White matter hyperintensities and lower extremity physical function before and after an aerobic exercise intervention in healthy older adults

Background: Age-related declines take many forms including white matter deterioration, cognitive impairments, and mobility limitations, all of which can have practical implications, such as falling and making risky pedestrian decisions. Modifiable lifestyle interventions, like physical activity, provide ways to mitigate or ameliorate the range of age-related declines. This dissertation examined the relationships between lower extremity physical function and a representative measure of age-related cerebral small vessel disease, white matter hyperintensity (WMH) volume in the brain, before and after an aerobic exercise intervention in a sample of relatively young and healthy older adults. Analyses also examined the role of WMH volume, physical function, and cognition on virtual reality street crossing risk assessment. Methods: Data were analyzed from 177 older adults (M age = 65) who completed the Fit and Active Senior Trial (FAST), a six-month physical activity intervention including three groups: stretching, strengthening, and stability (SSS); dance (Dance); aerobic walking (Walk). Results: The baseline relationship between greater WMH volume and worse lower extremity physical function was weak in this sample and, unsurprisingly, WMH volume did not change over the six-month intervention. Regardless of intervention group, greater standardized improvement in lower extremity physical function was significantly predicted by lower baseline WMH volume, greater baseline gait self-efficacy, and better baseline fitness, uniquely and in interaction. In a separate model, greater improvements in lower extremity physical function were observed in adults assigned to the Dance condition who had greater improvement in gait self-efficacy and/or lower initial WMH volume. Conclusions: The results reported here suggest that in sedentary older adults, the transition to physically active can benefit lower extremity physical function regardless of the type of activity. However, these gains seem to be greatest over the six-month period in individuals who at baseline have lower WMH volume, better gait self-efficacy, and better fitness

The effects of cell phone and text message conversations on simulated street crossing

A fully immersive, high fidelity street crossing simulator was used to examine the effects of texting on pedestrian street crossing performance. Research suggests that street crossing performance is impaired when pedestrians engage in cell phone conversations. Less is known about the impact of texting on street crossing performance. Thirty-two young adults completed three distraction conditions in a simulated street crossing task: no distraction, phone conversation, and texting. A hands-free headset and a mounted tablet were used to conduct the phone and texting conversations, respectively. Participants moved through the virtual environment via a manual treadmill, allowing them to select crossing gaps and change their gait. During the phone conversation and texting conditions, participants had fewer successful crossings and took longer to initiate crossing. Furthermore, in the texting condition, lower percentage of head orientation toward the tablet, fewer number of head orientations toward the tablet, and greater percentage of total characters typed before initiating crossing predicted greater crossing success. Our results suggest that 1) texting is as unsafe as phone conversations for street crossing performance, and 2) when subjects completed most of the texting task before initiating crossing they were more likely to make it safely across the street. Sending and receiving text messages negatively impact a range of real-world behaviors. These results may inform personal and policy decisions

Caloric vestibular stimulation for the management of motor and non-motor symptoms in Parkinson's disease

Introduction: A recent case study showed that repeated sessions of caloric vestibular stimulation (CVS) relieved motor and non-motor symptoms associated with Parkinson's disease (PD). Here we sought to confirm these results in a prospective, double-blind, randomized, placebo treatment-controlled study. Methods: 33 PD subjects receiving stable anti-Parkinsonian therapy completed an active (n = 16) or placebo (n = 17) treatment period. Subjects self-administered CVS at home twice-daily via a portable, pre-programmed, solid-state ThermoNeuroModulation (TNMTM) device, which delivered continually-varying thermal waveforms through aluminum ear-probes mounted on a wearable headset. Subjects were followed over a 4-week baseline period, 8 weeks of treatment and then at 5- and 24-weeks post-treatment. At each study visit, standardized clinical assessments were conducted during ON-medication states to evaluate changes in motor and non-motor symptoms, activities of daily living, and quality of life ratings. Results: Change scores between baseline and the end of treatment showed that active-arm subjects demonstrated clinically-relevant reductions in motor and non-motor symptoms that were significantly greater than placebo- arm subjects. Active treatment was also associated with improved scores on activities of daily living assessments. Therapeutic gains were still evident 5 weeks after the end of active treatment but had started to recede at 24 weeks follow-up. No serious adverse events were associated with device use, and there was high participant satisfaction and tolerability of treatment. Conclusion: The results provide evidence that repeated CVS can provide safe and enduring adjuvant relief for motor and non-motor symptoms associated with PD

