Cognitive and gait in Wilson's disease: a cognitive and motor dual-task study

Effects of exercise-cognitive dual-task training on elderly patients with cognitive frailty and depression

BACKGROUND

Cognitive frailty and depression are prevalent among the elderly, significantly impairing physical and cognitive functions, psychological well-being, and quality of life. Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.

AIM

To evaluate the effects of exercise-cognitive dual-task training on frailty, cognitive function, psychological status, and quality of life in elderly patients with cognitive frailty and depression.

METHODS

A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023. Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care. Frailty, cognitive function, balance and gait, psychological status, and quality of life were assessed before and after the intervention.

RESULTS

After the intervention, the frailty score of the observation group was (5.32 ± 0.69), lower than that of the control group (5.71 ± 0.55). The Montreal cognitive assessment basic scale score in the observation group was (24.06 ± 0.99), higher than the control group (23.43 ± 1.40). The performance oriented mobility assessment score in the observation group was (21.81 ± 1.24), higher than the control group (21.15 ± 1.26). The self-efficacy in the observation group was (28.27 ± 2.66), higher than the control group (30.05 ± 2.66). The anxiety score in the hospital anxiety and depression scale (HADS) for the observation group was (5.86 ± 0.68), lower than the control group (6.21 ± 0.64). The depression score in the HADS for the observation group was (5.67 ± 0.75), lower than the control group (6.27 ± 0.92). Additionally, the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group, with statistically significant differences (P < 0.05).

CONCLUSION

Exercise-cognitive dual-task training is beneficial for improving frailty, enhancing cognitive function, and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.

The cost implications of Wilson disease among hospitalized patients: analysis of USA hospitals

BACKGROUND AND AIM

In this study, we used a national cohort of patients with Wilson's disease (WD) to investigate the admissions, mortality rates, and costs over the captured period to assess specific subpopulations at higher burden.

METHODS

Patients with WD were selected using 2016-2019 National Inpatient Sample (NIS). The weighted estimates and patient data were stratified using demographics and medical characteristics. Regression curves were graphed to derive goodness-of-fit for each trend from which R2 and P values were calculated.

RESULTS

Annual total admissions per 100 000 hospitalizations due to WD were 1075, 1180, 1140, and 1330 ( R2  = 0.75; P  = 0.13) from 2016 to 2019. Within the demographics, there was an increase in admissions among patients greater than 65 years of age ( R2  = 0.90; P  = 0.05) and White patients ( R2  = 0.97; P  = 0.02). Assessing WD-related mortality rates, there was an increase in the mortality rate among those in the first quartile of income ( R2  = 1.00; P  < 0.001). The total cost for WD-related hospitalizations was $20.90, $27.23, $24.20, and $27.25 million US dollars for the years 2016, 2017, 2018, and 2019, respectively ( R2  = 0.47; P  = 0.32). There was an increasing total cost trend for Asian or Pacific Islander patients ( R2  = 0.90; P  = 0.05). Interestingly, patients with cirrhosis demonstrated a decreased trend in the total costs ( R2  = 0.97; P  = 0.02).

CONCLUSION

Our study demonstrated that certain ethnicity groups, income classes and comorbidities had increased admissions or costs among patients admitted with WD.