Cognitive Exercise Research Articles

Exercise as a Strategy for Brain Aging: Prevention and Treatment Insights

Objectives: Aging is a comprehensive biological process that leads to a decrease in the physiological function of many body organs. Among them, the central nervous system plays a pivotal role in aging, and in this regard, physical and cognitive activities and exercise are among of the most important interventions known for managing and hindering nervous disorders associated with aging. The purpose of this study was to investigate the effect of various types of activities and exercise on neurological disorders in older adults. Material and methods: To conduct this research, databases including Google Scholar, PubMed, Web of Science, and Scopus were thoroughly searched using the following terms: effect of aging on the brain, Alzheimer's, Parkinson's disease, stroke, and the effect of different types of exercises on the aging brain, focusing on articles published between 2005 and 2024. The selection of articles followed the framework for scoping reviews as outlined by Arksey and O'Malley. A total of 56 relevant articles were carefully examined and included in this review. Findings: The results of various studies showed that different physical exercises have different effects on diseases related to the nervous system and aging. Among them, the best types of physical exercises were moderate and high intensity exercises combined with cognitive exercises. Conclusion: Physical exercises of moderate to high intensity and the combination of physical and cognitive activities have more beneficial effects than exercises with lower intensity. In addition, exercises and dual physical-cognitive exercises group have a preventive and more effective role than other exercise modalities in dealing with brain and nervous system disorders in older adults.

Dementia and Video Games: Systematic and Bibliographic Review.

This systematic and bibliographic review examines publications in the field of dementia and video game research from 2004 to 2023. The main objective is to assess developments and trends in video game technology for dementia care and detection. The PubMed database was the primary source for publications. PRISMA guidelines were applied to structure this review. Ten variables were defined, investigated, and split into three main categories: bibliographic, medical, and technical. The results were synthesized using a quantitative approach to reduce bias through interpretation. Of 209 initial results, 77 publications have been included in the investigation. More studies focus on rehabilitation over assessment and detection of dementia. Clinical trials are typically conducted with limited participants. The most populated trials rarely enrol over 300 subjects. On average, around 38 subjects were enrolled in the trials. These studies are commonly supervised by a trainer or technology specialist, suggesting a technology gap in familiarity in the trial demographic. Most interventions assessed were custom-designed applications with a specific outcome, focusing on physical activity and cognitive exercises. As the first of its kind, this publication focuses on the technical aspects of applied technologies and development methods. Using video games to treat and detect patients with cognitive impairments like dementia can benefit healthcare professionals, caretakers, and patients.

A Study to Investigate the Efficacy of Cognitive Exercises on Fear of Falls and Dual Task Performance among Geriatric Population in Jalandhar

BACKGROUND- Elderly population is described as 65 years of age or aged. Young–old population consists of the age group between 65 and 75 years of age. The middle–old population consists of the age group between 75 and 85 years of age. Old – old population consists of age group older than 85 years of age. Cognition is a higher cortical function. It is the process of knowing and includes awareness and judgement. Cognitive decline affects the older population by decrease in some mental functions such as verbal capability, numerical abilities, and general knowledge. Various physiotherapeutic approaches have been incorporated for making quality of life of patient worthier. AIM- The aim of the study is to investigate the efficacy of cognitive exercises on cognitive functions, fear of falls and dual task performance among geriatric population. METHODOLOGY-The total duration of the study was one and a half years. Subjects meeting the inclusion and exclusion criteria were selected in the study and were assessed for cognitive functions, fear of falls and dual task performance. A minimum of 30 subjects were taken. They were given dual task intervention and single task performance exercises. The treatment was carried out for 4 days per week for 7 weeks. The data was collected for dependent variables at baseline and at 7th week post treatment. RESULTS-Data analysis was performed by SPSS Software version 18 and the variables were assessed using Paired T-test. The scores of the Falls Efficacy scale were also found to be significant when compared from baseline to 7th week with a p-value of <0.001. It was found that single task at baseline was significant. The results for average score of dual task activity of walking 4 meters with tossing ball was found to be significant at 7th week with p-value of <0.001. Dual task activity of walking 4 meters with cup of water was also found to be significant with p-value of <0.001. The dual task activity of walking 4 meters with dribbling a ball was significant by 7th week with p-value of <0.001. While analyzing the dual task cost for walking with tossing ball it was found that the results were non-significant with a p-value of 0.7157. The results were also non-significant with a p-value of 0.8845 by 7th week for walking with holding a cup of water. However, it was found that the results were significant for dual task cost for walking 4 meters with dribbling a ball at 7th week with a p-value of <0.001. CONCLUSION- The results have significant real -world ramifications for the health and standard of living of the aging population.

