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Sample records for older normal controls

  1. Normalization of emotion control scale

    Directory of Open Access Journals (Sweden)

    Hojatoolah Tahmasebian

    2014-09-01

    Full Text Available Background: Emotion control skill teaches the individuals how to identify their emotions and how to express and control them in various situations. The aim of this study was to normalize and measure the internal and external validity and reliability of emotion control test. Methods: This standardization study was carried out on a statistical society, including all pupils, students, teachers, nurses and university professors in Kermanshah in 2012, using Williams’ emotion control scale. The subjects included 1,500 (810 females and 690 males people who were selected by stratified random sampling. Williams (1997 emotion control scale, was used to collect the required data. Emotional Control Scale is a tool for measuring the degree of control people have over their emotions. This scale has four subscales, including anger, depressed mood, anxiety and positive affect. The collected data were analyzed by SPSS software using correlation and Cronbach's alpha tests. Results: The results of internal consistency of the questionnaire reported by Cronbach's alpha indicated an acceptable internal consistency for emotional control scale, and the correlation between the subscales of the test and between the items of the questionnaire was significant at 0.01 confidence level. Conclusion: The validity of emotion control scale among the pupils, students, teachers, nurses and teachers in Iran has an acceptable range, and the test itemswere correlated with each other, thereby making them appropriate for measuring emotion control.

  2. Lithium control during normal operation

    International Nuclear Information System (INIS)

    Suryanarayan, S.; Jain, D.

    2010-01-01

    Periodic increases in lithium (Li) concentrations in the primary heat transport (PHT) system during normal operation are a generic problem at CANDU® stations. Lithiated mixed bed ion exchange resins are used at stations for pH control in the PHT system. Typically tight chemistry controls including Li concentrations are maintained in the PHT water. The reason for the Li increases during normal operation at CANDU stations such as Pickering was not fully understood. In order to address this issue a two pronged approach was employed. Firstly, PNGS-A data and information from other available sources was reviewed in an effort to identify possible factors that may contribute to the observed Li variations. Secondly, experimental studies were carried out to assess the importance of these factors in order to establish reasons for Li increases during normal operation. Based on the results of these studies, plausible mechanisms/reasons for Li increases have been identified and recommendations made for proactive control of Li concentrations in the PHT system. (author)

  3. Relationship of metabolic and endocrine parameters to brain glucose metabolism in older adults: do cognitively-normal older adults have a particular metabolic phenotype?

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    Nugent, S; Castellano, C A; Bocti, C; Dionne, I; Fulop, T; Cunnane, S C

    2016-02-01

    Our primary objective in this study was to quantify whole brain and regional cerebral metabolic rates of glucose (CMRg) in young and older adults in order to determine age-normalized reference CMRg values for healthy older adults with normal cognition for age. Our secondary objectives were to--(i) report a broader range of metabolic and endocrine parameters including body fat composition that could form the basis for the concept of a 'metabolic phenotype' in cognitively normal, older adults, and (ii) to assess whether medications commonly used to control blood lipids, blood pressure or thyroxine affect CMRg values in older adults. Cognition assessed by a battery of tests was normal for age and education in both groups. Compared to the young group (25 years old; n = 34), the older group (72 years old; n = 41) had ~14% lower CMRg (μmol/100 g/min) specifically in the frontal cortex, and 18% lower CMRg in the caudate. Lower grey matter volume and cortical thickness was widespread in the older group. These differences in CMRg, grey matter volume and cortical thickness were present in the absence of any known evidence for prodromal Alzheimer's disease (AD). Percent total body fat was positively correlated with CMRg in many brain regions but only in the older group. Before and after controlling for body fat, HOMA2-IR was significantly positively correlated to CMRg in several brain regions in the older group. These data show that compared to a healthy younger adult, the metabolic phenotype of a cognitively-normal 72 year old person includes similar plasma glucose, insulin, cholesterol, triglycerides and TSH, higher hemoglobin A1c and percent body fat, lower CMRg in the superior frontal cortex and caudate, but the same CMRg in the hippocampus and white matter. Age-normalization of cognitive test results is standard practice and we would suggest that regional CMRg in cognitively healthy older adults should also be age-normalized.

  4. Comparison of anxiety as reported by older people with intellectual disabilities and by older people with normal intelligence

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    Hermans, H.; Beekman, A.T.F.; Evenhuis, H.M.

    2014-01-01

    Objectives Older people with intellectual disabilities (ID) may experience more and different symptoms of anxiety than older people with normal intelligence. Study questions: (1) Is the reported severity of anxiety in this group similar to that in the general older population; (2) Are specific

  5. Safety of disclosing amyloid status in cognitively normal older adults.

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    Burns, Jeffrey M; Johnson, David K; Liebmann, Edward P; Bothwell, Rebecca J; Morris, Jill K; Vidoni, Eric D

    2017-09-01

    Disclosing amyloid status to cognitively normal individuals remains controversial given our lack of understanding the test's clinical significance and unknown psychological risk. We assessed the effect of amyloid status disclosure on anxiety and depression before disclosure, at disclosure, and 6 weeks and 6 months postdisclosure and test-related distress after disclosure. Clinicians disclosed amyloid status to 97 cognitively normal older adults (27 had elevated cerebral amyloid). There was no difference in depressive symptoms across groups over time. There was a significant group by time interaction in anxiety, although post hoc analyses revealed no group differences at any time point, suggesting a minimal nonsustained increase in anxiety symptoms immediately postdisclosure in the elevated group. Slight but measureable increases in test-related distress were present after disclosure and were related to greater baseline levels of anxiety and depression. Disclosing amyloid imaging results to cognitively normal adults in the clinical research setting with pre- and postdisclosure counseling has a low risk of psychological harm. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  6. Destination memory in social interaction: better memory for older than for younger destinations in normal aging?

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    El Haj, Mohamad; Raffard, Stéphane; Fasotti, Luciano; Allain, Philippe

    2018-05-01

    Destination memory, a memory component allowing the attribution of information to its appropriate receiver (e.g., to whom did I lend my pen?), is compromised in normal aging. The present paper investigated whether older adults might show better memory for older destinations than for younger destinations. This hypothesis is based on empirical research showing better memory for older faces than for younger faces in older adults. Forty-one older adults and 44 younger adults were asked to tell proverbs to older and younger destinations (i.e., coloured faces). On a later recognition test, participants had to decide whether they had previously told some proverb to an older/younger destination or not. Prior to this task, participants reported their frequency of contact with other-age groups. The results showed lower destination memory in older adults than in younger adults. Interestingly, older adults displayed better memory for older than for younger destinations. The opposite pattern was seen in younger adults. The low memory for younger destinations, as observed in older adults, was significantly correlated with limited exposure to younger individuals. These findings suggest that for older adults, the social experience can play a crucial role in the destination memory, at least as far as exposure to other-age groups is concerned.

  7. Destination memory in social interaction: Better memory for older than for younger destinations in normal aging?

    NARCIS (Netherlands)

    El Haj, M.; Raffard, S.; Fasotti, L.; Allain, P.

    2018-01-01

    Destination memory, a memory component allowing the attribution of information to its appropriate receiver (e.g., to whom did I lend my pen?), is compromised in normal aging. The present paper investigated whether older adults might show better memory for older destinations than for younger

  8. Normal obstetric ultrasound reduces the risk of down syndrome in fetuses of older mothers

    International Nuclear Information System (INIS)

    Anderson, N. G.; Luehr, B.; Ng, R.

    2006-01-01

    The objective of this study is to determine whether a normal fetal morphology ultrasound scan in women older than 35 years reduces the risk of aneuploidy. We reviewed the results of amniocentesis and second trimester sonogram in all women older than 35 years from 1991 to 1995. None had prior screening. We excluded fetuses with structural anomalies. We determined the sensitivity and specificity of minor markers in detecting Down syndrome and also determined the reduction in risk of a normal sonogram. Among the 2060 women older than 35 years giving birth during the study period, 16 (0.78%) delivered an infant with Down syndrome. Of the 16 fetuses, two had no prenatal testing or ultrasound, two had invasive testing but no second trimester sonogram, five had a normal sonogram and seven had one or more sonographic markers of Down syndrome. At least 17% of women older than 35 years did not participate in prenatal testing or ultrasound. Ultrasound detected Down syndrome with a sensitivity of 59% (95% confidence interval: 45-72%), a false-positive rate of 10.6% (9.4-11.8%) and a positive predictor value of 1 in 9. The likelihood of having normal karyotype if the sonogram was normal was 0.46 (0.31-0.61). In women older than 35 years, a normal second trimester sonogram reduces the risk of Down syndrome by more than 50%. At least 17% of women older than 35 years do not participate in prenatal testing or ultrasound

  9. Balance control in older adults

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    Van Dieën, Jaap H.; Pijnappels, Mirjam

    2017-01-01

    To avoid falls during everyday movements, we need to maintain balance, i.e., control the position of our body's center of mass relative to our base of support. The balance control system comprises sensory subsystems, their afferent nerves, an extensive brain network, and the motor system.

  10. Upregulation of cognitive control networks in older adults’ speech comprehension

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    Julia eErb

    2013-12-01

    Full Text Available Speech comprehension abilities decline with age and with age-related hearing loss, but it is unclear how this decline expresses in terms of central neural mechanisms. The current study examined neural speech processing in a group of older adults (aged 56–77, n=16, with varying degrees of sensorineural hearing loss, and compared them to a cohort of young adults (aged 22–31, n=30, self-reported normal hearing. In an fMRI experiment, listeners heard and repeated back degraded sentences (4-band vocoding, which preserves the temporal envelope of the acoustic signal, while substantially degrading spectral information. Behaviourally, older adults adapted to degraded speech at the same rate as young listeners, although their overall comprehension of degraded speech was lower. Neurally, both older and young adults relied on the left anterior insula for degraded more than clear speech perception. However, anterior insula engagement in older adults was dependent on hearing acuity. Young adults additionally employed the anterior cingulate cortex (ACC. Interestingly, this age group × degradation interaction was driven by a reduced dynamic range in older adults, who displayed elevated levels of ACC activity in both conditions, consistent with a persistent upregulation in cognitive control irrespective of task difficulty. For correct speech comprehension, older adults recruited the middle frontal gyrus in addition to a core speech comprehension network on which young adults relied, suggestive of a compensatory mechanism. Taken together, the results indicate that older adults increasingly recruit cognitive control networks, even under optimal listening conditions, at the expense of these systems’ dynamic range.

  11. A high-glycemic diet is associated with cerebral amyloid burden in cognitively normal older adults.

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    Taylor, Matthew K; Sullivan, Debra K; Swerdlow, Russell H; Vidoni, Eric D; Morris, Jill K; Mahnken, Jonathan D; Burns, Jeffrey M

    2017-12-01

    Background: Little is known about the relation between dietary intake and cerebral amyloid accumulation in aging. Objective: We assessed the association of dietary glycemic measures with cerebral amyloid burden and cognitive performance in cognitively normal older adults. Design: We performed cross-sectional analyses relating dietary glycemic measures [adherence to a high-glycemic-load diet (HGLDiet) pattern, intakes of sugar and carbohydrates, and glycemic load] with cerebral amyloid burden (measured by florbetapir F-18 positron emission tomography) and cognitive performance in 128 cognitively normal older adults who provided eligibility screening data for the University of Kansas's Alzheimer's Prevention through Exercise (APEX) Study. The study began in November 2013 and is currently ongoing. Results: Amyloid was elevated in 26% ( n = 33) of participants. HGLDiet pattern adherence ( P = 0.01), sugar intake ( P = 0.03), and carbohydrate intake ( P = 0.05) were significantly higher in participants with elevated amyloid burden. The HGLDiet pattern was positively associated with amyloid burden both globally and in all regions of interest independently of age, sex, and education (all P ≤ 0.001). Individual dietary glycemic measures (sugar intake, carbohydrate intake, and glycemic load) were also positively associated with global amyloid load and nearly all regions of interest independently of age, sex, and educational level ( P ≤ 0.05). Cognitive performance was associated only with daily sugar intake, with higher sugar consumption associated with poorer global cognitive performance (global composite measure and Mini-Mental State Examination) and performance on subtests of Digit Symbol, Trail Making Test B, and Block Design, controlling for age, sex, and education. Conclusion: A high-glycemic diet was associated with greater cerebral amyloid burden, which suggests diet as a potential modifiable behavior for cerebral amyloid accumulation and subsequent Alzheimer

  12. Positioning effects on lung ventilation in older normal subjects: a technegas study

    International Nuclear Information System (INIS)

    Krieg, S.; McCarren, B.; Alison, J.; Cowell, S.F.; Leiper, C.; Bankstown-Lidcombe Hospital, Sydney, NSW; El Zein, H.

    2002-01-01

    Full text: While the effects of positioning on the distribution of ventilation in the lungs of younger subjects has been relatively well investigated, this is not so in the older age group. Known age-associated changes in the respiratory system are proposed to alter the distribution of ventilation in the lungs of older people. The aim of the present study was therefore to determine the effects of positioning on the distribution of ventilation in the lungs of older normal subjects. The distribution of ventilation in upright sitting and right side lying was measured in ten subjects using Technegas lung ventilation during tidal breathing. In the upright sitting position ventilation was preferentially distributed to the middle and basal regions (dependent regions). Right side lying ventilation was preferentially distributed to the right lung (dependent region). These results suggest that preferential distribution of ventilation to the dependent lung regions in older subjects is mainly due to the gravity-dependent gradient in pleural pressure. It is proposed that this distribution may partly result from loss of elasticity in the lungs with ageing. Predominantly, the distribution of ventilation in the lungs of older normal subjects in our study is similar to that previously described in younger subjects (Amis et al., 1984, Kaneko et al, 1966, Milic-Emili et al, 1966. This suggests that a similar pleural pressure gradient may exist in the lungs of older and younger subjects. This is an important implication as the majority of patients that physiotherapists treat with cardiopulmonary dysfunction are in the older age group. Further research is required to determine the effects of positioning on the distribution of ventilation in older patients with cardiopulmonary dysfunction to enable direct clinical implications to be made. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Association of Higher Cortical Amyloid Burden With Loneliness in Cognitively Normal Older Adults.

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    Donovan, Nancy J; Okereke, Olivia I; Vannini, Patrizia; Amariglio, Rebecca E; Rentz, Dorene M; Marshall, Gad A; Johnson, Keith A; Sperling, Reisa A

    2016-12-01

    Emotional and behavioral symptoms in cognitively normal older people may be direct manifestations of Alzheimer disease (AD) pathophysiology at the preclinical stage, prior to the onset of mild cognitive impairment. Loneliness is a perceived state of social and emotional isolation that has been associated with cognitive and functional decline and an increased risk of incident AD dementia. We hypothesized that loneliness might occur in association with elevated cortical amyloid burden, an in vivo research biomarker of AD. To determine whether cortical amyloid burden is associated with greater loneliness in cognitively normal older adults. Cross-sectional analyses using data from the Harvard Aging Brain Study of 79 cognitively normal, community-dwelling participants. A continuous, aggregate measure of cortical amyloid burden, determined by Pittsburgh Compound B-positron emission tomography (PiB-PET), was examined in association with loneliness in linear regression models adjusting for age, sex, apolipoprotein E ε4 (APOEε4), socioeconomic status, depression, anxiety, and social network (without and with the interaction of amyloid and APOEε4). We also quantified the association of high amyloid burden (amyloid-positive group) to loneliness (lonely group) using logistic regression, controlling for the same covariates, with the amyloid-positive group and the lonely group, each composing 32% of the sample (n = 25). Loneliness, as determined by the 3-item UCLA Loneliness Scale (possible range, 3-12, with higher score indicating greater loneliness). The 79 participants included 43 women and 36 men with a mean (SD) age of 76.4 (6.2) years. Mean (SD) cortical amyloid burden via PiB-PET was 1.230 (0.209), and the mean (SD) UCLA-3 loneliness score was 5.3 (1.8). Twenty-two (28%) had positive APOEε4 carrier status, and 25 (32%) were in the amyloid-positive group with cortical PiB distribution volume ratio greater than 1.2. Controlling for age, sex, APOEε4, socioeconomic

  14. Exploring the Factor Structure of Financial Capacity in Cognitively Normal and Impaired Older Adults.

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    Gerstenecker, Adam; Triebel, Kristen; Eakin, Amanda; Martin, Roy; Marson, Daniel

    2018-01-01

    To investigate the factor structure of financial capacity using a direct-performance measure of financial skills (The Financial Capacity Instrument [FCI]) as a proxy for the financial capacity construct. The study sample was composed of 440 older adults who represented the cognitive spectrum from normal cognitive aging to mild cognitive impairment (MCI) to mild dementia: 179 healthy older adults, 149 participants with MCI, and 112 participants with mild Alzheimer's dementia (AD). Both Velicer's Minimum Average Partial test and Horn's parallel analysis supported a four-factor solution which accounted for 46% of variance. The four extracted factors were interpreted as: (1) Basic Monetary Knowledge and Calculation Skills, (2) Financial Judgment, (3) Financial Conceptual Knowledge, and (4) Financial Procedural Knowledge. The study findings represent an important first step in empirically articulating the financial capacity construct in aging. The four identified factors can guide both clinical practice and future instrument utilization and development. Cognitively impaired older adults with MCI and mild AD dementia are likely to show financial changes in one or more of the four identified financial factors. Clinicians working with older adults should routinely examine for potential changes in these four areas of financial function.

  15. Esophageal Clearance Patterns in Normal Older Adults as Documented with Videofluoroscopic Esophagram

    Directory of Open Access Journals (Sweden)

    Janice Jou

    2009-01-01

    Full Text Available Normal esophageal bolus transport in asymptomatic healthy older adults has not been well defined, potentially leading to ambiguity in differentiating esophageal swallowing patterns of dysphagic and healthy individuals. This pilot study of 24 young (45–64 years and old (65+years men and women was designed to assess radiographic esophageal bolus movement patterns in healthy adults using videofluoroscopic recording. Healthy, asymptomatic adults underwent videofluoroscopic esophagram to evaluate for the presence of ineffective esophageal clearance, namely, intraesophageal stasis and intraesophageal reflux. Intraesophageal stasis and intraesophageal reflux were visualized radiographically in these normal subjects. Intraesophageal stasis occurred significantly more frequently with semisolid (96% compared with liquid (16% barium, suggesting that a variety of barium consistencies, as opposed to only the traditional fluids, would better define the spectrum of esophageal transport. Intraesophageal reflux was observed more frequently in older males than in their younger counterparts. The rates of intraesophageal stasis and intraesophageal reflux were potentially high given that successive bolus presentations were spaced 10 seconds apart. These findings suggest a need for a more comprehensive definition regarding the range of normal esophageal bolus transport to (a prevent misdiagnosis of dysphagia and (b to enhance generalization to functional eating, which involves solid foods in addition to liquids.

  16. The relationship between recognition memory for emotion-laden words and white matter microstructure in normal older individuals.

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    Saarela, Carina; Karrasch, Mira; Ilvesmäki, Tero; Parkkola, Riitta; Rinne, Juha O; Laine, Matti

    2016-12-14

    Functional neuroimaging studies have shown age-related differences in brain activation and connectivity patterns for emotional memory. Previous studies with middle-aged and older adults have reported associations between episodic memory and white matter (WM) microstructure obtained from diffusion tensor imaging, but such studies on emotional memory remain few. To our knowledge, this is the first study to explore associations between WM microstructure as measured by fractional anisotropy (FA) and recognition memory for intentionally encoded positive, negative, and emotionally neutral words using tract-based spatial statistics applied to diffusion tensor imaging images in an elderly sample (44 cognitively intact adults aged 50-79 years). The use of tract-based spatial statistics enables the identification of WM tracts important to emotional memory without a priori assumptions required for region-of-interest approaches that have been used in previous work. The behavioral analyses showed a positivity bias, that is, a preference for positive words, in recognition memory. No statistically significant associations emerged between FA and memory for negative or neutral words. Controlling for age and memory performance for negative and neutral words, recognition memory for positive words was negatively associated with FA in several projection, association, and commissural tracts in the left hemisphere. This likely reflects the complex interplay between the mnemonic positivity bias, structural WM integrity, and functional brain compensatory mechanisms in older age. Also, the unexpected directionality of the results indicates that the WM microstructural correlates of emotional memory show unique characteristics in normal older individuals.

  17. Amyloid burden and incident depressive symptoms in cognitively normal older adults.

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    Harrington, Karra D; Gould, Emma; Lim, Yen Ying; Ames, David; Pietrzak, Robert H; Rembach, Alan; Rainey-Smith, Stephanie; Martins, Ralph N; Salvado, Olivier; Villemagne, Victor L; Rowe, Christopher C; Masters, Colin L; Maruff, Paul

    2017-04-01

    Several studies have reported that non-demented older adults with clinical depression show changes in amyloid-β (Aβ) levels in blood, cerebrospinal fluid and on neuroimaging that are consistent with those observed in patients with Alzheimer's disease. These findings suggest that Aβ may be one of the mechanisms underlying the relation between the two conditions. We sought to determine the relation between elevated cerebral Aβ and the presence of depression across a 54-month prospective observation period. Cognitively normal older adults from the Australian Imaging Biomarkers and Lifestyle study who were not depressed and had undergone a positron emission tomography scan to classify them as either high Aβ (n = 81) or low Aβ (n = 278) participated. Depressive symptoms were assessed using the Geriatric Depression Scale - Short Form at 18-month intervals over 54 months. Whilst there was no difference in probable depression between groups at baseline, incidence was 4.5 (95% confidence interval [CI] 1.3-16.4) times greater within the high Aβ group (9%) than the low Aβ group (2%) by the 54-month assessment. Results of this study suggest that elevated Aβ levels are associated with a 4.5-fold increased likelihood of developing clinically significant depressive symptoms on follow-up in preclinical Alzheimer's disease. This underscores the importance of assessing, monitoring and treating depressive symptoms in older adults with elevated Aβ. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Responsible and controlled use: Older cannabis users and harm reduction.

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    Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

    2015-08-01

    Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg's classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. We present selected findings from our qualitative study of Baby Boomer (born 1946-1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users' perspectives. Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Participants followed rituals or cultural practices, characterized by sanctions that helped define "normal" or "acceptable" cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Cerebral Blood Flow and Amyloid-β Interact to Affect Memory Performance in Cognitively Normal Older Adults

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    Katherine J. Bangen

    2017-06-01

    Full Text Available Cerebral blood flow (CBF alterations and amyloid-β (Aβ accumulation have been independently linked to cognitive deficits in older adults at risk for dementia. Less is known about how CBF and Aβ may interact to affect cognition in cognitively normal older adults. Therefore, we examined potential statistical interactions between CBF and Aβ status in regions typically affected in Alzheimer’s disease (AD within a sample of older adults from the Alzheimer’s Disease Neuroimaging Initiative (ADNI study. Sixty-two cognitively normal participants (mean age = 72 years underwent neuroimaging and memory testing. Arterial spin labeling magnetic resonance imaging was used to quantify CBF and florbetapir PET amyloid imaging was used to measure Aβ deposition. Aβ status (i.e., positivity versus negativity was determined based on established cutoffs (Landau et al., 2013. The Rey Auditory Verbal Learning Test was used to assess memory. Linear regression models adjusted for age, education, and sex, demonstrated significant interactions between CBF and Aβ status on memory performance. Among Aβ positive older adults, there were significant negative associations between higher CBF in hippocampus, posterior cingulate, and precuneus and poorer memory performance. In contrast, among Aβ negative older adults, there were no significant associations between CBF and cognition. Our findings extend previous CBF studies of dementia risk by reporting interactions between Aβ status and CBF on memory performance in a sample of well-characterized, cognitively normal older adults. Results suggest that differential CBF-cognition associations can be identified in healthy, asymptomatic Aβ positive older adults relative to Aβ negative individuals. Associations between higherCBF and poorer memory among Aβ positive older adults may reflect a cellular and/or vascular compensatory response to pathologic processes whereby higher CBF is needed to maintain normal memory

  20. Responsible and controlled use: Older cannabis users and harm reduction

    Science.gov (United States)

    Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

    2015-01-01

    Background Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg’s classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. Methods We present selected findings from our qualitative study of Baby Boomer (born 1946–1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users’ perspectives. Results Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Conclusion Participants followed rituals or cultural practices, characterized by sanctions that helped define “normal” or “acceptable” cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. PMID:25911027

  1. Altered characteristics of balance control in obese older adults.

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    Melzer, Itshak; Oddsson, Lars I E

    2016-01-01

    Obesity is one of the most significant epidemiological trends of the last decades. Recently it was found that obese individuals show postural instability. Balance control mechanisms in obese older adults were less studied. Therefore we aimed to investigate the effect of obesity on balance control mechanisms in older adults. Parameters from Stabilogram-Diffusion Analysis (SDA) and measures from summary statistics of foot centre-of-pressure (COP) displacements along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions were used to characterize postural control in 22 obese (30-postural control process in obese older adults. A greater sway displacement before closed-loop feedback mechanisms are called into play was seen in the ML direction that may lead to a higher risk of instability and fall events. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  2. Self-rated driving habits among older adults with clinically-defined mild cognitive impairment, clinically-defined dementia, and normal cognition.

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    O'Connor, Melissa L; Edwards, Jerri D; Bannon, Yvonne

    2013-12-01

    Older adults with clinically-defined dementia may report reducing their driving more than cognitively normal controls. However, it is unclear how these groups compare to individuals with clinically-defined mild cognitive impairment (MCI) in terms of driving behaviors. The current study investigated self-reported driving habits among adults age 60 and older with clinical MCI (n=41), clinical mild dementia (n=40), and normal cognition (n=43). Participants reported their driving status, driving frequency (days per week), and how often they avoided accessing the community, making left turns, driving at night, driving in unfamiliar areas, driving on high-traffic roads, and driving in bad weather. After adjusting for education, a MANCOVA revealed that participants with MCI and dementia avoided unfamiliar areas and high-traffic roads significantly more than normal participants. Participants with dementia also avoided left turns and accessing the community more than those with normal cognition and MCI (pdriving variables did not significantly differ between groups. Thus, older adults with clinically-defined MCI, as well as those with dementia, avoided some complex driving situations more than cognitively intact adults. However, all diagnostic groups had similar rates of driving cessation and frequency. Future research should examine the safety implications of such findings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Evidence of disrupted high-risk human papillomavirus DNA in morphologically normal cervices of older women.

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    Leonard, Sarah M; Pereira, Merlin; Roberts, Sally; Cuschieri, Kate; Nuovo, Gerard; Athavale, Ramanand; Young, Lawrence; Ganesan, Raji; Woodman, Ciarán B

    2016-02-15

    High-risk human papillomavirus (HR-HPV) causes nearly 100% of cervical carcinoma. However, it remains unclear whether HPV can establish a latent infection, one which may be responsible for the second peak in incidence of cervical carcinoma seen in older women. Therefore, using Ventana in situ hybridisation (ISH), quantitative PCR assays and biomarkers of productive and transforming viral infection, we set out to provide the first robust estimate of the prevalence and characteristics of HPV genomes in FFPE tissue from the cervices of 99 women undergoing hysterectomy for reasons unrelated to epithelial abnormality. Our ISH assay detected HR-HPV in 42% of our study population. The majority of ISH positive samples also tested HPV16 positive using sensitive PCR based assays and were more likely to have a history of preceding cytological abnormality. Analysis of subsets of this population revealed HR-HPV to be transcriptionally inactive as there was no evidence of a productive or transforming infection. Critically, the E2 gene was always disrupted in those HPV16 positive cases which were assessed. These findings point to a reservoir of transcriptionally silent, disrupted HPV16 DNA in morphologically normal cervices, re-expression of which could explain the increase in incidence of cervical cancer observed in later life.

  4. Salivary function and glycemic control in older persons with diabetes.

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    Chavez, E M; Taylor, G W; Borrell, L N; Ship, J A

    2000-03-01

    There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study's purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population. Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated (age range, 54-90 years). Diabetic status was determined by a glycosylated hemoglobin (HbA(1c)) test and a 2-hour glucose tolerance test. Poor glycemic control was defined as HbA(1c) >9%. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire. Persons with poorly controlled diabetes had lower (P =.01) stimulated parotid flow rates than persons with well-controlled diabetes and nondiabetic control subjects. There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.

  5. Glucose hypometabolism is highly localized, but lower cortical thickness and brain atrophy are widespread in cognitively normal older adults.

    Science.gov (United States)

    Nugent, Scott; Castellano, Christian-Alexandre; Goffaux, Philippe; Whittingstall, Kevin; Lepage, Martin; Paquet, Nancy; Bocti, Christian; Fulop, Tamas; Cunnane, Stephen C

    2014-06-01

    Several studies have suggested that glucose hypometabolism may be present in specific brain regions in cognitively normal older adults and could contribute to the risk of subsequent cognitive decline. However, certain methodological shortcomings, including a lack of partial volume effect (PVE) correction or insufficient cognitive testing, confound the interpretation of most studies on this topic. We combined [(18)F]fluorodeoxyglucose ([(18)F]FDG) positron emission tomography (PET) and magnetic resonance (MR) imaging to quantify cerebral metabolic rate of glucose (CMRg) as well as cortical volume and thickness in 43 anatomically defined brain regions from a group of cognitively normal younger (25 ± 3 yr old; n = 25) and older adults (71 ± 9 yr old; n = 31). After correcting for PVE, we observed 11-17% lower CMRg in three specific brain regions of the older group: the superior frontal cortex, the caudal middle frontal cortex, and the caudate (P ≤ 0.01 false discovery rate-corrected). In the older group, cortical volumes and cortical thickness were 13-33 and 7-18% lower, respectively, in multiple brain regions (P ≤ 0.01 FDR correction). There were no differences in CMRg between individuals who were or were not prescribed antihypertensive medication. There were no significant correlations between CMRg and cognitive performance or metabolic parameters measured in fasting plasma. We conclude that highly localized glucose hypometabolism and widespread cortical thinning and atrophy can be present in older adults who are cognitively normal, as assessed using age-normed neuropsychological testing measures. Copyright © 2014 the American Physiological Society.

  6. Speech perception in older listeners with normal hearing:conditions of time alteration, selective word stress, and length of sentences.

    Science.gov (United States)

    Cho, Soojin; Yu, Jyaehyoung; Chun, Hyungi; Seo, Hyekyung; Han, Woojae

    2014-04-01

    Deficits of the aging auditory system negatively affect older listeners in terms of speech communication, resulting in limitations to their social lives. To improve their perceptual skills, the goal of this study was to investigate the effects of time alteration, selective word stress, and varying sentence lengths on the speech perception of older listeners. Seventeen older people with normal hearing were tested for seven conditions of different time-altered sentences (i.e., ±60%, ±40%, ±20%, 0%), two conditions of selective word stress (i.e., no-stress and stress), and three different lengths of sentences (i.e., short, medium, and long) at the most comfortable level for individuals in quiet circumstances. As time compression increased, sentence perception scores decreased statistically. Compared to a natural (or no stress) condition, the selectively stressed words significantly improved the perceptual scores of these older listeners. Long sentences yielded the worst scores under all time-altered conditions. Interestingly, there was a noticeable positive effect for the selective word stress at the 20% time compression. This pattern of results suggests that a combination of time compression and selective word stress is more effective for understanding speech in older listeners than using the time-expanded condition only.

  7. Eye Movements Affect Postural Control in Young and Older Females.

    Science.gov (United States)

    Thomas, Neil M; Bampouras, Theodoros M; Donovan, Tim; Dewhurst, Susan

    2016-01-01

    Visual information is used for postural stabilization in humans. However, little is known about how eye movements prevalent in everyday life interact with the postural control system in older individuals. Therefore, the present study assessed the effects of stationary gaze fixations, smooth pursuits, and saccadic eye movements, with combinations of absent, fixed and oscillating large-field visual backgrounds to generate different forms of retinal flow, on postural control in healthy young and older females. Participants were presented with computer generated visual stimuli, whilst postural sway and gaze fixations were simultaneously assessed with a force platform and eye tracking equipment, respectively. The results showed that fixed backgrounds and stationary gaze fixations attenuated postural sway. In contrast, oscillating backgrounds and smooth pursuits increased postural sway. There were no differences regarding saccades. There were also no differences in postural sway or gaze errors between age groups in any visual condition. The stabilizing effect of the fixed visual stimuli show how retinal flow and extraocular factors guide postural adjustments. The destabilizing effect of oscillating visual backgrounds and smooth pursuits may be related to more challenging conditions for determining body shifts from retinal flow, and more complex extraocular signals, respectively. Because the older participants matched the young group's performance in all conditions, decreases of posture and gaze control during stance may not be a direct consequence of healthy aging. Further research examining extraocular and retinal mechanisms of balance control and the effects of eye movements, during locomotion, is needed to better inform fall prevention interventions.

  8. A randomized controlled trial to promote volunteering in older adults.

    Science.gov (United States)

    Warner, Lisa M; Wolff, Julia K; Ziegelmann, Jochen P; Wurm, Susanne

    2014-12-01

    Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  9. Motor-evoked potential amplitudes elicited by transcranial magnetic stimulation do not differentiate between patients and normal controls.

    Science.gov (United States)

    Grunhaus, Leon; Polak, Dana; Amiaz, Revital; Dannon, Pinhas N

    2003-12-01

    Transcranial magnetic stimulation (TMS) applied over the motor cortex depolarizes neurons and leads to motor-evoked potentials (MEP). To assess cortico-spinal excitability we compared the motor threshold (MT) and the averaged MEP amplitude generated by TMS in patients with major depression (MD) and matched controls. Nineteen patients, who where participants in a protocol comparing the antidepressant effects of rTMS with those of ECT, and thirteen age- and gender-matched normal controls were studied. MT was similar between patients and normal controls. The MEP amplitude response was significantly increased by rTMS, however, the magnitude of the response was similar in patients and normal controls. Correlations between the averaged MEP amplitude and age revealed that older subjects demonstrated significantly lower responses at all time-points. We conclude that cortico-spinal excitability is increased following rTMS, however, differences between patients and normal controls were not apparent with the paradigm used.

  10. Adaptive nonlinear control using input normalized neural networks

    International Nuclear Information System (INIS)

    Leeghim, Henzeh; Seo, In Ho; Bang, Hyo Choong

    2008-01-01

    An adaptive feedback linearization technique combined with the neural network is addressed to control uncertain nonlinear systems. The neural network-based adaptive control theory has been widely studied. However, the stability analysis of the closed-loop system with the neural network is rather complicated and difficult to understand, and sometimes unnecessary assumptions are involved. As a result, unnecessary assumptions for stability analysis are avoided by using the neural network with input normalization technique. The ultimate boundedness of the tracking error is simply proved by the Lyapunov stability theory. A new simple update law as an adaptive nonlinear control is derived by the simplification of the input normalized neural network assuming the variation of the uncertain term is sufficiently small

  11. High proportions of older people with normal nutritional status have poor protein intake and low diet quality.

    Science.gov (United States)

    Jyväkorpi, S K; Pitkälä, K H; Puranen, T M; Björkman, M P; Kautiainen, H; Strandberg, T E; Soini, H H; Suominen, M H

    2016-01-01

    The Mini Nutritional Assessment (MNA) is a well-validated instrument examining the nutritional status of older people. The aim of this study was to examine how older people's energy and nutrient intakes are associated with the MNA and to determine how sensitive and specific MNA is in identifying those having low energy and protein intakes. This cross-sectional study combined data from five nutritional studies (N=900): both home-dwelling and institutionalized older people without and with disabilities. Their nutritional status was assessed with MNA, and nutrient intakes were retrieved from 1 to 3day food diaries. Nutrient intakes were divided according to MNA status (normal nutritional status, at-risk of malnutrition, malnourished). Sensitivity, specificity, and likelihood ratios of MNA of various cut-off points were tested with recommended protein and energy intakes. ROC curves was constructed. Energy, protein and most nutrient intakes showed logical linear trends according to MNA classes. However, more than three-fourths of the participants with MNA>23.5 had lower than recommended protein intakes. Sensitivity of MNA ranged from 0.32 to 0.82 for recommended energy (F:1570kcal/d/M:2070kcal/d) and protein intakes (1.0g/kg BW or 1.2g/kgBW) cut-off points, and specificity from 0.75 to 0.25, respectively. AUC values were low (0.52-0.53). MNA status was consistently associated with nutrient intakes and diet quality. However, a high proportion of older people even with normal nutritional status had poor energy and protein intakes. Thus, MNA does not identify all those with poor nutrient intakes who may be at risk of developing malnutrition. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Contributions to lateral balance control in ambulatory older adults.

