Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Nurse Practitioner Screening Practices for Mild Cognitive Impairment in the Older Adult

Abstract Nurse practitioners (NPs/APRNs) who provide primary care services may be the first line providers in situations where adults present with symptoms of memory loss and forgetfulness. Though protocols are available for evaluating dementia, specific guidelines for evaluating early cognitive changes, Mild Cognitive Impairment (MCI), are lacking. This descriptive research project assesses the knowledge, current screening methods, and barriers to screening for MCI by nurse practitioners (APRNs) in the state of Georgia. One hundred and thirty two NPs participated in the survey. Forty-five percent of the participants were unfamiliar with the diagnostic category of MCI. Of the major barriers identified, fifty eight percent of APRNs identified not having enough time, thirty-four percent were unsure of the best screening methods, and twenty percent of participants were unsure of protocols. Using Spearman rho correlation, MCI screening was significantly correlated with completion of continuing education (CEUs) for both MCI (rs = .245, p \u3c .006) and dementia (rs = .243, p \u3c .006). The Spearman’s rho revealed a statistically significant relationship between MCI screening and routinely screening for depression (rs = .478, p \u3c.000). The second stage of this project was to develop practice protocols for MCI. A practitioner panel was recruited from the participants in the initial survey. The protocol and evaluation algorithm is presented and discussed

Physical activity and exercise for the prevention and management of mild cognitive impairment and dementia:A collaborative international guideline

Background: Physical activity and exercise have been suggested as effective interventions for the prevention and management of mild cognitive impairment (MCI) and dementia, but there are no international guidelines. Objectives: To create a set of evidence- and expert consensus-based prevention and management recommendations regarding physical activity (any bodily movement produced by skeletal muscles that results in energy expenditure) and exercise (a subset of physical activity that is planned, structured, repetitive), applicable to a range of individuals from healthy older adults to those with MCI/dementia. Methods: Guideline content was developed with input from several scientific and lay representatives' societies. A systematic search across multidisciplinary databases was carried out until October 2021. Recommendations for prevention and management were developed according to the GRADE and complemented by consensus statements from the expert panels. Recommendations: Physical activity may be considered for the primary prevention of dementia. In people with MCI there is continued uncertainty about the role of physical activity in slowing the conversion to dementia. Mind-body interventions have the greatest supporting evidence. In people with moderate dementia, exercise may be used for maintaining disability and cognition. All these recommendations were based on a very low/low certainty of evidence. Conclusions: Although the scientific evidence on the beneficial role of physical activity and exercise in preserving cognitive functions in subjects with normal cognition, MCI or dementia is inconclusive, this panel, composed of scientific societies and other stakeholders, recommends their implementation based on their beneficial effects on almost all facets of health

Physical activity and exercise for the prevention and management of mild cognitive impairment and dementia: a collaborative international guideline

Background: Physical activity and exercise have been suggested as effective interventions for the prevention and management of mild cognitive impairment (MCI) and dementia, but there are no international guidelines. Objectives: To create a set of evidence- and expert consensus-based prevention and management recommendations regarding physical activity (any bodily movement produced by skeletal muscles that results in energy expenditure) and exercise (a subset of physical activity that is planned, structured, repetitive), applicable to a range of individuals from healthy older adults to those with MCI/dementia. Methods: Guideline content was developed with input from several scientific and lay representatives’ societies. A systematic search across multidisciplinary databases was carried out until October 2021. Recommendations for prevention and management were developed according to the GRADE and complemented by consensus statements from the expert panels. Recommendations: Physical activity may be considered for the primary prevention of dementia. In people with MCI there is continued uncertainty about the role of physical activity in slowing the conversion to dementia. Mind–body interventions have the greatest supporting evidence. In people with moderate dementia, exercise may be used for maintaining disability and cognition. All these recommendations were based on a very low/low certainty of evidence. Conclusions: Although the scientific evidence on the beneficial role of physical activity and exercise in preserving cognitive functions in subjects with normal cognition, MCI or dementia is inconclusive, this panel, composed of scientific societies and other stakeholders, recommends their implementation based on their beneficial effects on almost all facets of health

Physical activity and exercise for the prevention and management of mild cognitive impairment and dementia: a collaborative international guideline

Cognition; Dementia; ExerciseCognició; Demència; ExerciciCognición; Demencia; EjercicioBackground Physical activity and exercise have been suggested as effective interventions for the prevention and management of mild cognitive impairment (MCI) and dementia, but there are no international guidelines. Objectives To create a set of evidence- and expert consensus-based prevention and management recommendations regarding physical activity (any bodily movement produced by skeletal muscles that results in energy expenditure) and exercise (a subset of physical activity that is planned, structured, repetitive), applicable to a range of individuals from healthy older adults to those with MCI/dementia. Methods Guideline content was developed with input from several scientific and lay representatives’ societies. A systematic search across multidisciplinary databases was carried out until October 2021. Recommendations for prevention and management were developed according to the GRADE and complemented by consensus statements from the expert panels. Recommendations Physical activity may be considered for the primary prevention of dementia. In people with MCI there is continued uncertainty about the role of physical activity in slowing the conversion to dementia. Mind–body interventions have the greatest supporting evidence. In people with moderate dementia, exercise may be used for maintaining disability and cognition. All these recommendations were based on a very low/low certainty of evidence. Conclusions Although the scientific evidence on the beneficial role of physical activity and exercise in preserving cognitive functions in subjects with normal cognition, MCI or dementia is inconclusive, this panel, composed of scientific societies and other stakeholders, recommends their implementation based on their beneficial effects on almost all facets of health.Open access funding provided by Università degli Studi di Palermo within the CRUI-CARE Agreement

