Search

Background: Adults with Down syndrome (DS) are at risk for age-related painful physical conditions, but also for under-reporting pain. Pictograms may facilitate self-report of pain, because they seem suitable for the global visual processing in DS and for iconic representation of abstract concepts. Method: Participants (N = 39, M age = 41.2) assigned pain qualities to pictograms, rated pain affect levels in facial scales (pictograms vs. drawn faces), and performed cognitive tests. Results: Recognition of all intended pain qualities was above chance level. Pain affect levels of both facial scales were ordered equally well. Both facial scales were preferred equally well. Comprehension of the 3 scales was positively associated with mental age, receptive language ability, and verbal memory. Most participants (74%) had pictograms in their direct environment, mainly to communicate activities or objects. Conclusion: Using pictograms may optimise communication about pain for a subgroup of cognitively higher functioning adults with DS.

The objective of this study was to analyze the effects of a physical activity program including both aerobic exercise and cognitively engaging physical activities on children's physical fitness and executive functions. Children from 3 primary schools (aged 8-12 years) were recruited. A quasi-experimental design was used. Children in the intervention group (n = 53; 19 boys, 34 girls) participated in a 22-week physical activity program for 30 min during lunch recess, twice a week. Children in the control group (n = 52; 32 boys, 20 girls) followed their normal lunch routine. Aerobic fitness, speed and agility, and muscle strength were assessed using the Eurofit test battery. Executive functions were assessed using tasks measuring inhibition (Stroop test), working memory (Visual Memory Span test, Digit Span test), cognitive flexibility (Trailmaking test), and planning (Tower of London). Children in the intervention group showed significantly greater improvement than children in the control group on the Stroop test and Digit Span test, reflecting enhanced inhibition and verbal working memory skills, respectively. No differences were found on any of the physical fitness variables. A physical activity program including aerobic exercise and cognitively engaging physical activities can enhance aspects of executive functioning in primary school children. [ABSTRACT FROM AUTHOR]

Background Understanding if and how pain influences activities of daily living (ADL) in dementia is essential to improving pain management and ADL functioning. This study examined the relationship between the course of pain and change in ADL functioning, both generally and regarding specific ADL functions. Methods Participants were Dutch nursing home residents (n  = 229) with advanced dementia. ADL functioning was assessed with the Katz ADL scale, and pain with the Dutch version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-D). Changes of PACSLAC-D and Katz ADL scores were computed based on the difference in scores between baseline, 3-month and 6-month follow-up. Multivariate linear regression models were used to assess the relationships between change in pain score, change in total ADL score and specific ADL item scores during follow-up. Results At baseline, residents had a median ADL score of 18 (interquartile range 13–22, range 6–24) and 48% of the residents were in pain (PACSLAC-D ≥ 4). Residents with pain were more ADL dependent than residents without pain. A change in pain score within the first 3 months was a significant predictor for a decline in ADL functioning over the 6-month follow-up (B = 0.10, SE = 0.05, P  = 0.045), and specifically, a decline on the items 'transferring' over the 6-month follow-up and 'feeding' during the first 3 months of follow-up. Conclusions Pain is associated with ADL functioning cross-sectionally, and a change in pain score predicts a decline in ADL functioning, independent of dementia severity. Awareness of (changes in) ADL activities is clearly important and might result in both improved recognition of pain and improved pain management. [ABSTRACT FROM AUTHOR]

Background: Brain-derived neurotropic factor (BDNF) plays a vital role in neuronal survival and plasticity and facilitates long-term potentiation, essential for memory. Alterations in BDNF signaling have been associated with cognitive impairment, dementia, and Alzheimer's disease. Although peripheral BDNF levels are reduced in dementia patients, it is unclear whether changes in BDNF levels precede or follow dementia onset.Objective: In the present study, we examined the association between BDNF plasma levels and dementia risk over a follow-up period of up to 16 years.Methods: Plasma BDNF levels were assessed in 758 participants of the Rotterdam Study. Dementia was assessed from baseline (1997-1999) to follow-up until January 2016. Associations of plasma BDNF and incident dementia were assessed with Cox proportional hazards models, adjusted for age and sex. Associations between plasma BDNF and lifestyle and metabolic factors are investigated using linear regression.Results: During a follow up of 3,286 person-years, 131 participants developed dementia, of whom 104 had Alzheimer's disease. We did not find an association between plasma BDNF and risk of dementia (adjusted hazard ratio 0.99; 95%CI 0.84-1.16). BDNF levels were positively associated with age (B = 0.003, SD = 0.001, p = 0.002), smoking (B = 0.08, SE = 0.01, p = < 0.001), and female sex (B = 0.03, SE = 0.01, p = 0.03), but not with physical activity level (B = -0.01, SE = 0.01, p = 0.06).Conclusion: The findings suggest that peripheral BDNF levels are not associated with an increased risk of dementia. [ABSTRACT FROM AUTHOR]

Introduction: The American College of Sports Medicine prescribes regular performance of at least moderate-intensity physical activity for healthy aging. This study examined whether 1 session of 30 min of chair-assisted exercises for the elderly meets this intensity criterion. Method: This cross-sectional study included 47 cognitively healthy volunteers (mean age 84 years). During the performance of 30 min of chair-assisted exercises the authors determined oxygen uptake (VO2), carbon dioxide production, heart rate (HR), and rating of perceived exertion (RPE). These measures were expressed as a percentage of the estimated maximal VO2 (VO2max) and the estimated maximal HR (HRmax) and estimated as metabolic equivalent units (METs). Results: Participants performed chair-assisted exercises at 61.0% ± 14.7% of VO2max, 67.6% ± 11.3% HRmax, 3.9 ± 0.9 METs, and 13.1 ± 2.1 RPE. Conclusions: The intensity of these chair-assisted exercises is at least moderate for older adults, which is necessary for healthy aging. [ABSTRACT FROM AUTHOR]

Objectives: Over the past decade, a trend has been noticed in the Netherlands to replace large-scaled special care units (SCUs) caring for 20–30 residents with dementia by small-scaled SCUs caring for up to 8 residents. Systematic evaluations, however, have yielded a differentiated picture of the effects. As the impact on psychotropic drug use has hardly been addressed thus far, we examined the (potential) impact of psychotropic drug use when moving residents with dementia from large-scaled to small-scaled SCUs. Methods: We conducted a non-randomized, controlled study with a six-month follow-up. Among 145 residents with dementia living a large-scaled SCUs for dementia caring for 20–30 residents per unit, a total of 77 residents were moved to small-scaled SCUs caring for up to 8 residents per unit. Psychotropic drug use, classified according to the Anatomical Therapeutic Chemical Classification (ATC) system was monitored at 2 months before replacement, as well as at 3 and 6 months thereafter. Repeated measures ANOVAs were conducted for the mean Defined Daily Doses (DDDs) of both groups. Results: No significant differences between both groups in psychotropic medication use were found over a period of 8 months. Conclusion: Prescription of psychotropic drugs does not change after a transfer from a large-scaled SCU to a small-scaled SCU of patients with moderate to severe dementia. Current Controlled Trials: ISRCTN11151241. [ABSTRACT FROM AUTHOR]