    Science.gov (United States)

    Sparto, Patrick J; Newman, A B; Simonsick, E M; Caserotti, P; Strotmeyer, E S; Kritchevsky, S B; Yaffe, K; Rosano, C

    2018-06-01

    In older adults, impaired control of standing balance in the lateral direction is associated with the increased risk of falling. Assessing the factors that contribute to impaired standing balance control may identify areas to address to reduce falls risk. To investigate the contributions of physiological factors to standing lateral balance control. Two hundred twenty-two participants from the Pittsburgh site of the Health, Aging and Body Composition Study had lateral balance control assessed using a clinical sensory integration balance test (standing on level and foam surface with eyes open and closed) and a lateral center of pressure tracking test using visual feedback. The center of pressure was recorded from a force platform. Multiple linear regression models examined contributors of lateral control of balance performance, including concurrently measured tests of lower extremity sensation, knee extensor strength, executive function, and clinical balance tests. Models were adjusted for age, body mass index, and sex. Larger lateral sway during the sensory integration test performed on foam was associated with longer repeated chair stands time. During the lateral center of pressure tracking task, the error in tracking increased at higher frequencies; greater error was associated with worse executive function. The relationship between sway performance and physical and cognitive function differed between women and men. Contributors to control of lateral balance were task-dependent. Lateral standing performance on an unstable surface may be more dependent upon general lower extremity strength, whereas visual tracking performance may be more dependent upon cognitive factors. Lateral balance control in ambulatory older adults is associated with deficits in strength and executive function.

  13. Parental Perceptions of Child Behavior Problems, Parenting Self-Esteem, and Mothers' Reported Stress in Younger and Older Hyperactive and Normal Children.

    Science.gov (United States)

    Mash, Eric J.; Johnston, Charlotte

    1983-01-01

    Examined parental perceptions of child behavior, parenting self-esteem, and mothers' reported stress for younger and older hyperactive and normal children. Parenting self-esteem was lower in parents of hyperactives than in parents of normal children. Self-esteem related to skill/knowledge as a parent was age related. (Author/RC)

  14. Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

    Directory of Open Access Journals (Sweden)

    Bamford Claire

    2012-10-01

    Full Text Available Abstract Background Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT to understand the barriers and facilitators to implementing the guidelines and inform future implementation. Methods We conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews to explore the views of managers, care staff, catering staff, and domestic staff. Data were analyzed thematically and discussed in data workshops; emerging themes were then mapped to the constructs of NPT. Results Many staff perceived the guidelines as unnecessarily restrictive and irrelevant to older people. In terms of NPT, the guidelines simply did not make sense (coherence, and as a result, relatively few staff invested in the guidelines (cognitive participation. Even where staff supported the guidelines, implementation was hampered by a lack of nutritional knowledge and institutional support (collective action. Finally, the absence of observable benefits to clients confirmed the negative preconceptions of many staff, with limited evidence of reappraisal following implementation (reflexive monitoring. Conclusions The successful implementation of the nutrition guidelines requires that the fundamental issues relating to their perceived value and fit with other priorities and goals be addressed. Specialist support is needed to equip staff with the technical knowledge and skills required for menu analysis and development and to

  15. Video game training enhances cognitive control in older adults.

    Science.gov (United States)

    Anguera, J A; Boccanfuso, J; Rintoul, J L; Al-Hashimi, O; Faraji, F; Janowich, J; Kong, E; Larraburo, Y; Rolle, C; Johnston, E; Gazzaley, A

    2013-09-05

    Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations. It is clear that multitasking behaviour has become ubiquitous in today's technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population. Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months. Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal-posterior theta coherence). Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later. These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool

  16. Prevalence of sarcopenia among older community-dwelling people with normal health and nutritional state.

    Science.gov (United States)

    Hedayati, Kerstin Khalaj; Dittmar, Manuela

    2010-01-01

    This study analyzed whether sarcopenia, a risk factor for disability in the aged, also occurs in healthy community-dwelling elders with normal nutritional state. As indicators, body cell mass (BCM) and lean body mass (LBM) were determined in 110 Germans (ages 60-83) using bioimpedance analysis. Nutritional status, muscle function, anthropometry, and physical activity level were investigated. Sarcopenia was already present in well nourished healthy elders. Its prevalence depended on the measure of muscle mass used (BCM percent, 22 percent males, 20 percent females; LBM percent, 4 percent males, 11 percent females). In conclusion, screening for presence of sarcopenia is needed in healthy, well-nourished elderly populations requiring an international standardization. Copyright © Taylor & Francis Group, LLC

  17. Neuroimaging Characteristics of Small-Vessel Disease in Older Adults with Normal Cognition, Mild Cognitive Impairment, and Alzheimer Disease

    Directory of Open Access Journals (Sweden)

    Alberto Mimenza-Alvarado

    2018-05-01

    Full Text Available Introduction: Cerebral small-vessel disease (SVD represents the most frequent type of vascular brain lesions, often coexisting with Alzheimer disease (AD. By quantifying white matter hyperintensities (WMH and hippocampal and parietal atrophy, we aimed to describe the prevalence and severity of SVD among older adults with normal cognition (NC, mild cognitive impairment (MCI, and probable AD and to describe associated risk factors. Methods: This study included 105 older adults evaluated with magnetic resonance imaging and clinical and neuropsychological tests. We used the Fazekas scale (FS for quantification of WMH, the Scheltens scale (SS for hippocampal atrophy, and the Koedam scale (KS for parietal atrophy. Logistic regression models were performed to determine the association between FS, SS, and KS scores and the presence of NC, MCI, or probable AD. Results: Compared to NC subjects, SVD was more prevalent in MCI and probable AD subjects. After adjusting for confounding factors, logistic regression showed a positive association between higher scores on the FS and probable AD (OR = 7.6, 95% CI 2.7–20, p < 0.001. With the use of the SS and KS (OR = 4.5, 95% CI 3.5–58, p = 0.003 and OR = 8.9, 95% CI 1–72, p = 0.04, respectively, the risk also remained significant for probable AD. Conclusions: These results suggest an association between severity of vascular brain lesions and neurodegeneration.

  18. Effect of musical training on pitch discrimination performance in older normal-hearing and hearing-impaired listeners

    DEFF Research Database (Denmark)

    Bianchi, Federica; Dau, Torsten; Santurette, Sébastien

    2017-01-01

    -discrimination performance for NH listeners. It is unclear whether a comparable effect of musical training occurs for listeners whose sensory encoding of F0 is degraded. To address this question, F0 discrimination was investigated for three groups of listeners (14 young NH, 9 older NH and 10 HI listeners), each......Hearing-impaired (HI) listeners, as well as elderly listeners, typically have a reduced ability to discriminate the fundamental frequency (F0) of complex tones compared to young normal-hearing (NH) listeners. Several studies have shown that musical training, on the other hand, leads to improved F0...... including musicians and non-musicians, using complex tones that differed in harmonic content. Musical training significantly improved F0 discrimination for all groups of listeners, especially for complex tones containing low-numbered harmonics. In a second experiment, the sensitivity to temporal fine...

  19. Multifactorial intervention for diabetes control among older users of insulin

    Directory of Open Access Journals (Sweden)

    Rafael Vaz Machry

    2018-05-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day. Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22% and 8.54% (SE = 0.24%, p < 0.001 and 8.09% (SE = 0.21%, p < 0.001 at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up. Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes.

  20. Multifactorial intervention for diabetes control among older users of insulin

    Science.gov (United States)

    Machry, Rafael Vaz; Pedroso, Henrique Umpierre; Vasconcellos, Luthiele Silva; Nunes, Rafaela Ramos; Evaldt, Cibelle de Abreu; Yunes, Eduardo Bardou; Rodrigues, Ticiana da Costa

    2018-01-01

    ABSTRACT OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day). Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22%) and 8.54% (SE = 0.24%, p < 0.001) and 8.09% (SE = 0.21%, p < 0.001) at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up). Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes. PMID:29791677

  1. Beta normal control of TFTR using fuzzy logic

    International Nuclear Information System (INIS)

    Lawson, J.E.; Bell, M.G.; Marsala, R.J.; Mueller, D.

    1995-01-01

    In TFTR plasmas heated by neutral beam injection, the fusion power yield increases rapidly with the plasma pressure. However, the pressure is limited by the onset of instabilities which may result in plasma disruptions that would have had an adverse effect on the performance of subsequent discharges and increase the risk of damage to internal components. The likelihood of disruption has been found to correlate with the normalized beta, defined as βN = 2 x 10 8 μ circle left angle p perpendicular to right angle a / BTIp where left angle p perpendicular to right angle is the volume-average plasma perpendicular pressure, a the mid-plane minor radius of the plasma, BT the toroidal magnetic field and Ip the plasma current. Other variables, such as the peaking of the plasma pressure and current profiles, have been found to influence the threshold of βN at which the probability of disruption begins to increase significantly. For TFTR plasmas with high fusion performance (TFTR ''supershots'') the probability of disruption has been found to increase rapidly for βN > 1.8. Since confinement in this regime is affected by plasma-wall interaction, which can vary from shot to shot, operation at high βN with preprogrammed heating power pulses can produce an unacceptably high risk of disruption. To reduce the risk of producing beta-limit disruptions during neutral beam heating experiments, a control system, the Neutral Beam Power Feedback System (NBPFS), has been developed to modulate the total heating power by switching individual neutral beam sources on and off in response to the evolution of the normalized beta so that the limit will not be exceeded. The value of βN is calculated in real time and transmitted to the NBPFS. The value of βN and its calculated time derivative are input to a fuzzy logic controller which implements a proportional-derivative control based on the difference between βN and a programmed reference level βNREF which can be programmed as a function

  2. STAT proteins: from normal control of cellular events to tumorigenesis.

    Science.gov (United States)

    Calò, Valentina; Migliavacca, Manuela; Bazan, Viviana; Macaluso, Marcella; Buscemi, Maria; Gebbia, Nicola; Russo, Antonio

    2003-11-01

    Signal transducers and activators of transcription (STAT) proteins comprise a family of transcription factors latent in the cytoplasm that participate in normal cellular events, such as differentiation, proliferation, cell survival, apoptosis, and angiogenesis following cytokine, growth factor, and hormone signaling. STATs are activated by tyrosine phosphorylation, which is normally a transient and tightly regulates process. Nevertheless, several constitutively activated STATs have been observed in a wide number of human cancer cell lines and primary tumors, including blood malignancies and solid neoplasias. STATs can be divided into two groups according to their specific functions. One is made up of STAT2, STAT4, and STAT6, which are activated by a small number of cytokines and play a distinct role in the development of T-cells and in IFNgamma signaling. The other group includes STAT1, STAT3, and STAT5, activated in different tissues by means of a series of ligands and involved in IFN signaling, development of the mammary gland, response to GH, and embriogenesis. This latter group of STATS plays an important role in controlling cell-cycle progression and apoptosis and thus contributes to oncogenesis. Although an increased expression of STAT1 has been observed in many human neoplasias, this molecule can be considered a potential tumor suppressor, since it plays an important role in growth arrest and in promoting apoptosis. On the other hand, STAT3 and 5 are considered as oncogenes, since they bring about the activation of cyclin D1, c-Myc, and bcl-xl expression, and are involved in promoting cell-cycle progression, cellular transformation, and in preventing apoptosis.

  3. Too much or too little step width variability is associated with a fall history in older persons who walk at or near normal gait speed

    Directory of Open Access Journals (Sweden)

    Newman Anne B

    2005-07-01

    Full Text Available Abstract Background Decreased gait speed and increased stride time, stride length, double support time, and stance time variability have consistently been associated with falling whereas step width variability has not been strongly related to falls. The purpose was to examine the linear and nonlinear associations between gait variability and fall history in older persons and to examine the influence of gait speed. Methods Gait characteristics and fall history were obtained in 503 older adults (mean age = 79; 61% female participating in the Cardiovascular Health Study who could ambulate independently. Gait characteristics were recorded from two trials on a 4 meter computerized walkway at the subject's self-selected walking speed. Gait variability was calculated as the coefficient of variation. The presence of a fall in the past 12 months was determined by interview. The nonlinear association between gait variability and fall history was examined using a simple three level classification derived from the distribution of the data and from literature based cut-points. Multivariate logistic regression was used to examine the association between step width variability (extreme or moderate and fall history stratifying by gait speed (1.0 m/s and controlling for age and gender. Results Step length, stance time, and step time variability did not differ with respect to fall history (p > .33. Individuals with extreme step width variability (either low or high step width variability were more likely to report a fall in the past year than individuals with moderate step width variability. In individuals who walked ≥ 1.0 m/s (n = 281, after controlling for age, gender, and gait speed, compared to individuals with moderate step width variability individuals with either low or high step width variability were more likely to have fallen in the past year (OR and 95% CI 4.38 [1.79–10.72]. The association between step width variability and fall history was not

  4. WAIS Performance in Unincarcerated Groups of MMPI-Defined Sociopaths and Normal Controls

    Science.gov (United States)

    Allain, Albert N.

    1974-01-01

    This investigation examines WAIS performance in groups of 32 sociopaths and 33 normal controls defined by Minnesota Multiphasic Personality Inventory criteria. Sociopaths and normal controls show no differences in overall level of intellectual functioning. (Author)

  5. Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA in Older Adults

    Directory of Open Access Journals (Sweden)

    Mihaela Teodorescu

    2013-01-01

    Full Text Available Background/Objectives. Asthma in older individuals is poorly understood. We aimed to characterize the older asthma phenotype and test its association with obstructive sleep apnea (OSA. Design. Cross-sectional. Setting. Pulmonary and Asthma/Allergy clinics. Participants. 659 asthma subjects aged 18–59 years (younger and 154 aged 60–75 (older. Measurements. Sleep Apnea scale of Sleep Disorders Questionnaire (SA-SDQ, asthma severity step (1–4, severe if step 3 or 4, established OSA diagnosis, continuous positive airway pressure (CPAP use, and comorbidities. Results. Older versus younger had worse control, as assessed by asthma step, lung function, and inhaled corticosteroid use. Among older subjects, after controlling for known asthma aggravators, OSA diagnosis was the only factor robustly associated with severe asthma: on average, OSA was associated with nearly 7 times greater likelihood of severe asthma in an older individual (OR=6.67. This relationship was of greater magnitude than in younger subjects (OR=2.16. CPAP use attenuated the likelihood of severe asthma in older subjects by 91% (P=0.005, much more than in the younger asthmatics. Conclusion. Diagnosed OSA increases the risk for worse asthma control in older patients, while CPAP therapy may have greater impact on asthma outcomes. Unrecognized OSA may be a reason for poor asthma control, particularly among older patients.

  6. Motion Normalized Proportional Control for Improved Pattern Recognition-Based Myoelectric Control.

    Science.gov (United States)

    Scheme, Erik; Lock, Blair; Hargrove, Levi; Hill, Wendy; Kuruganti, Usha; Englehart, Kevin

    2014-01-01

    This paper describes two novel proportional control algorithms for use with pattern recognition-based myoelectric control. The systems were designed to provide automatic configuration of motion-specific gains and to normalize the control space to the user's usable dynamic range. Class-specific normalization parameters were calculated using data collected during classifier training and require no additional user action or configuration. The new control schemes were compared to the standard method of deriving proportional control using a one degree of freedom Fitts' law test for each of the wrist flexion/extension, wrist pronation/supination and hand close/open degrees of freedom. Performance was evaluated using the Fitts' law throughput value as well as more descriptive metrics including path efficiency, overshoot, stopping distance and completion rate. The proposed normalization methods significantly outperformed the incumbent method in every performance category for able bodied subjects (p < 0.001) and nearly every category for amputee subjects. Furthermore, one proposed method significantly outperformed both other methods in throughput (p < 0.0001), yielding 21% and 40% improvement over the incumbent method for amputee and able bodied subjects, respectively. The proposed control schemes represent a computationally simple method of fundamentally improving myoelectric control users' ability to elicit robust, and controlled, proportional velocity commands.

  7. Seeing the Talker's Face Improves Free Recall of Speech for Young Adults with Normal Hearing but Not Older Adults with Hearing Loss

    Science.gov (United States)

    Rudner, Mary; Mishra, Sushmit; Stenfelt, Stefan; Lunner, Thomas; Rönnberg, Jerker

    2016-01-01

    Purpose: Seeing the talker's face improves speech understanding in noise, possibly releasing resources for cognitive processing. We investigated whether it improves free recall of spoken two-digit numbers. Method: Twenty younger adults with normal hearing and 24 older adults with hearing loss listened to and subsequently recalled lists of 13…

  8. Talker Differences in Clear and Conversational Speech: Perceived Sentence Clarity for Young Adults with Normal Hearing and Older Adults with Hearing Loss

    Science.gov (United States)

    Ferguson, Sarah Hargus; Morgan, Shae D.

    2018-01-01

    Purpose: The purpose of this study is to examine talker differences for subjectively rated speech clarity in clear versus conversational speech, to determine whether ratings differ for young adults with normal hearing (YNH listeners) and older adults with hearing impairment (OHI listeners), and to explore effects of certain talker characteristics…

  9. Interrelations of stress, optimism and control in older people's psychological adjustment.

    Science.gov (United States)

    Bretherton, Susan Jane; McLean, Louise Anne

    2015-06-01

    To investigate the influence of perceived stress, optimism and perceived control of internal states on the psychological adjustment of older adults. The sample consisted of 212 older adults, aged between 58 and 103 (M = 80.42 years, SD = 7.31 years), living primarily in retirement villages in Melbourne, Victoria. Participants completed the Perceived Stress Scale, Life Orientation Test-Revised, Perceived Control of Internal States Scale and the World Health Organisation Quality of Life-Bref. Optimism significantly mediated the relationship between older people's perceived stress and psychological health, and perceived control of internal states mediated the relationships among stress, optimism and psychological health. The variables explained 49% of the variance in older people's psychological adjustment. It is suggested that strategies to improve optimism and perceived control may improve the psychological adjustment of older people struggling to adapt to life's stressors. © 2014 ACOTA.

  10. Control Systems with Normalized and Covariance Adaptation by Optimal Control Modification

    Science.gov (United States)

    Nguyen, Nhan T. (Inventor); Burken, John J. (Inventor); Hanson, Curtis E. (Inventor)

    2016-01-01

    Disclosed is a novel adaptive control method and system called optimal control modification with normalization and covariance adjustment. The invention addresses specifically to current challenges with adaptive control in these areas: 1) persistent excitation, 2) complex nonlinear input-output mapping, 3) large inputs and persistent learning, and 4) the lack of stability analysis tools for certification. The invention has been subject to many simulations and flight testing. The results substantiate the effectiveness of the invention and demonstrate the technical feasibility for use in modern aircraft flight control systems.

  11. Daily Bicycling in Older Adults May Be Effective to Reduce Fall Risks - A Case Control Study.

    Science.gov (United States)

    Batcir, Shani; Melzer, Itshak

    2018-01-18

    Older adults gain many health benefits from riding bicycles regularly. We aimed to explore whether older persons who ride bicycles regularly have better balance than controls. Balance control and voluntary stepping were assessed in 20 older adults aged 65 to 85 who live in an agricultural community village who regularly ride bicycles (BR), and 30 age- and gender-matched non-bicycle riders (NBR). Self-reported function and fear of fall were also assessed. Bicycle riders showed significantly better balance, faster voluntary stepping, and better self-reported advanced lower extremity function compared with NBR. The results might suggest that bicycling regularly preserves balance control and speed of voluntary stepping in older adults because bicycling might maintain specific balance coordination patterns. The results should be treated with caution since BR were older adults who selected an active life style (i.e., bicycling as well as living in an agricultural village) that may bias the results.

  12. Negative psychosocial and heavy physical workloads associated with musculoskeletal pain interfering with normal life in older adults: cross-sectional analysis.

    Science.gov (United States)

    Lilje, Stina C; Skillgate, Eva; Anderberg, Peter; Berglund, Johan

    2015-07-01

    Pain is one of the most frequent reasons for seeking health care, and is thus a public health problem. Although there is a progressive increase in pain and impaired physical function with age, few studies are performed on older adults. The aim of this study was to investigate if there are associations between musculoskeletal pain interfering with normal life in older adults and physical and psychosocial workloads through life. The association of heavy physical workload and negative psychosocial workload and musculoskeletal pain interfering with normal life (SF 12) was analyzed by multiple logistic regression. The model was adjusted for eight background covariates: age, gender, growing-up environment, educational level, if living alone or not, obesity, smoking, and leisure physical activity. Negative psychosocial and heavy physical workloads were independently associated with musculoskeletal pain interfering with normal life (adjusted OR: 4.44, 95% CI: 2.84-6.92), and (adjusted OR: 1.88, 95% CI: 1.20-2.93), respectively. The background covariates female gender and higher education were also associated with musculoskeletal pain interfering with normal life, and physical leisure activity was inversely associated. The findings suggest that negative psychosocial and heavy physical workloads are strongly associated with musculoskeletal pain interfering with normal life in older adults. © 2015 the Nordic Societies of Public Health.

  13. Multi-chronic musculoskeletal pain is a useful clinical index to predict the risk of falls in older adults with normal motor function.

    Science.gov (United States)

    Asai, Tsuyoshi; Misu, Shogo; Sawa, Ryuichi; Doi, Takehiko; Yamada, Minoru

    2015-10-01

    The number of chronic musculoskeletal pain sites (nCMSP) is reportedly associated with risk of falls. Older participants in community-based research show a wide range of physical functions, but few studies have focused on the risk of falls in older adults with normal motor function (NMF). Clarification of the effects of pain on dual-tasking performance is also important, given the strong link between falls and dual-tasking. The objectives were to investigate the associations between: (1) nCMSP and falls; and (2) nCMSP and dual-task performance in older adults with NMF. A total of 112 older adults with NMF (44 men, 68 women; 73.4 ± 4.6 years) were classified as fallers (n = 22) or non-fallers (n = 90) according to their fall history. Musculoskeletal pain in the lower body was assessed using questions ascertaining pain in musculoskeletal sites (back, hip, knee, foot, or toe). Participants were assigned to three pain groups according to nCMSP. Basic physical performances and gait performances (normal gait, fast gait, or dual-task gait) were measured. The nCMSP represented a significant risk factor for falls according to logistic regression modeling after adjusting for the five chair stand test and fear of falls. The nCMSP was not associated with any gait variables. Potential fall risk may be increased by nCMSP, even in older adults with NMF. Pain-related reduction in attention resources may not represent a risk factor for falls among older adults with NMF. The nCMSP represents a potential risk factor for falls in older adults with NMF.

  14. Studies on renin stimulation in normal controls and in patients with essential hypertension

    International Nuclear Information System (INIS)

    Koh, C.S.; Choe, K.W.; Lee, H.K.; Lee, J.S.

    1978-01-01

    To find out a convenient and reliable method of detecting low renin status, we employed intravenous furosemine injection as a stimulatory maneuver. The results thus obtained were compared with those from the postural stimuli and basal plasma renin activity (PRA) in relation to sodium excretion. Intravenous furosemide test was performed in 66 control subjects and 44 patients with essential hypertension. The results were as follow; 1) Mean PRA in control subjects rose from 2.5+-1.95 ng/ml/hr (basal) to 4.5+-2.51, 5.2+-2.49 and 4.2+-2.44 ng/ml/hr at 1, 2 and 3hrs after IV injection. One-hour response is more convenient in clinical practice. 2) Postural stimuli by assuming an upright posture for 3hrs gave rise to considerable increase in PRA (4.0+-2.92 from 2.4+-1.85), but we found it less convenient than stimulation with furosemide. 3) The increase in PRA was much less marked in patients with essential hypertension as a whole (2.9+-2.75). Hyporesponsiveness to furosemide stimuli was found in 34.1%. Of these hyporesponders, a third had a normal basal PRA, indicating the need for this kind stimulatory procedure. 4) Younger age group showed greater renin responsiveness than older age group after furosemide stimuli. Likewise mean age of low renin patients (52.9+-5.38 years old) was significantly higher than that of high and normal renin patients (44.1+-13.78 years old). (author)

  15. Studies on Renin Stimulation in Normal Controls and in Patients with Essential Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Chang Soon; Choe, Kang Won; Lee, Hong Kyu; Lee, Jung Sang [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1978-03-15

    To find out a convenient and reliable method of detecting low renin status, we employed intravenous furosemide injection as a stimulatory maneuver. The results thus obtained were compared with those from the postural stimuli and basal plasma renin activity (PRA) in relation to sodium excretion. Intravenous furosemide test was performed in 66 control subjects and 44 patients with essential hypertension. The results were as follow; 1) Mean PRA in control subjects rose from 2.5+-1.95 ng/ml/hr (basal) to 4.5+-2.51, 5.2+-2.49 and 4.2+-2.44 ng/ml/hr at 1, 2 and 3 hrs after IV injection. One-hour response is more convenient in clinical practice. 2) Postural stimuli by assuming an upright posture for 3 hrs gave rise to considerable increase in PRA (4.0+-2.92 from 2.4+-1.85), but we found it less convenient than stimulation with furosemide. 3) The increase in PRA was much less marked in patients with essential hypertension as a whole (2.9+-2.75). Hyporesponsiveness to furosemide stimuli was found in 34.1%. Of these hyporesponders, a third had a normal basal PRA, indicating the need for this kind stimulatory procedure. 4) Younger age group showed greater renin responsiveness than older age group after furosemide stimuli. Likewise mean age of low renin patients (52.9+-5.38 years old) was significantly higher than that of high and normal renin patients (44.1+-13.78 years old).

  16. Studies on Renin Stimulation in Normal Controls and in Patients with Essential Hypertension

    International Nuclear Information System (INIS)

    Koh, Chang Soon; Choe, Kang Won; Lee, Hong Kyu; Lee, Jung Sang

    1978-01-01

    To find out a convenient and reliable method of detecting low renin status, we employed intravenous furosemide injection as a stimulatory maneuver. The results thus obtained were compared with those from the postural stimuli and basal plasma renin activity (PRA) in relation to sodium excretion. Intravenous furosemide test was performed in 66 control subjects and 44 patients with essential hypertension. The results were as follow; 1) Mean PRA in control subjects rose from 2.5±1.95 ng/ml/hr (basal) to 4.5±2.51, 5.2±2.49 and 4.2±2.44 ng/ml/hr at 1, 2 and 3 hrs after IV injection. One-hour response is more convenient in clinical practice. 2) Postural stimuli by assuming an upright posture for 3 hrs gave rise to considerable increase in PRA (4.0±2.92 from 2.4±1.85), but we found it less convenient than stimulation with furosemide. 3) The increase in PRA was much less marked in patients with essential hypertension as a whole (2.9±2.75). Hyporesponsiveness to furosemide stimuli was found in 34.1%. Of these hyporesponders, a third had a normal basal PRA, indicating the need for this kind stimulatory procedure. 4) Younger age group showed greater renin responsiveness than older age group after furosemide stimuli. Likewise mean age of low renin patients (52.9±5.38 years old) was significantly higher than that of high and normal renin patients (44.1±13.78 years old).

  17. The Effects of Performance Fatigability on Postural Control and Rehabilitation in the Older Patient.

    Science.gov (United States)

    Papa, Evan V; Hassan, Mahdi; Bugnariu, Nicoleta

    2016-09-01

    Fatigue is common in older adults and has a significant effect on quality of life. Despite the high prevalence of fatigue in older individuals, several aspects are poorly understood. It is important to differentiate subjective fatigue complaints from fatigability of motor performance because the two are independent constructs with potentially distinct consequences on mobility. Performance fatigability is the magnitude of change in a performance criterion over a given time of task performance. Performance fatigability is a compulsory element of any strength training program, yet strength training is an important component of rehabilitation programs for older adults. The consequences of fatigability for older adults suggest that acute exercise of various types may result in acute impairments in postural control. The effects of performance fatigability on postural control in older adults are evaluated here to aid the rehabilitation clinician in making recommendations for evaluation of fall risks and exercise prescription.

  18. A normalized PID controller in networked control systems with varying time delays.

    Science.gov (United States)

    Tran, Hoang-Dung; Guan, Zhi-Hong; Dang, Xuan-Kien; Cheng, Xin-Ming; Yuan, Fu-Shun

    2013-09-01

    It requires not only simplicity and flexibility but also high specified stability and robustness of system to design a PI/PID controller in such complicated networked control systems (NCSs) with delays. By gain and phase margins approach, this paper proposes a novel normalized PI/PID controller for NCSs based on analyzing the stability and robustness of system under the effect of network-induced delays. Specifically, We take into account the total measured network delays to formulate the gain and phase margins of the closed-loop system in the form of a set of equations. With pre-specified values of gain and phase margins, this set of equations is then solved for calculating the closed forms of control parameters which enable us to propose the normalized PI/PID controller simultaneously satisfying the following two requirements: (1) simplicity without re-solving the optimization problem for a new process, (2) high flexibility to cope with large scale of random delays and deal with many different processes in different conditions of network. Furthermore, in our method, the upper bound of random delay can be estimated to indicate the operating domain of proposed PI/PID controller. Finally, simulation results are shown to demonstrate the advantages of our proposed controller in many situations of network-induced delays. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  19. Free and Cued Memory in relation to Biomarker-Defined Abnormalities in Clinically Normal Older Adults and Those at Risk for Alzheimer’s Disease

    Science.gov (United States)

    Papp, Kathryn V.; Amariglio, Rebecca E.; Mormino, Elizabeth; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Objectives Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer’s disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. Methods A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ−/ND−), Stage 1 (Aβ+/ND−), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer’s associated pathology (SNAP; Aβ−/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Results Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Conclusions Clinically

  20. Free and cued memory in relation to biomarker-defined abnormalities in clinically normal older adults and those at risk for Alzheimer's disease.

    Science.gov (United States)

    Papp, Kathryn V; Amariglio, Rebecca E; Mormino, Elizabeth C; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A; Sperling, Reisa A; Rentz, Dorene M

    2015-07-01

    Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer's disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ-/ND-), Stage 1 (Aβ+/ND-), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer's associated pathology (SNAP; Aβ-/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Clinically normal older adults with underlying evidence of

  1. Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial

    OpenAIRE

    Dias, João Marcos; Cisneros, Lígia; Dias, Rosângela; Fritsch, Carolina; Gomes, Wellington; Pereira, Leani; Santos, Mary Luci; Ferreira, Paulo Henrique

    2017-01-01

    Background Currently, there is poor evidence of the effect of hydrotherapy alone on patients with hip or knee osteoarthritis. Objectives The study aimed to assess the impact of hydrotherapy on pain, function, and muscle function in older women with knee osteoarthritis. Methods A randomized controlled trial was conducted to evaluate the efficacy of hydrotherapy in women with knee osteoarthritis. Seventy-three women aged 65 and older were randomized to hydrotherapy (n = 36) or a control group (...

  2. Safety margins in older adults increase with improved control of a dynamic object

    Science.gov (United States)

    Hasson, Christopher J.; Sternad, Dagmar

    2014-01-01

    Older adults face decreasing motor capabilities due to pervasive neuromuscular degradations. As a consequence, errors in movement control increase. Thus, older individuals should maintain larger safety margins than younger adults. While this has been shown for object manipulation tasks, several reports on whole-body activities, such as posture and locomotion, demonstrate age-related reductions in safety margins. This is despite increased costs for control errors, such as a fall. We posit that this paradox could be explained by the dynamic challenge presented by the body or also an external object, and that age-related reductions in safety margins are in part due to a decreased ability to control dynamics. To test this conjecture we used a virtual ball-in-cup task that had challenging dynamics, yet afforded an explicit rendering of the physics and safety margin. The hypotheses were: (1) When manipulating an object with challenging dynamics, older adults have smaller safety margins than younger adults. (2) Older adults increase their safety margins with practice. Nine young and 10 healthy older adults practiced moving the virtual ball-in-cup to a target location in exactly 2 s. The accuracy and precision of the timing error quantified skill, and the ball energy relative to an escape threshold quantified the safety margin. Compared to the young adults, older adults had increased timing errors, greater variability, and decreased safety margins. With practice, both young and older adults improved their ability to control the object with decreased timing errors and variability, and increased their safety margins. These results suggest that safety margins are related to the ability to control dynamics, and may explain why in tasks with simple dynamics older adults use adequate safety margins, but in more complex tasks, safety margins may be inadequate. Further, the results indicate that task-specific training may improve safety margins in older adults. PMID:25071566

  3. Safety Margins in Older Adults Increase with Improved Control of a Dynamic Object

    Directory of Open Access Journals (Sweden)

    Christopher James Hasson

    2014-07-01

    Full Text Available Older adults face decreasing motor capabilities due to pervasive neuromuscular degradations. As a consequence errors in movement control increase. Thus, older individuals should maintain larger safety margins than younger adults. While this has been shown for object manipulation tasks, several reports on whole-body activities, such as posture and locomotion, however demonstrate age-related reductions in safety margins. This is despite increased costs for control errors, such as a fall. We posit that this paradox could be explained by the dynamic challenge presented by the body or an external object, and that age-related reductions in safety margins are in part due to a decreased ability to control dynamics. To test this conjecture we used a virtual ball-in-cup task that had challenging dynamics, yet afforded an explicit rendering of the physics and safety margin. The hypotheses were: 1 When manipulating an object with challenging dynamics, older adults have smaller safety margins than younger adults. 2 Older adults increase their safety margins with practice. Nine young and 10 healthy older adults practiced moving the virtual ball-in-cup to a target location in exactly two seconds. The accuracy and precision of the timing error quantified skill and the ball energy relative to an escape threshold quantified the safety margin. Compared to the young adults, older adults had increased timing errors, greater variability, and decreased safety margins. With practice, both young and older adults improved their ability to control the object with decreased timing errors and variability, and increased their safety margins. These results suggest that safety margins are related to the ability to control dynamics, and may explain why in tasks with simple dynamics older adults use adequate safety margins, but in more complex tasks, safety margins may be inadequate. Further, the results indicate that task-specific training may improve safety margins in older

  4. Effects of glucose, insulin, and insulin resistance on cerebral 18F-FDG distribution in cognitively normal older subjects

    Science.gov (United States)

    Onishi, Airin; Fujiwara, Yoshinori; Ishiwata, Kiichi; Ishii, Kenji

    2017-01-01

    Background Increasing plasma glucose levels and insulin resistance can alter the distribution pattern of fluorine-18-labeled fluorodeoxyglucose (18F-FDG) in the brain and relatively reduce 18F-FDG uptake in Alzheimer's disease (AD)-related hypometabolic regions, leading to the appearance of an AD-like pattern. However, its relationship with plasma insulin levels is unclear. We aimed to compare the effects of plasma glucose levels, plasma insulin levels and insulin resistance on the appearance of the AD-like pattern in 18F-FDG images. Methods Fifty-nine cognitively normal older subjects (age = 75.7 ± 6.4 years) underwent 18F-FDG positron emission tomography along with measurement of plasma glucose and insulin levels. As an index of insulin resistance, the Homeostasis model assessment of Insulin Resistance (HOMA-IR) was calculated. Results Plasma glucose levels, plasma insulin levels, and HOMA-IR were 102.2 ± 8.1 mg/dL, 4.1 ± 1.9 μU/mL, and 1.0 ± 0.5, respectively. Whole-brain voxelwise analysis showed a negative correlation of 18F-FDG uptake with plasma glucose levels in the precuneus and lateral parietotemporal regions (cluster-corrected p < 0.05), and no correlation with plasma insulin levels or HOMA-IR. In the significant cluster, 18F-FDG uptake decreased by approximately 4–5% when plasma glucose levels increased by 20 mg/dL. In the precuneus region, volume-of-interest analysis confirmed a negative correlation of 18F-FDG uptake with plasma glucose levels (r = -0.376, p = 0.002), and no correlation with plasma insulin levels (r = 0.156, p = 0.12) or HOMA-IR (r = 0.096, p = 0.24). Conclusion This study suggests that, of the three parameters, plasma glucose levels have the greatest effect on the appearance of the AD-like pattern in 18F-FDG images. PMID:28715453

  5. Effects of glucose, insulin, and insulin resistance on cerebral 18F-FDG distribution in cognitively normal older subjects.

    Directory of Open Access Journals (Sweden)

    Kenji Ishibashi

    Full Text Available Increasing plasma glucose levels and insulin resistance can alter the distribution pattern of fluorine-18-labeled fluorodeoxyglucose (18F-FDG in the brain and relatively reduce 18F-FDG uptake in Alzheimer's disease (AD-related hypometabolic regions, leading to the appearance of an AD-like pattern. However, its relationship with plasma insulin levels is unclear. We aimed to compare the effects of plasma glucose levels, plasma insulin levels and insulin resistance on the appearance of the AD-like pattern in 18F-FDG images.Fifty-nine cognitively normal older subjects (age = 75.7 ± 6.4 years underwent 18F-FDG positron emission tomography along with measurement of plasma glucose and insulin levels. As an index of insulin resistance, the Homeostasis model assessment of Insulin Resistance (HOMA-IR was calculated.Plasma glucose levels, plasma insulin levels, and HOMA-IR were 102.2 ± 8.1 mg/dL, 4.1 ± 1.9 μU/mL, and 1.0 ± 0.5, respectively. Whole-brain voxelwise analysis showed a negative correlation of 18F-FDG uptake with plasma glucose levels in the precuneus and lateral parietotemporal regions (cluster-corrected p < 0.05, and no correlation with plasma insulin levels or HOMA-IR. In the significant cluster, 18F-FDG uptake decreased by approximately 4-5% when plasma glucose levels increased by 20 mg/dL. In the precuneus region, volume-of-interest analysis confirmed a negative correlation of 18F-FDG uptake with plasma glucose levels (r = -0.376, p = 0.002, and no correlation with plasma insulin levels (r = 0.156, p = 0.12 or HOMA-IR (r = 0.096, p = 0.24.This study suggests that, of the three parameters, plasma glucose levels have the greatest effect on the appearance of the AD-like pattern in 18F-FDG images.