Effects of home-based exercise alone or combined with cognitive training on cognition in community-dwelling older adults: A randomized clinical trial

BackgroundStructured and supervised physical exercise and cognitive training are two efficient ways to enhance cognition in older adults. Performing both within a combined intervention could maximize their effect on cognition due to their potential synergy on brain functions. During the COVID-19 pandemic, these interventions were particularly relevant due to the collateral impact of social restrictions regarding physical activity and the level of cognitive stimulation. However, the benefits of remotely monitored intervention combining physical exercise and cognitive training for older adult cognition remain to be demonstrated. Methods127 older adults (age: 65.20 ± 7.95) were randomized in two arms, encouraging self-engagement in six months of home-based physical exercise alone or combined with cognitive training, monitored by phone once a week. Neuropsychological assessment was performed under videoconference supervision at baseline and after three and six months. Composite Z-scores were calculated for processing speed, executive functioning, working, and episodic memory to assess changes after three and six months of training. The weekly metabolic expenditure of self-reported activities was estimated using the compendium of physical activity to distinguish participants performing higher and lower doses of exercise (median split). Results106 participants (83.46 %) completed the 6-month training. Results showed a greater Z-score change in executive functioning for participants in the combined arm than those who only exercised (F = 4.127, p = 0.046, ηp2 = 0.050). Group x Exercise dose interaction was observed for episodic memory Z-score change (F = 6.736, p = 0.011, ηp2 = 0.070), with a greater improvement for participants performing higher doses of exercise compared to those who performed a lower dose, only in exercise alone arm. Performing a higher dose of exercise increased the working memory Z-score change in both intervention arms compared to a lower dose (F = 7.391, p = 0.008, η p2 = 0.076). ConclusionRemote combined training may lead to larger improvement in executive functioning than exercise alone. Physical exercise showed a dose-related improvement in working and episodic memory performances. The combination of cognitive interventions mitigated the effects of exercise on episodic memory. These results suggest that home-based exercise and cognitive training may help improve older adults' cognition. Trial registrationCOVEPIC was retrospectively registered on December 03, 2020. Clinical trials Identifier: NCT04635462 - https://clinicaltrials.gov/ct2/show/record/NCT04635462?term=NCT04635462&draw=2&rank=1

The effects of conventional treatment in addition to Pilates on biopsychosocial status in chronic neck pain: A randomized clinical trial.

Although guidelines and systematic reviews recommend the use of exercise in the treatment of chronic pain and neck pain, there are no clear recommendations for conservative treatments frequently used in clinics. The effect of supporting clinical Pilates exercises with passive physiotherapy methods on biopsychosocial status is still unknown. The objective was to investigate the effects of conventional treatment (CT) in addition to clinical Pilates on pain levels, physical condition, functional status, and psychosocial status in individuals with chronic neck pain. Fifty women were randomly divided into 2groups, the clinical Pilates group (Pilates, n= 25), and the group receiving CT in addition to clinical Pilates (Pilates-CT, n= 25). Both groups received treatment 3days a week for 6weeks. The CT program involved the implementation of hot pack (HP) application, Transcutaneous Electrical Nerve Stimulation (TENS), and therapeutic ultrasound (US) to the cervical area. CT in addition to Pilates was more effective in reducing the Visual Analog Scale (at rest and during activity), Neck Disability Index, Fear-Avoidance Beliefs Questionnaire, NeckPix Scale, Hospital Anxiety and Depression Scale-depression, and Cognitive Exercise Therapy Approach-Biopsychosocial questionnaire scores (p< 0.05) and in increasing the degree of change in the extension range of motion (ROM) and cervical flexor endurance values and scores in the energy parameter of Short Form-36 (p< 0.05). CT provided in addition to Pilates was more effective in reducing pain levels, disability, fear of movement, depression levels, and negative biopsychosocial status and improving extension ROM and cervical flexor endurance, neck awareness, and the energy/vitality parameter of quality of life in individuals with chronic neck pain.