Validation of a 5-minute VPC Test to Assess and Compare Cognitively Intact Individuals and Individuals with Cognitive Impairments

The prevalence of cognitive impairments in the older adult population is growing. Finding treatment solutions to impede a cognitive decline can possibly lead to fewer cases of mild cognitive impairment, dementia, and Alzheimer’s disease. A Visual Paired Comparison (VPC) could serve as a tool to predict, monitor, and regulate people who are susceptible to a cognitive decline. The purpose of this study was to 1) to determine the validity of the Neurotrack 5-minute VPC test with the Neurotrack 30-minute VPC test, 2) to determine the test-retest reliability of the Neurotrack 5-minute VPC test, 3) to compare Neurotrack 5-minute VPC scores between individuals with cognitive impairment (Mild Cognitive Impairment and/or Alzheimer\u27s Disease) to cognitively intact adults, 4) lastly to compare Neurotrack VPC results with other cognitive tasks (MoCA, NIH toolbox, Dual task) performed within the study. This study included older adults age 60+ split into cognitively intact individuals and cognitively impaired individuals based from the MoCA. Analysis was ran on 28 subject in which 11 were cognitively impaired (mean=.687; Std=.137) and 17 were cognitively intact (mean=.851; Std=.044). The relationship between 5-minute VPC and the 30-minute VPC revealed a positive associations for both the first (r=.504; p=.006) and second (r=.420; p=.019) time points/trials. No significant differences between the 2 time points/trials (p=.212) which indicates a reliable 5-minute VPC test. A significant difference was found between the groups (p=.000). Domain-specific cognitive functions were examined through other assessments, in which the 5-minute VPC test was correlated to each of these tests. This study suggests that VPC to be a potentially reliable tool to assess cognitive function

Balance on the Brain: a randomised controlled trial evaluating the effect of a multimodal exercise programme on physical performance, falls, quality of life and cognition for people with mild cognitive impairment—study protocol

Introduction: Exercise and physical activity have been shown to improve cognition for people living with mild cognitive impairment (MCI). There is strong evidence for the benefits of aerobic exercise and medium evidence for participating in regular strength training for people with MCI. However, people living with MCI fall two times as often as those without cognitive impairment and the evidence is currently unknown as to whether balance training for people with MCI is beneficial, as has been demonstrated for older people without cognitive impairment. The aim of this study is to determine whether a balance-focused multimodal exercise intervention improves balance and reduces falls for people with MCI, compared with a control group receiving usual care. Methods and analysis: This single blind randomised controlled trial (Balance on the Brain) will be offered to 396 people with MCI living in the community. The multimodal exercise intervention consists of two balance programmes and a walking programme to be delivered by physiotherapists over a 6-month intervention period. All participants will be followed up over 12 months (for the intervention group, this involves 6-month intervention and 6-month maintenance). The primary outcomes are (1) balance performance and (2) rate of falls. Physical performance, levels of physical activity and sedentary behaviour, quality of life and cognition are secondary outcomes. A health economic analysis will be undertaken to evaluate the cost-effectiveness of the intervention compared with usual care. Ethics and dissemination: Ethics approval has been received from the South Metropolitan Health Service Human Research Ethics Committee (HREC), Curtin University HREC and the Western Australia Department of Health HREC; and approval has been received to obtain data for health costings from Services Australia. The results will be disseminated through peer-review publications, conference presentations and online platforms

Balance on the Brain: a randomised controlled trial evaluating the effect of a multimodal exercise programme on physical performance, falls, quality of life and cognition for people with mild cognitive impairment—study protocol

This project is funded by the National Health and Medical Research Council (NHMRC) (Investigator Grant--APP1174739) and Curtin University.Introduction Exercise and physical activity have been shown to improve cognition for people living with mild cognitive impairment (MCI). There is strong evidence for the benefits of aerobic exercise and medium evidence for participating in regular strength training for people with MCI. However, people living with MCI fall two times as often as those without cognitive impairment and the evidence is currently unknown as to whether balance training for people with MCI is beneficial, as has been demonstrated for older people without cognitive impairment. The aim of this study is to determine whether a balance-focused multimodal exercise intervention improves balance and reduces falls for people with MCI, compared with a control group receiving usual care. Methods and analysis This single blind randomised controlled trial (Balance on the Brain) will be offered to 396 people with MCI living in the community. The multimodal exercise intervention consists of two balance programmes and a walking programme to be delivered by physiotherapists over a 6-month intervention period. All participants will be followed up over 12 months (for the intervention group, this involves 6-month intervention and 6-month maintenance). The primary outcomes are (1) balance performance and (2) rate of falls. Physical performance, levels of physical activity and sedentary behaviour, quality of life and cognition are secondary outcomes. A health economic analysis will be undertaken to evaluate the cost-effectiveness of the intervention compared with usual care. Ethics and dissemination Ethics approval has been received from the South Metropolitan Health Service Human Research Ethics Committee (HREC), Curtin University HREC and the Western Australia Department of Health HREC; and approval has been received to obtain data for health costings from Services Australia. The results will be disseminated through peer-review publications, conference presentations and online platforms.National Health and Medical Research Council (NHMRC) of Australia APP1174739Curtin Universit