  6. Disentangling cognition and emotion in older adults: the role of cognitive control and mental health in emotional conflict adaptation.

    Science.gov (United States)

    Hantke, Nathan C; Gyurak, Anett; Van Moorleghem, Katie; Waring, Jill D; Adamson, Maheen M; O'Hara, Ruth; Beaudreau, Sherry A

    2017-08-01

    Recent research suggests cognition has a bidirectional relationship with emotional processing in older adults, yet the relationship is still poorly understood. We aimed to examine a potential relationship between late-life cognitive function, mental health symptoms, and emotional conflict adaptation. We hypothesized that worse cognitive control abilities would be associated with poorer emotional conflict adaptation. We further hypothesized that a higher severity of mental health symptoms would be associated with poorer emotional conflict adaptation. Participants included 83 cognitively normal community-dwelling older adults who completed a targeted mental health and cognitive battery, and emotion and gender conflict-adaptation tasks. Consistent with our hypothesis, poorer performance on components of cognitive control, specifically attention and working memory, was associated with poorer emotional conflict adaptation. This association with attention and working memory was not observed in the non-affective-based gender conflict adaptation task. Mental health symptoms did not predict emotional conflict adaptation, nor did performance on other cognitive measures. Our findings suggest that emotion conflict adaptation is disrupted in older individuals who have poorer attention and working memory. Components of cognitive control may therefore be an important potential source of inter-individual differences in late-life emotion regulation and cognitive affective deficits. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Exploratory Factor Analysis of the Anxiety Control Questionnaire among Older Adults

    Science.gov (United States)

    Gerolimatos, Lindsay A.; Gould, Christine E.; Edelstein, Barry A.

    2012-01-01

    Among young adults and clinical populations, perceived inability to control internal and external events is associated with anxiety. At present, it is unclear what role perceived anxiety control plays in anxiety among older adults. The Anxiety Control Questionnaire (ACQ) was developed to assess one's perceived ability to cope with anxiety-related…

  8. Perceived control in health care: a conceptual model based on experiences of frail older adults

    NARCIS (Netherlands)

    Claassens, L; Widdershoven, G A; Van Rhijn, S C; Van Nes, F; Broese van Groenou, M I; Deeg, D J H; Huisman, M

    2014-01-01

    Frail older adults are increasingly encouraged to be in control of their health care, in Western societies. However, little is known about how they themselves perceive control in health care. Therefore, this study aims to investigate the concept of health care-related perceived control from the

  9. Differences in knowledge of dementia among older adults with normal cognition, mild cognitive impairment, and dementia: A representative nationwide sample of Korean elders.

    Science.gov (United States)

    Lee, Jun-Young; Park, Soowon; Kim, Ki Woong; Kwon, Ji Eyon; Park, Joon Hyuk; Kim, Moon Doo; Kim, Bong-Jo; Kim, Jeong Lan; Moon, Seok Woo; Bae, Jae Nam; Ryu, Seung-Ho; Yoon, Jong Chul; Lee, Nam-Jin; Lee, Dong Young; Lee, Dong Woo; Lee, Seok Bum; Lee, Jung Jae; Lee, Chang-Uk; Jhoo, Jin Hyeong; Cho, Maeng Je

    2016-01-01

    Lack of knowledge about a disease could impede early diagnosis and may lead to delays in seeking appropriate medical care. The aim of this study was to explore knowledge of dementia (KOD) and to find the determinants of KOD among three groups: older adults with normal cognition, mild cognitive impairment (MCI), and dementia. A representative nationwide sample of 6141 Korean elders aged 65 years or older participated in face-to-face interviews and answered 14 questions pertaining to general information, etiology, symptoms, and treatment of dementia. Stepwise multiple regressions and path analyses probed the relationships between various sociodemographic variables and KOD. The percentage of correct responses was only 62%. The item 'A person who remembers things that happened in the past does not have dementia' was answered correctly (false) by only 24.8-27% of the respondents in all groups. Older adults with normal cognition had higher KOD scores than those with MCI or dementia. In the normal-cognition group, KOD scores were higher among highly educated, younger, and literate women with no depression and a family history of dementia. In contrast with the determinants in the normal-cognition group, only the ability to read and write predicted KOD scores in the dementia group. Efforts to enhance KOD in elder adults are needed. Public education regarding the differences between dementia and healthy aging may increase KOD among normal elders and those with MCI. Among elders with dementia, educational materials that do not require literacy may be more helpful in increasing KOD with the aim of preventing treatment delay. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Falls and Postural Control in Older Adults With Eye Refractive Errors

    Directory of Open Access Journals (Sweden)

    Afsun Nodehi-Moghadam

    2016-04-01

    Conclusion: Vision impairment of older adults due to refractive error is not associated with an increase in falls. Furthermore, TUG test results did not show balance disorders in these groups. Further research, such as assessment of postural control with advanced devices and considering other falling risk factors is also needed to identify the predictors of falls in older adults with eye refractive errors.

  11. The psychometric properties of the Chinese version-reintegration to normal living index (C-RNLI) for identifying participation restriction among community-dwelling frail older people.

    Science.gov (United States)

    Liu, Justina Yat-Wa; Ma, Ka Wai

    2017-01-31

    The Reintegration to Normal Living Index (RNLI) was developed to measure reintegration to normal living after major traumas/illnesses. Its psychometric properties remain unknown when used to measure participation restriction under the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF) framework. This study examines the psychometric properties of the Chinese version-RNLI to measure WHO-ICF participation restriction among community-dwelling pre-frail and frail older people. A cross-sectional study was conducted in community and day-care centres in Hong Kong between May 2015 and January 2016. Through face-to-face interviews, information was collected on the participants' demographic background, medical history, frailty status, depressive mood, functional performance in daily activities, and participation restriction. The internal consistency, test-retest reliability, and construct and convergent validity of the C-RNLI were assessed. Two hundred and ninety-nine pre-frail or frail community-dwelling older people with a mean age of 79.53 were recruited. A confirmatory factor analysis showed that the C-RNLI has a two-factor structure comprised of "participation in physical activities" and "participation in social events". The test-retest coefficient was 0.71. The Cronbach's alpha of the total C-RNLI score, and those of the factors "participation in physical activities" and "participation in social events" were 0.88, 0.82 and 0.84, respectively. Pre-frail older people had significantly higher scores for the factors "participation in physical activities" (z = -5.05, older people. Older people from community centres had significantly higher scores for the factors "participation in physical activities" (z = -4.48, older people from day-care centres. The factors "participation in physical activities" and "participation in social events" of the C-RNLI were significantly convergent with depressive mood (r s  = -0

  12. Timed Up and Go test, atrophy of medial temporal areas and cognitive functions in community-dwelling older adults with normal cognition and mild cognitive impairment.

    Science.gov (United States)

    Kose, Yujiro; Ikenaga, Masahiro; Yamada, Yosuke; Morimura, Kazuhiro; Takeda, Noriko; Ouma, Shinji; Tsuboi, Yoshio; Yamada, Tatsuo; Kimura, Misaka; Kiyonaga, Akira; Higaki, Yasuki; Tanaka, Hiroaki

    2016-12-01

    This study aimed to ascertain if performance on the Timed Up and Go (TUG) test is associated with indicators of brain volume and cognitive functions among community-dwelling older adults with normal cognition or mild cognitive impairment. Participants were 80 community-dwelling older adults aged 65-89years (44 men, 36 women), including 20 with mild cognitive impairment. Participants completed the TUG and a battery of cognitive assessments, including the Mini-Mental State Examination (MMSE), the Logical Memory I and II (LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and the Trail Making Test A and B (TMT-A, TMT-B). Bilateral, right- and left-side medial temporal area atrophy as well as whole gray and white matter indices were determined with the Voxel-based Specific Regional Analysis System for Alzheimer's Disease. We divided participants into three groups based on TUG performance: "better" (≤6.9s); "normal" (7-10s); and "poor" (≥10.1s). Worse TMT-A and TMT-B performance showed significant independent associations with worse TUG performance (Pareas were significantly independently associated with worse TUG performance (Parea atrophy in community-dwelling older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Assessing dynamic postural control during exergaming in older adults : A probabilistic approach

    NARCIS (Netherlands)

    Soancatl Aguilar, V.; Lamoth, C. J. C.; Maurits, N.M.; Roerdink, J. B. T. M.

    Digital games controlled by body movements (exergames) have been proposed as a way to improve postural control among older adults. Exergames are meant to be played at home in an unsupervised way. However, only few studies have investigated the effect of unsupervised home-exergaming on postural

  14. Aging, subjective experience, and cognitive control: dramatic false remembering by older adults.

    Science.gov (United States)

    Jacoby, Larry L; Bishara, Anthony J; Hessels, Sandra; Toth, Jeffrey P

    2005-05-01

    Recent research suggests that older adults are more susceptible to interference effects than are young adults; however, that research has failed to equate differences in original learning. In 4 experiments, the authors show that older adults are more susceptible to interference effects produced by a misleading prime. Even when original learning was equated, older adults were 10 times as likely to falsely remember misleading information and were much less likely to increase their accuracy by opting not to answer under conditions of free responding. The results are well described by a multinomial model that postulates multiple modes of cognitive control. According to that model, older adults are likely to be captured by misleading information, a form of goal neglect or deficit in inhibitory functions. Copyright 2005 APA, all rights reserved.

  15. The Counseling Older Adults to Control Hypertension (COACH) Trial: design and methodology of a group-based lifestyle intervention for hypertensive minority older adults

    OpenAIRE

    Ogedegbe, Gbenga; Fernandez, Senaida; Luerassi, Leanne; Silver, Stephanie A.; Kong, Jian; Midberry, Sara; de la Calle, Franze; Plumhoff, Jordan; Sethi, Sheba; Choudhury, Evelyn; Teresi, Jeanne A.

    2013-01-01

    The disproportionately high prevalence of hypertension and its associated mortality and morbidity in minority older adults is a major public health concern in the United States. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes on blood pressure reduction, these approaches remain largely untested among minority elders in community-based settings. The Counseling Older Adults to Control Hypertension trial is a two-arm randomized controlled trial of 2...

  16. Self-reported diabetes in older people: comparison of prevalences and control measures

    Directory of Open Access Journals (Sweden)

    Sheila Rizzato Stopa

    2014-08-01

    Full Text Available OBJECTIVE The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. METHODS Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5% and the Pearson’s Chi-square (Rao-Scott tests were performed. The variables without overlap between the confidence intervals were not tested. RESULTS The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6 in 2003 and 20.1% (95%CI 17.3;23.1 in 2008, which indicates a growth over this period (p at the limit of significance. The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. CONCLUSIONS Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients.

  17. Single Stance Stability and Proprioceptive Control in Older Adults Living at Home: Gender and Age Differences

    Directory of Open Access Journals (Sweden)

    Dario Riva

    2013-01-01

    Full Text Available In developed countries, falls in older people represent a rising problem. As effective prevention should start before the risk becomes evident, an early predictor is needed. Single stance instability would appear as a major risk factor. Aims of the study were to describe single stance stability, its sensory components, and their correlation with age and gender. A random sample of 597 older adults (319 men, 278 women living at home, aged 65–84, was studied. Stability tests were performed with an electronic postural station. The single stance test showed the impairment of single stance stability in older individuals (75–84 yrs. The significant decline of stability in the older subjects may be explained by the impairment of proprioceptive control together with the decrease in compensatory visual stabilization and emergency responses. Younger subjects (65–74 yrs exhibited better, but still inadequate, proprioceptive control with compensatory visual stabilization. Gender differences appeared in older subjects: women were significantly less stable than men. The measurement of the sensory components of single stance stability could aid in the early detection of a decay in antigravity movements many years before the risk of falling becomes evident. Adequate proprioceptive control could mitigate the effects of all other risks of falling.

  18. Single Stance Stability and Proprioceptive Control in Older Adults Living at Home: Gender and Age Differences

    Science.gov (United States)

    Riva, Dario; Mamo, Carlo; Fanì, Mara; Saccavino, Patrizia; Rocca, Flavio; Momenté, Manuel; Fratta, Marianna

    2013-01-01

    In developed countries, falls in older people represent a rising problem. As effective prevention should start before the risk becomes evident, an early predictor is needed. Single stance instability would appear as a major risk factor. Aims of the study were to describe single stance stability, its sensory components, and their correlation with age and gender. A random sample of 597 older adults (319 men, 278 women) living at home, aged 65–84, was studied. Stability tests were performed with an electronic postural station. The single stance test showed the impairment of single stance stability in older individuals (75–84 yrs). The significant decline of stability in the older subjects may be explained by the impairment of proprioceptive control together with the decrease in compensatory visual stabilization and emergency responses. Younger subjects (65–74 yrs) exhibited better, but still inadequate, proprioceptive control with compensatory visual stabilization. Gender differences appeared in older subjects: women were significantly less stable than men. The measurement of the sensory components of single stance stability could aid in the early detection of a decay in antigravity movements many years before the risk of falling becomes evident. Adequate proprioceptive control could mitigate the effects of all other risks of falling. PMID:23984068

  19. Effect of interactive cognitive motor training on gait and balance among older adults: A randomized controlled trial.

    Science.gov (United States)

    Kao, Ching-Chiu; Chiu, Huei-Ling; Liu, Doresses; Chan, Pi-Tuan; Tseng, Ing-Jy; Chen, Ruey; Niu, Shu-Fen; Chou, Kuei-Ru

    2018-06-01

    Aging is a normal degenerative process that results in a decline in the gait and balance performance of older adults. Interactive cognitive motor training is an intervention that integrates cognitive and motor tasks to promote individuals' physical and cognitive fall risk factors. However, the additive effects of the interactive cognitive motor training on objective quantitative data and comprehensive descriptions of gait and balance warrants further investigation. To investigate the effect of interactive cognitive motor training on older adults' gait and balance from immediate to long-term time points. A double-blind randomized control trial. Four senior service centers and community service centers in Taiwan. 62 older adults who met the inclusion criteria. The study participants were older adults without cognitive impairment, and they were randomly allocated to the experimental group or active control group. In both groups, older adults participated in three sessions of 30-min training per week for a total of 8 weeks, with the total number of training sessions being 24. The primary outcome was gait performance, which was measured using objective and subjective indicators. iWALK was used as an objective indicator to measure pace and dynamic stability; the Functional Gait Assessment was employed as a subjective indicator. The secondary outcome was balance performance, which was measured using iSWAY. A generalized estimating equation was used to identify whether the results of the two groups differ after receiving different intervention measures; the results were obtained from immediate to long-term posttests. Stride length in the pace category of the experimental group improved significantly in immediate posttest (p = 0.01), 3-month follow-up (p = 0.01), and 6-month follow-up (p = 0.04). The range of motion of the leg exhibited significant improvement in immediate posttest (p = 0.04) and 3-month follow-up (p = 0.04). The Functional Gait

  20. Gender Differences in Hypertension Control Among Older Korean Adults: Korean Social Life, Health, and Aging Project

    Directory of Open Access Journals (Sweden)

    Sang Hui Chu

    2015-01-01

    Full Text Available Objectives: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients’ attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. Methods: This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Results: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one’s blood pressure level (odds ratio [OR], 2.86; p=0.003 and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011 might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013. Conclusions: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

  1. Electroacupuncture for older adults with mild cognitive impairment: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Leung, Albert Wing Nang; Lam, Linda Chiu Wa; Kwan, Andrew Ka Lun; Tsang, Celia Lai Lin; Zhang, Hong Wei; Guo, Yuan Qi; Xu, Chuan Shan

    2015-05-27

    Mild cognitive impairment is an intermediary state between normal aging and clinical Alzheimer's disease. Early intervention of mild cognitive impairment may be an important strategy in the management of Alzheimer's disease. The proposal aims to evaluate if electroacupuncture would optimize cognitive function in subjects with mild cognitive impairment and understand the role of electroacupuncture in the treatment of Alzheimer's disease. A randomised patient- and assessor-blind sham-controlled trial is designed to assess whether electroacupuncture intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment. One hundred and fifty subjects aged 65 years of age or over with a diagnosis of mild cognitive impairment are recruited from the community and elderly centre in Hong Kong. All subjects are randomly allocated into two groups (75 subjects each group): the electroacupuncture group and sham control. Participants in the electroacupuncture group receive electroacupuncture stimulation by sterile, disposable acupuncture needles inserted to the acupoints with a depth of 1 to 3 cm. The acupuncture needles are subjected to 2 Hz electroacupuncture with an intensity of 5 to 10 mA. Each participant receives electroacupuncture for 8 weeks (once a day, 3 days a week) and the treatment lasts for 30 minutes each time. For sham electroacupuncture, needles are inserted to a depth of 1 to 2 mm, and connected to the electroacupuncture device without any current passing through. Outcome measures (including primary and secondary outcome measures) are collected at baseline, at the end day of intervention, and months 4 and 6 after intervention. The primary outcome is measured by the Alzheimer Disease Assessment Scale-Cognitive subscale. Secondary outcomes are measured by the mini-mental state examination, category fluency text and the Short Form 12. The study will provide evidence for evaluating and understanding the role of electroacupuncture

  2. Can executive control be influenced by performance feedback? Two experimental studies with younger and older adults

    Directory of Open Access Journals (Sweden)

    Barbara eDrueke

    2012-04-01

    Full Text Available Executive control describes a wide range of cognitive processes which are critical for the goal-directed regulation of stimulus processing and action regulation. Previous studies have shown that executive control performance declines with age but yet, it is still not clear whether different internal and external factors - as performance feedback and age - influence these cognitive processes and how they might interact with each other. Therefore, we investigated feedback effects in the flanker task in young as well as in older adults in two experiments. Performance feedback significantly improved executive performance in younger adults at the expense of errors. In older adults, feedback also led to higher error rates, but had no significant effect on executive performance which might be due to stronger interference. Results indicate that executive functions can be positively influenced by performance feedback in younger adults, but not necessarily in older adults.

  3. Migration of Older to New Digital Control Systems in Nuclear Power Plant Main Control Rooms

    Energy Technology Data Exchange (ETDEWEB)

    Kovesdi, Casey Robert [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey Clark [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-04-01

    The United States (U.S.) Department of Energy (DOE) Office of Nuclear Energy (NE) has the primary mission to advance nuclear power by resolving socio-technical issues through research and development (R&D). One DOE-NE activity supporting this mission is the Light Water Reactor Sustainability (LWRS) program. LWRS has the overall objective to sustain the operation of existing commercial nuclear power plants (NPPs) through conducting R&D across multiple “pathways,” or R&D focus areas. The Advanced Instrumentation, Information, and Control (II&C) Systems Technologies pathway conducts targeted R&D to address aging and reliability concerns with the legacy instrumentation and control (I&C) and related information systems in operating U.S. NPPs. This work involves (1) ensuring that legacy analog II&C systems are not life-limiting issues for the LWR fleet, and (2) implementing digital II&C technology in a manner that enables broad innovation and business improvement in the NPP operating model. Under the LWRS Advanced II&C pathway, Human Factors experts at Idaho National Laboratory (INL) have been conducting R&D in support of NPP main control room (MCR) modernization activities. Work in prior years has focused on migrating analog I&C systems to new digital I&C systems (). In fiscal year 2016 (FY16), one new focus area for this research is migrating older digital I&C systems to new and advanced digital I&C systems. This report summarizes a plan for conducting a digital-to-digital migration of a legacy digital I&C system to a new digital I&C system in support of control room modernization activities.

  4. Migration of Older to New Digital Control Systems in Nuclear Power Plant Main Control Rooms

    International Nuclear Information System (INIS)

    Kovesdi, Casey Robert; Joe, Jeffrey Clark

    2016-01-01

    The United States (U.S.) Department of Energy (DOE) Office of Nuclear Energy (NE) has the primary mission to advance nuclear power by resolving socio-technical issues through research and development (R&D). One DOE-NE activity supporting this mission is the Light Water Reactor Sustainability (LWRS) program. LWRS has the overall objective to sustain the operation of existing commercial nuclear power plants (NPPs) through conducting R&D across multiple ''pathways,'' or R&D focus areas. The Advanced Instrumentation, Information, and Control (II&C) Systems Technologies pathway conducts targeted R&D to address aging and reliability concerns with the legacy instrumentation and control (I&C) and related information systems in operating U.S. NPPs. This work involves (1) ensuring that legacy analog II&C systems are not life-limiting issues for the LWR fleet, and (2) implementing digital II&C technology in a manner that enables broad innovation and business improvement in the NPP operating model. Under the LWRS Advanced II&C pathway, Human Factors experts at Idaho National Laboratory (INL) have been conducting R&D in support of NPP main control room (MCR) modernization activities. Work in prior years has focused on migrating analog I&C systems to new digital I&C systems (). In fiscal year 2016 (FY16), one new focus area for this research is migrating older digital I&C systems to new and advanced digital I&C systems. This report summarizes a plan for conducting a digital-to-digital migration of a legacy digital I&C system to a new digital I&C system in support of control room modernization activities.

  5. Fitness, Balance Efficacy, and Postural Control in Community-Dwelling Older Adults

    OpenAIRE

    Anna Lee; John R. Biggan; Christopher Ray

    2016-01-01

    Age-related declines in postural control and physical fitness are strong risk factors for falls in older adults. Balance efficacy has been utilized to identify poor postural control, reduced physical function, and fall risk. However, it is not clear as to whether balance efficacy is truly a better predictor of functional fitness outcomes or postural control. Distinguishing these associations is an important step in the...

  6. Locus of control and coping strategies in older persons with and without depression.

    Science.gov (United States)

    Bjørkløf, Guro Hanevold; Engedal, Knut; Selbæk, Geir; Maia, Deborah Bezerra; Coutinho, Evandro Silvia Freire; Helvik, Anne-Sofie

    2016-08-01

    To compare locus of control and coping strategies in older persons with and without depression. This cross-sectional study included 144 depressed in-patients from seven psychogeriatric hospital units, and 106 community-dwelling older persons without depression. All participants were 60 years and older. Locus of control was assessed by a 17-items self-report questionnaire with six response categories. Coping strategies were assessed by a 26-items self-report questionnaire with five response categories. For analytical purposes, age (controlling for demographics, health, and social variables, the depressed in-patients showed a higher external locus of control orientation and a less frequent use of problem-focused coping strategies compared with the non-depressed group. No differences in use of emotion-focused strategies were found between the two groups. Compared with the non-depressed old persons, the depressed hospitalized older persons were characterized by perceptions of less personal control, and less use of problem-focused strategies, what also might have brought positive alterations into their situation.

  7. A Proteomic Analysis of Human Follicular Fluid: Comparison between Younger and Older Women with Normal FSH Levels

    Directory of Open Access Journals (Sweden)

    Mahmoud Hashemitabar

    2014-09-01

    Full Text Available The follicular fluid (FF is produced during folliculogenesis and contains a variety of proteins that play important roles in follicle development and oocyte maturation. Age-related infertility is usually considered as a problem that can be solved by assisted reproduction technology. Therefore, the identification of novel biomarkers that are linked to reproductive aging is the subject of this study. FF was obtained from healthy younger (20–32 years old and older (38–42 years old women undergoing intracytoplasmic sperm injection (ICSI due to male factor infertility. The FF was analyzed by two-dimensional gel electrophoresis (2-DE. The power of two-dimensional gel electrophoresis and the identification of proteins were exploited using matrix-assisted laser desorption-ionization time-of-flight/time-of-flight (MALDI-TOF-TOF mass spectrometry. Twenty three protein spots showed reproducible and significant changes in the aged compared to the young group. Of these, 19 protein spots could be identified using MALDI-TOF-TOF-MS. As a result of MASCOT search, five unique downregulated proteins were identified in the older group. These were identified as serotransferrin, hemopexin precursor, complement C3, C4 and kininogen. A number of protein markers were found that may help develop diagnostic methods of infertility.

  8. Seeing the Talker's Face Improves Free Recall of Speech for Young Adults With Normal Hearing but Not Older Adults With Hearing Loss.

    Science.gov (United States)

    Rudner, Mary; Mishra, Sushmit; Stenfelt, Stefan; Lunner, Thomas; Rönnberg, Jerker

    2016-06-01

    Seeing the talker's face improves speech understanding in noise, possibly releasing resources for cognitive processing. We investigated whether it improves free recall of spoken two-digit numbers. Twenty younger adults with normal hearing and 24 older adults with hearing loss listened to and subsequently recalled lists of 13 two-digit numbers, with alternating male and female talkers. Lists were presented in quiet as well as in stationary and speech-like noise at a signal-to-noise ratio giving approximately 90% intelligibility. Amplification compensated for loss of audibility. Seeing the talker's face improved free recall performance for the younger but not the older group. Poorer performance in background noise was contingent on individual differences in working memory capacity. The effect of seeing the talker's face did not differ in quiet and noise. We have argued that the absence of an effect of seeing the talker's face for older adults with hearing loss may be due to modulation of audiovisual integration mechanisms caused by an interaction between task demands and participant characteristics. In particular, we suggest that executive task demands and interindividual executive skills may play a key role in determining the benefit of seeing the talker's face during a speech-based cognitive task.

  9. Detecting altered postural control after cerebral concussion in athletes with normal postural stability

    OpenAIRE

    Cavanaugh, J; Guskiewicz, K; Giuliani, C; Marshall, S; Mercer, V; Stergiou, N

    2005-01-01

    Objective: To determine if approximate entropy (ApEn), a regularity statistic from non-linear dynamics, could detect changes in postural control during quiet standing in athletes with normal postural stability after cerebral concussion.

  10. Seasonal variation of imipramine binding in the blood platelets of normal controls and depressed patients

    International Nuclear Information System (INIS)

    Arora, R.C.; Meltzer, H.Y.

    1988-01-01

    Imipramine binding (IB) was studied in the blood platelets from normal controls and depressed patients over a 4-year period (1981-1984) to determine if seasonal variation was present in Bmax or KD. Bimonthly variation in the Bmax of IB was found in normal controls studied longitudinally. No such variation was found when individual values from normal controls were examined on a monthly or seasonal basis. Bmax in depressed patients showed a significant seasonal, but not monthly, variation. KD of IB varied in normal controls using monthly or seasonal data, but not in the probably more reliable bimonthly data. These results suggest that IB studies comparing groups of subjects should match groups for season of the year or, for greater accuracy, month of the year

  11. Effects of music on depression in older people: a randomised controlled trial.

    Science.gov (United States)

    Chan, Moon Fai; Wong, Zi Yang; Onishi, Hideaki; Thayala, Naidu Vellasamy

    2012-03-01

    To determine the effect of music on depression levels in older adults. Background.  Depression is a common psychiatric disorder in older adults, and its impacts on this group of people, along with its conventional treatment, merit our attention. Conventional pharmacological methods might result in dependence and impairment in psychomotor and cognitive functioning. Listening to music, which is a non-pharmacological method, might reduce depression. A randomised controlled study. The study was conducted from July 2009-June 2010 at participants' home in Singapore. In total, 50 older adults (24 using music and 26 control) completed the study after being recruited. Participants listened to their choice of music for 30 minutes per week for eight weeks. Depression scores were collected once a week for eight weeks. Depression levels reduced weekly in the music group, indicating a cumulative dose effect, and a statistically significant reduction in depression levels was found over time in the music group compared with non-music group. Listening to music can help older people to reduce their depression level. Music is a non-invasive, simple and inexpensive therapeutic method of improving life quality in community-dwelling older people. © 2011 Blackwell Publishing Ltd.

  12. TRX Suspension Training: A New Functional Training Approach for Older Adults - Development, Training Control and Feasibility.

    Science.gov (United States)

    Gaedtke, Angus; Morat, Tobias

    Because of its proximity to daily activities functional training becomes more important for older adults. Sling training, a form of functional training, was primarily developed for therapy and rehabilitation. Due to its effects (core muscle activation, strength and balance improvements), sling training may be relevant for older adults. However, to our knowledge no recent sling training program for healthy older adults included a detailed training control which is indeed an essential component in designing and implementing this type of training to reach positive effects. The purpose of this study was to develop a TRX Suspension Training for healthy older adults (TRX-OldAge) and to evaluate its feasibility. Eleven participants finished the 12 week intervention study. All participants trained in the TRX-OldAge whole-body workout which consists of seven exercises including 3-4 progressively advancing stages of difficulty for every exercise. At each stage, intensity could be increased through changes in position. Feasibility data was evaluated in terms of training compliance and a self-developed questionnaire for rating TRX-OldAge. The training compliance was 85 %. After study period, 91 % of the participants were motivated to continue with the program. The training intensity, duration and frequency were rated as optimal. All participants noted positive effects whereas strength gains were the most. On the basis of the detailed information about training control, TRX-OldAge can be individually adapted for each older adult appropriate to its precondition, demands and preference.

  13. Older adults utilize less efficient postural control when performing pushing task.

    Science.gov (United States)

    Lee, Yun-Ju; Chen, Bing; Aruin, Alexander S

    2015-12-01

    The ability to maintain balance deteriorates with increasing age. The aim was to investigate the role of age in generation of anticipatory (APA) and compensatory (CPA) postural adjustments during pushing an object. Older (68.8 ± 1.0 years) and young adults (30.1 ± 1.4 years) participated in the experiment involving pushing an object (a pendulum attached to the ceiling) using both hands. Electrical activity of six leg and trunk muscles and displacements of the center of pressure (COP) were recorded and analyzed during the APA and CPA phases. The onset time, integrals of muscle activity, and COP displacements were determined. In addition, the indexes of co-activation and reciprocal activation of muscles for the shank, thigh, and trunk segments were calculated. Older adults, compared to young adults, showed less efficient postural control seen as delayed anticipatory muscle onset times and delayed COP displacements. Moreover, older adults used co-activation of muscles during the CPA phase while younger subjects utilized reciprocal activation of muscles. The observed diminished efficiency of postural control during both anticipatory and compensatory postural adjustments observed in older adults might predispose them to falls while performing tasks involving pushing. The outcome provides a background for future studies focused on the optimization of the daily activities of older adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Amyloid imaging in cognitively normal older adults: comparison between 18F-flutemetamol and 11C-Pittsburgh compound B

    International Nuclear Information System (INIS)

    Adamczuk, Katarzyna; Schaeverbeke, Jolien; Neyens, Veerle; Dupont, Patrick; Nelissen, Natalie; Vandenbulcke, Mathieu; Goffin, Karolien; Lilja, Johan; Hilven, Kelly; Laere, Koen van; Vandenberghe, Rik

    2016-01-01

    Preclinical, or asymptomatic, Alzheimer's disease (AD) refers to the presence of positive AD biomarkers in the absence of cognitive deficits. This research concept is being applied to define target populations for clinical drug development. In a prospective community-recruited cohort of cognitively intact older adults, we compared two amyloid imaging markers within subjects: 18 F-flutemetamol and 11 C-Pittsburgh compound B (PIB). In 32 community-recruited cognitively intact older adults aged between 65 and 80 years, we determined the concordance between binary classification based on 18 F-flutemetamol versus 11 C-PIB according to semiquantitative assessment (standardized uptake value ratio in composite cortical volume, SUVR comp ) and, alternatively, according to visual reads. We also determined the correlation between 18 F-flutemetamol and 11 C-PIB SUVR and evaluated how this was affected by the reference region chosen (cerebellar grey matter versus pons) and the use of partial volume correction (PVC) in this population. Binary classification based on semiquantitative assessment was concordant between 18 F-flutemetamol and 11 C-PIB in 94 % of cases. Concordance of blinded binary visual reads between tracers was 84 %. The Spearman correlation between 18 F-flutemetamol and 11 C-PIB SUVR comp with cerebellar grey matter as reference region was 0.84, with a slope of 0.98. Correlations in neocortical regions were significantly lower with the pons as reference region. PVC improved the correlation in striatum and medial temporal cortex. For the definition of preclinical AD based on 18 F-flutemetamol, concordance with 11 C-PIB was highest using semiquantitative assessment with cerebellar grey matter as reference region. (orig.)

  15. The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review.

    Science.gov (United States)

    Agmon, Maayan; Lavie, Limor; Doumas, Michail

    2017-06-01

    Degraded hearing in older adults has been associated with reduced postural control and higher risk of falls. Both hearing loss (HL) and falls have dramatic effects on older persons' quality of life (QoL). A large body of research explored the comorbidity between the two domains. The aim of the current review is to describe the comorbidity between HL and objective measures of postural control, to offer potential mechanisms underlying this relationship, and to discuss the clinical implications of this comorbidity. PubMed and Google Scholar were systematically searched for articles published in English up until October 15, 2015, using combinations of the following strings and search words: for hearing: Hearing loss, "Hearing loss," hearing, presbycusis; for postural control: postural control, gait, postural balance, fall, walking; and for age: elderly, older adults. Of 211 screened articles, 7 were included in the systematic review. A significant, positive association between HL and several objective measures of postural control was found in all seven studies, even after controlling for major covariates. Severity of hearing impairment was connected to higher prevalence of difficulties in walking and falls. Physiological, cognitive, and behavioral processes that may influence auditory system and postural control were suggested as potential explanations for the association between HL and postural control. There is evidence for the independent relationship between HL and objective measures of postural control in the elderly. However, a more comprehensive understanding of the mechanisms underlying this relationship is yet to be elucidated. Concurrent diagnosis, treatment, and rehabilitation of these two modalities may reduce falls and increase QoL in older adults. American Academy of Audiology

  16. Influence of hip and knee osteoarthritis on dynamic postural control parameters among older fallers.

    Science.gov (United States)

    Mat, Sumaiyah; Ng, Chin Teck; Tan, Maw Pin

    2017-03-06

    To compare the relationship between postural control and knee and hip osteoarthritis in older adults with and without a history of falls. Fallers were those with ≥ 2 falls or 1 injurious fall over 12 months. Non-fallers were volunteers with no falls in the past year. Radiological evidence of osteoarthritis with no reported symptoms was considered "asymptomatic osteoarthritis", while "symptomatic osteoarthritis" was defined as radiographic osteoarthritis with pain or stiffness. Dynamic postural control was quantified with the limits of stability test measured on a balance platform (Neurocom® Balancemaster, California, USA). Parameters assessed were end-point excursion, maximal excursion, and directional control. A total of 102 older individuals, mean age 73 years (standard deviation 5.7) years were included. The association between falls and poor performance in maximal excursion and directional control was confounded by age and comorbidities. In the same linear equation model with falls, symptomatic osteoarthritis remained independently associated with poor end-point excursion (β-coefficient (95% confidence interval) -6.80 (-12.14 to -1.42)). Poor performance in dynamic postural control (maximal excursion and directional control) among fallers was not accounted for by hip/knee osteoarthritis, but was confounded by old age and comorbidities. Loss of postural control due to hip/knee osteoarthritis is not a risk factor for falls among community-dwelling older adults.

  17. Comparison of Visual Function in Older Eyes in the Earliest Stages of Age-related Macular Degeneration to Those in Normal Macular Health.

    Science.gov (United States)

    Owsley, Cynthia; Huisingh, Carrie; Clark, Mark E; Jackson, Gregory R; McGwin, Gerald

    2016-01-01

    To compare the ability of several visual functional tests in terms of the strength of their associations with the earliest phases of age-related macular degeneration (AMD), which bears on their potential to serve as functional endpoints in evaluating treatments for early AMD and prevention strategies. Eyes from adults ≥60 years old were identified as being in normal macular health or in the earliest stages of AMD (steps 2, 3 or 4) through grading of color stereo-fundus photos by an experienced grader masked to all other study variables who used the 9-step Age-Related Eye Disease Study (AREDS) classification system for AMD severity. Visual function was assessed using the following tests: best-corrected visual acuity, low luminance visual acuity, spatial contrast sensitivity, macular cone-mediated light sensitivity and rod-mediated dark adaptation. A total of 1260 eyes were tested from 640 participants; 1007 eyes were in normal macular health (defined as step 1 in AREDS system) and 253 eyes had early AMD (defined as steps 2, 3 or 4). Adjusting for age and gender, early AMD eyes had two times the odds of having delayed rod-mediated dark adaptation than eyes in normal macular health (p = 0.0019). Visual acuity, low luminance acuity, spatial contrast sensitivity and macular light sensitivity did not differ between normal eyes and early AMD eyes. Eyes in the earliest phases of AMD were two times more likely to have delayed rod-mediated dark adaptation, as assessed by the rod-intercept, as compared to older eyes in normal macular health, whereas there was no difference in early AMD versus normal eyes in tests of visual acuity, low luminance acuity, macular light sensitivity and spatial contrast sensitivity.