NEUROBICS: A VITAL ADJUNCT TO PHYSICAL THERAPY IN IMPROVING COGNITIVE AND PHYSICAL FUNCTIONS IN A PREGNANT WOMAN WITH WERNICKE'S ENCEPHALOPATHY - A CASE REPORT.

Background: Wernicke’s Encephalopathy (WE) is a neurological disorder caused by thiamine deficiency, leading to cognitive and physical impairments like confusion, ataxia, and ophthalmoplegia. Pregnant women with WE face additional challenges due to pregnancy demands. This case report examines the use of neurobics—cognitive exercises to stimulate brain function - as an adjunct to physical therapy in enhancing cognitive and physical recovery in a pregnant woman with WE. Objective: This report aims to demonstrate the benefits of combining neurobics with physical therapy to improve cognitive and physical outcomes in a pregnant woman with WE. Case Presentation: A 28-year-old pregnant woman in her second trimester, diagnosed with WE, presented with confusion, ataxia, and visual disturbances. After stabilization with intravenous thiamine, a rehabilitation program combining neurobics and physical therapy was initiated. Physical therapy targeted balance, coordination, and strength, while neurobics engaged the brain with unusual sensory stimuli and non-routine tasks to enhance cognitive function. Results: After four weeks, the patient’s cognitive function improved, with her MoCA score increasing from 4 to 17. Significant gains were seen in executive function, attention, language, visuospatial skills, and orientation, though memory remained unchanged. Ataxia symptoms also improved, with her SARA score reducing from 22 to 14. Conclusion: The integration of neurobics with physical therapy offered a comprehensive approach to rehabilitation in this pregnant woman with WE. Neurobics enhanced cognitive recovery alongside physical rehabilitation, suggesting its potential as a valuable adjunct in managing WE.

Comparative effects of cognitive and instability resistance training versus instability resistance training on balance and cognition in elderly women

This study investigates the effects of integrated instability resistance training and cognitive training (IRCT) versus isolated instability resistance training (IRT) on balance, gait, muscle strength, and cognitive functions in elderly women.This randomized controlled trial included 36 participants, with 18 in the IRCT group and 18 in the IRT group. The sample size was estimated to achieve a statistical power of 0.95 with a large effect size (0.40; n = 12 each group). The closed-eye single-leg stand test was measured for static balance, the closed-eye stepping test, and the Timed Up and Go Test (TUGT) were measured for dynamic balance. Dual-task balance was assessed by combining the TUGT with cognitive tasks (TUGT-C) and motor tasks (TUGT-M). Gait performance was evaluated using a gait function system. Lower limb muscle strength was measured with the 30-Second Chair Stand Test. Cognitive function was assessed through the Trail Making Test (TMT), Digit Span Test (DST), Stroop Color and Word Test (Stroop), and Digit Symbol Substitution Test (DSST). Results IRCT group showed better improvements in both cognitive (p < 0.001) and motor (p = 0.812 for baseline; p < 0.001 for post-intervention) dual-task abilities, IRCT also experienced better enhancement in certain cognitive functions, particularly in the TMT (p = 0.001) and DSST (p = 0.022) compared to the IRT group. Both groups demonstrated enhancements in walking abilities as shown on selective markers of the gait performance test (p < 0.05) and leg muscle strength via 30-Second Chair (p < 0.001 for time main effect). These results suggest that combining cognitive exercises with physical training more effectively addresses the complex challenges associated with aging in women. The study highlights the potential of comprehensive training approaches in boosting health and quality of life for the elderly, with implications for developing tailored exercise programs focused on reducing fall risks and enhancing quality of life in this population.

A qualitative analysis of participant experience during an EEG-linked auditory targeted cognitive training exercise: Implications for implementation and protocol optimization

Auditory-based targeted cognitive training (ATCT) is an emerging adaptive neuroplasticity-based intervention. Previous studies have shown that electroencephalographic (EEG) biomarkers of auditory information processing assessed at the start of ATCT have predicted cognitive, clinical, and functional gains from a full 30–40 hour ATCT program, but participant attitudes related to coupling EEG to ATCT are not well-known. This study assessed stakeholder feedback related to EEG biomarker collection as part of ATCT to optimize future EEG-informed ATCT studies. Semi-structured interviews assessed attitudes of ATCT-naïve participants (n=50) living with a range of psychiatric disorders and cognitive function who underwent EEG assessment associated with a 1 hour ATCT exercise. A deductive approach was used to code the data and an iterative approach was employed to identify key emerging themes. Interview data yielded 62 unique themes related to EEG biomarker collection and ATCT. Qualitative analysis identified positive and negative elements of participants’ experience of EEG-informed ATCT as well as ways to streamline the EEG experience. Results suggest EEG-informed ATCT studies may be optimized using actionable improvements to current protocols leveraged from themes identified.