Active Experiencing Training Improves Episodic Memory Recall in Older Adults

Active experiencing (AE) is an intervention aimed at attenuating cognitive declines with mindfulness training via an immersive acting program, and has produced promising results in older adults with limited formal education. Yet, the cognitive mechanism(s) of intervention benefits and generalizability of gains across cognitive domains in the course of healthy aging is unclear. We addressed these issues in an intervention trial of older adults (N = 179; mean age = 69.46 years at enrollment; mean education = 16.80 years) assigned to an AE condition (n = 86) or an active control group (i.e., theatre history; n = 93) for 4 weeks. A cognitive battery was administered before and after intervention, and again at a 4-month follow-up. Group differences in change in cognition were tested in latent change score models (LCSM). In the total sample, several cognitive abilities demonstrated significant repeated-testing gains. AE produced greater gains relative to the active control only in episodic recall, with gains still evident up to 4 months after intervention. Intervention conditions were similar in the magnitude of gains in working memory, executive function and processing speed. Episodic memory is vulnerable to declines in aging and related neurodegenerative disease, and AE may be an alternative or supplement to traditional cognitive interventions with older adults

The cortical structure of functional networks associated with age-related cognitive abilities in older adults.

Age and cortical structure are both associated with cognition, but characterizing this relationship remains a challenge. A popular approach is to use functional network organization of the cortex as an organizing principle for post-hoc interpretations of structural results. In the current study, we introduce two complimentary approaches to structural analyses that are guided by a-priori functional network maps. Specifically, we systematically investigated the relationship of cortical structure (thickness and surface area) of distinct functional networks to two cognitive domains sensitive to age-related decline thought to rely on both common and distinct processes (executive function and episodic memory) in older adults. We quantified the cortical structure of individual functional network's predictive ability and spatial extent (i.e., number of significant regions) with cognition and its mediating role in the age-cognition relationship. We found that cortical thickness, rather than surface area, predicted cognition across the majority of functional networks. The default mode and somatomotor network emerged as particularly important as they appeared to be the only two networks to mediate the age-cognition relationship for both cognitive domains. In contrast, thickness of the salience network predicted executive function and mediated the age-cognition relationship for executive function. These relationships remained significant even after accounting for global cortical thickness. Quantifying the number of regions related to cognition and mediating the age-cognition relationship yielded similar patterns of results. This study provides a potential approach to organize and describe the apparent widespread regional cortical structural relationships with cognition and age in older adults

Active Experiencing Training Improves Episodic Memory Recall in Older Adults

ABSTRACT The main objective of the present research is to propose a suitable associative model for the aforementioned producers that serves as the main basis for the commercialization of their product. In the present work we explain the associative models that serve as a source of information to determine which is the right one for them, as well as the advantages involved in implementing associativity within a given sector. From the general objective, it began to collect information that allows knowing the appropriate associative model, such as the benefits it provides, for this a survey was conducted to the producers and an interview to the Representative of the Regional Bureau of Agriculture of Cajamarca, specialist on issues of associativity. The main results obtained through the application of these instruments, is that the best associative model for producers of sugarcane of the Guayabo - Contumazá farmhouse is the Agrarian Cooperative, and the advantages that would be obtained from this implementation are: complementation of capabilities, economy at scales, negotiating force, possibility of brand, less intermediaries. With the development of this thesis is intended to serve as a methodological aid to students who are studying the race, and especially to Cajamarca producers, from different sectors, to keep in mind that the implementation of a model of associativity is essential to generate a competitive advantage and a sustainable and commercial development, because the union is strength. Keywords: Associative model, producer, sugarcane, commercialization, schnapps.TesisLa presente investigación, tiene como objetivo primordial proponer un modelo de asociatividad adecuado para los productores anteriormente mencionados que sirva como base principal para la comercialización de su producto. En este estudio se explica los modelos de asociatividad que sirve como fuente de información para determinar cuál es el indicado para ellos, así como las ventajas que involucra implementar la asociatividad dentro de un determinado sector. A partir del objetivo general, se empezó a recolectar información que permita conocer el modelo asociativo adecuado, como los beneficios que este proporciona, para ello se realizó una encuesta a los productores y una entrevista al Representante de la Dirección Regional de Agricultura de Cajamarca, especialista en temas de asociatividad. Los principales resultados que se obtuvieron a través de la aplicación de dichos instrumentos, es que, el mejor modelo asociativo para los productores de la caña de azúcar del caserío Guayabo – Contumazá es la Cooperativa Agraria, y las ventajas que se obtendría a partir de esta implementación son: complementación de capacidades, economía a escalas, fuerza negociadora, posibilidad de marca, menos intermediarios. Con la elaboración de esta tesis se pretende que sirva de ayuda metodológica a los estudiantes que vienen cursando la carrera, y sobre todo a los productores cajamarquinos, de los distintos sectores, que tengan presente que la implementación de un modelo de asociatividad es fundamental para generar una ventaja competitiva y un desarrollo sostenible y comercial, porque la unión hace la fuerza. Palabras claves: Modelo de asociatividad, productor, caña de azúcar, comercialización, aguardiente

Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors

Publisher's PDFIncreased survival rates among breast cancer patients have drawn significant attention to consequences of both the presence of cancer, and the subsequent treatment-related impact on the brain. The incidence of breast cancer and the effects of treatment often result in alterations in the microstructure of white matter and impaired cognitive functioning. However, physical activity is proving to be a successful modifiable lifestyle factor in many studies that could prove beneficial to breast cancer survivors. This study investigates the link between white matter lesion volume, moderate physical activity, and cognition in breast cancer survivors following treatment compared to non-cancer age-matched controls. Results revealed that brain structure significantly predicted cognitive function via mediation of physical activity in breast cancer survivors. Overall, the study provided preliminary evidence suggesting moderate physical activity may help reduce the treatment related risks associated with breast cancer, including changes to WM integrity and cognitive impairment.University of Delaware, College of Health Sciences, Department of Behavioral Health and Nutritio

Caloric Vestibular Stimulation for the Management of Motor and Non-Motor Symptoms in Parkinson\u27s Disease

INTRODUCTION: A recent case study showed that repeated sessions of caloric vestibular stimulation (CVS) relieved motor and non-motor symptoms associated with Parkinson\u27s disease (PD). Here we sought to confirm these results in a prospective, double-blind, randomized, placebo treatment-controlled study. METHODS: 33 PD subjects receiving stable anti-Parkinsonian therapy completed an active (n = 16) or placebo (n = 17) treatment period. Subjects self-administered CVS at home twice-daily via a portable, pre-programmed, solid-state ThermoNeuroModulation (TNM™) device, which delivered continually-varying thermal waveforms through aluminum ear-probes mounted on a wearable headset. Subjects were followed over a 4-week baseline period, 8 weeks of treatment and then at 5- and 24-weeks post-treatment. At each study visit, standardized clinical assessments were conducted during ON-medication states to evaluate changes in motor and non-motor symptoms, activities of daily living, and quality of life ratings. RESULTS: Change scores between baseline and the end of treatment showed that active-arm subjects demonstrated clinically-relevant reductions in motor and non-motor symptoms that were significantly greater than placebo-arm subjects. Active treatment was also associated with improved scores on activities of daily living assessments. Therapeutic gains were still evident 5 weeks after the end of active treatment but had started to recede at 24 weeks follow-up. No serious adverse events were associated with device use, and there was high participant satisfaction and tolerability of treatment. CONCLUSION: The results provide evidence that repeated CVS can provide safe and enduring adjuvant relief for motor and non-motor symptoms associated with PD

Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors

<div><p>Increased survival rates among breast cancer patients have drawn significant attention to consequences of both the presence of cancer, and the subsequent treatment-related impact on the brain. The incidence of breast cancer and the effects of treatment often result in alterations in the microstructure of white matter and impaired cognitive functioning. However, physical activity is proving to be a successful modifiable lifestyle factor in many studies that could prove beneficial to breast cancer survivors. This study investigates the link between white matter lesion volume, moderate physical activity, and cognition in breast cancer survivors following treatment compared to non-cancer age-matched controls. Results revealed that brain structure significantly predicted cognitive function via mediation of physical activity in breast cancer survivors. Overall, the study provided preliminary evidence suggesting moderate physical activity may help reduce the treatment related risks associated with breast cancer, including changes to WM integrity and cognitive impairment.</p></div

Effects of Gait Self-Efficacy and Lower-Extremity Physical Function on Dual-Task Performance in Older Adults

Objectives. Despite evidence of self-efficacy and physical function’s influences on functional limitations in older adults, few studies have examined relationships in the context of complex, real-world tasks. The present study tested the roles of self-efficacy and physical function in predicting older adults’ street-crossing performance in single- and dual-task simulations. Methods. Lower-extremity physical function, gait self-efficacy, and street-crossing success ratio were assessed in 195 older adults (60–79 years old) at baseline of a randomized exercise trial. During the street-crossing task, participants walked on a self-propelled treadmill in a virtual reality environment. Participants crossed the street without distraction (single-task trials) and conversed on a cell phone (dual-task trials). Structural equation modeling was used to test hypothesized associations independent of demographic and clinical covariates. Results. Street-crossing performance was better on single-task trials when compared with dual-task trials. Direct effects of self-efficacy and physical function on success ratio were observed in dual-task trials only. The total effect of self-efficacy was significant in both conditions. The indirect path through physical function was evident in the dual-task condition only. Conclusion. Physical function can predict older adults’ performance on high fidelity simulations of complex, real-world tasks. Perceptions of function (i.e., self-efficacy) may play an even greater role. The trial is registered with United States National Institutes of Health ClinicalTrials.gov (ID: NCT01472744; Fit & Active Seniors Trial)