  18. Cognitive tasks promote automatization of postural control in young and older adults.

    Science.gov (United States)

    Potvin-Desrochers, Alexandra; Richer, Natalie; Lajoie, Yves

    2017-09-01

    Researchers looking at the effects of performing a concurrent cognitive task on postural control in young and older adults using traditional center-of-pressure measures and complexity measures found discordant results. Results of experiments showing improvements of stability have suggested the use of strategies such as automatization of postural control or stiffening strategy. This experiment aimed to confirm in healthy young and older adults that performing a cognitive task while standing leads to improvements that are due to automaticity of sway by using sample entropy. Twenty-one young adults and twenty-five older adults were asked to stand on a force platform while performing a cognitive task. There were four cognitive tasks: simple reaction time, go/no-go reaction time, equation and occurrence of a digit in a number sequence. Results demonstrated decreased sway area and variability as well as increased sample entropy for both groups when performing a cognitive task. Results suggest that performing a concurrent cognitive task promotes the adoption of an automatic postural control in young and older adults as evidenced by an increased postural stability and postural sway complexity. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. (Costeffectiveness of life review for Older Adults: Design of a randomized controlled trial

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    Onrust Simone

    2008-06-01

    Full Text Available Abstract Background Depression in older adults is a serious health problem with a poor prognosis. There is a need for indicated preventive psychological interventions for older adults, that show to be promising in preventing depressive disorders. Methods/design This manuscript describes the design of a study evaluating 'Looking for Meaning', a newly developed prevention course for older adults with depressive symptoms, based on life-review. Both clinical and economic effectiveness are evaluated in a pragmatic randomized controlled trial. The control condition of this 12-session preventive intervention is a 20-minute video movie. The primary outcome is symptoms of depression at post-treatment and follow-up (6 months after post-treatment. Secondary outcomes are symptoms of anxiety, satisfaction with life, mastery, reminiscence styles, quality of life, and health care costs. An additional result of this study is the insight into the working elements of the course, provided by the qualitative study. The qualitative data, mainly based on 20 open-ended interviews with participants, are to be analyzed with an emphasis on newly emerging insight. Discussion This study will add to the existing scientific knowledge in several ways, especially by also including an economic evaluation and a qualitative study to gain insight into the working mechanisms of the course, both rather new in the field of life review. Positive results of this study will make an evidence-based intervention to improve public health among older people available. Trial registration Current Controlled Trials Ltd, ISRCTN66645855

  20. Perturbation Training Can Reduce Community-Dwelling Older Adults’ Annual Fall Risk: A Randomized Controlled Trial

    Science.gov (United States)

    Bhatt, Tanvi; Yang, Feng; Wang, Edward

    2014-01-01

    Background. Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults’ annual falls risk in their everyday living. Methods. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). Results. With this single session of repeated-slip exposure, training cut older adults’ annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. Conclusion. A single session of repeated-slip exposure could improve community-dwelling older adults’ resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. PMID:24966227

  1. Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial.

    Science.gov (United States)

    Pai, Yi-Chung; Bhatt, Tanvi; Yang, Feng; Wang, Edward

    2014-12-01

    Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults' annual falls risk in their everyday living. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). With this single session of repeated-slip exposure, training cut older adults' annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. A single session of repeated-slip exposure could improve community-dwelling older adults' resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults.

    Science.gov (United States)

    Donoghue, Orna A; Cronin, Hilary; Savva, George M; O'Regan, Claire; Kenny, Rose Anne

    2013-05-01

    Fear of falling (FOF) is associated with poor physical and psychosocial health and can have debilitating consequences especially when it leads to activity restriction. This study examined whether normal and dual task gait disruptions were independently associated with FOF and activity restriction or if they were fully explained by impaired health status. Data was obtained from The Irish Longitudinal Study on Ageing (TILDA). Community dwelling adults ≥65 years, with a Mini-Mental State Examination score ≥18 and who completed a gait assessment (n=1307) were divided into three groups: no FOF, FOF but no activity restriction (FOF-NAR), FOF with activity restriction (FOF-AR). Physical, psychosocial and cognitive measures were obtained and gait characteristics were assessed using a GAITRite(®) mat during normal and dual task (cognitive) walking. After adjusting for sociodemographics, physical, mental and cognitive health, FOF was associated with reduced gait speed and stride length and increased double support phase and step width in normal and dual task conditions; these changes were most pronounced in those who restrict activities as a result of FOF. These gait changes may be associated with an increased fall risk, however some changes especially increased step width may also reflect positive, compensatory adaptations to FOF. The results also highlight the importance of treating underlying health impairments and preventing the transition from FOF to activity restriction. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials

    OpenAIRE

    Ellis, G.; Whitehead, M.A.; Robinson, D.; O'Neill, D.; Langhorne, P.

    2011-01-01

    Objective - To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency.\\ud \\ud Search strategy - We searched the EPOC Register, Cochrane’s Controlled Trials Register, the Database of Abstracts of Reviews of Effects (DARE), Medline, Embase, CINAHL, AARP Ageline, and handsearched high yield journals.\\ud \\ud Selection criteria - Randomised controlled trials of comprehensive geriatric assessment (whether by mobile teams or in designat...

  4. The Effects of Multisensory Balance Training on Postural Control in Older Adults

    OpenAIRE

    Farnoosh Shams; Afsoun Hassani Mehraban; Ghorban Taghizadeh

    2011-01-01

    Objectives: It has been found that older adults fall or sway significantly more than younger ones under sensory conflict conditions. Considering the prospects of future increases in the elderly population size of Iran and the lack of proper postural control and the high costs of its probable consequences, this study investigated the effects of multi balance training on postural control. Methods & Materials: In this semi-experimental study, 34 elderly women participated in two training and...

  5. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials

    OpenAIRE

    de Labra, Carmen; Guimaraes-Pinheiro, Christyanne; Maseda, Ana; Lorenzo, Trinidad; Mill?n-Calenti, Jos? C.

    2015-01-01

    Background Low physical activity has been shown to be one of the most common components of frailty, and interventions have been considered to prevent or reverse this syndrome. The purpose of this systematic review of randomized, controlled trials is to examine the exercise interventions to manage frailty in older people. Methods The PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched using specific keywords and Medical Subject Headings for random...

  6. Intermittent use of an "anchor system" improves postural control in healthy older adults.

    Science.gov (United States)

    Freitas, Milena de Bem Zavanella; Mauerberg-deCastro, Eliane; Moraes, Renato

    2013-07-01

    Haptic information, provided by a non-rigid tool (i.e., an "anchor system"), can reduce body sway in individuals who perform a standing postural task. However, it was not known whether or not continuous use of the anchor system would improve postural control after its removal. Additionally, it was unclear as to whether or not frequency of use of the anchor system is related to improved control in older adults. The present study evaluated the effect of the prolonged use of the anchor system on postural control in healthy older individuals, at different frequencies of use, while they performed a postural control task (semi-tandem position). Participants were divided into three groups according to the frequency of the anchor system's use (0%, 50%, and 100%). Pre-practice phase (without anchor) was followed by a practice phase (they used the anchor system at the predefined frequency), and a post-practice phase (immediate and late-without anchor). All three groups showed a persistent effect 15min after the end of the practice phase (immediate post-practice phase). However, only the 50% group showed a persistent effect in the late post-practice phase (24h after finishing the practice phase). Older adults can improve their postural control by practicing the standing postural task, and use of the anchor system limited to half of their practice time can provide additional improvement in their postural control. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Characteristics of balance control in older persons who fall with injury--a prospective study.

    Science.gov (United States)

    Kurz, Ilan; Oddsson, Lars; Melzer, Itshak

    2013-08-01

    Older adults who have recently fallen demonstrate increased postural sway compared with non-fallers. However, the differences in postural control between older adults who were seriously injured (SI) as a result of a fall, compared with those who fell but were not injured (NSI) and non-fallers (NFs), has not been investigated. The objective of the present study was to investigate the underlying postural control mechanisms related to injuries resulting from a fall. Both traditional postural sway measures of foot center-of-pressure (CoP) displacements and fractal measures, the Stabilogram-Diffusion Analysis (SDA), were used to characterize the postural control. One hundred older adults aged 65-91years were tested during narrow base upright stance in eyes closed condition; falls were monitored over a 1-year period. Forty-nine older adults fell during the 1-year follow-up, 13 were seriously injured as a result of a fall (SI), 36 were not injured (NSI), and 49 were non-fallers (NFs); two passed away. The SDA showed significantly higher short-term diffusion coefficients and critical displacements in SI in the anterior-posterior direction compared with both NSI and NF. However, in the medio-lateral direction there were no statistically significant differences between groups. For the traditional measures of sway, the average anterior-posterior CoP range was also larger in SI individuals. This work suggests that older fallers with a deterioration of anterior-posterior postural control may be at higher risk of serious injury following fall events. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial.

    Science.gov (United States)

    Epstein, Dana R; Sidani, Souraya; Bootzin, Richard R; Belyea, Michael J

    2012-06-01

    Recently, the use of multicomponent insomnia treatment has increased. This study compares the effect of single component and multicomponent behavioral treatments for insomnia in older adults after intervention and at 3 months and 1 yr posttreatment. A randomized, controlled study. Veterans Affairs medical center. 179 older adults (mean age, 68.9 yr ± 8.0; 115 women [64.2%]) with chronic primary insomnia. Participants were randomly assigned to 6 wk of stimulus control therapy (SCT), sleep restriction therapy (SRT), the 2 therapies combined into a multicomponent intervention (MCI), or a wait-list control group. Primary outcomes were subjective (daily sleep diary) and objective (actigraphy) measures of sleep-onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), and sleep efficiency (SE). Secondary outcomes were clinical measures including response and remission rates. There were no differences between the single and multicomponent interventions on primary sleep outcomes measured by diary and actigraphy. All treatments produced significant improvement in diary-reported sleep in comparison with the control group. Effect sizes for sleep diary outcomes were medium to large. Treatment gains were maintained at follow-up for diary and actigraph measured SOL, WASO, and SE. The MCI group had the largest proportion of treatment remitters. For older adults with chronic primary insomnia, the findings provide initial evidence that SCT, SRT, and MCI are equally efficacious and produce sustainable treatment gains on diary, actigraphy, and clinical outcomes. From a clinical perspective, MCI may be a preferred treatment due to its higher remission rate. Behavioral Intervention for Insomnia in Older Adults. NCT01154023. URL: http://clinicaltrials.gov/ct2/show/NCT01154023?term=Behavioral+Intervention+for+Insomnia+in+Older+Adults&rank=1.

  9. Memory for general and specific value information in younger and older adults: measuring the limits of strategic control.

    Science.gov (United States)

    Castel, Alan D; Farb, Norman A S; Craik, Fergus I M

    2007-06-01

    The ability to selectively remember important information is a critical function of memory. Although previous research has suggested that older adults are impaired in a variety of episodic memory tasks, recent work has demonstrated that older adults can selectively remember high-value information. In the present research, we examined how younger and older adults selectively remembered words with various assigned numeric point values, to see whether younger adults could remember more specific value information than could older adults. Both groups were equally good at recalling point values when recalling the range of high-value words, but younger adults outperformed older adults when recalling specific values. Although older adults were more likely to recognize negative value words, both groups exhibited control by not recalling negative value information. The findings suggest that although both groups retain high-value information, older adults rely more on gist-based encoding and retrieval operations, whereas younger adults are able to remember specific numeric value information.

  10. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life

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    Ho HY

    2018-01-01

    Full Text Available Hsiu-Yu Ho,1,2 Mei-Hui Chen,2,3 Meei-Fang Lou1 1School of Nursing, College of Medicine, National Taiwan University, 2Department of Nursing, Yuanpei University of Medical Technology, 3National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China Background: Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adults living with comorbidities that include diabetes. Aim: The aim of this study was to explore the experience of older adults living with comorbidities including diabetes. Methods: A qualitative approach was employed. Data were collected from a selected field of 12 patients with diabetes mellitus in a medical center in northern Taiwan. The data were analyzed by Colaizzi’s phenomenological methodology, and four criteria of Lincoln and Guba were used to evaluate the rigor of the study. Results: The following 5 themes and 14 subthemes were derived: 1 expecting to heal or reduce the symptoms of the disease (trying to alleviate the distress of symptoms and trusting in health practitioners combining the use of Chinese and Western medicines; 2 comparing complex medical treatments (differences in physician practices and presentation, conditionally adhering to medical treatment, and partnering with medical professionals; 3 inconsistent information (inconsistent health information and inconsistent medical advice; 4 impacting on daily life (activities are limited and hobbies cannot be maintained and psychological distress; and 5 weighing the pros and cons (taking the initiative to deal with issues, limiting activity, adjusting mental outlook and pace of life, developing strategies for individual health regimens, and seeking support. Surmounting these challenges in order to live a normal life was explored. Conclusion: This study found that the experience of older adults

  11. Prevalence of overweight misperception and weight control behaviors among normal weight adolescents in the United States

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    Kathleen S. Talamayan

    2006-01-01

    Full Text Available Weight perceptions and weight control behaviors have been documented with underweight and overweight adolescents, yet limited information is available on normal weight adolescents. This study investigates the prevalence of overweight misperceptions and weight control behaviors among normal weight adolescents in the U.S. by sociodemographic and geographic characteristics. We examined data from the 2003 Youth Risk Behavior Survey (YRBS. A total of 9,714 normal weight U.S. high school students were included in this study. Outcome measures included self-reported height and weight measurements, overweight misperceptions, and weight control behaviors. Weighted prevalence estimates and odds ratios were computed. There were 16.2% of normal weight students who perceived themselves as overweight. Females (25.3% were more likely to perceive themselves as overweight than males (6.7% (p < 0.05. Misperceptions of overweight were highest among white (18.3% and Hispanic students (15.2% and lowest among black students (5.8%. Females (16.8% outnumbered males (6.8% in practicing at least one unhealthy weight control behavior (use of diet pills, laxatives, and fasting in the past 30 days. The percentage of students who practiced at least one weight control behavior was similar by ethnicity. There were no significant differences in overweight misperception and weight control behaviors by grade level, geographic region, or metropolitan status. A significant portion of normal weight adolescents misperceive themselves as overweight and are engaging in unhealthy weight control behaviors. These data suggest that obesity prevention programs should address weight misperceptions and the harmful effects of unhealthy weight control methods even among normal weight adolescents.

  12. The Effects of Slackline Balance Training on Postural Control in Older Adults.

    Science.gov (United States)

    Thomas, Monika; Kalicinski, Michael

    2016-07-01

    The present study investigated whether slackline training enhances postural control in older adults. Twenty-four participants were randomized into an intervention and a control group. The intervention group received 6 weeks of slackline training, two times per week. Pre-post measurement included the time of different standing positions on a balance platform with and without an external disturbance and the acceleration of the balance platform. Results showed significantly improved standing times during one-leg stance without external disturbance and a significantly reduced acceleration of the balance platform for the intervention group after the training period during tandem stance with and without an external disturbance. We conclude that slackline training in older adults has a positive impact on postural control and thus on the reduction of fall risk.

  13. Dynamic stability control in forward falls: postural corrections after muscle fatigue in young and older adults.

    Science.gov (United States)

    Mademli, Lida; Arampatzis, Adamantios; Karamanidis, Kiros

    2008-06-01

    Many studies report that muscle strength loss may alter the human system's capacity to generate rapid force for balance corrections after perturbations, leading to deficient recovery behaviours. Yet little is known regarding the effect of modifications in the neuromuscular system induced by fatigue on dynamic stability control during postural perturbations. This study investigates the effect of muscle strength decline induced by fatiguing contractions on the dynamic stability control of young and older adults during forward falls. Eleven young and eleven older male adults had to regain balance after sudden falls before and after submaximal fatiguing knee extension-flexion contractions. Young subjects had a higher margin of stability than older ones before and after the fatiguing task. This reflects their enhanced ability in using mechanisms for maintaining dynamic stability (i.e. a greater base of support). The margin of stability, the boundary of the base of support and the position of the extrapolated centre of mass, remained unaffected by the reduction in muscle strength induced by the fatiguing contractions, indicating an appropriate adjustment of the motor commands to compensate the deficit in muscle strength. Both young and older adults were able to counteract the decreased horizontal ground reaction forces after the fatiguing task by flexing their knee to a greater extent, leading to similar decreases in the horizontal velocity of centre of mass as in the pre fatigue condition. The results demonstrate the ability of the central nervous system to rapidly modify the execution of postural corrections including mechanisms for maintaining dynamic stability.

  14. Fitness, Balance Efficacy, and Postural Control in Community-Dwelling Older Adults

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    Anna Lee

    2016-02-01

    Full Text Available Age-related declines in postural control and physical fitness are strong risk factors for falls in older adults. Balance efficacy has been utilized to identify poor postural control, reduced physical function, and fall risk. However, it is not clear as to whether balance efficacy is truly a better predictor of functional fitness outcomes or postural control. Distinguishing these associations is an important step in the future derivation of physiotherapeutic programming to remediate acute and chronic decline. Therefore, the purpose of this cross-sectional study was to partition which measures are more associated with balance efficacy, fitness, or postural control. One hundred eleven community-dwelling older adults participated and were asked to complete the Balance Efficacy Scale (BES, a functional fitness measure (the Senior Fitness Test [SFT], and a measure of postural control (the Sensory Organization Test [SOT].We found that the SFT was more significantly associated with balance efficacy (R2 = .37 than the SOT (R2 = .08 in older adults. Overall, aerobic endurance, functional mobility in the SFT, and the vestibular score on the SOT were significantly associated with balance efficacy. We concluded that clinicians utilizing the BES as a preliminary screen should recommend physiotherapy follow-up activities that build endurance (walking, lower extremity functional mobility (sit-to-stand, and vestibular function (head movement while walking. Understanding the links between a preliminary screening tool and the physiological needs of the patient will allow for targeted activities to be prescribed.

  15. Improved postural control after dynamic balance training in older overweight women.

    Science.gov (United States)

    Bellafiore, Marianna; Battaglia, Giuseppe; Bianco, Antonino; Paoli, Antonio; Farina, Felicia; Palma, Antonio

    2011-01-01

    Many studies have reported a greater frequency of falls among older women than men in conditions which stress balance. Previously, we found an improvement in static balance in older women with an increased support surface area and equal load redistribution on both feet, in response to a dynamic balance training protocol. The aim of the present study was to examine whether the same training program and body composition would have effects on the postural control of older overweight women. Ten healthy women (68.67 ± 5.50 yrs; 28.17 ± 3.35 BMI) participated in a five-week physical activity program. This included dynamic balance exercises, such as heel-to-toe walking in different directions, putting their hands on their hips, eyes open (EO) or closed (EC), with a tablet on their heads, going up and down one step, and walking on a mat. Postural stability was assessed before and after training with an optoelectronic platform and a uni-pedal balance performance test. Body composition of the trunk, upper limbs and lower limbs was measured by bio-impedance analysis. The mean speed (MS), medial-lateral MS (MS-x), anterior-posterior MS (MS-y), sway path (SP) and ellipse surface area (ESA) of the pressure center was reduced after training in older women. However, only MS, MS-x, MS-y and SP significantly decreased in bipodalic conditions with EO and MS-y also with EC (punipedal static balance. Our dynamic balance training protocol appears to be feasible, safe and repeatable for older overweight women and to have positive effects in improving their lateral and anterior-posterior postural control, mainly acting on the visual and skeletal muscle components of the balance control system.

  16. Diurnal changes in postural control in normal children: Computerized static and dynamic assessments.

    Science.gov (United States)

    Bourelle, Sophie; Taiar, Redha; Berge, Benoit; Gautheron, Vincent; Cottalorda, Jerome

    2014-01-01

    Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7-8 a.m. in the morning) and after (4-7 p.m. in the afternoon) school on regular school days using the Balance Master® evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training) or in abnormal conditions (e.g., mTBI-associated balance disorders), be better performed late in the afternoon.

  17. External validity of randomized controlled trials in older adults, a systematic review.

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    Floor J van Deudekom

    Full Text Available To critically assess the external validity of randomized controlled trials (RCTs it is important to know what older adults have been enrolled in the trials. The aim of this systematic review is to study what proportion of trials specifically designed for older patients report on somatic status, physical and mental functioning, social environment and frailty in the patient characteristics.PubMed was searched for articles published in 2012 and only RCTs were included. Articles were further excluded if not conducted with humans or only secondary analyses were reported. A random sample of 10% was drawn. The current review analyzed this random sample and further selected trials when the reported mean age was ≥ 60 years. We extracted geriatric assessments from the population descriptives or the in- and exclusion criteria.In total 1396 trials were analyzed and 300 trials included. The median of the reported mean age was 66 (IQR 63-70 and the median percentage of men in the trials was 60 (IQR 45-72. In 34% of the RCTs specifically designed for older patients somatic status, physical and mental functioning, social environment or frailty were reported in the population descriptives or the in- and exclusion criteria. Physical and mental functioning was reported most frequently (22% and 14%. When selecting RCTs on a mean age of 70 or 80 years the report of geriatric assessments in the patient characteristics was 46% and 85% respectively but represent only 5% and 1% of the trials.Somatic status, physical and mental functioning, social environment and frailty are underreported even in RCTs specifically designed for older patients published in 2012. Therefore, it is unclear for clinicians to which older patients the results can be applied. We recommend systematic to transparently report these relevant characteristics of older participants included in RCTs.

  18. Normalization of RNA-seq data using factor analysis of control genes or samples

    Science.gov (United States)

    Risso, Davide; Ngai, John; Speed, Terence P.; Dudoit, Sandrine

    2015-01-01

    Normalization of RNA-seq data has proven essential to ensure accurate inference of expression levels. Here we show that usual normalization approaches mostly account for sequencing depth and fail to correct for library preparation and other more-complex unwanted effects. We evaluate the performance of the External RNA Control Consortium (ERCC) spike-in controls and investigate the possibility of using them directly for normalization. We show that the spike-ins are not reliable enough to be used in standard global-scaling or regression-based normalization procedures. We propose a normalization strategy, remove unwanted variation (RUV), that adjusts for nuisance technical effects by performing factor analysis on suitable sets of control genes (e.g., ERCC spike-ins) or samples (e.g., replicate libraries). Our approach leads to more-accurate estimates of expression fold-changes and tests of differential expression compared to state-of-the-art normalization methods. In particular, RUV promises to be valuable for large collaborative projects involving multiple labs, technicians, and/or platforms. PMID:25150836

  19. Gender differences in nigrostriatal dopaminergic innervation are present at young-to-middle but not at older age in normal adults.

    Science.gov (United States)

    Wong, Ka Kit; Müller, Martijn L T M; Kuwabara, Hiroto; Studenski, Stephanie A; Bohnen, Nicolaas I

    2012-01-01

    Gender differences in brain dopaminergic activity have been variably reported in the literature. We performed an evaluation for gender effects on striatal dopamine transporter (DAT) binding in a group of normal subjects. Community-dwelling adults (n = 85, 50F/35M, mean age 62.7 ± 16.2 SD, range 20-85) underwent DAT [(11)C]2-β-carbomethoxy-3β-(4-fluorophenyl) tropane (β-CFT) positron emission tomography (PET) imaging. Gender effects for DAT binding were compared using ANCOVA for two subgroups; young-to-middle aged adults and older adults, using an age threshold of 60 years. There were 54 subjects (24M/30F; mean age 72.9 ± 7.3) 60 years and older and 31 (11M/20F; mean age 45.0 ± 11.4) subjects younger than 60. Age-adjusted striatal DAT gender effects were present in the young-to-middle (F = 10.4, P = 0.003) but not in the elderly age group (F = 0.5, ns). Gender differences in nigrostriatal dopaminergic innervation are present, with higher levels of DAT binding in young-to-middle age women compared to men, but not present in the elderly. Published by Elsevier Ltd.

  20. Functional-Strengthening: A Pilot Study on Balance Control Improvement in Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Micah D. Josephson

    2017-09-01

    Full Text Available Adults over the age of 65 have a 1 in 3 chance of falling; in 2012, more than $30 billion was spent on medical costs due to these falls. The division of resistance training and neuromotor training balance improvement interventions has shown to yield low to moderate results. Athletes combine both resistance training and skill development (function training to improve skilled performance. Older adults may not be performing high-level sports activities, but still require strength, power, and functional fitness levels to perform relatively high-level skills. The purpose of this study was to determine the effects of combining resistance and functional training into functional-strength training on dynamic balance control in moderately active older adults. Eighteen healthy older adults were divided into three groups; functional resistance, standard resistance, and control. All groups met for their intervention twice a week for six weeks. Dynamic balance was assessed using the Fullerton Advanced Balance Scale (0-40. Results of individual paired T-tests showed a significant improvement in balance control in the functional resistance group (t(5 =-3.492, p=.017 and a very large effect size (d=1.33 whereas neither the standard resistance nor control group had a significant reduction in the risk of falls. Manipulating multidimensional, neuromotor function during resistance training exercises is an effective method of applying the overload principle in order to reduce falls risk in moderately active seniors.

  1. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life

    Science.gov (United States)

    Ho, Hsiu-Yu; Chen, Mei-Hui

    2018-01-01

    Background Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adults living with comorbidities that include diabetes. Aim The aim of this study was to explore the experience of older adults living with comorbidities including diabetes. Methods A qualitative approach was employed. Data were collected from a selected field of 12 patients with diabetes mellitus in a medical center in northern Taiwan. The data were analyzed by Colaizzi’s phenomenological methodology, and four criteria of Lincoln and Guba were used to evaluate the rigor of the study. Results The following 5 themes and 14 subthemes were derived: 1) expecting to heal or reduce the symptoms of the disease (trying to alleviate the distress of symptoms and trusting in health practitioners combining the use of Chinese and Western medicines); 2) comparing complex medical treatments (differences in physician practices and presentation, conditionally adhering to medical treatment, and partnering with medical professionals); 3) inconsistent information (inconsistent health information and inconsistent medical advice); 4) impacting on daily life (activities are limited and hobbies cannot be maintained and psychological distress); and 5) weighing the pros and cons (taking the initiative to deal with issues, limiting activity, adjusting mental outlook and pace of life, developing strategies for individual health regimens, and seeking support). Surmounting these challenges in order to live a normal life was explored. Conclusion This study found that the experience of older adults living with comorbidities including diabetes was similar to that of a single disease, but the extent was greater than a single disease. The biggest difference is that the elderly think that their most serious problem is not diabetes, but rather, the comorbidities causing life limitations

  2. IMPROVING QUALITY OF STATISTICAL PROCESS CONTROL BY DEALING WITH NON‐NORMAL DATA IN AUTOMOTIVE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Zuzana ANDRÁSSYOVÁ

    2012-07-01

    Full Text Available Study deals with an analysis of data to the effect that it improves the quality of statistical tools in processes of assembly of automobile seats. Normal distribution of variables is one of inevitable conditions for the analysis, examination, and improvement of the manufacturing processes (f. e.: manufacturing process capability although, there are constantly more approaches to non‐normal data handling. An appropriate probability distribution of measured data is firstly tested by the goodness of fit of empirical distribution with theoretical normal distribution on the basis of hypothesis testing using programme StatGraphics Centurion XV.II. Data are collected from the assembly process of 1st row automobile seats for each characteristic of quality (Safety Regulation ‐S/R individually. Study closely processes the measured data of an airbag´s assembly and it aims to accomplish the normal distributed data and apply it the statistical process control. Results of the contribution conclude in a statement of rejection of the null hypothesis (measured variables do not follow the normal distribution therefore it is necessary to begin to work on data transformation supported by Minitab15. Even this approach does not reach a normal distributed data and so should be proposed a procedure that leads to the quality output of whole statistical control of manufacturing processes.

  3. Controlling the number of graphene sheets exfoliated from graphite by designed normal loading and frictional motion

    International Nuclear Information System (INIS)

    Lee, Seungjun; Lu, Wei

    2014-01-01

    We use molecular dynamics to study the exfoliation of patterned nanometer-sized graphite under various normal loading conditions for friction-induced exfoliation. Using highly ordered pyrolytic graphite (HOPG) as well as both amorphous and crystalline SiO 2 substrate as example systems, we show that the exfoliation process is attributed to the corrugation of the HOPG surface and the atomistic roughness of the substrate when they contact under normal loading. The critical normal strain, at which the exfoliation occurs, is higher on a crystalline substrate than on an amorphous substrate. This effect is related to the atomistic flatness and stiffness of the crystalline surface. We observe that an increase of the van der Waals interaction between the graphite and the substrate results in a decrease of the critical normal strain for exfoliation. We find that the magnitude of the normal strain can effectively control the number of exfoliated graphene layers. This mechanism suggests a promising approach of applying designed normal loading while sliding to pattern controlled number of graphene layers or other two-dimensional materials on a substrate surface.

  4. Assessment of balance control in relation to fall risk among older people

    OpenAIRE

    Nordin, Ellinor

    2008-01-01

    Falls and their consequences among older people are a serious medical and public health problem. Identifying individuals at risk of falling is therefore a major concern. The purpose of this thesis was to evaluate measurement tools of balance control and their predictive value when screening for fall risk in physically dependent individuals ≥65 years old living in residential care facilities, and physically independent individuals ≥75 years old living in the community. Following baseline asses...

  5. Assessing dynamic postural control during exergaming in older adults: A probabilistic approach.

    Science.gov (United States)

    Soancatl Aguilar, V; Lamoth, C J C; Maurits, N M; Roerdink, J B T M

    2018-02-01

    Digital games controlled by body movements (exergames) have been proposed as a way to improve postural control among older adults. Exergames are meant to be played at home in an unsupervised way. However, only few studies have investigated the effect of unsupervised home-exergaming on postural control. Moreover, suitable methods to dynamically assess postural control during exergaming are still scarce. Dynamic postural control (DPC) assessment could be used to provide both meaningful feedback and automatic adjustment of exergame difficulty. These features could potentially foster unsupervised exergaming at home and improve the effectiveness of exergames as tools to improve balance control. The main aim of this study is to investigate the effect of six weeks of unsupervised home-exergaming on DPC as assessed by a recently developed probabilistic model. High probability values suggest 'deteriorated' postural control, whereas low probability values suggest 'good' postural control. In a pilot study, ten healthy older adults (average 77.9, SD 7.2 years) played an ice-skating exergame at home half an hour per day, three times a week during six weeks. The intervention effect on DPC was assessed using exergaming trials recorded by Kinect at baseline and every other week. Visualization of the results suggests that the probabilistic model is suitable for real-time DPC assessment. Moreover, linear mixed model analysis and parametric bootstrapping suggest a significant intervention effect on DPC. In conclusion, these results suggest that unsupervised exergaming for improving DPC among older adults is indeed feasible and that probabilistic models could be a new approach to assess DPC. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. A longitudinal analysis of salivary flow in control subjects and older adults with type 2 diabetes.

    Science.gov (United States)

    Chávez, E M; Borrell, L N; Taylor, G W; Ship, J A

    2001-02-01

    Many diabetics complain of xerostomia, a condition that can affect oral health, nutritional status, and diet selection. This study's purposes were (1) to investigate the effect on salivary flow of type 2 diabetes and change in glycemic control in a group of older adults over time and (2) to compare flow rates with subjective complaints of xerostomia. A total of 39 older adults, 24 with type 2 diabetes and 15 who were nondiabetic (controls), aged 54-90 years, participated in a 1-year follow-up study. Diabetic status was determined by means of glycosylated hemoglobin (HbA1c) levels and 2-hour glucose tolerance tests. Poor glycemic control was defined as HbA1c > 9%. Unstimulated whole, unstimulated parotid, and stimulated parotid saliva flow rates were measured for all subjects by a single examiner at baseline and 1 year later. Each subject completed a standardized xerostomia questionnaire at every visit. Age, sex, and duration of diabetes did not adversely affect salivary flow rates. Subjects with poorly controlled diabetes had significantly lower stimulated parotid saliva flow rates at both visits. There were no significant changes in flow rates over time on the basis of diabetic status or glycemic control. Subjects with diabetes reported significantly more complaints of thirst but not of xerostomia at 1 year. These results suggest that older adults with poorly controlled diabetes may have impaired salivary flow in comparison with subjects with better controlled diabetes and nondiabetic subjects, yet they may not have concomitant xerostomic complaints. There were no significant changes in salivary flow rates or glycemic control over the 1-year period.

  7. Interuncal distance measurements in normal controls and patients with dementia. MR imaging study

    International Nuclear Information System (INIS)

    Ishii, Kazunari; Kitagaki, Hajime; Sakamoto, Setsu; Yamaji, Shigeru; Kono, Michio.

    1995-01-01

    To evaluate the utility of measuring interuncal distance (IUD) as a reflection of the limbic system, we compared the IUD of 60 dementia patients with that of 10 normal controls. We also measured the width of the intracranial compartment (W1 and W2) to correct for differences in individual brain size, and calculated the ratio of IUD/W1 and IUD/W2. IUD could not separate patients with dementia from normal controls, but there were significant differences in IUD/W1 and IUD/W2 between patients with dementia and normal controls. IUD, IUD/W1 and IUD/W2 did not correlate with Mini-Mental Examination score or ADAS score in patients with dementia. We conclude that IUD measurement is not helpful in distinguishing patients with mild stage dementia from normal aged people or as a scale for dementia. However, we suggest that IUD/W1 and IUD/W2 can discriminate between cases of mild dementia and normal aged people. (author)

  8. Association between vitamin D and pressure ulcers in older ambulatory adults: results of a matched case–control study

    Directory of Open Access Journals (Sweden)

    Kalava UR

    2011-08-01

    Full Text Available Usha R Kalava1, Stephen S Cha2, Paul Y Takahashi1,31Department of Internal Medicine, Division of Primary Care Internal Medicine, 2Department of Biostatistics, 3Kogod Center of Aging, Mayo Clinic, Rochester, MN, USABackground: Pressure ulcers are common among older adults, but knowledge about nutritional risk factors is still developing. Vitamin D deficiency is common in the elderly population and is required for normal skin proliferation. The role of vitamin D in pressure ulceration and wound healing is not known. The purpose of this case–control study was to determine the association between vitamin D levels and pressure ulceration in an older community-dwelling cohort.Methods: All cases and controls were community-dwelling elderly older than 60 years in a primary care panel in Olmsted County, MN. Pressure ulcer cases were defined clinically. The controls were age-matched and gender-matched to controls without pressure ulceration. The main exposure variable was 25-hydroxyvitamin D levels in both groups. The other exposure variable was the Charlson Comorbidity Index used to measure medical comorbidity. The analysis included univariate and conditional logistic regression for 25-hydroxyvitamin D levels.Results: The average (standard deviation age of the study participants with a pressure ulcer was 80.46 years (±8.67, and the average vitamin D level was 30.92 ng/mL (±12.46. In univariate analysis, Vitamin D deficiency (levels < 25 ng/mL was associated with pressure ulcers (odds ratio: 1.871, P = 0.0154. Comorbidities of the subjects calculated using the Charlson Comorbidity Index were also associated with pressure ulcers (odds ratio: 1.136, P < 0.001. In the final conditional logistical regression model, the association of Vitamin D and pressure ulcers became nonsignificant after adjustment for comorbid illness.Conclusion: Medical comorbidities increased the risk of pressure ulceration. Vitamin D deficiency was not an independent risk factor

  9. Delayed Compensatory Postural Adjustments After Lateral Perturbations Contribute to the Reduced Ability of Older Adults to Control Body Balance.

    Science.gov (United States)

    Claudino, Renato; Dos Santos, Marcio José; Mazo, Giovana Zarpellon

    2017-10-01

    The goal of this study was to investigate the timing of compensatory postural adjustments in older adults during body perturbations in the mediolateral direction, circumstances that increase their risk of falls. The latencies of leg and trunk muscle activation to body perturbations at the shoulder level and variables of center of pressure excursion, which characterize postural stability, were analyzed in 40 older adults (nonfallers and fallers evenly split) and in 20 young participants. The older adults exhibited longer latencies of muscular activation in eight out of 15 postural muscles as compared with young participants; for three muscles, the latencies were longer for the older fallers than nonfallers. Simultaneously, the time for the center of pressure displacement reached its peak after the perturbation was significant longer in both groups of older adults. The observed delays in compensatory postural adjustments may affect the older adults' ability to prompt control body balance after postural disturbances and predispose them to falls.

  10. Chronic pain self-management for older adults: a randomized controlled trial [ISRCTN11899548

    Directory of Open Access Journals (Sweden)

    Cain Kevin C

    2004-07-01

    Full Text Available Abstract Background Chronic pain is a common and frequently disabling problem in older adults. Clinical guidelines emphasize the need to use multimodal therapies to manage persistent pain in this population. Pain self-management training is a multimodal therapy that has been found to be effective in young to middle-aged adult samples. This training includes education about pain as well as instruction and practice in several management techniques, including relaxation, physical exercise, modification of negative thoughts, and goal setting. Few studies have examined the effectiveness of this therapy in older adult samples. Methods/Design This is a randomized, controlled trial to assess the effectiveness of a pain self-management training group intervention, as compared with an education-only control condition. Participants are recruited from retirement communities in the Pacific Northwest of the United States and must be 65 years or older and experience persistent, noncancer pain that limits their activities. The primary outcome is physical disability, as measured by the Roland-Morris Disability Questionnaire. Secondary outcomes are depression (Geriatric Depression Scale, pain intensity (Brief Pain Inventory, and pain-related interference with activities (Brief Pain Inventory. Randomization occurs by facility to minimize cross-contamination between groups. The target sample size is 273 enrolled, which assuming a 20% attrition rate at 12 months, will provide us with 84% power to detect a moderate effect size of .50 for the primary outcome. Discussion Few studies have investigated the effects of multimodal pain self-management training among older adults. This randomized controlled trial is designed to assess the efficacy of a pain self-management program that incorporates physical and psychosocial pain coping skills among adults in the mid-old to old-old range.

  11. Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.

