Function In Elderly Persons Research Articles

Healthy Dietary Pattern Improves Cognitive Function in Elderly Persons With Periodontitis: A Cross-Sectional Study of NHANES

AimCognitive decline is more prevalent in elderly persons with periodontitis. Greater adherence to Healthy Eating Index (HEI)-2015 has been reported to improve cognitive function in the elderly population. However, whether the benefits of HEI-2015 on cognitive function apply to elderly patients with periodontitis remains unknown. MethodsThis is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). The data were extracted from database 2011–2014. Cognitive function was measured through the Consortium to Establish a Registry for Alzheimer's Disease battery for immediate recall (CERAD-WL) and delayed recall (CERAD-DR), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The data of HEI-2015 were acquired from 24-hour dietary recalls. Weighted linear regression models were performed to investigate the association between HEI-2015 and cognitive function in elderly patients with periodontitis. The associations were further investigated in subgroups of sex, cardiovascular disease status, and depression status. ResultsA total of 1862 participants were included, and 1223 of them had periodontitis. Periodontitis was negatively associated with cognitive function (β = −0.45; 95% confidence interval [CI], −0.87 to −0.03). No statistically significant relationship was observed between HEI-2015 and cognitive function (β = 0.33; 95% CI, −0.02 to 0.69). Low HEI-2015 score was associated with high odds of cognitive decline in patients with periodontitis (β = −0.73; 95% CI, −1.25 to −0.21; P for trend = .01). Higher HEI-2015 was related to the lower incidence of cognitive function decline in patients with periodontitis who were female (β = −0.53; 95% CI, −1.03 to −0.03), had a socioeconomic status from 0 to 3 (β = −0.55; 95% CI, −1.00 to −0.09), did not have cardiovascular disease (β = −0.60; 95% CI, −1.14 to −0.05), and did not have depression (β = −0.57; 95% CI, −1.11 to −0.03). ConclusionsGreater HEI-2015 adherence may improve cognitive function amongst elderly patients with periodontitis. Further studies were needed to investigate this association in elderly persons with periodontitis.

Effects of Rehabilitative Exercises on Swallowing Function in Elderly People: A Pilot Randomized Controlled Trial

Background: Swallowing problems are common in healthy elders. Swallowing difficulties are the cause of medical and psychosocial complications in old age. Thus, to prevent and minimize these complications, diagnosis and proper interventions are important. Objectives: This study aimed to investigate the effects of rehabilitative exercises on swallowing function and quality of life in older adults. Methods: A total of forty healthy elders were randomly assigned to the rehabilitative exercises group (n = 20) and the compensatory group (n = 20). Inclusion criteria in this study were as follows: age 60 - 80; the presence of swallowing problems assessed clinically by a speech therapist; no history of swallowing treatment, pneumonia or head and neck surgery, and other neurological or general disorders that can influence swallowing function. Randomization was undertaken using a block randomization technique. Rehabilitative exercises, including muscle strengthening exercises, were used in 3 sets of 10 per muscle group and three times per week for one month for the rehabilitative exercise group. In order to evaluate the outcomes, the Mann Assessment of Swallowing Ability (MASA) and the P-dysphagia handicap index (P-DHI) were administered. Statistical analysis of data was done by the use of parametric statistical tests such as independent t-test, paired sample t-test, and nonparametric tests such as Mann-Whitney test, and P-value ≤ 0.05 was considered to be statistically significant. Results: There were no significant differences between the two groups regarding demographic and clinical swallowing function before intervention (P ≤ 0.05). There was a significant improvement in the clinical function of swallowing and swallow-related quality of life in the group which received the rehabilitative exercises compared to the group that received only the compensatory methods (P < 0.001). Conclusions: Our research has indicated that swallowing rehabilitative exercises are more effective in improving clinical swallowing function in elderly persons than compensatory exercises.

Female dominance of both spatial cognitive dysfunction and neuropsychiatric symptoms in a mouse model of Alzheimer's disease.