A Brief Analysis of the Application of Mindfulness-Based Cognitive Therapy in Reducing the Sense of Loneliness Among International Students

With the deepening of globalization, the number of international students has grown significantly. In unfamiliar environments, these students face challenges such as academic pressure and cross-cultural adaptation, which often lead to feelings of loneliness. In severe cases, loneliness can negatively impact their mental health and daily lives. As a psychological intervention, mindfulness-based cognitive therapy (MBCT) integrates mindfulness training with cognitive exercises, making its application in mental health highly significant. This paper first explains the definition and origin of MBCT and discusses its value in regulating emotions, changing thought patterns, and maintaining mental health. Based on the current causes of loneliness among international students, this paper explores targeted applications of MBCT to offer practical intervention methods that promote the holistic and healthy growth of international students.

Computerized cognitive games versus cognitive exergame: the comparison of motor and cognitive functions enhancement in the elderly

BackgroundConsidering the importance of cognitive and motor functions of the elderly people, the present study was conducted to evaluate the effectiveness of a cognitive exergame, called Neurolight compared to computerized cognitive games, in enhancing core executive functions and motor performance.MethodsA total of 36 individuals in the age range of 60 to 69 years were studied in the form of three groups: The control group continued their daily activities, while the Neurolight group underwent a cognitive-motor training and the Maghzineh performed a computer-based cognitive training program for 24 sessions. Before and after interventions, working memory, inhibitory control, and balance were measured respectively by the N-back, Stroop, and TUG tests.ResultsThe results showed that cognitive-motor exercises using Neurolight, for 24 sessions, were able to significantly improve working memory, inhibitory control, and balance in individuals in this age group.ConclusionThis finding supports the other studies suggesting combined cognitive and physical exercises for better effect. Based on its findings, the use of this exercise system can be suggested to coaches and therapists working with the elderly.

Masked Taper With Behavioral Intervention for Discontinuation of Benzodiazepine Receptor Agonists

Placebo effects are commonly observed in benzodiazepine receptor agonist hypnotic clinical trials. Clinical guidelines recommend discontinuing benzodiazepine receptor agonist hypnotics (particularly in older adults) and administering cognitive behavioral therapy for insomnia (CBTI) as first-line therapy for insomnia. It is unknown whether a novel intervention that masks the daily dose of benzodiazepine receptor agonist during tapering and augments CBTI with novel cognitive and behavioral exercises targeting placebo effect mechanisms improves benzodiazepine receptor agonist discontinuation. To compare a masked benzodiazepine receptor agonist taper plus augmented CBTI vs an unmasked taper plus standard CBTI. This randomized clinical trial conducted at an academic medical center and a Department of Veterans Affairs medical center included adults aged 55 years or older who had used lorazepam, alprazolam, clonazepam, temazepam, and/or zolpidem for current or prior insomnia, at doses of less than 8-mg diazepam-equivalent 2 or more nights per week for at least 3 months. Data were collected between December 2018 and November 2023. Data analyses were conducted between November 2023 and July 2024. Masked taper plus cognitive behavioral therapy-augmented program (MTcap); standard CBTI plus supervised (unmasked) gradual taper (SGT). The primary efficacy outcome was percentage achieving benzodiazepine receptor agonist discontinuation 6 months after treatment ended (6-month; intention-to-treat) measured with 7-day self-reported medication logs and for a subset, urine tests. Secondary outcomes were Insomnia Severity Index scores at 1 week posttreatment and 6 months posttreatment, percentage of participants that have discontinued benzodiazepine receptor agonist use at 1 week posttreatment, and benzodiazepine receptor agonist dose and the Dysfunctional Beliefs About Sleep-Medication subscale at 1 week and 6 months posttreatment. Of 338 participants who underwent in-depth screening, 188 participants (mean [SD] age, 69.8 [8.3] years, 123 male [65.4%] and 65 female [35.6%]) were randomly assigned to MTcap (n = 92) or SGT (n = 96). Compared with SGT, MTcap resulted in greater benzodiazepine receptor agonist discontinuation at 6 months (MTcap = 64 [73.4%], SGT = 52 [58.6%]; odds ratio [OR], 1.95; 95% CI 1.03-3.70; P = .04) and 1 week posttreatment (MTcap = 76 [88.4%], SGT = 62 [67.4%]; OR, 3.68; 95% CI, 1.67-8.12; P = .001) and reduced frequency of benzodiazepine receptor agonist use (nights/week) at 1 week posttreatment (-1.31; 95% CI, -2.05 to -0.57; P < .001). Insomnia Severity Index improved with no significant between-group difference at follow-up (baseline to 1 week posttreatment, 1.38; P = .16; baseline to 6 months, 0.16; P = .88). This randomized clinical trial found that a program combining masked tapering with novel cognitive and behavioral exercises targeting placebo mechanisms improved the percentage of long-term benzodiazepine receptor agonist discontinuation compared with standard CBTI plus an unmasked taper. ClinicalTrials.gov Identifier: NCT03687086.