    Science.gov (United States)

    Duan-Porter, Wei; Hastings, Susan Nicole; Neelon, Brian; Van Houtven, Courtney Harold

    2017-01-11

    Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for established "classic" biomedical risk factors. We also determined if an enhanced risk model with control beliefs improved identification of individuals with low vs. high mortality risk. We used nationally representative data from the Health and Retirement Study (2006-2012) for adults 50 years or older in 2006 (n = 7313) or 2008 (n = 6301). We assessed baseline perceived global control (measured as 2 dimensions-"constraints" and "mastery"), and health-specific control. We also obtained baseline data for 12 established biomedical risk factors of 4-year mortality: age, sex, 4 medical conditions (diabetes mellitus, cancer, lung disease and heart failure), body mass index less than 25 kg/m 2 , smoking, and 4 functional difficulties (with bathing, managing finances, walking several blocks and pushing or pulling heavy objects). Deaths within 4 years of follow-up were determined through interviews with respondents' family and the National Death Index. After accounting for classic biomedical risk factors, perceived constraints were significantly associated with higher mortality risk (third quartile scores odds ratio [OR] 1.37, 95% CI 1.03-1.81; fourth quartile scores OR 1.45, 95% CI, 1.09-1.92), while health-specific control was significantly associated with lower risk (OR 0.69-0.78 for scores above first quartile). Higher perceived mastery scores were not consistently associated with decreased risk. The enhanced model with control beliefs found an additional 3.5% of participants (n = 222) with low predicted risk of 4-year mortality (i.e., 4% or less); observed mortality for these individuals was 1.8% during follow-up. Compared with participants predicted to have low mortality risk only by the classic biomedical model

  12. Tumor control and normal tissue toxicity: The two faces of radiotherapy

    NARCIS (Netherlands)

    van Oorschot, B.

    2016-01-01

    This thesis discusses the two contrasting sides of radiotherapy: tumor control and normal tissue toxicity. On one hand, radiation treatment aims to target the tumor with the highest possible radiation dose, inducing as much lethal DNA damage as possible. On the other hand however, escalation of the

  13. Low empathy in deaf and hard of hearing (pre)adolescents compared to normal hearing controls

    NARCIS (Netherlands)

    Netten, A.P.; Rieffe, C.; Theunissen, S.C.P.M.; Soede, W.; Dirks, E.; Briaire, J.J.; Frijns, J.H.M.

    2015-01-01

    Objective The purpose of this study was to examine the level of empathy in deaf and hard of hearing (pre)adolescents compared to normal hearing controls and to define the influence of language and various hearing loss characteristics on the development of empathy. Methods The study group (mean age

  14. Dispositional mindfulness and the wandering mind: Implications for attentional control in older adults.

    Science.gov (United States)

    Fountain-Zaragoza, Stephanie; Londerée, Allison; Whitmoyer, Patrick; Prakash, Ruchika Shaurya

    2016-08-01

    Age-related cognitive decline brings decreases in functional status. Dispositional mindfulness, the tendency towards present-moment attention, is hypothesized to correspond with enhanced attention, whereas mind-wandering may be detrimental to cognition. The relationships among mindfulness, task-related and task-unrelated thought, and attentional control performance on Go/No-Go and Continuous Performance tasks were examined in older adults. Dispositional mindfulness was negatively associated with task-unrelated thought and was positively associated with reactive control, but not proactive control or Go/No-Go performance. Although mind-wandering was not directly associated with performance, task-unrelated thought mediated the mindfulness-proactive control relation. Fewer task-unrelated thoughts were associated with lower proactive control. Interestingly, this effect was moderated by working memory such that it was present for those with low-average, but not high, working memory. This study highlights the importance of dispositional mindfulness and mind-wandering propensity in accounting for individual differences in attentional control in older adults, providing important targets for future cognitive remediation interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Postural control assessment in students with normal hearing and sensorineural hearing loss.

    Science.gov (United States)

    Melo, Renato de Souza; Lemos, Andrea; Macky, Carla Fabiana da Silva Toscano; Raposo, Maria Cristina Falcão; Ferraz, Karla Mônica

    2015-01-01

    Children with sensorineural hearing loss can present with instabilities in postural control, possibly as a consequence of hypoactivity of their vestibular system due to internal ear injury. To assess postural control stability in students with normal hearing (i.e., listeners) and with sensorineural hearing loss, and to compare data between groups, considering gender and age. This cross-sectional study evaluated the postural control of 96 students, 48 listeners and 48 with sensorineural hearing loss, aged between 7 and 18 years, of both genders, through the Balance Error Scoring Systems scale. This tool assesses postural control in two sensory conditions: stable surface and unstable surface. For statistical data analysis between groups, the Wilcoxon test for paired samples was used. Students with hearing loss showed more instability in postural control than those with normal hearing, with significant differences between groups (stable surface, unstable surface) (ppostural control compared to normal hearing students of the same gender and age. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. 2-regularity and 2-normality conditions for systems with impulsive controls

    Directory of Open Access Journals (Sweden)

    Pavlova Natal'ya

    2007-01-01

    Full Text Available In this paper a controlled system with impulsive controls in the neighborhood of an abnormal point is investigated. The set of pairs (u,μ is considered as a class of admissible controls, where u is a measurable essentially bounded function and μ is a finite-dimensional Borel measure, such that for any Borel set B, μ(B is a subset of the given convex closed pointed cone. In this article the concepts of 2-regularity and 2-normality for the abstract mapping Ф, operating from the given Banach space into a finite-dimensional space, are introduced. The concepts of 2-regularity and 2-normality play a great role in the course of derivation of the first and the second order necessary conditions for the optimal control problem, consisting of the minimization of a certain functional on the set of the admissible processes. These concepts are also important for obtaining the sufficient conditions for the local controllability of the nonlinear systems. The convenient criterion for 2-regularity along the prescribed direction and necessary conditions for 2-normality of systems, linear in control, are introduced in this article as well.

  17. Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Lin Lou

    2017-01-01

    Full Text Available The purpose of this present study was to examine the effect of Taichi softball (TCSB on physical function in Chinese older adults. Eighty Chinese older adults were randomly assigned into either an experimental group experiencing four 90-minute TCSB sessions weekly for seven consecutive weeks or a control group. At baseline and 7 weeks later, all participants were asked to perform physical functional tests for both lower and upper limbs. Multiple separate Analyses of Variance (ANOVA with repeated measures were applied to evaluate the effects of TCSB on function-related outcomes between baseline and postintervention in the two groups. The findings indicate that a short-term and intensive TCSB training program does not only improve low limb-related physical function such as dynamic balance and leg strength, but also strengthen upper limb-related physical function (e.g., arm and forearm strength, shoulder mobility, fine motor control, handgrip strength, and fine motor function. Health professionals could take into account TCSB exercise as an alternative method to help maintain or alleviate the inevitable age-related physical function degeneration in healthy older adults. In addition, researchers could investigate the effect of TCSB exercise on physical function in special populations such as patients with different chronic diseases or neurological disorder (e.g., Parkinson’s disease.

  18. Psychosocial outcome and psychiatric comorbidity in older adolescents with Tourette syndrome: controlled study

    DEFF Research Database (Denmark)

    Gorman, Daniel A; Thompson, Nancy; Plessen, Kerstin J

    2010-01-01

    BACKGROUND: Children with Tourette syndrome generally experience improvement of tics by age 18 years, but psychosocial and comorbidity outcomes at this age are unclear. AIMS: To compare psychosocial outcomes and lifetime comorbidity rates in older adolescents with Tourette syndrome and controls. We...... hypothesised a priori that individuals with Tourette syndrome would have lower Children's Global Assessment Scale (CGAS) scores. METHOD: A total of 65 individuals with Tourette syndrome, identified in childhood, and 65 matched community controls without tic or obsessive-compulsive disorder (OCD) symptoms were......, learning disorder and conduct disorder (Ptic severity. CONCLUSIONS: Clinically ascertained children with Tourette syndrome typically have impaired psychosocial functioning...

  19. Low empathy in deaf and hard of hearing (preadolescents compared to normal hearing controls.

    Directory of Open Access Journals (Sweden)

    Anouk P Netten

    Full Text Available The purpose of this study was to examine the level of empathy in deaf and hard of hearing (preadolescents compared to normal hearing controls and to define the influence of language and various hearing loss characteristics on the development of empathy.The study group (mean age 11.9 years consisted of 122 deaf and hard of hearing children (52 children with cochlear implants and 70 children with conventional hearing aids and 162 normal hearing children. The two groups were compared using self-reports, a parent-report and observation tasks to rate the children's level of empathy, their attendance to others' emotions, emotion recognition, and supportive behavior.Deaf and hard of hearing children reported lower levels of cognitive empathy and prosocial motivation than normal hearing children, regardless of their type of hearing device. The level of emotion recognition was equal in both groups. During observations, deaf and hard of hearing children showed more attention to the emotion evoking events but less supportive behavior compared to their normal hearing peers. Deaf and hard of hearing children attending mainstream education or using oral language show higher levels of cognitive empathy and prosocial motivation than deaf and hard of hearing children who use sign (supported language or attend special education. However, they are still outperformed by normal hearing children.Deaf and hard of hearing children, especially those in special education, show lower levels of empathy than normal hearing children, which can have consequences for initiating and maintaining relationships.

  20. Low empathy in deaf and hard of hearing (pre)adolescents compared to normal hearing controls.

    Science.gov (United States)

    Netten, Anouk P; Rieffe, Carolien; Theunissen, Stephanie C P M; Soede, Wim; Dirks, Evelien; Briaire, Jeroen J; Frijns, Johan H M

    2015-01-01

    The purpose of this study was to examine the level of empathy in deaf and hard of hearing (pre)adolescents compared to normal hearing controls and to define the influence of language and various hearing loss characteristics on the development of empathy. The study group (mean age 11.9 years) consisted of 122 deaf and hard of hearing children (52 children with cochlear implants and 70 children with conventional hearing aids) and 162 normal hearing children. The two groups were compared using self-reports, a parent-report and observation tasks to rate the children's level of empathy, their attendance to others' emotions, emotion recognition, and supportive behavior. Deaf and hard of hearing children reported lower levels of cognitive empathy and prosocial motivation than normal hearing children, regardless of their type of hearing device. The level of emotion recognition was equal in both groups. During observations, deaf and hard of hearing children showed more attention to the emotion evoking events but less supportive behavior compared to their normal hearing peers. Deaf and hard of hearing children attending mainstream education or using oral language show higher levels of cognitive empathy and prosocial motivation than deaf and hard of hearing children who use sign (supported) language or attend special education. However, they are still outperformed by normal hearing children. Deaf and hard of hearing children, especially those in special education, show lower levels of empathy than normal hearing children, which can have consequences for initiating and maintaining relationships.

  1. Are your covariates under control? How normalization can re-introduce covariate effects.

    Science.gov (United States)

    Pain, Oliver; Dudbridge, Frank; Ronald, Angelica

    2018-04-30

    Many statistical tests rely on the assumption that the residuals of a model are normally distributed. Rank-based inverse normal transformation (INT) of the dependent variable is one of the most popular approaches to satisfy the normality assumption. When covariates are included in the analysis, a common approach is to first adjust for the covariates and then normalize the residuals. This study investigated the effect of regressing covariates against the dependent variable and then applying rank-based INT to the residuals. The correlation between the dependent variable and covariates at each stage of processing was assessed. An alternative approach was tested in which rank-based INT was applied to the dependent variable before regressing covariates. Analyses based on both simulated and real data examples demonstrated that applying rank-based INT to the dependent variable residuals after regressing out covariates re-introduces a linear correlation between the dependent variable and covariates, increasing type-I errors and reducing power. On the other hand, when rank-based INT was applied prior to controlling for covariate effects, residuals were normally distributed and linearly uncorrelated with covariates. This latter approach is therefore recommended in situations were normality of the dependent variable is required.

  2. Comparison of macular choroidal thickness among patients older than age 65 with early atrophic age-related macular degeneration and normals.

    Science.gov (United States)

    Sigler, Eric J; Randolph, John C

    2013-09-19

    To compare macular choroidal thickness between patients older than 65 years with early atrophic age-related macular degeneration (AMD) and normals. This was a consecutive, cross-sectional observational study. Enhanced depth imaging spectral-domain optical coherence tomography using horizontal raster scanning at 12 locations throughout the macula was performed in one eye of consecutive patients presenting with large soft drusen alone, drusen with additional features of early AMD, or a normal fundus. Choroidal thickness was measured at 7 points for each raster scan in the central 3 mm of the macula (total 84 points per eye). In addition, a single subfoveolar measurement was obtained for each eye. One hundred fifty eyes of 150 patients were included. There was no significant difference between mean refractive error for each diagnosis category via one-way ANOVA (P = 0.451). Mean macular choroidal thickness (CT) was 235 ± 49 μm (range, 125-334 μm; median 222 μm) for normals, 161 ± 39 μm (range, 89-260 μm; median = 158 μm) for the drusen group, and 115 ± 40 μm (range, 22-256 μm; median = 112 μm) for patients with AMD. Mean macular CT was significantly different via one-way ANOVA among all diagnosis categories (P < 0.001). The presence of features of early AMD without geographic atrophy and/or soft drusen alone is associated with decreased mean macular CT in vivo compared to that in patients with no chorioretinal pathology. Using enhanced depth imaging, measurement of a single subfoveolar choroidal thickness is highly correlated to mean central macular CT.

  3. Diurnal changes in postural control in normal children: Computerized static and dynamic assessments

    Directory of Open Access Journals (Sweden)

    Sophie Bourelle

    2014-07-01

    Full Text Available Mild traumatic brain injury (mTBI causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7-8 a.m. in the morning and after (4-7 p.m. in the afternoon school on regular school days using the Balance Master ® evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P < 0.05. By end of afternoon, the body weight was borne mainly on the left side with the knee fully extended and at various degrees of knee flexion. A significantly better directional control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P < 0.05. In summary, most of our findings are inconsistent with results from previous studies in adults, suggesting age-related differences in posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training or in abnormal conditions (e.g., mTBI-associated balance disorders, be better performed late in the afternoon.

  4. Reduced Cognitive-Motor Interference on Voluntary Balance Control in Older Tai Chi Practitioners.

    Science.gov (United States)

    Varghese, Rini; Hui-Chan, Christina W Y; Bhatt, Tanvi

    2016-01-01

    Recent dual-task studies suggest that Tai Chi practitioners displayed better control of standing posture and maintained a quicker response time of postural muscle activation during a stepping down activity. Whether this effect extends to voluntary balance control, specifically the limits of excursion of the center of pressure, remains to be examined. The purpose of this study was to evaluate the cognitive-motor interference pattern by examining the effects of a concurrently performed cognitive task on attention of voluntary balance control in older adults who are long-term practitioners of Tai Chi. Ten older Tai Chi practitioners and 10 age-matched nonpractitioners performed a voluntary balance task that required them to shift their weight to reach a preset target in the forward and backward directions, with (single task, ST) and without (dual task, DT) a secondary cognitive task, which was the counting backward task. The counting backward task required the individual to compute and verbalize a series of arithmetic differences between a given pair of randomly generated numbers. The cognitive task was also performed independently (cognitive-ST). All trials were performed in a random order. Balance outcomes included reaction time, movement velocity, and maximal excursion of the center of pressure provided by the NeuroCom system. Cognitive outcome was the number of correct responses generated within the 8-second trial during the ST and DT conditions. Outcome variables were analyzed using a 2-factor, group by task, analysis of variance. DT costs for the variables were calculated as the relative difference between ST and DT conditions and were compared between the 2 groups using independent t tests. Tai Chi practitioners displayed shorter reaction times (P older nonpractitioners for both directions; however, no difference was found between the maximal excursions of the 2 groups. Cost analyses revealed that reaction time and cognitive costs were significantly lower in

  5. A Decision Aid to Promote Appropriate Colorectal Cancer Screening among Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Lewis, Carmen L; Kistler, Christine E; Dalton, Alexandra F; Morris, Carolyn; Ferrari, Renée; Barclay, Colleen; Brewer, Noel T; Dolor, Rowena; Harris, Russell; Vu, Maihan; Golin, Carol E

    2018-07-01

    Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients and the need to align screening behavior with likelihood of net benefit. The purpose of this study was to test a novel use of a patient decision aid (PtDA) to promote appropriate CRC screening in older adults. A total of 424 patients ages 70 to 84 y who were not up to date with CRC screening participated in a double-blinded randomized controlled trial of a PtDA targeted to older adults making decisions about whether to undergo CRC screening from March 2012 to February 2015. Patients were randomized to a targeted PtDA or an attention control. The PtDA was designed to facilitate individualized decision making-helping patients understand the potential risks, benefits, and uncertainties of CRC screening given advanced age, health state, preferences, and values. Two composite outcomes, appropriate CRC screening behavior 6 mo after the index visit and appropriate screening intent immediately after the visit, were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, and no screening or intent for patients in poor health. Health state was determined by age and Charlson Comorbidity Index. Four hundred twelve (97%) and 421 (99%) patients were analyzed for the primary and secondary outcomes, respectively. Appropriate screening behavior at 6 mo was higher in the intervention group (55% v. 45%, P = 0.023) as was appropriate screening intent following the provider visit (61% v. 47%, P = 0.003). The study took place in a single geographic region. The appropriate CRC screening classification system used in this study has not been formally validated. A PtDA for older adults promoted appropriate CRC screening behavior and intent. Clinicaltrials.gov, registration number NCT01575990. https://clinicaltrials.gov/ct2/show/NCT01575990?term=epic-d&rank=1.

  6. Randomized controlled resistance training based physical activity trial for central European nursing home residing older adults.

    Science.gov (United States)

    Barthalos, Istvan; Dorgo, Sandor; Kopkáné Plachy, Judit; Szakály, Zsolt; Ihász, Ferenc; Ráczné Németh, Teodóra; Bognár, József

    2016-10-01

    Nursing home residing older adults often experience fear of sickness or death, functional impairment and pain. It is difficult for these older adults to maintain a physically active lifestyle and to keep a positive outlook on life. This study evaluated the changes in quality of life, attitude to aging, assertiveness, physical fitness and body composition of nursing home residing elderly through a 15-week organized resistance training based physical activity program. Inactive older adults living in a state financed nursing home (N.=45) were randomly divided into two intervention groups and a control group. Both intervention groups were assigned to two physical activity sessions a week, but one of these groups also had weekly discussions on health and quality of life (Mental group). Data on anthropometric measures, fitness performance, as well as quality of life and attitudes to aging survey data were collected. Due to low attendance rate 12 subjects were excluded from the analyses. Statistical analysis included Paired Samples t-tests and Repeated Measures Analysis of Variance. Both intervention groups significantly improved their social participation, and their upper- and lower-body strength scores. Also, subjects in the Mental group showed improvement in agility fitness test and certain survey scales. No positive changes were detected in attitude towards aging and body composition measures in any groups. The post-hoc results suggest that Mental group improved significantly more than the Control group. Regular physical activity with discussions on health and quality of life made a more meaningful difference for the older adults living in nursing home than physical activity alone. Due to the fact that all participants were influenced by the program, it is suggested to further explore this area for better understanding of enhanced quality of life.

  7. Sensorimotor control of balance: a Tai Chi solution for balance disorders in older subjects.

    Science.gov (United States)

    Tsang, William W N; Hui-Chan, Christina W Y

    2008-01-01

    In addition to environmental factors, deteriorating sensorimotor control of balance will predispose older adults to falls. Understanding the aging effects on sensorimotor control of balance performance is important for designing fall prevention programs for older adults. How repeated practice of Tai Chi can improve limb joint proprioception, integration of neural signals in the central nervous system for balance control, and motor output at the level of knee muscles is discussed in this chapter. Our previous studies showed that elderly Tai Chi practitioners performed significantly better than elderly nonpractitioners in (1) knee joint proprioception, (2) reduced or conflicting sensory situations that demand more visual or vestibular contributions, (3) standing balance control after vestibular stimulation without visual input, (4) voluntary weight shifting in different directions within the base of support, (5) single-leg stance during perturbations of the support surface, and (6) knee extensor and flexor muscle strength. In a prospective study, we further showed that 4 weeks of daily Tai Chi practice but not general education produced significant improvement in balance performance. The requirements of Tai Chi for accurate joint positioning and weight transfer involving smooth coordination of neck, trunk, upper and lower limb movements, make it particularly useful for improving the sensorimotor control of balance in the elderly. Because Tai Chi can be practiced any time and anywhere, and is well accepted by older people in both the East and now the West, it is especially suited to be a key component of a low-costing community-based fall prevention program alongside with education about environmental factors.

  8. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study

    Science.gov (United States)

    Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    Aim The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Methods Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. Results 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30–0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26–0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Conclusions Meeting with friends occasionally is associated with better glycemic control among older people. PMID:28060887

  9. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study.

    Science.gov (United States)

    Yokobayashi, Kenichi; Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30-0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26-0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Meeting with friends occasionally is associated with better glycemic control among older people.

  10. Biomechanics of normal and pathological gait: implications for understanding human locomotor control.

    Science.gov (United States)

    Winter, D A

    1989-12-01

    The biomechanical (kinetic) analysis of human gait reveals the integrated and detailed motor patterns that are essential in pinpointing the abnormal patterns in pathological gait. In a similar manner, these motor patterns (moments, powers, and EMGs) can be used to identify synergies and to validate theories of CNS control. Based on kinetic and EMG patterns for a wide range of normal subjects and cadences, evidence is presented that both supports and negates the central pattern generator theory of locomotion. Adaptive motor patterns that are evident in peripheral gait pathologies reinforce a strong peripheral rather than a central control. Finally, a three-component subtask theory of human gait is presented and is supported by reference to the motor patterns seen in a normal gait. The identified subtasks are (a) support (against collapse during stance); (b) dynamic balance of the upper body, also during stance; and (c) feedforward control of the foot trajectory to achieve safe ground clearance and a gentle heel contact.

  11. The association between depressive disorder and cardiac autonomic control in adults 60 years and older.

    Science.gov (United States)

    Licht, Carmilla M M; Naarding, Paul; Penninx, Brenda W J H; van der Mast, Roos C; de Geus, Eco J C; Comijs, Hannie

    2015-04-01

    Altered cardiac autonomic control has often been reported in depressed persons and might play an important role in the increased risk for cardiovascular disease (CVD). A negative association between cardiac autonomic control and depression might become specifically clinically relevant in persons 60 years or older as CVD risk increases with age. This study included data of 321 persons with a depressive disorder and 115 controls participating in the Netherlands Study of Depression in Older Persons (mean age = 70.3 years, 65.7% female). Respiratory sinus arrhythmia (RSA), heart rate (HR), and preejection period (PEP) were measured and compared between depressed persons and controls. In addition, the role of antidepressants and clinical characteristics (e.g., age of depression onset and comorbid anxiety) was examined. Compared with controls, depressed persons had lower RSA (mean [standard error of the mean] = 23.5 [1.2] milliseconds versus 18.6 [0.7] milliseconds, p = .001, d = 0.373) and marginally higher HR (73.1 [1.1] beats/min versus 75.6 [0.6] beats/min, p = .065, d = 0.212), but comparable PEP (113.9 [2.1] milliseconds versus 112.0 [1.2] milliseconds, p = .45, d = 0.087), fully adjusted. Antidepressants strongly attenuated the associations between depression and HR and RSA. Antidepressant-naïve depressed persons had similar HR and RSA to controls, whereas users of antidepressants showed significantly lower RSA. In addition, tricyclic antidepressant users had higher HR (p 768) and shorter PEP (p = .014, d = 0.395) than did controls. Depression was not associated with cardiac autonomic control, but antidepressants were in this sample. All antidepressants were associated with low cardiac parasympathetic control and specifically tricyclic antidepressants with high cardiac sympathetic control.

  12. A randomized controlled trial of brain training with non-action video games in older adults: Results of the 3-month follow-up

    Directory of Open Access Journals (Sweden)

    Soledad eBallesteros

    2015-04-01

    Full Text Available This randomized controlled study (ClinicalTrials.gov NCT02007616 investigated the maintenance of training effects of 20 1-hr non-action video game training sessions with selected games from a commercial package on several age-declining cognitive functions and subjective wellbeing after a 3-month no-contact period. Two groups of cognitively normal older adults participated in both the post-training (posttest and the present follow-up study, the experimental group who received training and the control group who attended several meetings with the research team during the study but did not receive training. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. Significant improvements in the trained group, and no variation in the control group had been previously found at posttest, in processing speed, attention and visual recognition memory, as well as in two dimensions of subjective wellbeing. In the current study, improvement from baseline to 3 months follow-up was found only in wellbeing (Affection and Assertivity dimensions in the trained group whereas there was no change in the control group. Previous significant improvements in processing speed, attention and spatial memory become nonsignificant after the 3-month interval. Training older adults with non-action video games enhanced aspects of cognition just after training but this effect disappeared after a 3-month no-contact follow-up period. Cognitive plasticity can be induced in older adults by training, but to maintain the benefits periodic boosting sessions would be necessary.

  13. Cognitive effects of calligraphy therapy for older people: a randomized controlled trial in Hong Kong

    Directory of Open Access Journals (Sweden)

    Kwok TCY

    2011-10-01

    Full Text Available Timothy CY Kwok1,2, Xue Bai1,3, Henry SR Kao4,5, Jessie CY Li1, Florence KY Ho11Jockey Club Centre for Positive Ageing; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong; 3Department of Social Work and Social Administration; 4Department of Psychology, The University of Hong Kong, Hong Kong; 5Department of Psychology, Fu Jen Catholic University, TaiwanBackground: This pilot study investigated the effects of calligraphy therapy on cognitive function in older Hong Kong Chinese people with mild cognitive impairment.Methods: A single-blind, randomized controlled trial was carried out in a sample of 31 adults aged 65 years or older with mild cognitive impairment. They were randomly assigned to receive either intensive calligraphy training led by a trained research assistant for eight weeks (calligraphy group, n = 14 or no calligraphy treatment (control group, n = 17. Participants' cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (CMMSE before and after calligraphy treatment. Repeated measures analysis of variance and paired samples t-tests were used to analyze the data.Results: A significant interaction effect of time and intervention was detected [F (1, 29 = 9.11, P = 0.005, η2= 0.24]. The calligraphy group was found to have a prominent increase in CMMSE global score, and scores in the cognitive areas of orientation, attention, and calculation after two months (∆M = 2.36, P < 0.01, whereas their counterparts in the control group experienced a decline in CMMSE score (∆M = -0.41, P < 0.05.Conclusion: Calligraphy therapy was effective for enhancing cognitive function in older people with mild cognitive impairment and should be incorporated as part of routine programs in both community and residential care settings.Keywords: calligraphy therapy, Chinese elderly, mild cognitive impairment, cognitive function, randomized controlled trial

  14. Non-MTC gait cycles: An adaptive toe trajectory control strategy in older adults.

    Science.gov (United States)

    Santhiranayagam, Braveena K; Sparrow, W A; Lai, Daniel T H; Begg, Rezaul K

    2017-03-01

    Minimum-toe-clearance (MTC) above the walking surface is a critical representation of toe-trajectory control due to its association with tripping risk. Not all gait cycles exhibit a clearly defined MTC within the swing phase but there have been few previous accounts of the biomechanical characteristics of non-MTC gait cycles. The present report investigated the within-subject non-MTC gait cycle characteristics of 15 older adults (mean 73.1 years) and 15 young controls (mean 26.1 years). Participants performed the following tasks on a motorized treadmill: preferred speed walking, dual task walking (carrying a glass of water) and a dual-task speed-matched control. Toe position-time coordinates were acquired using a 3 dimensional motion capture system. When MTC was present, toe height at MTC (MTC height ) was extracted. The proportion of non-MTC gait cycles was computed for the age groups and individuals. For non-MTC gait cycles an 'indicative' toe height at the individual's average swing phase time (MTC time ) for observed MTC cycles was averaged across multiple non-MTC gait cycles. In preferred-speed walking Young demonstrated 2.9% non-MTC gait cycles and Older 18.7%. In constrained walking conditions both groups increased non-MTC gait cycles and some older adults revealed over 90%, confirming non-MTC gait cycles as an ageing-related phenomenon in lower limb trajectory control. For all participants median indicative toe-height on non-MTC gait cycles was greater than median MTC height . This result suggests that eliminating the biomechanically hazardous MTC event by adopting more of the higher-clearance non-MTC gait cycles, is adaptive in reducing the likelihood of toe-ground contact. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Sex-specific effects of social networks on the prevalence, awareness, and control of hypertension among older Korean adults.

    Science.gov (United States)

    Baek, Jiwon; Hur, Nam Wook; Kim, Hyeon Chang; Youm, Yoosik

    2016-07-01

    Hypertension is a common chronic disease among older adults, and is associated with medical complications and mortality. This study aimed to examine the effects of social network characteristics on the prevalence, awareness, and control of hypertension among older adults. The Korean Social Life, Health, and Aging Project (KSHAP) interviewed 814 ≥ 60-year-old residents and their spouses from a rural township between December 2011 and March 2012 (response rate: 95%). We evaluated the data from 595 participants. Multivariate logistic regression models were used to assess the effects of network characteristics on hypertension. We observed strong sex-specific network effects on the prevalence, awareness, and control of hypertension. Among older women, network density was associated with hypertension awareness [odds ratio (OR): 2.63, 95% confidence interval (CI): 1.03-5.37] and control (OR: 1.72; 95% CI: 0.94-3.13). Among older men, large networks were associated with a lower prevalence of hypertension (OR: 0.75; 95% CI: 0.58-0.96). Compared to older women, older men with coarse networks exhibited better hypertension awareness (OR: 0.37; 95% CI: 0.14-0.95) and control (OR: 0.42; 95% CI: 0.19-0.91). Network size interacted with density for hypertension control (P = 0.051), with controlled hypertension being associated with large and course networks. A large network was associated with a lower risk for hypertension, and a coarse network was associated with hypertension awareness and control among older men. Older women with dense networks were most likely to exhibit hypertension awareness and control.

  16. Simulating the effect of muscle weakness and contracture on neuromuscular control of normal gait in children.

    Science.gov (United States)

    Fox, Aaron S; Carty, Christopher P; Modenese, Luca; Barber, Lee A; Lichtwark, Glen A

    2018-03-01

    Altered neural control of movement and musculoskeletal deficiencies are common in children with spastic cerebral palsy (SCP), with muscle weakness and contracture commonly experienced. Both neural and musculoskeletal deficiencies are likely to contribute to abnormal gait, such as equinus gait (toe-walking), in children with SCP. However, it is not known whether the musculoskeletal deficiencies prevent normal gait or if neural control could be altered to achieve normal gait. This study examined the effect of simulated muscle weakness and contracture of the major plantarflexor/dorsiflexor muscles on the neuromuscular requirements for achieving normal walking gait in children. Initial muscle-driven simulations of walking with normal musculoskeletal properties by typically developing children were undertaken. Additional simulations with altered musculoskeletal properties were then undertaken; with muscle weakness and contracture simulated by reducing the maximum isometric force and tendon slack length, respectively, of selected muscles. Muscle activations and forces required across all simulations were then compared via waveform analysis. Maintenance of normal gait appeared robust to muscle weakness in isolation, with increased activation of weakened muscles the major compensatory strategy. With muscle contracture, reduced activation of the plantarflexors was required across the mid-portion of stance suggesting a greater contribution from passive forces. Increased activation and force during swing was also required from the tibialis anterior to counteract the increased passive forces from the simulated dorsiflexor muscle contracture. Improvements in plantarflexor and dorsiflexor motor function and muscle strength, concomitant with reductions in plantarflexor muscle stiffness may target the deficits associated with SCP that limit normal gait. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Effects of Wall-Normal and Angular Momentum Injections in Airfoil Separation Control

    Science.gov (United States)

    Munday, Phillip M.; Taira, Kunihiko

    2018-05-01

    The objective of this computational study is to quantify the influence of wall-normal and angular momentum injections in suppressing laminar flow separation over a canonical airfoil. Open-loop control of fully separated, incompressible flow over a NACA 0012 airfoil at $\\alpha = 9^\\circ$ and $Re = 23,000$ is examined with large-eddy simulations. This study independently introduces wall-normal momentum and angular momentum into the separated flow using swirling jets through model boundary conditions. The response of the flow field and the surface vorticity fluxes to various combinations of actuation inputs are examined in detail. It is observed that the addition of angular momentum input to wall-normal momentum injection enhances the suppression of flow separation. Lift enhancement and suppression of separation with the wall-normal and angular momentum inputs are characterized by modifying the standard definition of the coefficient of momentum. The effect of angular momentum is incorporated into the modified coefficient of momentum by introducing a characteristic swirling jet velocity based on the non-dimensional swirl number. With this single modified coefficient of momentum, we are able to categorize each controlled flow into separated, transitional, and attached flows.

  18. Promoting advance planning for health care and research among older adults: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bravo Gina

    2012-01-01

    Full Text Available Abstract Background Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/Design Dyads (n = 240 comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance

  19. Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial.

    Science.gov (United States)

    Dias, João Marcos; Cisneros, Lígia; Dias, Rosângela; Fritsch, Carolina; Gomes, Wellington; Pereira, Leani; Santos, Mary Luci; Ferreira, Paulo Henrique

    Currently, there is poor evidence of the effect of hydrotherapy alone on patients with hip or knee osteoarthritis. The study aimed to assess the impact of hydrotherapy on pain, function, and muscle function in older women with knee osteoarthritis. A randomized controlled trial was conducted to evaluate the efficacy of hydrotherapy in women with knee osteoarthritis. Seventy-three women aged 65 and older were randomized to hydrotherapy (n=36) or a control group (n=37). The hydrotherapy group received the intervention program in a heated pool (twice per week for six weeks) and an educational protocol while the control group received an educational protocol only. Primary outcomes (before and post-treatment) were pain intensity (0-100) and function (0-100), assessed with the WOMAC questionnaire. Secondary outcomes (before and post-treatment) were knee extensor and knee flexor muscle performance (strength, power, and endurance), assessed by an isokinetic dynamometer. The magnitude of change between the groups for the outcomes was calculated using linear regression models adjusted by baseline outcome values. The hydrotherapy group had better outcomes for pain (adjusted mean difference=11 points, 95% CI: 3-18) and function (adjusted mean difference=12 points, 95% CI: 5-18). Patients receiving hydrotherapy had better performance for knee flexor and extensor strength, knee flexor power, and knee extensor endurance. Older women with knee osteoarthritis are likely to have benefits from a course of hydrotherapy exercises. Registry of clinical trials (Trial number RBR-8F57KR) - http://www.ensaiosclinicos.gov.br/rg/RBR-8f57kr/. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. ICG: a wiki-driven knowledgebase of internal control genes for RT-qPCR normalization.

    Science.gov (United States)

    Sang, Jian; Wang, Zhennan; Li, Man; Cao, Jiabao; Niu, Guangyi; Xia, Lin; Zou, Dong; Wang, Fan; Xu, Xingjian; Han, Xiaojiao; Fan, Jinqi; Yang, Ye; Zuo, Wanzhu; Zhang, Yang; Zhao, Wenming; Bao, Yiming; Xiao, Jingfa; Hu, Songnian; Hao, Lili; Zhang, Zhang

    2018-01-04

    Real-time quantitative PCR (RT-qPCR) has become a widely used method for accurate expression profiling of targeted mRNA and ncRNA. Selection of appropriate internal control genes for RT-qPCR normalization is an elementary prerequisite for reliable expression measurement. Here, we present ICG (http://icg.big.ac.cn), a wiki-driven knowledgebase for community curation of experimentally validated internal control genes as well as their associated experimental conditions. Unlike extant related databases that focus on qPCR primers in model organisms (mainly human and mouse), ICG features harnessing collective intelligence in community integration of internal control genes for a variety of species. Specifically, it integrates a comprehensive collection of more than 750 internal control genes for 73 animals, 115 plants, 12 fungi and 9 bacteria, and incorporates detailed information on recommended application scenarios corresponding to specific experimental conditions, which, collectively, are of great help for researchers to adopt appropriate internal control genes for their own experiments. Taken together, ICG serves as a publicly editable and open-content encyclopaedia of internal control genes and accordingly bears broad utility for reliable RT-qPCR normalization and gene expression characterization in both model and non-model organisms. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  1. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zhaosheng, Luan; Pengyong,; Xiqin, Sun; Wei, Wang; Huisheng, Liu; Wen, Zhou [88 Hospital PLA, Taian, SD (China). Dept. of Nuclear Medicine

    1992-11-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed.

  2. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Pengyong; Sun Xiqin; Wang Wei; Liu Huisheng; Zhou Wen

    1992-01-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed

  3. Controlled austempering of hammer forgings aimed at pseudo normalized microstructure directly after deformation

    Directory of Open Access Journals (Sweden)

    P. Skubisz

    2017-01-01

    Full Text Available The study concerns cost-effective realization of controlled thermomechanical processing (CTMP of medium-carbon and HSLA steel aimed at producing microstructure and properties equivalent to normalized condition directly after forging. The results of theoretical and physical modeling of hot forging with subsequent heat treating adopted for industrial realization in continuous manner were verified in semi-industrial conditions of a forge plant.