Alzheimer’s disease (AD) is a prevalent neurological disorder affecting memory function in elderly persons. Indeed, AD exhibits abnormality in cognitive behaviors and higher susceptibility to neuropsychiatric symptoms (NPS). Various factors including aging, sex difference and NPS severity, are implicated during in development of AD. In this study, we evaluated behavioral abnormalities of AD model, PDAPP transgenic mice at young age using the Morris Water Maze test, which was established to assess hippocampal-dependent learning and memory. We found that female AD model mice exhibited spatial learning dysfunction and highly susceptible to NPS such as anxiety and depression, whereas spatial reference memory function was comparable in female PDAPP Tg mice to female wild type (WT) mice. Spatial learning function was comparable in male AD model mice to male WT mice. Multiple regression analysis showed that spatial learning dysfunction was associated with NPS severity such as anxiety and depression. Furthermore, the analysis showed that spatial reference memory function was associated with status of depression, but not anxiety. Thus, these results suggest female dominance of spatial learning dysfunction in the AD model mice accompanying increased NPS severity. The understandings of AD model may be useful for the development of therapeutic agents and methods in human AD.

The association between age-related sensorineural hearing loss and saccular dysfunction in the elderly

Introduction: Presbycusis or age-related sensorineural hearing loss (ARSNHL) is a complex disorder that results in a slow deterioration in auditory function. A considerable high number of these presbycusis or ARSNHL patients also suffer from dizziness and related vestibular symptoms. Although auditory and vestibular systems are distinct, they work just alike. Hence, there is a great relation among their functions. Once one is stimulated, the other suffers changes as well. Methodology: Participants in this study comprised forty adult patients (60–75 years) divided into two groups: control group with normal hearing and without any vestibular symptoms or diagnosed vestibular diseases and study group with mild-to-moderately severe sensorineural hearing loss with or without dizziness in the form of a sense of imbalance during walking or a sense of rotation of the surrounding, especially on sitting or standing from lying position. All patients in this study were without any history of noise exposure in their life. The audiological status was measured with pure-tone audiometry and auditory brainstem response (ABR). The vestibular system was assessed using videonystagmography test battery and cervical vestibular-evoked myogenic potential (cVEMP). Timed up and go test was used as a quick screening tool for detecting balance problems. ABR and cVEMP results of the groups were calculated and compared. Results: The absolute peak latencies of ABR wave I, III, and V were prolonged in the study group than that in the control group. Vestibular-evoked myogenic potential results showed that P13 and N23 latencies were prolonged and P13–N23 amplitude was decreased in the study group when compared to the control group. Conclusion: Thoughtful examination of the vestibular system, in conjunction with auditory functions in elderly persons, is recommended. This may help discover their subclinical vestibular problem and guide physicians to design a suitable treatment plan that helps in decreasing the risk of falls for aged persons.

Decrease in inflammatory biomarker concentration by intervention with selenium and coenzyme Q10: a subanalysis of osteopontin, osteoprotergerin, TNFr1, TNFr2 and TWEAK

BackgroundInflammation is central to the pathogenesis of many diseases. Supplementation with selenium and coenzyme Q10 has been shown to reduce cardiovascular mortality, and increase cardiac function in elderly persons with a low intake of selenium. There are indications that one of the mechanisms of this positive effect is a decrease in inflammation.MethodsOsteopontin, osteoprotegerin, sTNF receptor 1, sTNF receptor 2 and the tumor necrosis factor-like weak inducer of apoptosis called TWEAK, were determined in plasma after 6 months and 42 months in 219 community-living elderly persons, of whom 119 received supplements of selenium (200 μg/day) and coenzyme Q10 (200 mg/day), and 101 received a placebo. Repeated measures of variance were used to evaluate the levels, and the results were validated through ANCOVA analyses with adjustments for important covariates.ResultsSignificantly lower concentrations of four of the five biomarkers for inflammation were observed as a result of the intervention with the supplements. Only TWEAK did not show significant differences.ConclusionIn this sub-analysis of the intervention with selenium and coenzyme Q10 or placebo in an elderly community-living population, biomarkers for inflammation were evaluated. A significantly lower concentration in four of the five biomarkers tested could be demonstrated as a result of the supplementation, indicating a robust effect on the inflammatory system. The decrease in inflammation could be one of the mechanisms behind the positive clinical results on reduced cardiovascular morbidity and mortality reported earlier as a result of the intervention. The study is small and should be regarded as hypothesis-generating, but nonetheless adds important data about mechanisms presently known to increase the risk of clinical effects such as reduced cardiovascular mortality, increased cardiac function and better health-related quality of life scoring, as previously demonstrated in the active treatment group .Trial registrationThe intervention study was registered at Clinicaltrials.gov, and has the identifier NCT01443780 and registered on 09/30/2011.

The Cognitive Telephone Screening Instrument (COGTEL): a reliable and valid tool for the assessment of cognitive functioning in the Brazilian elderly

Abstract Objectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.

Effect of SSRI and calcium channel blockers on depression symptoms and cognitive function in elderly persons treated for hypertension: three city cohort study.