Outcome Measures And Analysis Of Memory Movers- An Exercise Programme For The Brain, Body And Mind

Abstract Background Memory Movers is a six-week early intervention specialist programme designed for implementation in community settings to meet key healthcare needs for individuals experiencing memory difficulties/dementia and their family carers. This programme provides individuals with the knowledge, skills and education to care for their overall health and well-being. It supports mental health and well-being by utilising cognitive stimulation exercises in conjunction with physical health exercises and providing information and basic exercises in mental health. Methods The Specialist Mental Health Service for Older People collaborated with an Acute Hospital, local Council, and Sports and Wellbeing Partnership in designing a suitable, accessible programme to promote Mental Health and well-being in the community. The programme incorporates the following aspects of health: Memory, Movement, and Mental Health. Results Pre- and post-assessments were undertaken with results highlighting the following: The Life Satisfaction Scale improved by 6%; the Mood Rating Scale improved by 19% and the overall rating of experiencing feelings of anxiety was reduced by 14% within the final week. There was also a 101% increase in the average engagement in physical activity. A range of positive comments received from attendees were recorded on feedback questionnaires. Conclusion Findings highlighted that remaining active supports both physical and mental health. According to the HSE (2020), physical exercise can cause chemical changes in the brain, which can help improve mood. Cognitive stimulation is beneficial to brain health and cognition (Schulz 2015). These contribute to the overall well-being of individuals, promoting cognitive functioning and movement, as well as overall mental health and well-being. This programme also provides opportunities for social connection and integration with services.

Understanding Digital Dementia and Cognitive Impact in the Current Era of the Internet: A Review.

Dementia encompasses symptoms resulting from brain damage that impairs cognitive functions, surpassing natural aging effects. This condition affects emotional regulation, behavior, and motivation while preserving consciousness. Dr. Manfred Spitzer coined the term 'digital dementia,' highlighting the cognitive decline associated with excessive reliance on digital devices such as smartphones and Google, potentially exacerbating attention deficit hyperactivity disorder (ADHD) and memory loss. This condition mirrors terms like 'digital amnesia' and 'the Google Effect,' highlighting the brain's tendency to offload peripheral information, leading to panic and forgetfulness. Spitzer's book, Digital Dementia, focuses on gaming effects on children and has thus popularized the term. Teenagers are known to use electronic devices regularly, correlating with rising cognitive impairments. The advent of the internet's fifth generation (5G) has transformed technology use, impacting mental health treatments and clinical practices globally. Digital media's influence on the developing brain encompasses motor skills, language, and cognition. Excessive digital media use in young adults correlates with lower cognitive empathy, affecting interpersonal understanding and facial recognition. Studies link heavy reliance on web-based media to decreased white matter integrity, crucial for language skills. Adolescents may be more vulnerable to anxiety and unrealistic expectations due to digital media overuse. Digital media overuse impacts brain development, especially cognitive and inhibitory control, attention, memory, and reasoning, essential for adapting to dynamic environments. Early exposure to fast-paced media can impair motor skills, spatial awareness, problem-solving, and language learning. Neuroimaging studies reveal that environmental factors like screen usage affect brain networks controlling social-emotional behavior and executive functions. Overreliance on smartphones diminishes gray matter in key brain regions, affecting cognitive and emotional regulation. The internet generation, characterized by advancements such as Web 3.0, introduces artificial intelligence and semantic web technologies, reshaping digital content processing. The neurobiological basis of digital dementia involves changes in the brain structure and function, with excessive screen exposure linked to cognitive impairments. Neuroplasticity, or the brain's adaptability, plays a role in cognitive decline from digital media overuse. Early childhood and adolescent brain development stages exhibit significant plasticity, influencing cognitive trajectories. Addressing digital dementia requires strategies to reduce screen time, promote cognitive exercises, and enhance awareness. Parents should regulate children's screen usage, encourage digital detox periods, and substitute screen time with other activities. Cognitive training programs such as Cogmed (Neural Assembly Int AB, Stockholm, SWE) and CogniFit (San Francisco, CA, USA) can improve memory and attention in older adults. Promoting balanced technology use and educating on the risks of excessive digital media consumption is crucial for maintaining cognitive health in the digital age.