  4. Exercise training in older patients with systolic heart failure: Adherence, exercise capacity, inflammation and glycemic control

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming

    2009-01-01

    markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and -albumin/creatinin), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1......). There were no changes in quality of life. Conclusions. The effect of exercise training in these older CHF-patients was not as impressive as reported in younger and more selected patients. More studies on the efficiency of exercise training that reflect the age- and co-morbidity of the majority of CHF...

  5. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials.

    Science.gov (United States)

    de Labra, Carmen; Guimaraes-Pinheiro, Christyanne; Maseda, Ana; Lorenzo, Trinidad; Millán-Calenti, José C

    2015-12-02

    Low physical activity has been shown to be one of the most common components of frailty, and interventions have been considered to prevent or reverse this syndrome. The purpose of this systematic review of randomized, controlled trials is to examine the exercise interventions to manage frailty in older people. The PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched using specific keywords and Medical Subject Headings for randomized, controlled trials published during the period of 2003-2015, which enrolled frail older adults in an exercise intervention program. Studies where frailty had been defined were included in the review. A narrative synthesis approach was performed to examine the results. The Physiotherapy Evidence Database (PEDro scale) was used to assess the methodological quality of the selected studies. Of 507 articles, nine papers met the inclusion criteria. Of these, six included multi-component exercise interventions (aerobic and resistance training not coexisting in the intervention), one included physical comprehensive training, and two included exercises based on strength training. All nine of these trials included a control group receiving no treatment, maintaining their habitual lifestyle or using a home-based low level exercise program. Five investigated the effects of exercise on falls, and among them, three found a positive impact of exercise interventions on this parameter. Six trials reported the effects of exercise training on several aspects of mobility, and among them, four showed enhancements in several measurements of this outcome. Three trials focused on the effects of exercise intervention on balance performance, and one demonstrated enhanced balance. Four trials investigated functional ability, and two showed positive results after the intervention. Seven trials investigated the effects of exercise intervention on muscle strength, and five of them reported increases; three trials

  6. Performance of non-neurological older adults on the Wisconsin Card Sorting Test and the Stroop Color-Word Test: normal variability or cognitive impairment?

    Science.gov (United States)

    Gunner, Jessica H; Miele, Andrea S; Lynch, Julie K; McCaffrey, Robert J

    2012-06-01

    There is currently no standard criterion for determining abnormal test scores in neuropsychology; thus, a number of different criteria are commonly used. We investigated base rates of abnormal scores in healthy older adults using raw and T-scores from indices of the Wisconsin Card Sorting Test and Stroop Color-Word Test. Abnormal scores were examined cumulatively at seven cutoffs including >1.0, >1.5, >2.0, >2.5, and >3.0 standard deviations (SD) from the mean as well as those below the 10th and 5th percentiles. In addition, the number of abnormal scores at each of the seven cutoffs was also examined. Results showed when considering raw scores, ∼15% of individuals obtained scores>1.0 SD from the mean, around 10% were less than the 10th percentile, and 5% fell >1.5 SD or 1.0 and >1.5 SD from the mean, respectively. Roughly 15% and 5% fell at the 2.0 SD from the mean were infrequent. Although the presence of a single abnormal score at 1.0 and 1.5 SD from the mean or at the 10th and 5th percentiles was not unusual, the presence of ≥2 abnormal scores using any criteria was uncommon. Consideration of base rate data regarding the percentage of healthy individuals scoring in the abnormal range should help avoid classifying normal variability as neuropsychological impairment.

  7. Does cognitive training improve internal locus of control among older adults?

    Science.gov (United States)

    Wolinsky, Fredric D; Vander Weg, Mark W; Martin, René; Unverzagt, Frederick W; Willis, Sherry L; Marsiske, Michael; Rebok, George W; Morris, John N; Ball, Karlene K; Tennstedt, Sharon L

    2010-09-01

    We evaluated the effect of cognitive training among 1,534 participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial (RCT) on 5-year improvements in 3 cognitive-specific measures of locus of control-internal, chance, and powerful others. ACTIVE was a multisite RCT (age > or = 65), with 4 groups (memory, reasoning, speed of processing, and no-contact control). Complete 5-year follow-up data were available for 1,534 (55%) of the 2,802 participants. A propensity score model was used to adjust for potential attrition bias. Clinically important improvements (and decrements) in the cognitive-specific locus of control scale scores were defined as greater than or equal to 0.5 SD (medium) and greater than or equal to 1.0 SD (large). Multinomial logistic regression was used to simultaneously contrast those who improved and those who declined with those whose locus of control scale score was unchanged. Statistically significant effects reflecting medium-sized (> or = 0.5 SD) improvements in internal locus of control between baseline and the 5-year follow-up were found for the reasoning and speed of processing intervention groups who were 76% (p control group. No improvement effects were found on the chance or powerful others locus of control measures or for the memory intervention group. Cognitive training that targets reasoning and speed of processing can improve the cognitive-specific sense of personal control over one's life in older adults.

  8. Low Empathy in Deaf and Hard of Hearing (Pre)Adolescents Compared to Normal Hearing Controls

    Science.gov (United States)

    Netten, Anouk P.; Rieffe, Carolien; Theunissen, Stephanie C. P. M.; Soede, Wim; Dirks, Evelien; Briaire, Jeroen J.; Frijns, Johan H. M.

    2015-01-01

    Objective The purpose of this study was to examine the level of empathy in deaf and hard of hearing (pre)adolescents compared to normal hearing controls and to define the influence of language and various hearing loss characteristics on the development of empathy. Methods The study group (mean age 11.9 years) consisted of 122 deaf and hard of hearing children (52 children with cochlear implants and 70 children with conventional hearing aids) and 162 normal hearing children. The two groups were compared using self-reports, a parent-report and observation tasks to rate the children’s level of empathy, their attendance to others’ emotions, emotion recognition, and supportive behavior. Results Deaf and hard of hearing children reported lower levels of cognitive empathy and prosocial motivation than normal hearing children, regardless of their type of hearing device. The level of emotion recognition was equal in both groups. During observations, deaf and hard of hearing children showed more attention to the emotion evoking events but less supportive behavior compared to their normal hearing peers. Deaf and hard of hearing children attending mainstream education or using oral language show higher levels of cognitive empathy and prosocial motivation than deaf and hard of hearing children who use sign (supported) language or attend special education. However, they are still outperformed by normal hearing children. Conclusions Deaf and hard of hearing children, especially those in special education, show lower levels of empathy than normal hearing children, which can have consequences for initiating and maintaining relationships. PMID:25906365

  9. Psychosocial outcome and psychiatric comorbidity in older adolescents with Tourette syndrome: controlled study.

    Science.gov (United States)

    Gorman, Daniel A; Thompson, Nancy; Plessen, Kerstin J; Robertson, Mary M; Leckman, James F; Peterson, Bradley S

    2010-07-01

    Children with Tourette syndrome generally experience improvement of tics by age 18 years, but psychosocial and comorbidity outcomes at this age are unclear. To compare psychosocial outcomes and lifetime comorbidity rates in older adolescents with Tourette syndrome and controls. We hypothesised a priori that individuals with Tourette syndrome would have lower Children's Global Assessment Scale (CGAS) scores. A total of 65 individuals with Tourette syndrome, identified in childhood, and 65 matched community controls without tic or obsessive-compulsive disorder (OCD) symptoms were assessed around 18 years of age regarding psychosocial functioning and lifetime psychiatric disorders. Compared with controls, individuals with Tourette syndrome had substantially lower CGAS scores (P = 10(-8)) and higher rates of attention-deficit hyperactivity disorder (ADHD), major depression, learning disorder and conduct disorder (Ptic severity. Clinically ascertained children with Tourette syndrome typically have impaired psychosocial functioning and high comorbidity rates in late adolescence.

  10. Effects of a continuum of care intervention on frail older persons' life satisfaction: a randomized controlled study.

    Science.gov (United States)

    Berglund, Helene; Hasson, Henna; Kjellgren, Karin; Wilhelmson, Katarina

    2015-04-01

    The aim of this study was to analyse effects of a comprehensive continuum of care (intervention group) on frail older persons' life satisfaction, as compared to those receiving usual care (control group). The intervention included geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care-planning meetings in older persons' own homes. Improvements in older persons' subjective well-being have been shown in studies including care planning and coordination by a case manager. However, effects of more complex continuum of care interventions on frail older persons' life satisfaction are not well explored. Randomised controlled study. The validated LiSat-11 scale was used in face-to-face interviews to assess older persons' life satisfaction at baseline and at three, six and 12 months after the baseline. The odds ratio for improving or maintaining satisfaction was compared for intervention and control groups from baseline to three-month, three- to six-month as well as six- to 12-month follow-ups. Older persons who received the intervention were more likely to improve or maintain satisfaction than those who received usual care, between 6 and 12 month follow-ups, for satisfaction regarding functional capacity, psychological health and financial situation. A comprehensive continuum of care intervention comprising several components had a positive effect on frail older persons' satisfaction with functional capacity, psychological health and financial situation. Frail older persons represent a great proportion of the persons in need of support from the health care system. Health care professionals need to consider continuum of care interventions' impact on life satisfaction. As life satisfaction is an essential part of older persons' well-being, we propose that policy makers and managers promote comprehensive continuum of care solutions. © 2014 John Wiley & Sons Ltd.

  11. Effects of multicomponent training of cognitive control on cognitive function and brain activation in older adults.

    Science.gov (United States)

    Kim, Hoyoung; Chey, Jeanyung; Lee, Sanghun

    2017-11-01

    The aim of this study was to investigate the changes in cognitive functions and brain activation after multicomponent training of cognitive control in non-demented older adults, utilizing neuropsychological tests and fMRI. We developed and implemented a computerized Multicomponent Training of Cognitive Control (MTCC), characterized by task variability and adaptive procedures, in order to maximize training effects in cognitive control and transfer to other cognitive domains. Twenty-seven community-dwelling adults, aged 64-77 years, without any history of neurological or psychiatric problems, participated in this study (14 in the training group and 13 in the control group). The MTCC was administered to the participants assigned to the training group for 8 weeks, while those in the control group received no training. Neuropsychological tests and fMRI were administered prior to and after the training. Trained participants showed improvements in cognitive control, recognition memory and general cognitive functioning. Furthermore, the MTCC led to an increased brain activation of the regions adjacent to the baseline cognitive control-related areas in the frontoparietal network. Future studies are necessary to confirm our hypothesis that MTCC improves cognitive functioning of healthy elderly individuals by expanding their frontoparietal network that is involved in cognitive control. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Static and dynamic postural control in low-vision and normal-vision adults.

    Science.gov (United States)

    Tomomitsu, Mônica S V; Alonso, Angelica Castilho; Morimoto, Eurica; Bobbio, Tatiana G; Greve, Julia M D

    2013-04-01

    This study aimed to evaluate the influence of reduced visual information on postural control by comparing low-vision and normal-vision adults in static and dynamic conditions. Twenty-five low-vision subjects and twenty-five normal sighted adults were evaluated for static and dynamic balance using four protocols: 1) the Modified Clinical Test of Sensory Interaction on Balance on firm and foam surfaces with eyes opened and closed; 2) Unilateral Stance with eyes opened and closed; 3) Tandem Walk; and 4) Step Up/Over. The results showed that the low-vision group presented greater body sway compared with the normal vision during balance on a foam surface (p≤0.001), the Unilateral Stance test for both limbs (p≤0.001), and the Tandem Walk test. The low-vision group showed greater step width (p≤0.001) and slower gait speed (p≤0.004). In the Step Up/Over task, low-vision participants were more cautious in stepping up (right p≤0.005 and left p≤0.009) and in executing the movement (p≤0.001). These findings suggest that visual feedback is crucial for determining balance, especially for dynamic tasks and on foam surfaces. Low-vision individuals had worse postural stability than normal-vision adults in terms of dynamic tests and balance on foam surfaces.

  13. Assessing a cognitive music training for older participants: a randomised controlled trial.

    Science.gov (United States)

    Biasutti, Michele; Mangiacotti, Anthony

    2018-02-01

    In a randomised controlled trial, we investigated whether a cognitive training based on rhythm-music and music improvisation exercises had positive effects on executive functions in older participants. Thirty-five residents in a guest home with mild-moderate cognitive impairment and healthy ageing were randomly assigned to an experimental group (n = 18) featuring cognitive music training composed of 12 bi-weekly 70-min sessions, and a control group (n = 17) attended 12 bi-weekly 45-min sessions of gymnastic activities offered by the institute. A neuropsychological test battery was administered at baseline and at the end of treatment, including the Mini-Mental State Examination, verbal fluency test, Trail Making Test A, attentional matrices test and clock-drawing test. Pre-test and post-test comparison showed a significant improvement for the experimental group reflected in the Mini-Mental State Examination (F(1,33) = 13.906; p music-rhythmic exercises and music improvisation exercises is associated with improved cognitive functions in older people with mild-moderate cognitive impairment regardless of the individual's degree of cognitive reserve. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Cognitive Function in Normal-Weight, Overweight, and Obese Older Adults: An Analysis of the Advanced Cognitive Training for Independent and Vital Elderly Cohort

    Science.gov (United States)

    Kuo, Hsu-Ko; Jones, Richard N.; Milberg, William P.; Tennstedt, Sharon; Talbot, Laura; Morris, John N.; Lipsitz, Lewis A.

    2010-01-01

    OBJECTIVES To assess how elevated body mass index (BMI) affects cognitive function in elderly people. DESIGN Cross-sectional study. SETTING Data for this cross-sectional study were taken from a multicenter randomized controlled trial, the Advanced Cognitive Training for Independent and Vital Elderly trial. PARTICIPANTS The analytic sample included 2,684 normal-weight, overweight, or obese subjects aged 65 to 94. MEASUREMENTS Evaluation of cognitive abilities was performed in several domains: global cognition, memory, reasoning, and speed of processing. Cross-sectional association between body weight status and cognitive functions was analyzed using multiple linear regression. RESULTS Overweight subjects had better performance on a reasoning task (β = 0.23, standard error (SE) = 0.11, P = .04) and the Useful Field of View (UFOV) measure (β = −39.46, SE = 12.95, P = .002), a test of visuospatial speed of processing, after controlling for age, sex, race, years of education, intervention group, study site, and cardiovascular risk factors. Subjects with class I (BMI 30.0–34.9 kg/m2) and class II (BMI>35.0 kg/m2) obesity had better UFOV measure scores (β = −38.98, SE = 14.77, P = .008; β = −35.75, SE = 17.65, and P = .04, respectively) in the multivariate model than normal-weight subjects. The relationships between BMI and individual cognitive domains were nonlinear. CONCLUSION Overweight participants had better cognitive performance in terms of reasoning and visuospatial speed of processing than normal-weight participants. Obesity was associated with better performance in visuospatial speed of processing than normal weight. The relationship between BMI and cognitive function should be studied prospectively. PMID:16420204

  15. The Effects of Multisensory Balance Training on Postural Control in Older Adults

    Directory of Open Access Journals (Sweden)

    Farnoosh Shams

    2011-10-01

    Full Text Available Objectives: It has been found that older adults fall or sway significantly more than younger ones under sensory conflict conditions. Considering the prospects of future increases in the elderly population size of Iran and the lack of proper postural control and the high costs of its probable consequences, this study investigated the effects of multi balance training on postural control. Methods & Materials: In this semi-experimental study, 34 elderly women participated in two training and control groups with the mean ages of 72.4 and 72.9 respectively. Before and after training, to investigate the functional balance and postural control, the Berg Balance Scale and a force plate were used. The training group participated in multisensory balance training sessions of 1 hour classes held three days per week for five weeks. Data was analyzed using an independent sample and a paired t-test. Results: The analysis showed significant differences between the training group and the control after balance training in the measured parameters of postural control consisting of path length and mean velocity in the eyes open (P=0.001 and eyes closed (P=0.0001 conditions and the Berg Balance Scale (P=0.002. Conclusion: Results indicate that multisensory balance training can improve the parameters of postural control even in short term.

  16. Neuropsychological functioning in older people with type 2 diabetes: the effect of controlling for confounding factors.

    Science.gov (United States)

    Asimakopoulou, K G; Hampson, S E; Morrish, N J

    2002-04-01

    Neuropsychological functioning was examined in a group of 33 older (mean age 62.40 +/- 9.62 years) people with Type 2 diabetes (Group 1) and 33 non-diabetic participants matched with Group 1 on age, sex, premorbid intelligence and presence of hypertension and cardio/cerebrovascular conditions (Group 2). Data statistically corrected for confounding factors obtained from the diabetic group were compared with the matched control group. The results suggested small cognitive deficits in diabetic people's verbal memory and mental flexibility (Logical Memory A and SS7). No differences were seen between the two samples in simple and complex visuomotor attention, sustained complex visual attention, attention efficiency, mental double tracking, implicit memory, and self-reported memory problems. These findings indicate minimal cognitive impairment in relatively uncomplicated Type 2 diabetes and demonstrate the importance of control and matching for confounding factors.

  17. Effects of transcranial direct current stimulation on the control of finger force during dexterous manipulation in healthy older adults.

    Directory of Open Access Journals (Sweden)

    Pranav J Parikh

    Full Text Available The contribution of poor finger force control to age-related decline in manual dexterity is above and beyond ubiquitous behavioral slowing. Altered control of the finger forces can impart unwanted torque on the object affecting its orientation, thus impairing manual performance. Anodal transcranial direct current stimulation (tDCS over primary motor cortex (M1 has been shown to improve the performance speed on manual tasks in older adults. However, the effects of anodal tDCS over M1 on the finger force control during object manipulation in older adults remain to be fully explored. Here we determined the effects of anodal tDCS over M1 on the control of grip force in older adults while they manipulated an object with an uncertain mechanical property. Eight healthy older adults were instructed to grip and lift an object whose contact surfaces were unexpectedly made more or less slippery across trials using acetate and sandpaper surfaces, respectively. Subjects performed this task before and after receiving anodal or sham tDCS over M1 on two separate sessions using a cross-over design. We found that older adults used significantly lower grip force following anodal tDCS compared to sham tDCS. Friction measured at the finger-object interface remained invariant after anodal and sham tDCS. These findings suggest that anodal tDCS over M1 improved the control of grip force during object manipulation in healthy older adults. Although the cortical networks for representing objects and manipulative actions are complex, the reduction in grip force following anodal tDCS over M1 might be due to a cortical excitation yielding improved processing of object-specific sensory information and its integration with the motor commands for production of manipulative forces. Our findings indicate that tDCS has a potential to improve the control of finger force during dexterous manipulation in older adults.

  18. Hypnosis can reduce pain in hospitalized older patients: a randomized controlled study.

    Science.gov (United States)

    Ardigo, Sheila; Herrmann, François R; Moret, Véronique; Déramé, Laurence; Giannelli, Sandra; Gold, Gabriel; Pautex, Sophie

    2016-01-15

    Chronic pain is a common and serious health problem in older patients. Treatment often includes non pharmacological approaches despite a relatively modest evidence base in this population. Hypnosis has been used in younger adults with positive results. The main objective of this study was to measure the feasibility and efficacy of hypnosis (including self hypnosis) in the management of chronic pain in older hospitalized patients. A single center randomized controlled trial using a two arm parallel group design (hypnosis versus massage). Inclusion criteria were chronic pain for more than 3 months with impact on daily life activities, intensity of > 4; adapted analgesic treatment; no cognitive impairment. Brief pain inventory was completed. Fifty-three patients were included (mean age: 80.6 ± 8.2--14 men; 26 hypnosis; 27 massage. Pain intensity decreased significantly in both groups after each session. Average pain measured by the brief pain index sustained a greater decrease in the hypnosis group compared to the massage group during the hospitalisation. This was confirmed by the measure of intensity of the pain before each session that decreased only in the hypnosis group over time (P = 0.008). Depression scores improved significantly over the time only in the hypnosis group (P = 0.049). There was no effect in either group 3 months post hospitals discharge. Hypnosis represents a safe and valuable tool in chronic pain management of hospitalized older patients. In hospital interventions did not provide long term post discharge relief. ISRCTN15615614; registered 2/1/2015.

  19. Supported Discharge Teams for older people in hospital acute care: a randomised controlled trial.

    Science.gov (United States)

    Parsons, Matthew; Parsons, John; Rouse, Paul; Pillai, Avinesh; Mathieson, Sean; Parsons, Rochelle; Smith, Christine; Kenealy, Tim

    2018-03-01

    Supported Discharge Teams aim to help with the transition from hospital to home, whilst reducing hospital length-of-stay. Despite their obvious attraction, the evidence remains mixed, ranging from strong support for disease-specific interventions to less favourable results for generic services. To determine whether older people referred to a Supported Discharge Team have: (i) reduced length-of-stay in hospital; (ii) reduced risk of hospital readmission; and (iii) reduced healthcare costs. Randomised controlled trial with follow-up to 6 months; 103 older women and 80 men (n = 183) (mean age 79), in hospital, were randomised to receive either Supported Discharge Team or usual care. Home-based rehabilitation was delivered by trained Health Care Assistants up to four times a day, 7 days a week, under the guidance of registered nurses, allied health and geriatricians for up to 6 weeks. Participants randomised to the Supported Discharge Team spent less time in hospital during the index admission (mean 15.7 days) in comparison to usual care (mean 21.6 days) (mean difference 5.9: 95% CI 0.6, 11.3 days: P = 0.03) and spent less time in hospital in the 6 months following discharge home. Supported discharge group costs were calculated at mean NZ$10,836 (SD NZ$12,087) compared to NZ$16,943 (SD NZ$22,303) in usual care. A Supported Discharge Team can provide an effective means of discharging older people home early from hospital and can make a cost-effective contribution to managing increasing demand for hospital beds. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  20. How many items from a word list can Alzheimer's disease patients and normal controls recall? Do they recall in a similar way?

    Science.gov (United States)

    Chaves, Marcia Lorena Fagundes; Camozzato, Ana Luiza

    2007-01-01

    The serial position effect occurs when individuals are asked to recall a list of information that exceeds normal attention span. Alzheimer's disease (AD) patients show lower scores on word span recall tests when compared to healthy aging subjects, younger individuals or depressed patients. To evaluate the immediate free recall and the serial position effect of a 10-word list, emotionally neutral in tone, in Alzheimer's disease (AD) patients and two age-groups of healthy controls. The free word recall test was applied in a sample of 44 mild AD outpatients and 168 >50 year and 173 =50 year-old healthy controls. The span of recalled words and order of recollection of each item was recorded. Scores for serial position effect were analyzed.MMSE scores were recorded for all participants. Descriptive statistics and the ANOVA with Tukey test were performed. The controls scored significantly better than AD patients on the MMSE and word span (p=0.0001). Older controls word span mean ±SD was 5.65±1.75, younger controls was 5.99±1.27, and AD patients was 2.86±1.42. The best recalled item in all groups was the first item of the list. Primacy was observed across the three groups, although AD patients presented lower scores. Recency was diminished among AD patients compared to control groups. Primacy effect was observed in AD patients as well as in both normal control groups. Recency effect was presented by the normal control groups but was extremely poor among AD patients. The first item was universally best retrieved.

  1. Differential effects of a visuospatial attention task on measures of postural control in young and older adults.

    Science.gov (United States)

    Peterson, Jeffrey J; Keenan, Kevin G

    2018-02-01

    The purpose of this study was to examine the influence of a visuospatial attention task on three measures of postural control in young and older adults. 20 young (19-36  years) and 20 older (67-91 years) adults performed a choice stepping response time (CSRT) task, a submaximal dorsiflexion force steadiness task, and quiet standing in 3 bilateral stances. All tasks were performed with and without a visuospatial (VS) attention task that involved visualizing a star moving within a 2 × 2 grid. CSRT increased with the addition of the VS task in both groups (p   .084). The findings suggest that visuospatial attention differentially affects postural control in young and older adults and the effect is task-specific. These findings suggest the need to include stepping and force control tasks to further determine what role visuospatial attention plays in postural control. Copyright © 2017. Published by Elsevier Ltd.

  2. Plasma antibodies to Abeta40 and Abeta42 in patients with Alzheimer's disease and normal controls.

    Science.gov (United States)

    Xu, Wuhua; Kawarabayashi, Takeshi; Matsubara, Etsuro; Deguchi, Kentaro; Murakami, Tetsuro; Harigaya, Yasuo; Ikeda, Masaki; Amari, Masakuni; Kuwano, Ryozo; Abe, Koji; Shoji, Mikio

    2008-07-11

    Antibodies to amyloid beta protein (Abeta) are present naturally or after Abeta vaccine therapy in human plasma. To clarify their clinical role, we examined plasma samples from 113 patients with Alzheimer's disease (AD) and 205 normal controls using the tissue amyloid plaque immunoreactivity (TAPIR) assay. A high positive rate of TAPIR was revealed in AD (45.1%) and age-matched controls (41.2%), however, no significance was observed. No significant difference was observed in the MMS score or disease duration between TAPIR-positive and negative samples. TAPIR-positive plasma reacted with the Abeta40 monomer and dimer, and the Abeta42 monomer weakly, but not with the Abeta42 dimer. TAPIR was even detected in samples from young normal subjects and young Tg2576 transgenic mice. Although the Abeta40 level and Abeta40/42 ratio increased, and Abeta42 was significantly decreased in plasma from AD groups when compared to controls, no significant correlations were revealed between plasma Abeta levels and TAPIR grading. Thus an immune response to Abeta40 and immune tolerance to Abeta42 occurred naturally in humans without a close relationship to the Abeta burden in the brain. Clarification of the mechanism of the immune response to Abeta42 is necessary for realization of an immunotherapy for AD.

  3. Resourcefulness, positive cognitions, relocation controllability and relocation adjustment among older people: a cross-sectional study of cultural differences.

    Science.gov (United States)

    Bekhet, Abir K; Zauszniewski, Jaclene A

    2013-09-01

    The population of older people in both the United States and Egypt is expected to double by the year 2030. With ageing, chronic illnesses increase and many older people need to relocate to retirement communities. Research has shown that positive cognitions and resourcefulness are positively correlated with adaptive functioning and better adjustment. The purpose of this study was to examine and compare relocation controllability, positive cognitions, resourcefulness and relocation adjustment between American and Egyptian older people living in retirement communities. The purpose of this cultural comparison is to gain insight into influencing factors in each culture that might lead to interventions to help relocated older adults in both cultures adjust to their new surroundings. A cross-sectional, descriptive design was used to compare relocation controllability, positive cognitions, resourcefulness and relocation adjustment of a convenience sample of American older people (n = 104) and a convenience sample of Egyptian older people (n = 94). The study was a secondary analysis of two studies of older people residing in six retirement communities in Northeast Ohio and in five retirement communities in Alexandria, Egypt. Examination of mean scores and standard deviations on the measure of positive cognitions using independent sample t-tests indicated that on average, the American older people reported more positive cognitions (t (131.16) = 11.29, P difference between Egyptians and Americans in resourcefulness (t (174.16) = -0.97, P > 0.05). The results provide direction for the development of positive cognition interventions and engaging older people in the decision-making process to help them to adjust to relocation. Implications for practice.  Positive thinking and resourcefulness training interventions can be used by nurses to help relocated older people to adjust to the stress of relocation to retirement communities. These interventions can be used on primary

  4. Effects of Delay Duration on the WMS Logical Memory Performance of Older Adults with Probable Alzheimer's Disease, Probable Vascular Dementia, and Normal Cognition.

    Science.gov (United States)

    Montgomery, Valencia; Harris, Katie; Stabler, Anthony; Lu, Lisa H

    2017-05-01

    To examine how the duration of time delay between Wechsler Memory Scale (WMS) Logical Memory I and Logical Memory II (LM) affected participants' recall performance. There are 46,146 total Logical Memory administrations to participants diagnosed with either Alzheimer's disease (AD), vascular dementia (VaD), or normal cognition in the National Alzheimer's Disease Coordinating Center's Uniform Data Set. Only 50% of the sample was administered the standard 20-35 min of delay as specified by WMS-R and WMS-III. We found a significant effect of delay time duration on proportion of information retained for the VaD group compared to its control group, which remained after adding LMI raw score as a covariate. There was poorer retention of information with longer delay for this group. This association was not as strong for the AD and cognitively normal groups. A 24.5-min delay was most optimal for differentiating AD from VaD participants (47.7% classification accuracy), an 18.5-min delay was most optimal for differentiating AD versus normal participants (51.7% classification accuracy), and a 22.5-min delay was most optimal for differentiating VaD versus normal participants (52.9% classification accuracy). Considering diagnostic implications, our findings suggest that test administration should incorporate precise tracking of delay periods. We recommend a 20-min delay with 18-25-min range. Poor classification accuracy based on LM data alone is a reminder that story memory performance is only one piece of data that contributes to complex clinical decisions. However, strict adherence to the recommended range yields optimal data for diagnostic decisions. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Effectiveness of liaison psychiatric nursing in older medical inpatients with depression: a randomised controlled trial.

    Science.gov (United States)

    Cullum, Sarah; Tucker, Sue; Todd, Chris; Brayne, Carol

    2007-07-01

    To compare liaison psychiatric nursing with usual medical care in the management of older medical inpatients who screen positive for depression. Pragmatic randomised controlled trial. Medical wards of UK district general hospital in rural East Anglia. One hundred and thirty-eight medical inpatients aged 65+ screened positive on the 15-item geriatric depression scale (GDS). One hundred and twenty-one out of 138 screen positives entered the trial (58/121 fulfilled criteria for depressive disorder at baseline). (i) A liaison psychiatric nurse assessed participants, formulated a care plan for treatment of their depression, ensured its implementation through liaison with appropriate agencies, and monitored participants' mood and response to treatment for up to 12 weeks. (ii) Usual treatment by hospital and primary care staff. ICD-10 depressive disorder, change in GDS-15 score, quality-adjusted life weeks (QALWs) and patient satisfaction rating. Eighty-six out of 121 participants completed the 16-week trial. Participants in the intervention group were more satisfied with their care, but no significant differences in depressive disorder, depression rating or QALWs gained were found between groups. However, there was a trend towards improvement in the intervention group and effect sizes were higher in the subgroup with depressive disorder. This study is the first RCT to evaluate liaison psychiatric nursing specifically for depression in older medical inpatients; the findings suggest improvement in mental health and quality of life, but a larger trial is required to provide convincing evidence.

  6. Autonomous monitoring of control hardware to predict off-normal conditions using NIF automatic alignment systems

    International Nuclear Information System (INIS)

    Awwal, Abdul A.S.; Wilhelmsen, Karl; Leach, Richard R.; Miller-Kamm, Vicki; Burkhart, Scott; Lowe-Webb, Roger; Cohen, Simon

    2012-01-01

    Highlights: ► An automatic alignment system was developed to process images of the laser beams. ► System uses processing to adjust a series of control loops until alignment criteria are satisfied. ► Monitored conditions are compared against nominal values with an off-normal alert. ► Automated health monitoring system trends off-normals with a large image history. - Abstract: The National Ignition Facility (NIF) is a high power laser system capable of supporting high-energy-density experimentation as a user facility for the next 30 years. In order to maximize the facility availability, preventive maintenance enhancements are being introduced into the system. An example of such an enhancement is a camera-based health monitoring system, integrated into the automated alignment system, which provides an opportunity to monitor trends in measurements such as average beam intensity, size of the beam, and pixel saturation. The monitoring system will generate alerts based on observed trends in measurements to allow scheduled pro-active maintenance before routine off-normal detection stops system operations requiring unscheduled intervention.

  7. Autonomous monitoring of control hardware to predict off-normal conditions using NIF automatic alignment systems

    Energy Technology Data Exchange (ETDEWEB)

    Awwal, Abdul A.S., E-mail: awwal1@llnl.gov [Lawrence Livermore National Laboratory, Livermore, CA 94550 (United States); Wilhelmsen, Karl; Leach, Richard R.; Miller-Kamm, Vicki; Burkhart, Scott; Lowe-Webb, Roger; Cohen, Simon [Lawrence Livermore National Laboratory, Livermore, CA 94550 (United States)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer An automatic alignment system was developed to process images of the laser beams. Black-Right-Pointing-Pointer System uses processing to adjust a series of control loops until alignment criteria are satisfied. Black-Right-Pointing-Pointer Monitored conditions are compared against nominal values with an off-normal alert. Black-Right-Pointing-Pointer Automated health monitoring system trends off-normals with a large image history. - Abstract: The National Ignition Facility (NIF) is a high power laser system capable of supporting high-energy-density experimentation as a user facility for the next 30 years. In order to maximize the facility availability, preventive maintenance enhancements are being introduced into the system. An example of such an enhancement is a camera-based health monitoring system, integrated into the automated alignment system, which provides an opportunity to monitor trends in measurements such as average beam intensity, size of the beam, and pixel saturation. The monitoring system will generate alerts based on observed trends in measurements to allow scheduled pro-active maintenance before routine off-normal detection stops system operations requiring unscheduled intervention.

  8. Interactive Sensor-Based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial.

    Science.gov (United States)

    Schwenk, Michael; Grewal, Gurtej S; Holloway, Dustin; Muchna, Amy; Garland, Linda; Najafi, Bijan

    2016-01-01

    Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have deficits in sensory and motor skills leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training programs specifically developed for CIPN patients are lacking. This pilot study investigated the effect of an interactive motor adaptation balance training program based on wearable sensors for improving balance in older cancer patients with CIPN. Twenty-two patients (age: 70.3 ± 8.7 years) with objectively confirmed CIPN [vibration perception threshold (VPT) >25 V] were randomized to either an intervention (IG) or a control (CG) group. The IG received interactive game-based balance training including repetitive weight shifting and virtual obstacle crossing tasks. Wearable sensors provided real-time visual/auditory feedback from the lower limb trajectory and allowed the perception of motor errors during each motor action. The CG received no exercise intervention and continued their normal activity. Outcome measures were changes in sway of ankle, hip, and center of mass (CoM) in both mediolateral and anteroposterior (AP) directions during 30-second balance tests with increasing task difficulty [i.e. standing in feet-closed position with eyes open (EO) and eyes closed (EC), and in semi-tandem position with EO] at baseline and after the intervention. Additionally, gait performance (speed, variability) and fear of falling [Falls Efficacy Scale-International (FES-I)] were measured. Training was safe despite the participants' impaired health status, great severity of CIPN (VPT 49.6 ± 26.7 V), and great fear of falling (FES-I score 31.37 ± 11.20). After the intervention, sway of hip, ankle, and CoM was significantly reduced in the IG compared to the CG while standing in feet-closed position with EO (p = 0.010-0.022, except AP CoM sway) and in semi-tandem position (p = 0.008-0.035, except ankle sway). No significant effects were found for balance with

  9. Effectiveness of an exercise program on postural control in frail older adults

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    Alfieri FM

    2012-12-01

    Full Text Available Fábio Marcon Alfieri,1,2 Marcelo Riberto,3 Àngels Abril-Carreres,4 Maria Boldó-Alcaine,4 Elisabet Rusca-Castellet,4 Roser Garreta-Figuera,4 Linamara Rizzo Battistella51São Paulo Adventist University Center, São Paulo, Brazil; 2Institute of Physical and Rehabilitation Medicine Hospital of Clinics, University of São Paulo, Brazil; 3School of Medicine in Ribeirão Preto, University of São Paulo, Brazil; 4University Hospital Mútua Terrassa Department of Rehabilitation, University of Barcelona, Barcelona, Spain; 5School of Medicine, Institute of Physical Medicine and Rehabilitation, Clinics Hospital of University of São Paulo, São Paulo, BrazilBackground: Exercise programs have proved to be helpful for frail older adults. This study aimed to investigate the effects of an exercise program with a focus on postural control exercises in frail older adults.Method: Twenty-six older adults (76.7 ± 4.9 years deemed clinically stable, chosen from the Falls Unit, University Hospital Mútua Terrassa, Barcelona, Spain, participated in this single-group study. Volunteers' postural control was evaluated using the Timed Up and Go test (TUG and the Guralnik test battery, and their static and dynamic posturography were evaluated using the Synapsys Posturography System®. These evaluations were performed before and after the intervention program, which included an educational session and two weekly 1-hour sessions over an 8-week period of stretching exercises, proprioception, balance, and motor coordination. Data were analyzed using the Student's t-test or the Wilcoxon test, with a significance level of 5%.Results: The TUG and Guralnik tests did not show significant differences. Concerning static posturography, there was improvement in the base of support (P = 0.006, anteroposterior displacement with eyes open (P = 0.02 and closed (P = 0.03, and the total amplitude of the center of pressure with eyes closed (P = 0.02. Regarding dynamic posturography, a

  10. After total knee replacement younger patients demonstrate superior balance control compared to older patients when recovering from a forward fall.