Prospective study of 296 persons treated with SSRI and antihypertensive drugs. Baseline and two year clinic assessments were used to categorize participants as users of SSRI + CCB (n = 53) or users of SSRI + other antihypertensives (n = 243). Clinic visits were performed up to four times in a ten-year period to assess depression and cognitive function. The sample mean age was 75.2 ± 5.47 years and 78% of participants were female. At two year follow-up there was a significant group by time interaction showing lower Center for Epidemiological Studies-Depression (CESD) scores in the SSRI + CCB group, F(1,291) = 4.13, p = 0.043, η2p = 0.014. Over ten-years follow-up, SSRI + CCB use was associated with improved general cognitive function (Mini-Mental State Examination: β = 0.97; 95% CI 0.14 to 1.81, p = 0.023) and immediate visual memory (Boston Visual Retention Test: β = 0.69; 95% CI 0.06 to 1.32, p = 0.033). The findings provide general population evidence that SSRI augmentation with CCB may improve depression and cognitive function.

The relationship between presbycusis and vestibular activity

Introduction Presbycusis or age-related sensorineural hearing loss (SNHL) is a complex disorder that results in a slow deterioration in auditory function. A considerably high number of these patients with presbycusis or age-related SNHL also experience dizziness and related vestibular symptoms. Although auditory and vestibular systems are distinct, they work just alike. So, there is a great relation among their functions. Once one is stimulated, the other experiences changes as well. Participants and methods This study comprised 40 adult patients (50–75 years) without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with auditory brainstem response (ABR). The vestibular system was assessed using videonystagmography test battery, sensory organization test, and vestibular evoked myogenic potential (VEMP). ‘Get up and go’ test was used as a quick screening tool for detecting balance problems. Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). ABR and VEMP results of the groups were calculated and compared. Results Absolute peak latencies of ABR waves I, III, and V were prolonged in the study group than the control group (P Conclusion Thorough full examination of the vestibular system, in conjunction with auditory functions in elderly persons, is recommended. This may help to discover their subclinical vestibular problem and guide physicians to design a suitable treatment plan that helps in decreasing risk of falls for aged persons.

Relationship between instrumental activities of daily living and cognitive functions in elderly persons receiving day-care rehabilitation services

Relationship between instrumental activities of daily living and cognitive functions in elderly persons receiving day-care rehabilitation services

Lip closure training improves eating behaviors and prefrontal cortical hemodynamic activity and decreases daytime sleep in elderly persons

Previous research suggests that aging-related deterioration of oral functions causes not only eating/swallowing disorders but also various conditions such as sleep disorders and higher-order brain dysfunction. The aim of the present study was to examine the effects of lip closure training on eating behavior, sleep, and brain function in elderly persons residing in an elder care facility. The 20 elderly subjects (mean age, 86.3 ± 1.0 years) were assigned to a control group or a lip closure training (LCT) group, in which an oral rehabilitation device was used for daily LCT sessions over a 4-week period. Before and after the 4-week intervention period, maximal lip closure force was measured, and prefrontal cortical hemodynamic activity (changes in oxygenated hemoglobin concentration) during lip closure movements was measured with (LCT group) or without (control group) use of the oral rehabilitation device. We also analyzed eating behavior and daytime sleep before and after the intervention period.Compared with the control group, the LCT group showed improved maximal lip closure force, shortened eating time, decreased food spill rates, and decreased daytime sleeping. Furthermore, compared with the control group, the LCT group showed a significant increase in prefrontal cortical activity during lip closure. In addition, the increase rate in the right dorsolateral prefrontal cortical activity after the intervention period was significantly correlated with the increase rate in the maximal lip closure force after the intervention period.These findings suggest that LCT is useful in elderly individuals with decreased eating/oral and cognitive functions without the risk of pulmonary aspiration during training.