Integrative Neuro-social cognitive Strategy Programme for Instilling REcovery (INSPIRE): a community-based cognitive remediation trial-study procotol

BackgroundAdults with schizophrenia experience a range of neurocognitive problems that affect their daily functioning. Evidence for the efficacy of cognitive remediation in schizophrenia has been established, but its implementation in under-resourced community-based settings is less well-studied. In recent years, interventions have also focused on the strategy-learning approach in favor of drill-and-practice. Moreover, there is an increasing recognition to address social cognition and negative symptoms alongside neurocognition.This study attempts to carry out cognitive remediation in a community mental health setting. The Neuropsychological and Educational Approach to Remediation (NEAR) is used as the cognitive remediation intervention. Neurocognitive and social cognitive games will be introduced during the computer-assisted cognitive exercises sessions. In addition, the instructional technique will foster the use of metacognition and cognitive strategies. Moreover, metamotivation training will be the focus of some bridging sessions to enhance motivation to engage in goal-directed learning behaviors.The aims of the study are to 1) investigate the effects of cognitive remediation on neurocognition, social cognition and functional outcomes of participants with schizophrenia/schizoaffective disorders in community mental health settings; and 2) explore the mediators for change (eg: metamotivation, metacognition and negative symptoms) in cognitive performance and functional outcomes.MethodsThis randomized controlled trial will be conducted in three Singapore Anglican Community Services (SACS) centers, where standard psychiatric rehabilitation is delivered. Participants who are randomized to the experimental arm will receive cognitive remediation and psychiatric rehabilitation, while those randomized to the control arm will receive standard psychiatric rehabilitation only. Cognitive remediation is carried out three times a week for 12 weeks. It consists of computer-assisted cognitive exercises, as well as bridging groups to aid transfer of learning to daily living. Baseline, post-intervention and eight-week follow-up measurements will be collected. Group by time differences in cognitive performance, negative symptoms, metamotivation, metacognition, functioning and recovery will be analyzed across the three time points. Mediators for improvement in cognitive performance and functioning will also be explored.DiscussionFindings of this research will add to the body of knowledge about the key therapeutic ingredients within a strategy-based cognitive remediation program and improve its implementation within under-resourced community settings.Trial registrationThis study has been registered with ClinicalTrials.gov (ID: NCT06286202). Date of registration: 29 February 2024. Date of last update: 21 May 2024.

Integrating lived experience to develop a tailored sleep intervention for people living with dementia and carepartners.

Sleep disturbances are highly prevalent and have adverse health consequences for both people living with dementia and their carepartners. Despite this, they are under-addressed caregiving settings. This study aimed to explore these sleep disturbances and co-design a multimodal sleep intervention for people living with dementia and their carepartners. We conducted two focus groups and five semi-structured interviews (n = 4 people living with dementia, n = 6 carepartners). Active involvement of community advisors was sought throughout the design, development, and facilitation phases. Reflexive thematic analysis was used to explore sleep-related experiences and receive feedback to shape intervention development. People living with dementia reported disruptions to sleep and circadian rhythms, including sleep disturbances and confusion between day and night. Multiple sleep challenges were encountered by carepartners including insomnia, hypervigilance, and daytime impairment. The proposed sleep intervention was received positively, with significant insights emphasising the need for a multimodal toolkit approach, adaptation of the intervention across different dementia stages, and a focus on tailoring the program to carepartners. Sleep interventions for caregivers and care-recipients should target both sleep and daytime functioning to ensure holistic support. Participants were receptive towards time-friendly, online, multimodal sleep interventions that combine cognitive behaviour therapies, light therapy, mindfulness, and exercise elements.