    Science.gov (United States)

    Street, Brian D; Gage, William

    2017-05-01

    National joint replacement registries have reported a substantial growth in younger knee osteoarthritic patients (controlled perturbation have shown age-related differences between younger and older healthy adults, whether similar age-related differences exist among total knee replacement patients is unknown. A total of 59 participants, including 29 unilateral total knee replacement patients (six-months post-surgery) made up the four experimental groups: 1) younger patient (54.3 (SD 7.9) years), 2) younger control (55.2 (SD 4.0) years), 3) older patient (76.9 (SD 4.7) years), and 4) older control (77.7 (SD 4.1) years). Using a tether-release method to perturb balance and simulate a forward fall, center of mass and stepping characteristics were analyzed. Younger patients recovered following the perturbation with a significantly smaller center of mass displacement compared to the older patients (14.85 (SD 0.01) v. 18.13 (SD 0.02) %ht, p=0.02); utilizing a longer (0.43 (SD 0.02) v. 0.39 (SD 0.03) m, pcontrols in center of mass displacement or recovery step characteristics (p>0.05). The younger patients demonstrated superior center of mass control in response to a forward perturbation, suggesting that younger patients would be at a reduced risk of falling when recovering from a forward-directed postural perturbation compared to older patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Comparison of serum lipid profiles between normal controls and breast cancer patients

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    Pikul Laisupasin

    2013-01-01

    Full Text Available Background: Researchers have reported association of plasma/serum lipids and lipoproteins with different cancers. Increase levels of circulating lipids and lipoproteins have been associated with breast cancer risk. Aim: The aim of this study is to compare serum lipid profiles: total-cholesterol (T-CHOL, triglyceride (TG, high density lipoprotein-cholesterol (HDL-C, low density lipoprotein-cholesterol (LDL-C and very low density lipoprotein-cholesterol (VLDL-C between breast cancer patients and normal participants. Materials and Methods: A total of 403 women in this study were divided into two groups in the period during May 2006-April 2007. Blood samples were collected from 249 patients with early stage breast cancer and 154 normal controls for serum lipid profiles (T-CHOL, TG, HDL-C, LDL-C and VLDL-C analysis using Hitachi 717 Autoanalyzer (Roche Diagnostic GmbH, Germany. TG, LDL-C and VLDL-C levels in breast cancer group were significantly increased as compared with normal controls group (P < 0.001, whereas HDL-C and T-CHOL levels were not. Results: The results of this study suggest that increased serum lipid profiles may associate with breast cancer risk in Thai women. Further studies to group important factors including, cancer stages, types of cancer, parity, and menopausal status that may affect to lipid profiles in breast cancer patients along with an investigation of new lipid profiles to clarify most lipid factors that may involve in breast cancer development are needed.

  12. Identification of peripheral inflammatory markers between normal control and Alzheimer's disease.

    Science.gov (United States)

    Kim, Sam-Moon; Song, Juhee; Kim, Seungwoo; Han, Changsu; Park, Moon Ho; Koh, Youngho; Jo, Sangmee Ahn; Kim, Young-Youl

    2011-05-12

    Multiple pathogenic factors may contribute to the pathophysiology of Alzheimer's disease (AD). Peripheral blood markers have been used to assess biochemical changes associated with AD and mild cognitive impairment (MCI) and involved in their pathophysiology. Plasma samples and clinical data were obtained from participants in the Ansan Geriatric Study (AGE study). Plasma concentrations of four candidate biomarkers were measured in the normal control (NC), MCI, and AD group: interleukin-8 (IL-8), IL-10, monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-α (TNF-α).Body mass index (BMI), MMSE (Mini Mental State Examination), CDR(Clinical Dementia Rating) score and homocystein level were recorded with social and demographic information. Total of 59 subjects were randomly selected for this analysis [NC (n = 21), MCI(n = 20) and AD(n = 18)]. In demographic data, educational year was correlated with the diagnosis states (p homocystein of the three groups, but no significant differences were found in each groups. The plasma IL-8 level was lower in MCI and AD patients compared with the normal control group (respectively, p < 0.0001). The MCI and AD patients had similar MCP-1, IL-10, and TNF-α level. Our study suggests the existence of an independent and negative relationship between plasma IL-8 levels and functional status in MCI and AD patients.

  13. Reward value-based gain control: divisive normalization in parietal cortex.

    Science.gov (United States)

    Louie, Kenway; Grattan, Lauren E; Glimcher, Paul W

    2011-07-20

    The representation of value is a critical component of decision making. Rational choice theory assumes that options are assigned absolute values, independent of the value or existence of other alternatives. However, context-dependent choice behavior in both animals and humans violates this assumption, suggesting that biological decision processes rely on comparative evaluation. Here we show that neurons in the monkey lateral intraparietal cortex encode a relative form of saccadic value, explicitly dependent on the values of the other available alternatives. Analogous to extra-classical receptive field effects in visual cortex, this relative representation incorporates target values outside the response field and is observed in both stimulus-driven activity and baseline firing rates. This context-dependent modulation is precisely described by divisive normalization, indicating that this standard form of sensory gain control may be a general mechanism of cortical computation. Such normalization in decision circuits effectively implements an adaptive gain control for value coding and provides a possible mechanistic basis for behavioral context-dependent violations of rationality.

  14. Personality correlates of criminals: A comparative study between normal controls and criminals

    Science.gov (United States)

    Sinha, Sudhinta

    2016-01-01

    Background: Personality is a major factor in many kinds of behavior, one of which is criminal behavior. To determine what makes a criminal “a criminal,” we must understand his/her personality. This study tries to identify different personality traits which link criminals to their personality. Materials and Methods: In the present study, 37 male criminals of district jail of Dhanbad (Jharkhand) and 36 normal controls were included on a purposive sampling basis. Each criminal was given a personal datasheet and Cattel's 16 personality factors (PFs) scale for assessing their sociodemographic variables and different personality traits. Objective: The objective of this study was to examine the relation between personality traits and criminal behavior, and to determine whether such factors are predictive of future recidivism. Results: Results indicated high scores on intelligence, impulsiveness, suspicion, self-sufficient, spontaneity, self-concept control factors, and very low scores on emotionally less stable on Cattel's 16 PFs scale in criminals as compared with normal. Conclusion: Criminals differ from general population or non criminals in terms of personality traits. PMID:28163407

  15. Differential effects of mental stress on plasma homovanillic acid in schizophrenia and normal controls.

    Science.gov (United States)

    Sumiyoshi, T; Saitoh, O; Yotsutsuji, T; Itoh, H; Kurokawa, K; Kurachi, M

    1999-04-01

    We previously reported that mental stress by Kraepelin's arithmetic test decreases plasma homovanillic acid (pHVA) levels in psychiatrically normal healthy human subjects. The present study was undertaken to determine whether this pattern of changes in pHVA concentrations resulting from mental stress is altered in patients with schizophrenia. Fourteen male patients with schizophrenia including those under ongoing neuroleptic treatment and 14 normal male volunteers participated in the study. Following overnight fast and restricted physical activity, the subjects performed Kraepelin's arithmetic test for 30 minutes. Plasma samples were collected immediately before and after the test for measurement of pHVA levels. A significant diagnosis by Kraepelin's test effect was observed due to a decrease in pHVA levels by the Kraepelin test in control subjects but not in patients with schizophrenia. Changes in pHVA levels during the Kraepelin test positively correlated with pre-test pHVA levels in control subjects, while this correlation was not observed in patients with schizophrenia. These results may be further support for the presence of a dopamine-dependent restitutive system in the brain. The absence of response of pHVA levels to mental stress in patients with schizophrenia may indicate that the dopamine restitutive system in these patients is disrupted or already down-regulated, as previously predicted.

  16. Sex differences in plasma homovanillic acid levels in schizophrenia and normal controls: relation to neuroleptic resistance.

    Science.gov (United States)

    Sumiyoshi, T; Hasegawa, M; Jayathilake, K; Meltzer, H Y

    1997-03-01

    Plasma homovanillic acid (pHVA) levels were compared in a large number of neuroleptic-resistant and -responsive schizophrenic patients (male/female = 161/46) and normal controls (67/27), and correlated with various measures of psychopathology. Psychopathology was evaluated with the brief psychiatric rating scale, the Schedule for Affective Disorders and Schizophrenia-Change version (SADS-C) and SADS-C Global Assessment Scale, the Scale for Assessment of Negative Symptoms, the Scale for Assessment of Positive Symptoms (SAPS), and the Quality of Life Scale. No significant differences in pHVA levels between neuroleptic-resistant (n = 104) or -responsive (n = 103) schizophrenic patients, and normal controls, were found; however, there was a main effect for sex, due to higher pHVA levels in women than men. There were no diagnosis x gender or age effects on pHVA levels. No significant correlations were observed between psychopathology ratings and baseline pHVA levels, except with the Hallucinations subscale of SAPS in neuroleptic-responsive patients. Neither duration of neuroleptic washout nor plasma prolactin levels correlated with pHVA levels. Further studies on the origin and significance of the gender difference in pHVA are indicated.

  17. Dynamic balance control during stair negotiation for older adults and people with Parkinson disease.

    Science.gov (United States)

    Conway, Zachary J; Blackmore, Tim; Silburn, Peter A; Cole, Michael H

    2018-06-01

    It is well understood that stability during ambulation is reliant upon appropriate control of the trunk segment, but research shows that the rhythmicity of this segment is significantly reduced for people with Parkinson's disease (PD). Given the increased risk associated with stair ambulation, this study investigated whether people with PD demonstrate poorer trunk control during stair ambulation compared with age-matched controls. Trunk accelerations were recorded for twelve PD patients and age-matched controls during stair ascent and descent. Accelerations were used to derive measures of harmonic ratios and root mean square (RMS) acceleration to provide insight into the rhythmicity and amplitude of segmental motion. Compared with what is typically seen during level-ground walking, gait rhythmicity during stair negotiation was markedly reduced for older adults and people with PD. Furthermore, both groups exhibited significantly poorer trunk movements during stair descent compared to stair ascent, suggesting that both populations may face a greater risk of falling during this task. As stair negotiation is a common activity of daily life, the increased risk associated with this task should be considered when working with populations that have an increased risk of falling. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. The effect of an outdoor activities' intervention delivered by older volunteers on the quality of life of older people with severe mobility limitations: a randomized controlled trial.

    Science.gov (United States)

    Rantanen, Taina; Äyräväinen, Irma; Eronen, Johanna; Lyyra, Tiinamari; Törmäkangas, Timo; Vaarama, Marja; Rantakokko, Merja

    2015-04-01

    Older community-living disabled people often have unmet activity needs and participation restrictions potentially reducing their quality of life (QoL). We examined the effects of an individualized out-of-home activity intervention delivered by volunteers on QoL among community-living older people, who have difficulty accessing the outdoors independently. Volunteering, Access to Outdoor Activities and Wellbeing in Older People (VOW; ISRCTN56847832) was a two-arm randomized single-blinded, controlled effectiveness trial (RCT) in Jyväskylä, Finland. The inclusion criteria were: age 65 or over, severe mobility limitation, able to communicate, and agree to participate in a RCT. Each intervention group member was assigned a trained volunteer with whom out-of-home activities were done once a week for 3 months (e.g., running errands or recreational activities). The primary outcome was the environmental subscore of QoL assessed with WHOQOL-BREF. Secondary outcomes were the overall QoL, physical capacity, psychological well-being, and social relationships assessed with WHOQOL_BREF and lower-extremity performance assessed with Short Physical Performance Battery (SPPB). 121 people aged 67-92 years (mean age 81.9 years, SD 5.9, 90 % women) were randomized. No treatment effect on the environmental QoL subscore was observed, but for physical capacity subscore a significant treatment effect was observed (General Linear Model, Group by Time p = 0.001). No effects were observed for the other QoL subscores or for SPPB score. This study suggests that individualized out-of-home activity intervention delivered by volunteers may influence the QoL of old severely mobility-limited community-living people in a positive way. Further studies are needed to better understand how to improve QoL of older disabled community-living people and potentially buffer them against more severe care needs and institutionalization.

  19. Recruiting older people to a randomised controlled dietary intervention trial - how hard can it be?

    Directory of Open Access Journals (Sweden)

    Pockley A Graham

    2010-02-01

    Full Text Available Abstract Background The success of a human intervention trial depends upon the ability to recruit eligible volunteers. Many trials fail because of unrealistic recruitment targets and flawed recruitment strategies. In order to predict recruitment rates accurately, researchers need information on the relative success of various recruitment strategies. Few published trials include such information and the number of participants screened or approached is not always cited. Methods This paper will describe in detail the recruitment strategies employed to identify older adults for recruitment to a 6-month randomised controlled dietary intervention trial which aimed to explore the relationship between diet and immune function (The FIT study. The number of people approached and recruited, and the reasons for exclusion, will be discussed. Results Two hundred and seventeen participants were recruited to the trial. A total of 7,482 letters were sent to potential recruits using names and addresses that had been supplied by local Family (General Practices. Eight hundred and forty three potential recruits replied to all methods of recruitment (528 from GP letters and 315 from other methods. The eligibility of those who replied was determined using a screening telephone interview, 217 of whom were found to be suitable and agreed to take part in the study. Conclusion The study demonstrates the application of multiple recruitment methods to successfully recruit older people to a randomised controlled trial. The most successful recruitment method was by contacting potential recruits by letter on NHS headed note paper using contacts provided from General Practices. Ninety percent of recruitment was achieved using this method. Adequate recruitment is fundamental to the success of a research project, and appropriate strategies must therefore be adopted in order to identify eligible individuals and achieve recruitment targets. Trial registration number ISRCTN45031464.

  20. Altered postural control variability in older-aged individuals with a history of lateral ankle sprain.

    Science.gov (United States)

    Terada, Masafumi; Kosik, Kyle; Johnson, Nathan; Gribble, Phillip

    2018-02-01

    The current study aimed to examine postural control performance during a single-leg balance task in elderly individuals with and without a previous history of lateral ankle sprain (LAS). Eighteen adults with a previous history of LAS (mean age = 66 years old) and 12 healthy controls (mean age = 65 years old) were included in the study. Participants performed three trials of a single-leg balance task during an eyes-opened condition for 20-s. Center of pressure (COP) trajectories in the anteroposterior (AP) and mediolateral (ML) directions were collected with a force plate. The following postural control measures were calculated in the AP and ML directions: 1) Sample Entropy (SampEn); 2) Approximate Entropy (ApEn); 3) mean of Time-to-Boundary minima (mean TTB); and 4) COP velocity (COPV). Older-age participants with a history LAS exhibited lower ApEn-AP, SampEn-AP, and SampEn-ML values compared to healthy controls (p postural control patterns, less adaptability, and more difficulty maintaining COP during a single-leg balance task in adults with a previous history of LAS. Our data suggest that there is a need to consider history of musculoskeletal injury when evaluating factors for postural control and fall risk in the elderly. Future investigations are needed to assess the effect of LAS on age-related declines in postural control and discern associations between potential risk factors of fall-related injuries and LAS in an elderly population. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. The Counseling Older Adults to Control Hypertension (COACH) trial: design and methodology of a group-based lifestyle intervention for hypertensive minority older adults.

    Science.gov (United States)

    Ogedegbe, Gbenga; Fernandez, Senaida; Fournier, Leanne; Silver, Stephanie A; Kong, Jian; Gallagher, Sara; de la Calle, Franze; Plumhoff, Jordan; Sethi, Sheba; Choudhury, Evelyn; Teresi, Jeanne A

    2013-05-01

    The disproportionately high prevalence of hypertension and its associated mortality and morbidity in minority older adults is a major public health concern in the United States. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes on blood pressure reduction, these approaches remain largely untested among minority elders in community-based settings. The Counseling Older Adults to Control Hypertension trial is a two-arm randomized controlled trial of 250 African-American and Latino seniors, 60 years and older with uncontrolled hypertension, who attend senior centers. The goal of the trial is to evaluate the effect of a therapeutic lifestyle intervention delivered via group classes and individual motivational interviewing sessions versus health education, on blood pressure reduction. The primary outcome is change in systolic and diastolic blood pressure from baseline to 12 months. The secondary outcomes are blood pressure control at 12 months; changes in levels of physical activity; body mass index; and number of daily servings of fruits and vegetables from baseline to 12 months. The intervention group will receive 12 weekly group classes followed by individual motivational interviewing sessions. The health education group will receive an individual counseling session on healthy lifestyle changes and standard hypertension education materials. Findings from this study will provide needed information on the effectiveness of lifestyle interventions delivered in senior centers. Such information is crucial in order to develop implementation strategies for translation of evidence-based lifestyle interventions to senior centers, where many minority elders spend their time, making the centers a salient point of dissemination. Copyright © 2013. Published by Elsevier Inc.

  2. Economic evaluation of an extended nutritional intervention in older Australian hospitalized patients: a randomized controlled trial.

    Science.gov (United States)

    Sharma, Yogesh; Thompson, Campbell; Miller, Michelle; Shahi, Rashmi; Hakendorf, Paul; Horwood, Chris; Kaambwa, Billingsley

    2018-02-05

    Prevalence of malnutrition in older hospitalized patients is 30%. Malnutrition is associated with poor clinical outcomes in terms of high morbidity and mortality and is costly for hospitals. Extended nutrition interventions improve clinical outcomes but limited studies have investigated whether these interventions are cost-effective. In this randomized controlled trial, 148 malnourished general medical patients ≥60 years were recruited and randomized to receive either an extended nutritional intervention or usual care. Nutrition intervention was individualized and started with 24 h of admission and was continued for 3 months post-discharge with a monthly telephone call whereas control patients received usual care. Nutrition status was confirmed by Patient generated subjective global assessment (PG-SGA) and health-related quality of life (HRQoL) was measured using EuroQoL 5D (EQ-5D-5 L) questionnaire at admission and at 3-months follow-up. A cost-effectiveness analysis was conducted for the primary outcome (incremental costs per unit improvement in PG-SGA) while a cost-utility analysis (CUA) was undertaken for the secondary outcome (incremental costs per quality adjusted life year (QALY) gained). Nutrition status and HRQoL improved in intervention patients. Mean per included patient Australian Medicare costs were lower in intervention group compared to control arm (by $907) but these differences were not statistically significant (95% CI: -$2956 to $4854). The main drivers of higher costs in the control group were higher inpatient ($13,882 versus $13,134) and drug ($838 versus $601) costs. After adjusting outcomes for baseline differences and repeated measures, the intervention was more effective than the control with patients in this arm reporting QALYs gained that were higher by 0.0050 QALYs gained per patient (95% CI: -0.0079 to 0.0199). The probability of the intervention being cost-effective at willingness to pay values as low as $1000 per unit

  3. Ultrasonographic, quantitative comparison of lower extremity lymphedema versus normal control. Technical note with case reports

    Directory of Open Access Journals (Sweden)

    Vanessa Lôbo de Carvalho

    2018-01-01

    Full Text Available Characterization of tissue by ultrasonography (CATUS is a modern-day research endeavor intended to improve visual perception and image quantification. Visual perception increases with color. Quantification focuses on pixel echo brightnesses. A previously presented case report demonstrated reappearance of lymphatic channels a few days after manual drainage. Ultrasonographic images (US of lymphatic leg and foot were quantitated and compared to a normal extremity based on proportions of pixels in specific brightness intervals. Anatomy evaluated included control- subcutaneous and lymphatic compartments. US with 256 brightness levels were obtained at the proximal, mid and distal leg and foot. Control and lymphatic Gray Scale Medians (GSM and histograms were compared using t-test and Chi-square statistics. Average GSM was 97±9 (SD (82-114, n=12 images for control, greater than 51±15 (24-69, n=12 for lymphedematous leg/foot (P99% of pixels with brightness in the muscle-fiber range (41-196, in contrast to 62% for the lymphatic extremity (P<0.001. Lymphedema averaged 7%, 3%, 15% and 14% of pixels in blood, blood/fat, fat and fat/muscle-like regions (0-4, 5-7, 8-26, 27- 40 brightness intervals. Such regions were visually interpreted as lymphatic channels or lakes. Visual perception by colorization is subjective, but most people perceives details better, for example, during the day than at night. Furthermore, US images have 16 times more shades of gray, 256, than that perceived by the human visual system, 16 on average. Colorization improved perception of lymphatic channels and lakes by transforming blood echoes into red and lymphatic liquid with echoes similar to fat into yellow. Pixel proportions in low brightness intervals were higher in the lymphatic than in the normal extremity. Lymphedema severity was quantified. The CATUS technique may be used to monitor treatment effects or disease evolution.

  4. Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial.

    Science.gov (United States)

    Merom, Dafna; Mathieu, Erin; Cerin, Ester; Morton, Rachael L; Simpson, Judy M; Rissel, Chris; Anstey, Kaarin J; Sherrington, Catherine; Lord, Stephen R; Cumming, Robert G

    2016-08-01

    The prevention of falls among older people is a major public health challenge. Exercises that challenge balance are recognized as an efficacious fall prevention strategy. Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults, two of the strongest risk factors for falls in older people, this study aimed to determine whether social dance is effective in i) reducing the number of falls and ii) improving physical and cognitive fall-related risk factors. A parallel two-arm cluster randomized controlled trial was undertaken in 23 self-care retirement villages (clusters) around Sydney, Australia. Eligible villages had to have an appropriate hall for dancing, house at least 60 residents, and not be currently offering dance as a village activity. Retirement villages were randomised using a computer generated randomisation method, constrained using minimisation. Eligible participants had to be a resident of the village, be able to walk at least 50 m, and agree to undergo physical and cognitive testing without cognitive impairment. Residents of intervention villages (12 clusters) were offered twice weekly one-hour social dancing classes (folk or ballroom dancing) over 12 mo (80 h in total). Programs were standardized across villages and were delivered by eight dance teachers. Participants in the control villages (11 clusters) were advised to continue with their regular activities. falls during the 12 mo trial and Trail Making Tests. The Physiological Performance Assessment (i.e., postural sway, proprioception, reaction time, leg strength) and the Short Physical Performance Battery; health-related physical and mental quality of life from the Short-Form 12 (SF-12) Survey. Data on falls were obtained from 522 of 530 (98%) randomised participants (mean age 78 y, 85% women) and 424 (80%) attended the 12-mo reassessment, which was lower among folk dance participants (71%) than ballroom dancing (82%) or control

  5. Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

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    Atsushi K Kono

    Full Text Available BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS, which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years and 20 MFS cases (12 males, 8 females, mean age 37.1 years and 20 controls (12 males, 8 females, mean age 36.1 years both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4 and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values. The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls.

  6. Delirium markers in older fallers: a case-control study

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    Doherty K

    2014-11-01

    Full Text Available Kelly Doherty,1 Elizabeth Archambault,1 Brittany Kelly,1,2 James L Rudolph1,3,4 1Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA; 2School of Nursing, Science & Health Professions, Regis College, Boston, MA, USA; 3Division of Aging, Brigham and Women’s Hospital, Boston, MA, USA; 4Harvard Medical School, Boston, MA, USA Background: When a hospitalized older patient falls or develops delirium, there are significant consequences for the patient and the health care system. Assessments of inattention and altered consciousness, markers for delirium, were analyzed to determine if they were also associated with falls. Methods: This retrospective case-control study from a regional tertiary Veterans Affairs referral center identified falls and delirium risk factors from quality databases from 2010 to 2012. Older fallers with complete delirium risk assessments prior to falling were identified. As a control, non-fallers were matched at a 3:1 ratio. Admission risk factors that were compared in fallers and non-fallers included altered consciousness, cognitive performance, attention, sensory deficits, and dehydration. Odds ratio (OR was reported (95% confidence interval [CI]. Results: After identifying 67 fallers, the control population (n=201 was matched on age (74.4±9.8 years and ward (83.6% medical; 16.4% intensive care unit. Inattention as assessed by the Months of the Year Backward test was more common in fallers (67.2% versus 50.8%, OR=2.0; 95% CI: 1.1–3.7. Fallers tended to have altered consciousness prior to falling (28.4% versus 12.4%, OR=2.8; 95% CI: 1.3–5.8. Conclusion: In this case-control study, alterations in consciousness and inattention, assessed prior to falling, were more common in patients who fell. Brief assessments of consciousness and attention should be considered for inclusion in fall prediction. Keywords: geriatrics, patient centered outcomes research, patient safety

  7. Normal Control Study of Cerebral Blood Flow by 99mTc HM-PAO SPECT

    International Nuclear Information System (INIS)

    Koong, Sung Soo; Moon, Dae Hyuk; Lee, Bum Woo; Lee, Kyung Han

    1989-01-01

    Regional cerebral perfusion was evaluated in 15 normal controls by single photon emission computed tomography using 99m Tc HM-PAO. For quantitative analysis, 13 pairs of homologous region of interest (ROI) were drawn on three transverse slices matching the vascular territories and cerebral cortices, and normal values of 3 semiquantitative indices including 'Right to left ratio' (R/L ratio), 'Regional index' (RI), and 'Region to cerebellum ratio (R/cbll ratio) were calculated. Mean values of R/L ratios of homologous regions were ranged from 0.985 to 1.023, and mean ± 2 s.d. of all regions did not exceed 11% of mean. Significant difference of Rls (mean count per voxel of a ROI/mean count per voxel of total ROls) between regions were found (p<0.001) with highest values in occipital cortex and cerebellum. After attenuation correction, Rls in deep gray, cranial portion of anterior cerebral artery and vascular territories in the 2nd slice increased significantly (p<0.05-0.001) hut vise versa in other ROIs. Region to cerebellum ratios also showed regional difference similar to Rls.

  8. CRITICAL VELOCITY OF CONTROLLABILITY OF SLIDING FRICTION BY NORMAL OSCILLATIONS IN VISCOELASTIC CONTACTS

    Directory of Open Access Journals (Sweden)

    Mikhail Popov

    2016-12-01

    Full Text Available Sliding friction can be reduced substantially by applying ultrasonic vibration in the sliding plane or in the normal direction. This effect is well known and used in many applications ranging from press forming to ultrasonic actuators. One of the characteristics of the phenomenon is that, at a given frequency and amplitude of oscillation, the observed friction reduction diminishes with increasing sliding velocity. Beyond a certain critical sliding velocity, there is no longer any difference between the coefficients of friction with or without vibration. This critical velocity depends on material and kinematic parameters and is a key characteristic that must be accounted for by any theory of influence of vibration on friction. Recently, the critical sliding velocity has been interpreted as the transition point from periodic stick-slip to pure sliding and was calculated for purely elastic contacts under uniform sliding with periodic normal loading. Here we perform a similar analysis of the critical velocity in viscoelastic contacts using a Kelvin material to describe viscoelasticity. A closed-form solution is presented, which contains previously reported results as special cases. This paves the way for more detailed studies of active control of friction in viscoelastic systems, a previously neglected topic with possible applications in elastomer technology and in medicine.

  9. Brain parenchymal density measurements by CT in demented subjects and normal controls

    International Nuclear Information System (INIS)

    Gado, M.; Danziger, W.L.; Chi, D.; Hughes, C.P.; Coben, L.A.

    1983-01-01

    Parachymal density measurements of 14 regions of gray and white matter from each cerebral hemisphere were made from CT scans of 25 subjects who had varying degrees of dementia as measured by a global Clinical Dementia Rating, and also from CT scans of 33 normal control subjects. There were few significant differences between the two groups in the mean density value for each of the regions examined, although several individual psychometric tests did correlate with density changes. Moreover, for six regions in the cerebral cortex, and for one region in the thalamus of each hemisphere, we found no significant correlation between the gray-white matter density difference and dementia. There was, however, a loss of the discriminability between the gray and white matter with an increase in the size of the ventricles. These findings may be attributed to the loss of white matter volume

  10. Current physical activity improves balance control during sensory conflicting conditions in older adults.

    Science.gov (United States)

    Buatois, S; Gauchard, G C; Aubry, C; Benetos, A; Perrin, P

    2007-01-01

    Aging process is characterized by difficulties in ensuring balance control, especially in conditions of reduced or conflicting sensory information, leading to an increased risk of falling. Conversely, the practise of physical activities (PA) has been recognized as a good approach to improve the quality of balance control. This study aimed to investigate the influence of current and/or past PA on balance-related neurosensorial organization in older adults on the maintenance of the upright stance, especially during sensory conflicting situations. Postural control was evaluated by means of the Sensory Organization Test on 130 healthy noninstitutionalized volunteers aged over 65, split into four groups according to the presence or absence of PA before or after retirement. Subjects who practised PA for a long time (Gr1) and subjects who started PA after retirement (Gr2) displayed the best postural performances and better managed sensory conflicting situations compared to subjects who had stopped PA for many years (Gr3) and subjects who had never practised PA (Gr4). Multiple regression analyses revealed that current PA was the major determinant for postural parameters during sensorial conflict compared to age, gender, body mass index and past PA. Regular PA, even when started late in life, allows appropriate reorganization of the different components of postural control during sensory conflicting situations. Indeed, active subjects were more able to compensate for suppressed or perturbed sensory information by an increased usage of another referential and so to correct their posture by adopting a more appropriate balance strategy. Thus, PA counteracts the age-related decline of postural control and could consequently reduce the risk of falling.

  11. Unexpected perturbations training improves balance control and voluntary stepping times in older adults - a double blind randomized control trial.

    Science.gov (United States)

    Kurz, Ilan; Gimmon, Yoav; Shapiro, Amir; Debi, Ronen; Snir, Yoram; Melzer, Itshak

    2016-03-04

    Falls are common among elderly, most of them occur while slipping or tripping during walking. We aimed to explore whether a training program that incorporates unexpected loss of balance during walking able to improve risk factors for falls. In a double-blind randomized controlled trial 53 community dwelling older adults (age 80.1±5.6 years), were recruited and randomly allocated to an intervention group (n = 27) or a control group (n = 26). The intervention group received 24 training sessions over 3 months that included unexpected perturbation of balance exercises during treadmill walking. The control group performed treadmill walking with no perturbations. The primary outcome measures were the voluntary step execution times, traditional postural sway parameters and Stabilogram-Diffusion Analysis. The secondary outcome measures were the fall efficacy Scale (FES), self-reported late life function (LLFDI), and Performance-Oriented Mobility Assessment (POMA). Compared to control, participation in intervention program that includes unexpected loss of balance during walking led to faster Voluntary Step Execution Times under single (p = 0.002; effect size [ES] =0.75) and dual task (p = 0.003; [ES] = 0.89) conditions; intervention group subjects showed improvement in Short-term Effective diffusion coefficients in the mediolateral direction of the Stabilogram-Diffusion Analysis under eyes closed conditions (p = 0.012, [ES] = 0.92). Compared to control there were no significant changes in FES, LLFDI, and POMA. An intervention program that includes unexpected loss of balance during walking can improve voluntary stepping times and balance control, both previously reported as risk factors for falls. This however, did not transferred to a change self-reported function and FES. ClinicalTrials.gov NCT01439451 .

  12. Optimum parameters in a model for tumour control probability, including interpatient heterogeneity: evaluation of the log-normal distribution

    International Nuclear Information System (INIS)

    Keall, P J; Webb, S

    2007-01-01

    The heterogeneity of human tumour radiation response is well known. Researchers have used the normal distribution to describe interpatient tumour radiosensitivity. However, many natural phenomena show a log-normal distribution. Log-normal distributions are common when mean values are low, variances are large and values cannot be negative. These conditions apply to radiosensitivity. The aim of this work was to evaluate the log-normal distribution to predict clinical tumour control probability (TCP) data and to compare the results with the homogeneous (δ-function with single α-value) and normal distributions. The clinically derived TCP data for four tumour types-melanoma, breast, squamous cell carcinoma and nodes-were used to fit the TCP models. Three forms of interpatient tumour radiosensitivity were considered: the log-normal, normal and δ-function. The free parameters in the models were the radiosensitivity mean, standard deviation and clonogenic cell density. The evaluation metric was the deviance of the maximum likelihood estimation of the fit of the TCP calculated using the predicted parameters to the clinical data. We conclude that (1) the log-normal and normal distributions of interpatient tumour radiosensitivity heterogeneity more closely describe clinical TCP data than a single radiosensitivity value and (2) the log-normal distribution has some theoretical and practical advantages over the normal distribution. Further work is needed to test these models on higher quality clinical outcome datasets

  13. Effect of physical activity counseling on disability in older people: a 2-year randomized controlled trial.

    Science.gov (United States)

    von Bonsdorff, Mikaela B; Leinonen, Raija; Kujala, Urho M; Heikkinen, Eino; Törmäkangas, Timo; Hirvensalo, Mirja; Rasinaho, Minna; Karhula, Sirkka; Mänty, Minna; Rantanen, Taina

    2008-12-01

    To study the effect of a physical activity counseling intervention on instrumental activity of daily living (IADL) disability. Primary care-based, single-blind, randomized controlled trial. City of Jyväskylä, central Finland. Six hundred thirty-two people aged 75 to 81 who were able to walk 500 meters without assistance, were at most moderately physically active, had a Mini-Mental State Examination score greater than 21, had no medical contraindications for physical activity, and gave informed consent for participation. A single individualized physical activity counseling session with supportive phone calls from a physiotherapist every 4 months for 2 years and annual lectures on physical activity. Control group received no intervention. The outcome was IADL disability defined as having difficulties in or inability to perform IADL tasks. Analyses were carried out according to baseline IADL disability, mobility limitation, and cognitive status. At the end of the follow-up, IADL disability had increased in both groups (Pphysical activity counseling intervention had no effect on older sedentary community-dwelling persons with a wide range of IADL disability, although it prevented incident IADL disability. The results warrant further investigation to explore the benefits of a primary care-based physical activity counseling program on decreasing and postponing IADL disability.

  14. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial

    NARCIS (Netherlands)

    Uffelen, J.G.Z. van; Chinapaw, M.J.M.; Mechelen, W. van; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI.

  15. Interventions to Improve Medication Adherence among Older Adults: Meta-Analysis of Adherence Outcomes among Randomized Controlled Trials

    Science.gov (United States)

    Conn, Vicki S.; Hafdahl, Adam R.; Cooper, Pamela S.; Ruppar, Todd M.; Mehr, David R.; Russell, Cynthia L.

    2009-01-01

    Purpose: This study investigated the effectiveness of interventions to improve medication adherence (MA) in older adults. Design and Methods: Meta-analysis was used to synthesize results of 33 published and unpublished randomized controlled trials. Random-effects models were used to estimate overall mean effect sizes (ESs) for MA, knowledge,…

  16. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomized controlled trial

    NARCIS (Netherlands)

    van Uffelen, J.G.Z.; Chin A Paw, M.J.M.; van Mechelen, W.; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI.

  17. Effects of exercise on brain activity during walking in older adults: a randomized controlled trial.

    Science.gov (United States)

    Shimada, Hiroyuki; Ishii, Kenji; Makizako, Hyuma; Ishiwata, Kiichi; Oda, Keiichi; Suzukawa, Megumi

    2017-05-30

    Physical activity may preserve neuronal plasticity, increase synapse formation, and cause the release of hormonal factors that promote neurogenesis and neuronal function. Previous studies have reported enhanced neurocognitive function following exercise training. However, the specific cortical regions activated during exercise training remain largely undefined. In this study, we quantitatively and objectively evaluated the effects of exercise on brain activity during walking in healthy older adults. A total of 24 elderly women (75-83 years old) were randomly allocated to either an intervention group or a control group. Those in the intervention group attended 3 months of biweekly 90-min sessions focused on aerobic exercise, strength training, and physical therapy. We monitored changes in regional cerebral glucose metabolism during walking in both groups using positron emission tomography (PET) and [ 18 F]fluorodeoxyglucose (FDG). All subjects completed the 3-month experiment and the adherence to the exercise program was 100%. Compared with the control group, the intervention group showed a significantly greater step length in the right foot after 3 months of physical activity. The FDG-PET assessment revealed a significant post-intervention increase in regional glucose metabolism in the left posterior entorhinal cortex, left superior temporal gyrus, and right superior temporopolar area in the intervention group. Interestingly, the control group showed a relative increase in regional glucose metabolism in the left premotor and supplemental motor areas, left and right somatosensory association cortex, and right primary visual cortex after the 3-month period. We found no significant differences in FDG uptake between the intervention and control groups before vs. after the intervention. Exercise training increased activity in specific brain regions, such as the precuneus and entorhinal cortices, which play an important role in episodic and spatial memory. Further

  18. Pelvic Static Magnetic Stimulation to Control Urinary Incontinence in Older Women: A Randomized Controlled Trial

    Science.gov (United States)

    Wallis, Marianne C.; Davies, Elizabeth A.; Thalib, Lukman; Griffiths, Susan

    2012-01-01

    Objectives To determine the efficacy of non-invasive static magnetic stimulation (SMS) of the pelvic floor compared to placebo in the treatment of women aged 60 years and over with urinary incontinence for 6 months or more. Subjects and Methods A single-blinded randomized, placebo-controlled, parallel-group trial. Subjects were excluded if they had an implanted electronic device, had experienced a symptomatic urinary tract infection, or had commenced pharmacotherapy for the same in the previous 4 weeks, or if they were booked for pelvic floor or gynecological surgery within the next 3 months. Once written consent was obtained, subjects were randomly assigned to the active SMS group (n=50) or the placebo group (n=51). Treatment was an undergarment incorporating 15 static magnets of 800–1200 Gauss anterior, posterior, and inferior to the pelvis for at least 12 hours a day for 3 months. Placebo was the same protocol with inert metal disks replacing the magnets. Primary outcome measure was cessation of incontinence as measured by a 24-hour pad test. Secondary outcomes were frequency and severity of symptoms as measured by the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF), the Incontinence Severity Index, a Bothersomeness Visual Analog scale, and a 24-hour bladder diary. Data were collected at baseline and 12 weeks later. Results There were no statistically significant differences between groups in any of the outcome measures from baseline to 12 weeks. Initial evidence of subjective improvement in the treatment group compared to the placebo group was not sustained with sensitivity analysis. Conclusion This study found no evidence that static magnets cure or decrease the symptoms of urinary incontinence. Additional work into the basic physics of the product and garment design is recommended prior to further clinical trials research. PMID:21817123

  19. Plasma progranulin and relaxin levels in PCOS women with normal BMI compared to control healthy subjects

    Directory of Open Access Journals (Sweden)

    Samad Akbarzadeh

    2013-09-01

    Full Text Available Background: Poly Cystic Ovary Syndrome (PCOS is the most commonly encountered endocrine gland disease affecting 5-10 present of women at their reproductive age. This syndrome is associated with type 2 diabetes, dyslipidemia, and obesity. Progranulin and relaxin are adipokins that are related with carbohydrate and lipid metabolism. Due to limited data about progranulin and relaxin plasma levels´ in women with PCOS and normal BMI, this study was conducted. Material and Methods: This study is a cross-sectional. During the study 39 women with PCOS and BMI< 25 on the basis of Rotterdam criteria were chosen as the patient group and 38 healthy women were selected as the control group. The concentration of progranulin and relaxin were measured by ELISA technique. Results: The difference in Plasma concentration of progranulin and relaxin, and also some of the biochemical parameters in the patient group versus to the control group was not significant, but there was significant difference in the concentrations of VLDL, triglyceride (p=0.046, insulin (p=0.016, HOMA-IR (p=0.015, testosterone (p=0.01, and DHEAS (p=0.034 in the patients group compared to the control group. Conclusion: In this study, the difference in Plasma concentration of progranulin and relaxin in the patient group compared to the control group was not significant. It could be inferred that lack of change in plasma level of progranulin and relaxin in women with PCOS is related to BMI<25 and FBS<110. Moreoverestosterones, insulin, DHEAS and HOMA-IR changes could be better predictors of PCOS and its associated diabetes.

