Recommendations for ICT use in Alzheimer's disease assessment: Monaco CTAD Expert Meeting. J Nutr Health Aging 2013; 17:653-60. [PMID: 24097018 DOI: 10.1007/s12603-013-0046-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alzheimer disease (AD) and other related dementia represent a major challenge for health care systems within the aging population. It is therefore important to develop better instruments for assessing disease severity and disease progression to optimize patient's care and support to care providers, and also provide better tools for clinical research. In this area, Information and Communication Technologies (ICT) are of particular interest. Such techniques enable accurate and standardized assessments of patients' performance and actions in real time and real life situations. The aim of this article is to provide basic recommendation concerning the development and the use of ICT for Alzheimer's disease and related disorders. During he ICT and Mental Health workshop (CTAD meeting held in Monaco on the 30th October 2012) an expert panel was set up to prepare the first recommendations for the use of ICT in dementia research. The expert panel included geriatrician, epidemiologist, neurologist, psychiatrist, psychologist, ICT engineers, representatives from the industry and patient association. The recommendations are divided into three sections corresponding to 1/ the clinical targets of interest for the use of ICT, 2/ the conditions, the type of sensors and the outputs (scores) that could be used and obtained, 3/ finally the last section concerns specifically the use of ICT within clinical trials.
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Affiliation(s)
- P H Robert
- Pr Philippe. H. Robert, EA CoBTek - Centre Mémoire de Ressources et de Recherche, Pavillon Mossa, Hôpital de Cimiez 4 av Victoria 06000 - Nice France, E mail:
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