Acute Sleep Deprivation and Cerebral and Skeletal Muscle Oxygenation: A Review and Future Directions

Cerebral and skeletal muscle oxygenation are critical research areas for understanding blood flow and oxygen delivery during various physiological states, including cognitive tasks and exercise. Measuring oxygenated and deoxygenated hemoglobin through functional near-infrared spectrometry (fNIRS) enables non-invasive assessment of cerebral and skeletal muscle oxygenation. Research using fNIRS to explore oxygenation after sleep deprivation (SD) is limited and often contradictory. We reviewed how SD affects cerebral and muscle oxygenation as part of a broader review of how SD affects exercise through altered physiologic and perceptual responses. Herein, we consolidate existing knowledge, identify gaps, and suggest directions for future investigation. A comprehensive literature review was conducted via predefined search parameters using PubMed and Google Scholar, focusing on studies that employed fNIRS to measure cerebral and/or skeletal muscle oxygenation in humans after SD (total or partial) or in individuals with chronically fragmented sleep due to obstructive sleep apnea (OSA). Select studies report increased cerebral oxygenation post-SD, potentially due to compensatory mechanisms and increased brain activity. Contrarily, several studies indicate decreased cerebral oxygenation following SD, potentially due to impaired endothelial function, cortical neurovascular coupling, suppressed brain activity, or decreased oxygen consumption. Cerebral oxygenation may be associated with perceived exertion, suggesting meaningful links to exercise. Interestingly, exercise training may mitigate the effects of SD on oxygenation. The only study investigating skeletal muscle oxygenation with regards to sleep status found a lower tissue saturation index in OSA participants compared to controls, though hemoglobin parameters did not differ. The effect of SD on oxygenation remains equivocal, with no studies fully elucidating the mechanisms underlying these changes. This review is the foundation for an ongoing prospective study investigating the impact of acute SD on exercise capacity and fNIRS-derived cerebral and skeletal muscle oxygenation, with two participants enrolled to date and interim analyses planned at n=5 participants.

Attitudes of Nursing Home Managers Regarding Cognitively Stimulating Activities in People With Dementia: A Multicentre Cross-Sectional Study.

Group-based cognitive stimulation has shown short-term benefits for the cognitive outcomes of people with dementia living in nursing homes (NH). However, group participation can be a barrier for people with advanced dementia, bedridden people or isolated people. The CogStim24 project seeks to develop and implement a new psychosocial intervention based on cognitively stimulating (CS) activities integrated into daily nursing care. As part of the intervention development process, this study aimed to survey NH managers' attitudes and describe currently used approaches to CS activities in German NH. We performed a multicentre cross-sectional study between September and December 2021 in randomly recruited NH in the German federal state of North Rhine-Westphalia. NH representatives were asked to fill in a self-developed online questionnaire. We analysed data descriptively, presenting means and standard deviations. For case scenario questions, we used a summative content analysis. We contacted 354 NH and 106 agreed to participate. Representatives of 64 facilities completed the survey. Almost all stated to have implemented CS activities. Cognitive exercises (98%), physical and relaxation exercises (98%) and reminiscence therapy (95%) were most often used. The majority (96%) thought that CS activities could support people with dementia in maintaining their cognitive functions and that nurses should have a key role in the implementation of CS activities. More than half believed that regular CS activities were easy to implement alongside routine nursing care. Results indicate that CS activities are frequently applied in German NH. The positive attitude of NH managers regarding the implementation and effects of CS activities is an important implementation resource. Nursing staff should be more involved in providing CS activities for people with dementia. Training, information, and implementation material must be made available for nursing staff who wish to have an active role in providing CS activities.