Low Estimated Glomerular Filtration Rate (eGFR) is Associated with Skeletal Muscle Function Deficit in Elderly Persons

Physical performance is closely associated with chronic diseases and dysfunction of numerous organ systems. Old persons with chronic renal failure have shown the apparent decline in physical performance, especially in the end-stage. However, it is unclear whether the subclinical kidney dysfunction is associated with skeletal muscle function deficit in the elderly population. PURPOSE: To determine the association between renal function and skeletal muscle function deficit in old persons without nephropathy. METHODS: Eight hundred fifty-four Korean elderly (female, 75.3%) aged 65 to 89 years were included in this cross-sectional study. All participants were interviewed face-to-face and received measure of anthropometry, body composition and serum biomarkers of metabolic diseases. eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation based on serum creatinine concentration. The following physical performance tests were performed: handgrip strength (absolute and relative values), timed up-and-go (TUG), chair stand, 2 min stationary walking, figure-eight walk and sit-and-reach. Skeletal muscle function deficit was defined as a combination of weakness and slowness based on the relative handgrip strength (men <1.32, women <0.792) and converted TUG to walking speed (<0.8 m/s), respectively. RESULTS: Of the subjects, the prevalence of 30≤ eGFR <45 mL/min/1.73m2 was 16.2%. The subjects with 30≤ eGFR <45 mL/min/1.73m2 showed significantly lower physical performance for muscular strength and functional mobility than those with 45≤ eGFR <60 and eGFR ≥60 mL/min/1.73m2, respectively (all for p<0.05). Multinomial (polychotomous) logistic regression analysis, with three categories of eGFR as the dependent variable, showed the significant association between eGFR and skeletal muscle function status even after adjustment for potential confounders (odds ratios [95% CI] were 4.8 [1.3-17.2] for a GFR of 45 to 59, 12.9 [3.1-52.9] for above 60 mL/min/1.73m2, p for trend <0.01). CONCLUSION: Taken together, skeletal muscle function status is associated with even moderately reduced eGFR in an older population. This finding suggests that maintenance of physical and functional fitness may be a contributory factor for preserving renal function in elderly persons.

Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons

Background/Aims: This study used 3-Tesla magnetic resonance imaging (MRI) tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH) and cognitive function in elderly persons. Methods: Brain T2-weighted fluid-attenuated inversion recovery (FLAIR) and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tests and were classified as normal controls (n = 15) or with Alzheimer's dementia (n = 11). Tractography was generated by the Fiber Assignment by Continuous Tracking method. All tracts that crossed WMH were segmented. The average fractional anisotropy and average mean diffusivity of these tracts were quantified. We studied the association between cognitive test scores with the average mean diffusivity and average fractional anisotropy of tracts while controlling for age, total WMH volume and diagnosis. Results: An increased mean diffusivity of tracts crossing WMH was associated with worse performance on the Wechsler Memory Scale-III Longest Span Forward (p = 0.02). There was no association between the fractional anisotropy of tracts and performance on cognitive testing. Conclusion: The mean diffusivity of tracts crossing WMH measured by tractography is a novel correlate of performance on the Wechsler Memory Scale-III Longest Span Forward in elderly persons.

A Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study.

Elevated homocysteine concentrations are associated with a decline in physical function in elderly persons. Homocysteine-lowering therapy may slow down this decline. This study aimed to examine the effect of a 2-year intervention of vitamin B12 and folic acid supplementation on physical performance, handgrip strength, and risk of falling in elderly subjects in a double-blind, randomized placebo-controlled trial. Participants aged ≥65 years with elevated plasma homocysteine concentrations [12–50 µmol/L (n = 2919)] were randomly assigned to daily supplementation of 500 µg vitamin B12, 400 µg folic acid, and 600 IU vitamin D3, or to placebo with 600 IU vitamin D3. Physical performance (range 0–12) and handgrip strength (kg) were measured at baseline and after 2 years. Falls were reported prospectively on a research calendar. Intention-to-treat (primary) and per-protocol (secondary) analyses were performed. Physical performance level and handgrip strength significantly decreased during the follow-up period, but this decline did not differ between groups. Moreover, time to first fall was not significantly different (HR: 1.0, 95 % CI 0.9–1.2). Secondary analyses on a per-protocol base identified an interaction effect with age on physical performance. In addition, the treatment was associated with higher follow-up scores on the walking test (cumulative OR: 1.3, 95 % CI 1.1–1.5). Two-year supplementation of vitamin B12 and folic acid was neither effective in reducing the age-related decline in physical performance and handgrip strength, nor in the prevention of falling in elderly persons. Despite the overall null-effect, the results provide indications for a positive effect of the intervention on gait, as well as on physical performance among compliant persons >80 years. These effects should be further tested in future studies.

