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Objective: To summarize the effect of dual-task training on cognitive, physical function, and dual-task performance in people with mild cognitive impairment or dementia. Data sources: Embase, PEDro, PsycINFO, PubMed, CINAHL, The Cochrane Library, and a forward search conducted via Web of Science have been searched from inception to July 2023. Review methods: Good-quality randomized controlled trials compared dual-task training with no/placebo intervention or single-task training among people with a primary diagnosis of mild cognitive impairment or dementia were included. The PEDro scale was used to evaluate the methodological quality of individual studies. The Grading of Recommendations, Assessment, Development and Evaluations system was adopted to appraise the quality of evidence for each outcome. Results: Eighteen trials (1325 participants) were included, and 17 provided data for meta-analysis. Comparing with no intervention, dual-task training led to significant improvements on attention (mean difference (MD) = −20.66, 95%CI [−39.42, −1.90]), functional mobility (MD = −2.73; 95%CI [−3.98, −1.49]). Compared with single-task training, dual-task training had greater effects on overall cognitive function (standardized mean difference (SMD) = 0.29, 95%CI [0.09, 0.49]), balance (SMD = 0.78, 95%CI [0.40, 1.15]) and functional mobility (MD = −1.17; 95%CI [−1.77, −0.58]). Its effect on dual-task performance remains inconclusive due to the inconsistent results reported. Conclusion: Low- to moderate-quality evidence supports that dual-task training has beneficial effects on cognitive function and physical function in individuals with dementia or mild cognitive impairment. The optimal training protocol of dual-task training on cognitive and physical functions, and dual-task performance remains uncertain. Well-designed, randomized studies with large enough sample sizes are warranted. [ABSTRACT FROM AUTHOR]

Cerebrovascular disease (CVD) poses a major public health and socio-economic burden worldwide due to its high morbidity and mortality rates. Accurate assessment of cerebral arteries' haemodynamic plays a crucial role in the diagnosis and treatment management of CVD. The study compared a non-imaging transcranial Doppler ultrasound (TCD) and transcranial color-coded Doppler ultrasound (with (cTCCD) and without (ncTCCD)) angle correction in quantifying middle cerebral arteries (MCAs) haemodynamic parameters. A cross-sectional study involving 50 healthy adults aged ≥ 18 years was conducted. The bilateral MCAs were insonated via three trans-temporal windows (TTWs—anterior, middle, and posterior) using TCD, cTCCD, and ncTCCD techniques. The MCA peak systolic velocity (PSV) and mean flow velocity (MFV) were recorded at proximal and distal imaging depths that could be visualised on TCCD with a detectable spectral waveform. A total of 152 measurements were recorded in 41 (82%) subjects with at least one-sided open TTW across the three techniques. The mean PSVs measured using TCD, ncTCCD, and cTCCD were 83 ± 18 cm/s, 81 ± 19 cm/s, and 93 ± 21 cm/s, respectively. There was no significant difference in PSV between TCD and ncTCCD (bias = 2 cm/s, p = 1.000), whereas cTCCD yielded a significantly higher PSV than TCD and ncTCCD (bias = −10 cm/s, p < 0.001; bias = −12 cm/s, p ≤ 0.001, respectively). The bias in MFV between TCD and ncTCCD techniques was (bias = −0.5 cm/s; p = 1.000), whereas cTCCD demonstrated a higher MFV compared to TCD and ncTCCD (bias = −8 cm/s, p < 0.001; bias = −8 cm/s, p ≤ 0.001, respectively). TCCD is a practically applicable imaging technique in assessing MCA blood flow velocities. cTCCD is more accurate and tends to give higher MCA blood flow velocities than non-imaging TCD and ncTCCD techniques. ncTCCD is comparable to non-imaging TCD and should be considered in clinical cases where using both TCD and TCCD measurements is needed. [ABSTRACT FROM AUTHOR]