Feasibility of a nurse-initiated brief cognitive behavioral strategy intervention program for symptom clusters experienced by patients with advanced non-small cell lung cancer

BackgroundA nurse-initiated brief cognitive behavioral Strategy (CBS) intervention program has shown alleviation effects of single symptoms. However, the feasibility of the brief CBS for symptoms included in the Pain and Fatigue symptom clusters in patients with advanced nonsmall cell lung cancer (NSCLC) has not been evaluated. ObjectiveTo evaluate the feasibility of application of the nurse-initiated brief CBS intervention program focusing on pain and fatigue symptoms among the Pain and Fatigue/anorexia symptom clusters experienced by patients with advanced NSCLC. MethodsIn this one-group pretest-posttest design, participants were 15 outpatients with NSCLC undergoing medical treatment (UMIN 000026996). After expressing consent to the study participation, the participants completed a baseline questionnaire and were given a booklet explaining brief cognitive behavioral therapies (relaxation, problem-solving strategies for symptom relief), exercise therapy, and tools. We provided follow-up calls five times and evaluated the retention and changes in symptom severities till the 10th week after the intervention. ResultsOf 15 participants, 10 (66.7%) completed the program. For pain relief strategies, 87% chose deep breathing for relaxation, and 80% fatigue relief with exercises. The median symptom severities (at the baseline and Wk10) showed downward tendencies: pain (2.00, 1.00), sadness (1.00, 0.00), and anxiety (1.00, 0.50). Implications for practiceWe need a randomized controlled trial to further test the effectiveness of the intervention in alleviating symptom and improving QOL of this population. ConclusionsThe nurse-initiated brief CBS intervention program is clinically practical in this population. Nurses may provide useful support for patient symptom management by brief CBS.

Mental disorders after myocardial infarction: potential mediator role for chemokines in heart-brain interaction?

Acute myocardial infarction (MI) remains one of the leading causes of mortality and morbidity in the global communities. A prevailing topic that has attracted increasing attentions over the past few decades is the so-called heart-brain interaction, in particular following a major traumatic event such as MI. Increased prevalence of depression and other mental disorders has been recognized in cardiac patients after MI, coronary catheterization, or cardiothoracic surgeries. In this review, we focus on the potential pathogenic mechanisms and pre-clinical transcriptomic evidence for identifying potential mediators of post-MI depression. We first summarize the conventional mechanistic understanding that leads to the current clinical management of post-MI depression with the use of selective serotonin reuptake inhibitors (SSRIs) and cognitive behavior and exercise therapies. We further envisage a possible role played by certain chemokines, e.g., Chemokine (C-X-C motif) ligand 12 (CXCL12) and Chemokine (C-C motif) ligand 2 (CCL22), in serving as signaling molecules to connect the MI-induced heart damage to the pro-depressive changes in brain during the post-MI period. Future in-depth investigations into this chemokine hypothesis will be instrumental in developing new chemokine-targeted therapies for better management of the cardiac patients suffering from post-MI depression.

FC7: Effects of a multidomain cognitive stimulation program in older adults

Objectives: The aim of this study was to ascertain the influence of a six-month multidomain stimulation program on cognitive functioning.Methods: The sample comprised 25 older adults 60 years-old and older (Mage = 66.08 years), of whom 96% were women and 54% had high education. The intervention program had a duration of six months and was implemented in a group format in one-hour sessions on a weekly basis. Lessons on neuroprotective factors, training in practical compensatory strategies to improve daily performance, cognitive training exercises and recreational cognitive stimulation activities were included. In order to analyze participants’ cognitive functioning the following instruments were used: Mini-Mental State Examination, Rey Complex Figure Test, Digit Span Test, Stroop Test, Trail Making Test (Part A and Part B), Verbal Fluency Test, Boston Naming Test (Short Form) and Neuropsi Verbal Memory Subtest. Wilcoxon test was performed to test the impact of the intervention program on participants cognitive functioning.Results: Statistically significant differences were found after the six-month intervention in verbal memory encoding (W= –2.772, p&lt; 0.05), in spontaneous verbal memory retrieval(freerecall) (W= – 3.456, p&lt; 0.001), inverbal recognition memory (W = –3.184, p &lt; 0.001), in spontaneous visual memory retrieval (W = –2.056, p &lt; 0.05), and in naming by visual confrontation (W = –2.521, p &lt; 0.05). In all cases, participants increased their scores after taking part in multicomponent a six-month multidomain stimulationprogramConclusions: One of the biggest concerns among older people is the loss of cognitive abilities that may occur with ageing. Cognitive stimulation programs, if sufficiently comprehensive, can be a good tool to maintain and improve cognitive functions as we age.