Development of a novel oral jelly formulation for elderly patients

Deterioration of the swallowing function in elderly persons and drug refusal among the behavioral abnormalities in Alzheimer's disease (AD) are commonly reported. Therefore, we developed an easy-to-swallow jelly formulation of Donepezil HCl which AD patients can take as a dessert. The development process, however, was full of trade-off problems. (1) Need for evaluating the taste of a drug product vs. Safety of human sensory evaluation of the taste. The trade-off was resolved by using a taste sensor. (2) Speed of development vs. Safety of the manufacturing process. We put priority on the safety rather than speed, and a safer antioxidant agent was found. (3) Usability of the container for AD patients with dysphagia vs. Size of the container. We put priority on its being user-friendly rather than on the size and chose a stable wide-mouth cup. (4) Suitable texture of jelly for swallowing the drug product vs. Residual volume of jelly in the cup. We designed the texture so that the residual volume of jelly in the cup was reduced. (5) Easy peeling properties of aluminum seal vs. High sealing strength for sterilization. The sealing strength was adjusted so that it was adequate to sterilize the drug product. (6) One cup in a heat-sealed aluminum pillow package to prevent overdose vs. Seven cups in a pillow package. A single-dose package was relatively expensive, but it was chosen to assure safety. We faced many difficult trade-off problems in the development of process. However, they were resolved using technical innovations and a people-friendly policy. Finally, we were able to launch a novel oral jelly formulation for elderly patients.

Modified Constraint-Induced Therapy for the Lower Extremity in Elderly Persons With Chronic Stroke: Single-Subject Experimental Design Study

Background: Studies have demonstrated improvements in arm motor function after constraint-induced (CI) therapy. Few studies of CI therapy for lower extremity conditions have been done. Our purpose was to evaluate the effect of modified CI therapy for the lower extremity in terms of motor control in elderly persons with chronic stroke. Method: A single-subject experimental AB design was used, with 3 months of follow-up. The A phase consisted of a baseline period of 2 weeks with 6 measurements, and the B phase was a 4-week intervention with 8 measurements. Two men and 1 woman were included. The intervention consisted of intensive rehabilitation of the affected leg for 2 hours each weekday. A whole-leg orthosis was used to immobilize the nonaffected leg. The following tests were conducted: a step test for dynamic balance, Fugl-Meyer assessment for lower-extremity motor function, the Timed Up and Go test for mobility, and the 6-minute and 10-meter walk tests for walking ability. Statistical significance was analyzed by using Shewhart charts with a 2–standard deviation band method. Results: A positive change was observed in 14 of 18 variables. Significant improvements existed in 7 of the 14 positively changed variables. Positive changes remained in 13 of 14 variables at the 3-month follow-up evaluation. Conclusion: Modified CI therapy may result in positive changes in balance and motor function in elderly persons with chronic stroke.

Effects of Exercise Program Requiring Attention, Memory and Imitation on Cognitive Function in Elderly Persons: A Non-Randomized Pilot Study

Background: Square-Stepping Exercise (SSE) was developed as a novel exercise form that combines physical and cognitive training. Participants watch, recognize, memorize and follow step patterns which an instructor demonstrates on a 4 by 10 square-patterned SSE mat without viewing printed pattern diagrams. The purpose of this study was to examine the effects of SSE on cognitive function. Methods: Community-dwelling, healthy elderly persons were non-randomly divided into a weekly session group (WG) (26 participants) and a fortnightly session group (FG) (32 participants) for a six month intervention. SSE sessions lasted 50-60 minutes, and an SSE mat was provided to participants for home use. We asked participants to review printed pattern diagrams at home, then practice the SSE and record this in a log. Five cognitive tests were given preand post-intervention: cued recall, character position referencing, animal name listing, clock drawing and an analogy test. Results: Both groups significantly improved in the cued recall test (memory): 2.7 points [95% confidence interval (CI): 1.1-4.4] in the WG and 2.4 points [95%CI: 0.9-4.0] in the FG. Furthermore, the WG significantly improved in the character position referencing test (executive function) (5.6 points [95%CI: 2.8-8.3]). The three other cognitive function tests did not significantly improve. On the cued recall test, the rate of session participation and the rate of SSE performance for all designated days positively correlated in the WG/FG combined data. On the character position referencing test, the total SSE time and the number of days SSE was performed at home and in session were significant in the WG/FG combined data. Conclusion: The results of this pilot study indicate that SSE be could use as an intervention to promote cognitive function, especially memory and executive function. The amount and/or frequency of exposure to SSE would affect its impact on various types of cognitive function.

