Possible neurocognitive benefits of exercise in persons with heart failure

Connection between Lifestyle and Life Satisfaction of Older Adults in Relation to the Living Environment

BACKGROUND: Physical activity, healthy diet and avoiding risk factors are essential for a healthy lifestyle of older adults and for their life satisfaction. AIM: The aim of the research was to determine the connection between lifestyle and life satisfaction of older adults in relation to the living environment (home environment, institutional environment). METHODS: The research was based on a non-experimental quantitative research approach. We used the Oldwellactive standardised questionnaire to obtain lifestyle data and the SWLS scale to determine life satisfaction. The study included 656 older adults with an average age of 78.2 years who lived in a domestic (n = 380) and institutional environment (276). RESULTS: Older adults living in the home environment rate their lifestyle higher (AV = 2.38, SD = 0.77) than those in the institutional environment (AV = 2.31, SD = 0.88), the difference is not statistically significant p = 0.304). Eating habits with regard to the location of residence showed statistically significant differences in the consumption of meat, fish and fish products and milk and dairy products (p <0.001). In the institutional environment, older adults are more likely to perform balance-enhancing exercises, while they consume more alcohol in the home environment. By assessing conditional associations, we establish a positive association between life satisfaction and lifestyle (estimated value = 21,600, p = 0,000). Older adults living in the institutional environment are more satisfied with life (v= 23,097) than those living in the home environment (N= 21.774). CONCLUSION: The satisfaction of older adults with their life increases if an individual’s lifestyle improves. Older adults living in the institutional environment are more satisfied with life than those living in the home environment. In the future, it will be necessary to pay more attention to the study of living in a home environment, in accordance with the strategy of long-term care for the older adults.

Cognition, Physical Function, and Quality of Life in Older Patients With Acute Decompensated Heart Failure

BACKGROUND

Older adults with acute decompensated heart failure have persistently poor clinical outcomes. Cognitive impairment (CI) may be a contributing factor. However, the prevalence of CI and the relationship of cognition with other patient-centered factors such a physical function and quality of life (QOL) that also may contribute to poor outcomes are incompletely understood.

METHODS AND RESULTS

Older (≥60 years) hospitalized patients with acute decompensated heart failure were assessed for cognition (Montreal Cognitive Assessment [MoCA]), physical function (Short Physical Performance Battery [SPPB], 6-minute walk distance [6MWD]), and QOL (Kansas City Cardiomyopathy Questionnaire, Short Form-12). Among patients (N = 198, 72.1 ± 7.6 years), 78% screened positive for CI (MoCA of <26) despite rare medical record documentation (2%). Participants also had severely diminished physical function (SPPB 6.0 ± 2.5 units, 6MWD 186 ± 100 m) and QOL (scores of <50). MoCA positively related to SPPB (ß = 0.47, P < .001), 6MWD ß = 0.01, P = .006) and inversely related to Kansas City Cardiomyopathy Questionnaire Overall Score (ß = -0.05, P < .002) and Short Form-12 Physical Component Score (ß = -0.09, P = .006). MoCA was a small but significant predictor of the results on the SPPB, 6MWD, and Kansas City Cardiomyopathy Questionnaire.

CONCLUSIONS

Among older hospitalized patients with acute decompensated heart failure, CI is highly prevalent, is underrecognized clinically, and is associated with severe physical dysfunction and poor QOL. Formal screening may reduce adverse events by identifying patients who may require more tailored care.

Cognitive Deficit in Heart Failure and the Benefits of Aerobic Physical Activity

Heart Failure is a clinical syndrome prevalent throughout the world and a major contribution to mortality of cardiac patients in Brazil. In addition, this pathology is strongly related to cerebral dysfunction, with a high prevalence of cognitive impairment. Many mechanisms may be related to cognitive loss, such as cerebral hypoperfusion, atrophy and loss of gray matter of the brain, and dysfunction of the autonomic nervous system. The literature is clear regarding the benefits of aerobic physical activity in healthy populations in the modulation of the autonomic nervous system and in brain functions. Studies have shown that in the population of patients with heart failure, exercise is associated with an improvement in cognitive function, as well as in cardiac autonomic regulation. However, little emphasis has been given to the mechanisms by which aerobic physical activity can benefit brain functioning, the autonomic nervous system and result in better cognitive performance, particularly in patients with heart failure. Therefore, the present work presents the ways in which brain areas responsible for cognition also act in the modulation of the autonomic nervous system, and emphasizes its importance for the understanding of cognitive impairment in relation to the pathophysiology of heart failure. It is also described the way in which aerobic physical activity can promote benefits when it is integrated into the therapy, associated to a better prognosis of the clinical picture of these patients.

Improving cerebral oxygenation, cognition and autonomic nervous system control of a chronic alcohol abuser through a three-month running program

The abusive use of alcohol has shown to be associated to cerebral damage, impaired cognition, poor autonomic nervous control, impaired cardiovascular health, increased levels of stress and anxiety, depression symptoms and poor quality of life. Aerobic exercise has shown to be an efficient tool to reduce and overcome these issues. In this case report, a patient (forty-four years old, male) under treatment in public psychiatric hospital, classified as having a substance use disorder, underwent a three-month running program. The maximal oxygen consumption increased from 24.2 ml/kg/min to 30.1 ml/kg/min, running time increased from 6 min to 45 min (650%) and distance covered from 765 m to 8700 m (1037.2%). In prefrontal cortex oxygenation, oxyhemoglobin levels improved by 76.1%, deoxyhemoglobin decreased 96.9% and total hemoglobin increased 78.8% during exercise. Reaction time in the cognitive test during rest decreased 23%, and the number of correct answers increased by 266.6%. Parasympathetic cardiac parameters increased in several heart rate variability indices. Thus, we conclude that running exercise performed by an alcoholic patient hospitalized in a psychiatric hospital improves cerebral function, cognition and cardiovascular health.

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The subject improved the maximum consumption of oxygen.

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The subject increased the prefrontal cortex oxygenation, cognition and parasympathetic control.

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The subject decreased the need of intervention.

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First study to show long-term effects of exercise in the brain hemodynamics of an alcoholic