Objective: To consolidate the evidence on the effect of physical exercise on fear of falling in individuals with stroke. Data Sources: PubMed, CINAHL, Cochrane Database and MEDLINE Methods: An extensive database search was conducted to identify the randomised controlled trials that examined the effect of physical exercise on fear of falling post-stroke. Grading of Recommendation, Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence for each meta-analysis. Results: Fourteen trials totalling 1211 participants were included in this review. Thirteen of these (1180 participants) were included in the meta-analyses. In the primary analysis, very low-quality evidence suggested that exercise reduced fear of falling post-stroke (standardized mean difference (SMD) 0.48; 95% confidence interval (CI) 0.23 to 0.72). The effect was diminished at three- to six-month follow-up after exercise training ended (SMD −0.09; 95% CI −0.27 to 0.10; high-quality evidence). In the sensitivity analyses, the treatment effect was more pronounced in individuals with a lower baseline Berg balance score (BBS ≤45; SMD 0.53; 95%CI 0.17 to 0.88) and for those trials with exercise frequency of ≥3 sessions per week (SMD 0.70; 95%CI 0.39 to 1.01). Compared with circuit-based training consisting of a combination of walking, balance and strengthening exercises (SMD 0.27; 95% CI −0.09 to 0.63), walking programmes seemed to generate a larger effect on fear of falling (SMD 1.06; 95%CI 0.43 to 1.70). Conclusion: Physical exercise was beneficial for reducing fear of falling in individuals with stroke, particularly those with poorer balance ability. [ABSTRACT FROM AUTHOR]

Background and Objectives: Vitamin D deficiency is reportedly common, but we lack data from young adults. Such data are of interest because epidemiological data support vitamin D as a possible risk modulator for diabetes and cardiovascular ('cardiometabolic') disease. Our objectives were to assess vitamin D status (as plasma 25(OH)D concentration) and investigate associations between this and biomarkers of cardiometabolic disease risk in a group of still-healthy young adults in Hong Kong.Methods and Study Design: In this observational study, fasting venous blood was collected from 196 (63 males, 133 females), young (18-26 years) non-smoking, nonobese, consenting adults in good general health. Plasma 25(OH)D was measured by LC-MS/MS. A panel of established cardiometabolic risk factors (HbA1c, plasma glucose, lipid profile, hsCRP) and blood pressure were also measured.Results: Mean (SD) plasma 25(OH)D concentration was 42.1 (13.0), with range 15.7-86.8 nmol/L; 141/196 subjects (72%) had vitamin D deficiency (25(OH)D <50 nmol/L); 13/184 (6.6%) were severely deficient (<25 nmol/L). Inverse association was seen between 25(OH)D and fasting glucose (r=-0.18; p<0.05). Higher HbA1c and TC:HDL-C ratio and lower HDL-C were seen in those with plasma 25(OH)D <25 nmol/L (p<0.05).Conclusions: Vitamin D deficiency was highly prevalent and associated with poorer cardiometabolic risk profile in these young adults. Public health strategies for addressing vitamin D deficiency are needed urgently. These new data provide support for further study on vitamin D deficiency as a modifiable risk factor for cardiometabolic disease and the ameliorative effects of increased vitamin D intake on cardiometabolic disease risk profile of vitamin D-deficient young adults. [ABSTRACT FROM AUTHOR]

Background and Objectives: Vitamin D deficiency is reportedly common, but we lack data from young adults. Such data are of interest because epidemiological data support vitamin D as a possible risk modulator for diabetes and cardiovascular ('cardiometabolic') disease. Our objectives were to assess vitamin D status (as plasma 25(OH)D concentration) and investigate associations between this and biomarkers of cardiometabolic disease risk in a group of still-healthy young adults in Hong Kong., Methods and Study Design: In this observational study, fasting venous blood was collected from 196 (63 males, 133 females), young (18-26 years) non-smoking, nonobese, consenting adults in good general health. Plasma 25(OH)D was measured by LC-MS/MS. A panel of established cardiometabolic risk factors (HbA1c, plasma glucose, lipid profile, hsCRP) and blood pressure were also measured., Results: Mean (SD) plasma 25(OH)D concentration was 42.1 (13.0), with range 15.7-86.8 nmol/L; 141/196 subjects (72%) had vitamin D deficiency (25(OH)D <50 nmol/L); 13/184 (6.6%) were severely deficient (<25 nmol/L). Inverse association was seen between 25(OH)D and fasting glucose (r=-0.18; p<0.05). Higher HbA1c and TC:HDL-C ratio and lower HDL-C were seen in those with plasma 25(OH)D <25 nmol/L (p<0.05)., Conclusions: Vitamin D deficiency was highly prevalent and associated with poorer cardiometabolic risk profile in these young adults. Public health strategies for addressing vitamin D deficiency are needed urgently. These new data provide support for further study on vitamin D deficiency as a modifiable risk factor for cardiometabolic disease and the ameliorative effects of increased vitamin D intake on cardiometabolic disease risk profile of vitamin D-deficient young adults.