Empower to Enrich the Elderly Program: For Vulnerable Older Adults in Nigeria

Background: The process of ageing involves a combination of biological, psychological, and social factors. The rising proportion of older adults and increase in life expectancy have increased interest in maintaining and promoting cognitive health in later life. Participation in cognitively stimulating activities has been considered to maintain or strengthen cognitive skills, thereby reducing age-related cognitive decline. An important aspect of healthy ageing is the promotion of good mental health and well-being in later life. Objective: The aim of the study was to examine how older adults’ empowerment improve cognition, mental and physical well-being in the community. Methodology: A sample of 20 purposively selected older adults in the community were empowered in their different vocation of choice. Data was collected via in-depth interview and observations. An interpretive-descriptive analysis was used to facilitate data analysis. Results: The associated benefits of empowerment of older adults to improve their cognition emerged into five themes: quality of life; increased physical function; social interaction; socio-economic effect; and mental stability. Conclusion: Empowerment-based programs should be provided for older people in the society for them to take advantage of the opportunities to feel safe, supported and optimistic about life and its possibilities

Polyphenol Content and Modulatory Activities of Some Tropical Dietary Plant Extracts on the Oxidant Activities of Neutrophils and Myeloperoxidase

Young leaves of Manihot esculenta Crantz (Euphorbiaceae), Abelmoschus esculentus (Malvaceae), Hibiscus acetosella (Malvaceae) and Pteridium aquilinum (Dennstaedtiaceae) are currently consumed as green vegetables by peoples in sub-Saharan Africa, Latin America, Asia and their migrants living in Western Europe. Sub-Saharan peoples use Manihot, Abelmoschus and Hibiscus also in the folk medicine to alleviate fever and pain, in the treatment of conjunctivitis, rheumatism, hemorrhoid, abscesses, ... The present study investigates the effects of aqueous extracts of those plants on the production of reactive oxygen species (ROS) and the release of myeloperoxidase (MPO) by equine neutrophils activated with phorbol 12-myristate 13-acetate (PMA). The ROS production was measured by lucigenin-enhanced chemiluminescence (CL), and the release of total MPO by an ELISA method. The study also investigates the effect of the extracts on the activity of MPO by studying its nitration activity on tyrosine and by using a new technique called SIEFED (Specific Immunological Extraction Followed by Enzymatic Detection) that allows studying the direct interaction of compounds with the enzyme. In all experiments, the aqueous extracts of the plants developed concentration-dependent inhibitory effects. A moderate heat treatment did not significantly modify the inhibitory capacity of the extracts in comparison to not heated ones. Total polyphenol and flavonoid contents were determined with an HPLC-UV/DAD analysis and a spectroscopic method using Folin-Ciocalteu reagent. Some polyphenols with well-known antioxidant activities (caffeic acid, chlorogenic acid, hyperoside, rosmarinic acid and rutin) were found in the extracts and may partly explain the inhibitory activities observed. The role of those dietary and medicinal plants in the treatment of ROS-dependent inflammatory diseases could have new considerations for health

Walking the talk for dementia: a unique immersive, embodied, and multi‐experiential initiative

Coping with dementia requires an integrated approach encompassing personal, health, research, and community domains. Here we describe “Walking the Talk for Dementia,” an immersive initiative aimed at empowering people with dementia, enhancing dementia understanding, and inspiring collaborations. This initiative involved 300 participants from 25 nationalities, including people with dementia, care partners, clinicians, policymakers, researchers, and advocates for a 4-day, 40 km walk through the Camino de Santiago de Compostela, Spain. A 2-day symposium after the journey provided novel transdisciplinary and horizontal structures, deconstructing traditional hierarchies. The innovation of this initiative lies in its ability to merge a physical experience with knowledge exchange for diversifying individuals' understanding of dementia. It showcases the transformative potential of an immersive, embodied, and multi-experiential approach to address the complexities of dementia collaboratively. The initiative offers a scalable model to enhance understanding, decrease stigma, and promote more comprehensive and empathetic dementia care and research

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

The 2022 symposium on dementia and brain aging in low‐ and middle‐income countries: Highlights on research, diagnosis, care, and impact

Two of every three persons living with dementia reside in low‐ and middle‐income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high‐income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC‐focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. Highlights: Two‐thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs

Intermediate Care and Its Impact on The Functional Health and Quality of Life of Older Adult Stroke Survivors in Southwest Nigeria.

Background: Stroke is the leading cause of functional disabilities and the second cause of disease morbidity and mortality globally. With the increasing population ageing, there is a rise in the prevalence of stroke across the world. Objectives: This study aimed to investigate the impact of the intermediate care model on the functional health and quality of life of older adult stroke survivors in southwest Nigeria. Methods: A systematic review and mixed method (qualitative and quantitative) were to answer research questions. The systematic review followed (Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Eighteen (18) Informal caregivers of stroke survivors participated in focus group discussions, 8 formal care providers and 8 community gatekeepers participated in key informant interviews. Data was analyzed thematically using NVivo version 12 pro. Older adult stroke survivors and family caregivers (n=58) were recruited at the study’s final phase. The intervention included caregiver training provided at discharge and telephone follow-up for eight weeks. Pre- and post-tests were carried out before the intervention and at the eighth week respectively. Data was obtained on stroke survivors' functional health and quality of life. Findings: Systematic review revealed that home-based care options include physical therapy, occupational therapy, speech therapy, and meaningful task-specific for training patients. Findings from this qualitative study identified four major themes; experiences in stroke management; community gatekeepers’ perceived social and welfare support needed for older adult stroke patients; strategies that promote interpersonal relationships between formal and informal care providers on home-based care treatment; identification of home-based care needs of older adult stroke patients. There were significant improvements in the Stroke Specific Quality of Life (p<0.001) and functional outcome (p<0.001) across all domains in the post-intervention phase. Conclusion: This study highlights the need for effective intervention for improving the functional health and quality of life of older adult stroke survivors. Overall, study findings reflect that the delivery of home-based intermediate care model through combining caregivers’ training and telephone follow-up could be effective for continuous stroke care in Nigeria

Exploring the Experiences of Family Caregivers in the Management of Stroke Among Older Adults in Nigeria: A Qualitative Study

Background Stroke, a significant neurological condition, often results in older adults’ survivors relying on family caregivers, including children and spouses, leading to increased challenges for caregivers. Objective This study investigates the experiences of family caregivers caring for older adults’stroke patients, focusing on the context of stroke management. Methods Participants were purposively sampled, and three focus group discussions involving family caregivers (n=18) of older adults who had experienced strokes were conducted. Conversations were recorded, translated, transcribed, and subjected to thematic analysis utilizing NVivo (version 12 pro) software. Results Thematic analysis yielded five distinct themes. The first theme illuminated family caregivers’ insights regarding the management of stroke in their members or significant others. The second theme emphasized the support and information received at the medical facility. The third theme showcased the perceived value of the information provided. The fourth theme highlighted unmet needs for both information and training in social support. The final theme illuminated the participants’ preferences for how they would like to receive information and training. Conclusion This study highlights family caregivers’ experiences, encompassing a range of burdens, stresses, and challenges while caring for older adult’s stroke survivors. Findings emphasize the necessity for formal caregivers to provide adequate information, support, and training to family caregivers, thereby alleviating their burdens and enhancing stroke management in a home environment