Muscle Synergy Analysis Between Young and Elderly People in Standing-Up Motion

Standing up is fundamental to daily activities of the elderly. It is necessary both to enhance muscle strength and to strengthen muscle coordination for improvement of their motor function. In this paper, we extract important data related to muscle coordination, called synergy, to perform standing motion by young and elderly participants. The contribution of muscle synergy to body kinematics is calculated through neural networks that estimate joint torque and body kinematics. To explain deficient motor function in elderly persons, extracted synergy is classified into 4 clusters based on how synergy contribute to body kinematics. Cluster analysis explains that elderly participants have weaker synergy than young persons in bending their backs to generate momentum. Compared to younger persons, older persons require additional muscle coordination to stabilize posture after standing-up in order to avoid falling.

The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia

The aims of this study were to determine the effectiveness of group music therapy for improving depression and delaying the deterioration of cognitive functions in elderly persons with dementia. The study had a prospective, parallel-group design with permuted-block randomization. Older persons with dementia (N = 104) were randomly assigned to the experimental or control group. The experimental group received 12 sessions of group music therapy (two 30-min sessions per week for 6 weeks), and the control group received usual care. Data were collected 4 times: (1) 1 week before the intervention, (2) the 6th session of the intervention, (3) the 12th session of the intervention, and (4) 1 month after the final session. Group music therapy reduced depression in persons with dementia. Improvements in depression occurred immediately after music therapy and were apparent throughout the course of therapy. The cortisol level did not significantly decrease after the group music therapy. Cognitive function significantly improved slightly at the 6th session, the 12th session, and 1 month after the sessions ended; in particular, short-term recall function improved. The group music therapy intervention had the greatest impact in subjects with mild and moderate dementia. The group music intervention is a noninvasive and inexpensive therapy that appeared to reduce elders' depression. It also delayed the deterioration of cognitive functions, particularly short-term recall function. Group music therapy may be an appropriate intervention among elderly persons with mild and moderate dementia.

Is power training or conventional resistance training better for function in elderly persons? A meta-analysis

to determine the effects of power training with high movement velocity compared with conventional resistance training with low movement velocity for older community-dwelling people. systematic review of randomised controlled trials. the Cochrane Central Register of Controlled TRIALS, PubMed (Medline), EMBASE, CINAHL, PEDro and Scholar-Google. all randomised or quasi-randomised trials investigating power training with high movement velocity versus conventional resistance training with low movement velocity in elderly persons over the age of 60 years. The primary outcomes were measures of functional outcomes; secondary outcomes were balance, gait, strength, power, muscle volume and adverse effects. eleven trials were identified involving 377 subjects. The pooled effect size for the follow-up values of the functional outcomes was 0.32 in favour of the power training (95% CI 0.06 to 0.57) and 0.38 (95% CI -0.51 to 1.28) for the change value. The pooled effect from three studies for self-reported function was 0.16 in favour of power training (95% CI -0.17 to 0.49). power training is feasible for elderly persons and has a small advantage over strength training for functional outcomes. No firm conclusion can be made for safety.

Cognitive function in elderly marathon runners: Cross-sectional data from the marathon trial (apsoem)

Cognitive impairment of the elderly contributes to morbidity, loss of quality of life, and impairment of work ability in aging western societies. Thus strategies to maintain cognitive function at an advanced age imply a great challenge to Occupational Medicine. To study whether intensive endurance exercise training is associated with better cognitive performance and increases brain-derived neurotrophic factor (BDNF) and insulin-like growth factor (IGF). Active elderly marathon runners or bicyclists older than 60 years were recruited and matched with an inactive control group according to age, sex, and education years. After exclusion of various diseases according to the study protocol 56 athletes and 58 controls could be selected for follow-up studies. The influence of endurance training on cognitive function was assessed by the use of the Vienna Neuropsychological Test Battery and the CERAD test battery. Other relevant outcomes were the levels of BDNF, IGF-1, Apo e4 carrier state, and self-ratings. The elderly marathon group performed better only in one specific cognitive task (the Five Point Test, p = 0.04) and almost significantly better in one additional test (the NAI Stroop Test, p = 0.08). Neither BDNF nor IGF-1 was related to the duration of daily exercise and no differences in the basal levels of these humoral growth factors in the exercise and the control cohort were found. Interestingly, we also found significantly decreased BDNF levels in subjects with Alzheimer's disease in the family in spite of the maintained normal cognitive performance (p = 0.01). These results suggest that extensive endurance exercise training might be beneficial for maintaining cognitive function in elderly persons. Our data demonstrate that beneficial endurance training effects are not linked to the upregulation of the examined neurotrophins. Since we found reduced BDNF-levels in subjects with a positive family history of Alzheimer's disease, we speculate that BDNF-reduction might precede cognitive impairment.