  20. BDNF serum levels are not related to cognitive functioning in older depressed patients and controls

    NARCIS (Netherlands)

    Dols, A.; Thesing, C.; Bouckaert, F.; Oude Voshaar, R.C.; Comijs, H.C.; Stek, M.L.

    2015-01-01

    Background: Depression and cognitive decline are highly prevalent in older persons and both are associated with low serum brain derived neurotrophic factor (BDNF). Mutual pathways of depression and cognitive decline in older persons may explain the overlap in symptoms and low serum BDNF. We

  1. BDNF serum levels are not related to cognitive functioning in older depressed patients and controls

    NARCIS (Netherlands)

    Dols, Annemiek; Thesing, Carisha S.; Bouckaert, Filip; Oude Voshaar, Richard; Comijs, Hannie C.; Stek, M. L.

    Background: Depression and cognitive decline are highly prevalent in older persons and both are associated with low serum brain derived neurotrophic factor (BDNF). Mutual pathways of depression and cognitive decline in older persons may explain the overlap in symptoms and low serum BDNF. We

  2. (Cost)effectiveness of life review for Older Adults: Design of a randomized controlled trial

    NARCIS (Netherlands)

    Pot, A.M.; Melenhorst, A.S.; Onrust, S.; Bohlmeijer, E.

    2008-01-01

    Background Depression in older adults is a serious health problem with a poor prognosis. There is a need for indicated preventive psychological interventions for older adults, that show to be promising in preventing depressive disorders. Methods/design This manuscript describes the design of a study

  3. (Cost)effectiveness of life review for Older Adults: Design of a randomized controlled trial

    NARCIS (Netherlands)

    Pot, A.M.; Melenhorst, A.S.; Onrust, S.; Bohlmeijer, E.

    2008-01-01

    Background. Depression in older adults is a serious health problem with a poor prognosis. There is a need for indicated preventive psychological interventions for older adults, that show to be promising in preventing depressive disorders. Methods/design. This manuscript describes the design of a

  4. (Cost)effectiveness of life review for older adults : design of a randomized controlled trial

    NARCIS (Netherlands)

    Pot, Anne Margriet; Melenhorst, Anne-Sophie; Onrust, Simone; Bohlmeijer, Ernst T.

    2008-01-01

    Background: Depression in older adults is a serious health problem with a poor prognosis. There is a need for indicated preventive psychological interventions for older adults, that show to be promising in preventing depressive disorders. Methods/design: This manuscript describes the design of a

  5. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life

    OpenAIRE

    Ho, Hsiu-Yu; Chen, Mei-Hui; Lou, Meei-Fang

    2018-01-01

    Hsiu-Yu Ho,1,2 Mei-Hui Chen,2,3 Meei-Fang Lou1 1School of Nursing, College of Medicine, National Taiwan University, 2Department of Nursing, Yuanpei University of Medical Technology, 3National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China Background: Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adult...

  6. The Role of Health Locus of Control in Predicting Depression Symptoms in a Sample of Iranian Older Adults with Chronic Diseases.

    Science.gov (United States)

    Aflakseir, Abdul-Aziz; Mohammad-Abadi, Mohammad-Saleh

    2016-04-01

    The purpose of this study was to examine the prediction of depression on a group of Iranian older adults based on components of health locus of control. Sixty-six men and 42 women over the age of 55 were recruited from the retirement clubs in Shiraz, using convenience sampling. The participants completed the research questionnaires including the Geriatric Depression Scale (GDS) and the Multidimensional Health Locus of Control Scale (MHLC). The findings on health locus of control revealed that the highest score was on internal locus of control followed by God, powerful others and chance. The mean score on depression was on a normal range. Multiple regression analysis showed that two independent variables including internal control (ß = -.32, p control (ß = -.20, = p locus of control such as chance and powerful others as well as age did not predict depression. Findings also revealed that the independents variables explained 26% of the total variance of depression (R2 = .26, p locus of control on depression.

  7. Relational Stability in the Expression of Normality, Variation, and Control of Thyroid Function

    Science.gov (United States)

    Hoermann, Rudolf; Midgley, John E. M.; Larisch, Rolf; Dietrich, Johannes W.

    2016-01-01

    Thyroid hormone concentrations only become sufficient to maintain a euthyroid state through appropriate stimulation by pituitary thyroid-stimulating hormone (TSH). In such a dynamic system under constant high pressure, guarding against overstimulation becomes vital. Therefore, several defensive mechanisms protect against accidental overstimulation, such as plasma protein binding, conversion of T4 into the more active T3, active transmembrane transport, counter-regulatory activities of reverse T3 and thyronamines, and negative hypothalamic–pituitary–thyroid feedback control of TSH. TSH has gained a dominant but misguided role in interpreting thyroid function testing in assuming that its exceptional sensitivity thereby translates into superior diagnostic performance. However, TSH-dependent thyroid disease classification is heavily influenced by statistical analytic techniques such as uni- or multivariate-defined normality. This demands a separation of its conjoint roles as a sensitive screening test and accurate diagnostic tool. Homeostatic equilibria (set points) in healthy subjects are less variable and do not follow a pattern of random variation, rather indicating signs of early and progressive homeostatic control across the euthyroid range. In the event of imminent thyroid failure with a reduced FT4 output per unit TSH, conversion efficiency increases in order to maintain FT3 stability. In such situations, T3 stability takes priority over set point maintenance. This suggests a concept of relational stability. These findings have important implications for both TSH reference limits and treatment targets for patients on levothyroxine. The use of archival markers is proposed to facilitate the homeostatic interpretation of all parameters. PMID:27872610

  8. The control effect in a detached laminar boundary layer of an array of normal synthetic jets

    Science.gov (United States)

    Valenzuela Calva, Fernando; Avila Rodriguez, Ruben

    2016-11-01

    In this work, 3D numerical simulations of an array of three normal circular synthetic jets embedded in an attached laminar boundary layer that separates under the influence of an inclined flap are performed for flow separation control. At the beginning of the present study, three cases are used to validate the numerical simulation with data obtained from experiments. The experimental data is chosen based on the cases which presented higher repeatability and reliability. Simulations showed reasonable agreement when compared with experiments. The simulations are undertaken at three synthetic jet operating conditions, i.e. Case A: L = 2, VR = 0.32; Case B: L = 4, VR = 0.64 and Case C: L = 6, VR = 0.96. The vortical structures produced for each synthetic jet operating condition are hairpin vortices for Case A and tilted vortices for Case B and C, respectively. By examining the spatial wall shear stress variations, the effect on the boundary layer prior to separation of the middle synthetic jet is evaluated. For effective flow control, produced at a relatively low the finding from this study suggests that hairpin vortical structures are more desirable structures. Universidad Nacional Autonoma de Mexico.

  9. MicroRNAs in Control of Stem Cells in Normal and Malignant Hematopoiesis.

    Science.gov (United States)

    Roden, Christine; Lu, Jun

    2016-09-01

    Studies on hematopoietic stem cells (HSCs) and leukemia stem cells (LSCs) have helped to establish the paradigms of normal and cancer stem cell concepts. For both HSCs and LSCs, specific gene expression programs endowed by their epigenome functionally distinguish them from their differentiated progenies. MicroRNAs (miRNAs), as a class of small non-coding RNAs, act to control post-transcriptional gene expression. Research in the past decade has yielded exciting findings elucidating the roles of miRNAs in control of multiple facets of HSC and LSC biology. Here we review recent progresses on the functions of miRNAs in HSC emergence during development, HSC switch from a fetal/neonatal program to an adult program, HSC self-renewal and quiescence, HSC aging, HSC niche, and malignant stem cells. While multiple different miRNAs regulate a diverse array of targets, two common themes emerge in HSC and LSC biology: miRNA mediated regulation of epigenetic machinery and cell signaling pathways. In addition, we propose that miRNAs themselves behave like epigenetic regulators, as they possess key biochemical and biological properties that can provide both stability and alterability to the epigenetic program. Overall, the studies of miRNAs in stem cells in the hematologic contexts not only provide key understandings to post-transcriptional gene regulation mechanisms in HSCs and LSCs, but also will lend key insights for other stem cell fields.

  10. Control of upper airway muscle activity in younger versus older men during sleep onset

    Science.gov (United States)

    Fogel, Robert B; White, David P; Pierce, Robert J; Malhotra, Atul; Edwards, Jill K; Dunai, Judy; Kleverlaan, Darci; Trinder, John

    2003-01-01

    Pharyngeal dilator muscles are clearly important in the pathophysiology of obstructive sleep apnoea syndrome (OSA). We have previously shown that the activity of both the genioglossus (GGEMG) and tensor palatini (TPEMG) are decreased at sleep onset, and that this decrement in muscle activity is greater in the apnoea patient than in healthy controls. We have also previously shown this decrement to be greater in older men when compared with younger ones. In order to explore the mechanisms responsible for this decrement in muscle activity nasal continuous positive airway pressure (CPAP) was applied to reduce negative pressure mediated muscle activation. We then investigated the effect of sleep onset (transition from predominantly α to predominantly θ EEG activity) on ventilation, upper airway muscle activation and upper airway resistance (UAR) in middle-aged and younger healthy men. We found that both GGEMG and TPEMG were reduced by the application of nasal CPAP during wakefulness, but that CPAP did not alter the decrement in activity in either muscle seen in the first two breaths following an α to θ transition. However, CPAP prevented both the rise in UAR at sleep onset that occurred on the control night, and the recruitment in GGEMG seen in the third to fifth breaths following the α to θ transition. Further, GGEMG was higher in the middle-aged men than in the younger men during wakefulness and was decreased more in the middle-aged men with the application of nasal CPAP. No differences were seen in TPEMG between the two age groups. These data suggest that the initial sleep onset reduction in upper airway muscle activity is due to loss of a ‘wakefulness’ stimulus, rather than to loss of responsiveness to negative pressure. In addition, it suggests that in older men, higher wakeful muscle activity is due to an anatomically more collapsible upper airway with more negative pressure driven muscle activation. Sleep onset per se does not appear to have a greater

  11. The relation between depression, coping and health locus of control: differences between older and younger patients, with and without cancer.

    Science.gov (United States)

    Aarts, Jurian W F; Deckx, Laura; van Abbema, Doris L; Tjan-Heijnen, Vivianne C G; van den Akker, Marjan; Buntinx, Frank

    2015-08-01

    Depression is an important health issue in cancer patients. People use different coping strategies and health locus of control to manage stressful situations, which relate to different risks of depression. Coping strategies and health locus of control can be changed by cognitive behavioral interventions. In a cohort study, we investigated differences in coping strategy and health locus of control in older (≥70 years) and middle-aged (50-69 years) cancer patients, and older patients without cancer (≥70 years), and their association with presence of depression. We also investigated how these factors interact. We used the short version of the Utrecht Coping List, the Multidimensional Health Locus of Control scale, and the 15-item Geriatric Depression Scale. Data were available from 1317 participants. Overall prevalence of depression was 12%. Older cancer patients tended to use an avoiding coping strategy more frequently than middle-aged cancer patients. This was associated with higher risk of depression. Older cancer patients less often used an active coping strategy, in comparison with middle-aged cancer patients, which was associated with a lower risk of depression. Especially in women using a seeking social support strategy, there was a lower risk of depression. Overall, the internal health locus of control was associated with higher and the external 'powerful others' locus with lower risk of depression. Older cancer patients strongly differ from middle-aged cancer patients, in particular with respect to coping. Interventions to prevent or alleviate depression should incorporate these differences. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Aging and insulin signaling differentially control normal and tumorous germline stem cells.

    Science.gov (United States)

    Kao, Shih-Han; Tseng, Chen-Yuan; Wan, Chih-Ling; Su, Yu-Han; Hsieh, Chang-Che; Pi, Haiwei; Hsu, Hwei-Jan

    2015-02-01

    Aging influences stem cells, but the processes involved remain unclear. Insulin signaling, which controls cellular nutrient sensing and organismal aging, regulates the G2 phase of Drosophila female germ line stem cell (GSC) division cycle in response to diet; furthermore, this signaling pathway is attenuated with age. The role of insulin signaling in GSCs as organisms age, however, is also unclear. Here, we report that aging results in the accumulation of tumorous GSCs, accompanied by a decline in GSC number and proliferation rate. Intriguingly, GSC loss with age is hastened by either accelerating (through eliminating expression of Myt1, a cell cycle inhibitory regulator) or delaying (through mutation of insulin receptor (dinR) GSC division, implying that disrupted cell cycle progression and insulin signaling contribute to age-dependent GSC loss. As flies age, DNA damage accumulates in GSCs, and the S phase of the GSC cell cycle is prolonged. In addition, GSC tumors (which escape the normal stem cell regulatory microenvironment, known as the niche) still respond to aging in a similar manner to normal GSCs, suggesting that niche signals are not required for GSCs to sense or respond to aging. Finally, we show that GSCs from mated and unmated females behave similarly, indicating that female GSC-male communication does not affect GSCs with age. Our results indicate the differential effects of aging and diet mediated by insulin signaling on the stem cell division cycle, highlight the complexity of the regulation of stem cell aging, and describe a link between ovarian cancer and aging. © 2014 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

  13. Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults.

    Science.gov (United States)

    Pociask, Fredrick D; DiZazzo-Miller, Rosanne; Goldberg, Allon; Adamo, Diane E

    2016-01-01

    Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  14. Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias

    Directory of Open Access Journals (Sweden)

    Felipe B. Schuch

    Full Text Available Objective: To evaluate the antidepressant effects of exercise in older adults, using randomized controlled trial (RCT data. Methods: We conducted a meta-analysis of exercise in older adults, addressing limitations of previous works. RCTs of exercise interventions in older people with depression (≥ 60 years comparing exercise vs. control were eligible. A random-effects meta-analysis calculating the standardized mean difference (SMD (95% confidence interval [95%CI], meta-regressions, and trim, fill, and fail-safe number analyses were conducted. Results: Eight RCTs were included, representing 138 participants in exercise arms and 129 controls. Exercise had a large and significant effect on depression (SMD = -0.90 [95%CI -0.29 to -1.51], with a fail-safe number of 71 studies. Significant effects were found for 1 mixed aerobic and anaerobic interventions, 2 at moderate intensity, 3 that were group-based, 4 that utilized mixed supervised and unsupervised formats, and 5 in people without other clinical comorbidities. Conclusion: Adjusting for publication bias increased the beneficial effects of exercise in three subgroup analysis, suggesting that previous meta-analyses have underestimated the benefits of exercise due to publication bias. We advocate that exercise be considered as a routine component of the management of depression in older adults.

  15. Normalizing the Paranormal: Short-term and Long-term Change in Belief in the Paranormal among Older Learners during a Short Course.

    Science.gov (United States)

    Banziger, George

    1983-01-01

    Participants in a summer Elderhostel program, all of whom were 55 years of age or over, were exposed to a one-week course on parapsychology which emphasized skeptical inquiry. As a result of the course, the older adults became more skeptical in their belief of the paranormal. (RM)

  16. Volume-controlled histographic analysis of pulmonary parenchyma in normal and diffuse parenchymal lung disease: a pilot study

    International Nuclear Information System (INIS)

    Park, Hyo Yong; Lee, Jongmin; Kim, Jong Seob; Won, Chyl Ho; Kang, Duk Sik; Kim, Myoung Nam

    2000-01-01

    To evaluate the clinical usefulness of a home-made histographic analysis system using a lung volume controller. Our study involved ten healthy volunteers, ten emphysema patients, and two idiopathic pulmonary fibrosis (IPF) patients. Using a home-made lung volume controller, images were obtained in the upper, middle, and lower lung zones at 70%, 50%, and 20% of vital capacity. Electron beam tomography was used and scanning parameters were single slice mode, 10-mm slice thickness, 0.4-second scan time, and 35-cm field of view. Usinga home-made semi-automated program, pulmonary parenchyma was isolated and a histogrm then obtained. Seven histographic parameters, namely mean density (MD), density at maximal frequency (DMF), maximal ascending gradient (MAG),maximal ascending gradient density (MAGD), maximal sescending gradient (MDG), maximal descending gradient density (MDGD), and full width at half maximum (FWHM) were derived from the histogram. We compared normal controls with abnormal groups including emphysema and IPF patients at the same respiration levels. A normal histographic zone with ± 1 standard deviation was obtained. Histographic curves of normal controls shifted toward the high density level, and the width of the normal zone increased as the level of inspiration decreased. In ten normal controls, MD, DMF, MAG, MAGD, MDG, MDGD, and FWHM readings at a 70% inspiration level were lower than those at 20% (p less than0.05). At the same level of inspiration, histograms of emphysema patients were locatedat a lower density area than those of normal controls. As inspiration status decreased, histograms of emphysema patients showed diminished shift compared with those of normal controls. At 50% and 20% inspiration levels, the MD, DMF, and MAGD readings of emphysema patients were significantly lower than those of normal controls (p less than 0.05). Compared with those of normal controls, histogrms of the two IPF patients obtained at three inspiration levels were

  17. Volume-controlled histographic analysis of pulmonary parenchyma in normal and diffuse parenchymal lung disease: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyo Yong; Lee, Jongmin; Kim, Jong Seob; Won, Chyl Ho; Kang, Duk Sik [School of Medicine, Kyungpook National University, Taegu (Korea, Republic of); Kim, Myoung Nam [The University of Iowa (United States)

    2000-06-01

    To evaluate the clinical usefulness of a home-made histographic analysis system using a lung volume controller. Our study involved ten healthy volunteers, ten emphysema patients, and two idiopathic pulmonary fibrosis (IPF) patients. Using a home-made lung volume controller, images were obtained in the upper, middle, and lower lung zones at 70%, 50%, and 20% of vital capacity. Electron beam tomography was used and scanning parameters were single slice mode, 10-mm slice thickness, 0.4-second scan time, and 35-cm field of view. Usinga home-made semi-automated program, pulmonary parenchyma was isolated and a histogrm then obtained. Seven histographic parameters, namely mean density (MD), density at maximal frequency (DMF), maximal ascending gradient (MAG),maximal ascending gradient density (MAGD), maximal sescending gradient (MDG), maximal descending gradient density (MDGD), and full width at half maximum (FWHM) were derived from the histogram. We compared normal controls with abnormal groups including emphysema and IPF patients at the same respiration levels. A normal histographic zone with {+-} 1 standard deviation was obtained. Histographic curves of normal controls shifted toward the high density level, and the width of the normal zone increased as the level of inspiration decreased. In ten normal controls, MD, DMF, MAG, MAGD, MDG, MDGD, and FWHM readings at a 70% inspiration level were lower than those at 20% (p less than0.05). At the same level of inspiration, histograms of emphysema patients were locatedat a lower density area than those of normal controls. As inspiration status decreased, histograms of emphysema patients showed diminished shift compared with those of normal controls. At 50% and 20% inspiration levels, the MD, DMF, and MAGD readings of emphysema patients were significantly lower than those of normal controls (p less than 0.05). Compared with those of normal controls, histogrms of the two IPF patients obtained at three inspiration levels were

  18. Can cognitive enhancers reduce the risk of falls in older people with Mild Cognitive Impairment? A protocol for a randomised controlled double blind trial

    Directory of Open Access Journals (Sweden)

    Wells Jennie L

    2009-08-01

    Full Text Available Abstract Background Older adults with cognitive problems have a higher risk of falls, at least twice that of cognitively normal older adults. The consequences of falls in this population are very serious: fallers with cognitive problems suffer more injuries due to falls and are approximately five times more likely to be admitted to institutional care. Although the mechanisms of increased fall risk in cognitively impaired people are not completely understood, it is known that impaired cognitive abilities can reduce attentional resource allocation while walking. Since cognitive enhancers, such as cholinesterase inhibitors, improve attention and executive function, we hypothesise that cognitive enhancers may reduce fall risk in elderly people in the early stages of cognitive decline by improving their gait and balance performance due to an enhancement in attention and executive function. Method/Design Double blinded randomized controlled trial with 6 months follow-up in 140 older individuals with Mild Cognitive Impairment (MCI. Participants will be randomized to the intervention group, receiving donepezil, and to the control group, receiving placebo. A block randomization by four and stratification based on fall history will be performed. Primary outcomes are improvements in gait velocity and reduction in gait variability. Secondary outcomes are changes in the balance confidence, balance sway, attention, executive function, and number of falls. Discussion By characterizing and understanding the effects of cognitive enhancers on fall risk in older adults with cognitive impairments, we will be able to pave the way for a new approach to fall prevention in this population. This RCT study will provide, for the first time, information regarding the effect of a medication designed to augment cognitive functioning have on the risk of falls in older adults with Mild Cognitive Impairment. We expect a significant reduction in the risk of falls in this

  19. Rat optic nerve head anatomy within 3D histomorphometric reconstructions of normal control eyes.

    Science.gov (United States)

    Pazos, Marta; Yang, Hongli; Gardiner, Stuart K; Cepurna, William O; Johnson, Elaine C; Morrison, John C; Burgoyne, Claude F

    2015-10-01

    The purpose of this study is to three-dimensionally (3D) characterize the principal macroscopic and microscopic relationships within the rat optic nerve head (ONH) and quantify them in normal control eyes. Perfusion-fixed, trephinated ONH from 8 normal control eyes of 8 Brown Norway Rats were 3D histomorphometrically reconstructed, visualized, delineated and parameterized. The rat ONH consists of 2 scleral openings, (a superior neurovascular and inferior arterial) separated by a thin connective tissue strip we have termed the "scleral sling". Within the superior opening, the nerve abuts a prominent extension of Bruch's Membrane (BM) superiorly and is surrounded by a vascular plexus, as it passes through the sclera, that is a continuous from the choroid into and through the dural sheath and contains the central retinal vein (CRV), (inferiorly). The inferior scleral opening contains the central retinal artery and three long posterior ciliary arteries which obliquely pass through the sclera to obtain the choroid. Bruch's Membrane Opening (BMO) is irregular and vertically elongated, enclosing the nerve (superiorly) and CRV and CRA (inferiorly). Overall mean BMO Depth, BMO Area, Choroidal Thickness and peripapillary Scleral Thickness were 29 μm, 56.5 × 10(3) μm(2), 57 μm and 104 μm respectively. Mean anterior scleral canal opening (ASCO) and posterior scleral canal opening (PSCO) radii were 201 ± 15 μm and 204 ± 16 μm, respectively. Mean optic nerve area at the ASCO and PSCO were 46.3 × 10(3)±4.4 × 10(3) μm(2) and 44.1 × 10(3)±4.5 × 10(3) μm(2) respectively. In conclusion, the 3D complexity of the rat ONH and the extent to which it differs from the primate have been under-appreciated within previous 2D studies. Properly understood, these anatomic differences may provide new insights into the relative susceptibilities of the rat and primate ONH to elevated intraocular pressure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults †.

    Science.gov (United States)

    Frames, Christopher W; Soangra, Rahul; Lockhart, Thurmon E; Lach, John; Ha, Dong Sam; Roberto, Karen A; Lieberman, Abraham

    2018-05-24

    Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m², using a force plate and an inertial measurement unit affixed at the sternum. Participants' fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

  1. PROBLEMS EMERGING FROM THE CARE OF OLDER PEOPLE:WHO CARE, WHO PAY AND WHO CONTROL

    Directory of Open Access Journals (Sweden)

    Ayşe Canatan

    2011-07-01

    Full Text Available Population of the world is aging rapidly because ofdeveloping technology abouthealth system and decreasing ratio of child bearing. The care of older people isone of the important problems of the social world in every where. This problem isnot seen as actual yet in Turkey. But population ofTurkey increases rapidly.Enrolling to a social security system is not sufficient to economic independency ofolder people. Modernization made some changes to traditional society. Forexample women work outside of home, children g otokindergartens in early ages.Families are living inside small apartments. All these changes effect also olderpeople. They do not find any place in nuclear family. People in their old ages haveto live lonely up to their need to care. Elderly care is the big problem ofthemselves and their adult children or their closerelatives. Who do care ourelderly, who pay the care and who control the care.Our social security law mustbe developed to provide of the needs of elderly population especially coming thatsounds like an avalanche. In this presentation it will be given a frame of problemand its solutions.

  2. Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Christopher W. Frames

    2018-05-01

    Full Text Available Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

  3. Norovirus Infection in Older Adults: Epidemiology, Risk Factors, and Opportunities for Prevention and Control.

    Science.gov (United States)

    Cardemil, Cristina V; Parashar, Umesh D; Hall, Aron J

    2017-12-01

    Norovirus is the leading cause of acute gastroenteritis. In older adults, it is responsible for an estimated 3.7 million illnesses; 320,000 outpatient visits; 69,000 emergency department visits; 39,000 hospitalizations; and 960 deaths annually in the United States. Older adults are particularly at risk for severe outcomes, including prolonged symptoms and death. Long-term care facilities and hospitals are the most common settings for norovirus outbreaks in developed countries. Diagnostic platforms are expanding. Several norovirus vaccines in clinical trials have the potential to reap benefits. This review summarizes current knowledge on norovirus infection in older adults. Published by Elsevier Inc.

  4. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Ellis, Graham; Whitehead, Martin A; Robinson, David; O'Neill, Desmond; Langhorne, Peter

    2011-10-27

    To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency. We searched the EPOC Register, Cochrane's Controlled Trials Register, the Database of Abstracts of Reviews of Effects (DARE), Medline, Embase, CINAHL, AARP Ageline, and handsearched high yield journals. Randomised controlled trials of comprehensive geriatric assessment (whether by mobile teams or in designated wards) compared with usual care. Comprehensive geriatric assessment is a multidimensional interdisciplinary diagnostic process used to determine the medical, psychological, and functional capabilities of a frail elderly person to develop a coordinated and integrated plan for treatment and long term follow-up. Three independent reviewers assessed eligibility and trial quality and extracted published data. Two additional reviewers moderated. Twenty two trials evaluating 10,315 participants in six countries were identified. For the primary outcome "living at home," patients who underwent comprehensive geriatric assessment were more likely to be alive and in their own homes at the end of scheduled follow-up (odds ratio 1.16 (95% confidence interval 1.05 to 1.28; P = 0.003; number needed to treat 33) at a median follow-up of 12 months versus 1.25 (1.11 to 1.42; P P P = 0.001) and were more likely to experience improved cognition (standardised mean difference 0.08, 0.01 to 0.15; P = 0.02) in the comprehensive geriatric assessment group. Comprehensive geriatric assessment increases patients' likelihood of being alive and in their own homes after an emergency admission to hospital. This seems to be especially true for trials of wards designated for comprehensive geriatric assessment and is associated with a potential cost reduction compared with general medical care.

  5. Identification of peripheral inflammatory markers between normal control and Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Jo Sangmee

    2011-05-01

    Full Text Available Abstract Background Multiple pathogenic factors may contribute to the pathophysiology of Alzheimer's disease (AD. Peripheral blood markers have been used to assess biochemical changes associated with AD and mild cognitive impairment (MCI and involved in their pathophysiology. Methods Plasma samples and clinical data were obtained from participants in the Ansan Geriatric Study (AGE study. Plasma concentrations of four candidate biomarkers were measured in the normal control (NC, MCI, and AD group: interleukin-8 (IL-8, IL-10, monocyte chemoattractant protein-1 (MCP-1, and tumor necrosis factor-α (TNF-α. Body mass index (BMI, MMSE (Mini Mental State Examination, CDR(Clinical Dementia Rating score and homocystein level were recorded with social and demographic information. Results Total of 59 subjects were randomly selected for this analysis [NC (n = 21, MCI(n = 20 and AD(n = 18]. In demographic data, educational year was correlated with the diagnosis states (p p Conclusions Our study suggests the existence of an independent and negative relationship between plasma IL-8 levels and functional status in MCI and AD patients.

  6. A new normalizing algorithm for BAC CGH arrays with quality control metrics.

    Science.gov (United States)

    Miecznikowski, Jeffrey C; Gaile, Daniel P; Liu, Song; Shepherd, Lori; Nowak, Norma

    2011-01-01

    The main focus in pin-tip (or print-tip) microarray analysis is determining which probes, genes, or oligonucleotides are differentially expressed. Specifically in array comparative genomic hybridization (aCGH) experiments, researchers search for chromosomal imbalances in the genome. To model this data, scientists apply statistical methods to the structure of the experiment and assume that the data consist of the signal plus random noise. In this paper we propose "SmoothArray", a new method to preprocess comparative genomic hybridization (CGH) bacterial artificial chromosome (BAC) arrays and we show the effects on a cancer dataset. As part of our R software package "aCGHplus," this freely available algorithm removes the variation due to the intensity effects, pin/print-tip, the spatial location on the microarray chip, and the relative location from the well plate. removal of this variation improves the downstream analysis and subsequent inferences made on the data. Further, we present measures to evaluate the quality of the dataset according to the arrayer pins, 384-well plates, plate rows, and plate columns. We compare our method against competing methods using several metrics to measure the biological signal. With this novel normalization algorithm and quality control measures, the user can improve their inferences on datasets and pinpoint problems that may arise in their BAC aCGH technology.

  7. Space Deficits in Parkinson’s Disease Patients: Quantitative or Qualitative Differences from Normal Controls?

    Directory of Open Access Journals (Sweden)

    D. Natsopoulos

    1993-01-01

    Full Text Available Twenty-seven patients with idiopathic Parkinson's disease (PD and the same number of normal controls (NCs were studied on a test battery including five conceptual categories of spatial ability. The two groups of subjects were matched for age, sex, years of education, socioeconomic status and non-verbal (Raven Standard Progressive Matrices intelligence. A multivariate analysis of variance (MANOVA showed that the PD patients performed less efficiently on almost all the tasks. A logistic regression analysis (LRA classified 81.48% of the subjects into the PD group and 92.59% into NC group, indicating that left-right and back-front Euclidean orientation, three dimensional mental rotation and visuospatial immediate recognition memory of mirror image patterns discriminate well between the two groups. Application of a structural model (confirmatory factor analysis demonstrated that both PD patients and the NC group stemmed from a homogeneous population, suggesting that the differences found between the two groups are of a quantitative rather than of a qualitative nature.

  8. PET imaging and quantitation of Internet-addicted patients and normal controls

    Science.gov (United States)

    Jeong, Ha-Kyu; Kim, Hee-Joung; Jung, Haijo; Son, Hye-Kyung; Kim, Dong-Hyeon; Yun, Mijin; Shin, Yee-Jin; Lee, Jong-Doo

    2002-04-01

    Internet addicted patients (IAPs) have widely been increased, as Internet games are becoming very popular in daily life. The purpose of this study was to investigate regional brain activation patterns associated with excessive use of Internet games in adolescents. Six normal controls (NCs) and eight IAPs who were classified as addiction group by adapted version of DSM-IV for pathologic gambling were participated. 18F-FDG PET studies were performed for all adolescents at their rest and activated condition after 20 minutes of each subject's favorite Internet game. To investigate quantitative metabolic differences in both groups, all possible combinations of group comparison were carried out using Statistical Parametric Mapping (SPM 99). Regional brain activation foci were identified on Talairach coordinate. SPM results showed increased metabolic activation in occipital lobes for both groups. Higher metabolisms were seen at resting condition in IAPs than that of in NCs. In comparison to both groups, IAPs showed different patterns of regional brain metabolic activation compared with that of NCs. It suggests that addictive use of Internet games may result in functional alteration of developing brain in adolescents.

  9. A New Normalizing Algorithm for BAC CGH Arrays with Quality Control Metrics

    Directory of Open Access Journals (Sweden)

    Jeffrey C. Miecznikowski

    2011-01-01

    Full Text Available The main focus in pin-tip (or print-tip microarray analysis is determining which probes, genes, or oligonucleotides are differentially expressed. Specifically in array comparative genomic hybridization (aCGH experiments, researchers search for chromosomal imbalances in the genome. To model this data, scientists apply statistical methods to the structure of the experiment and assume that the data consist of the signal plus random noise. In this paper we propose “SmoothArray”, a new method to preprocess comparative genomic hybridization (CGH bacterial artificial chromosome (BAC arrays and we show the effects on a cancer dataset. As part of our R software package “aCGHplus,” this freely available algorithm removes the variation due to the intensity effects, pin/print-tip, the spatial location on the microarray chip, and the relative location from the well plate. removal of this variation improves the downstream analysis and subsequent inferences made on the data. Further, we present measures to evaluate the quality of the dataset according to the arrayer pins, 384-well plates, plate rows, and plate columns. We compare our method against competing methods using several metrics to measure the biological signal. With this novel normalization algorithm and quality control measures, the user can improve their inferences on datasets and pinpoint problems that may arise in their BAC aCGH technology.

  10. Making working memory work: A meta-analysis of executive control and working memory training in younger and older adults

    OpenAIRE

    Karbach, Julia; Verhaeghen, Paul

    2014-01-01

    This meta-analysis examined the effects of process-based cognitive training (49 studies) in the domains of executive function and working memory in older adults (>60 years). The interventions resulted in significant effects on the trained task (pre-to-posttest net gain: MSD = 0.5 compared to active control, MSD = 0.8 compared to passive control; net posttest effect: MSD = 1.2 compared to active control, MSD = 1.1 compared to passive control), significant near transfer (pre-post: MSD = 0.3, 0....

  11. Clinical and psychological features of normal-weight women with subthreshold anorexia nervosa: a pilot case-control observational study.

    Science.gov (United States)

    Tagliabue, Anna; Ferraris, Cinzia; Martinelli, Valentina; Pinelli, Giovanna; Repossi, Ilaria; Trentani, Claudia

    2012-01-01

    Weight preoccupations have been frequently reported in normal-weight subjects. Subthreshold anorexia nervosa (s-AN, all DSM IV TR criteria except amenorrhea or underweight) is a form of eating disorder not otherwise specified that has received scarce scientific attention. Under a case-control design we compared the general characteristics, body composition, and psychopathological features of normal-weight patients with s-AN with those of BMI- and sex-matched controls. Participants in this pilot study included 9 normal-weight women who met the DSM IV TR criteria for s-AN and 18 BMI-matched normal-weight controls. The general characteristics of the study participants were collected by questionnaire. Body composition was measured by bioelectrical impedance. Behavioral and psychological measures included the standardized symptom checklist (SCL-90-R) and the eating disorder inventory (EDI-2). There were no differences in age, education, employment status, marital status, and history of previous slimming treatment in the two study groups. In addition, anthropometric measures and body composition of s-AN patients and BMI-matched normal weight controls were not significantly different. In the s-AN subgroup, we found a significant relationship between waist circumference and the SCL-90-R obsessivity-compulsivity scale (n=9, r=-0.69, pstudy cohort. These pilot results suggest that psychopathological criteria (particularly related to the obsessivity-compulsivity dimension) may be more useful than anthropometric measures for screening of s-AN in normal-weight women.

  12. Effects of regular Tai Chi practice and jogging on neuromuscular reaction during lateral postural control in older people.

    Science.gov (United States)

    Wang, Shao-Jun; Xu, Dong-Qing; Li, Jing-Xian

    2017-01-01

    This study examined the effects of regular Tai Chi practice and jogging on the neuromuscular activity of the trunk, hip, and ankle joint muscles of older people during lateral postural perturbation. A total of 42 older people participated in the study and formed the Tai Chi, jogging, and sedentary control groups. Electromyography signals were collected from the peroneus longus, anterior tibialis, gluteus medius, and erector spinae during unpredictable mediolateral perturbation. The Tai Chi group exhibited significantly faster latencies of the tibialis anterior and erector spinae than the control group. The jogging group showed a significantly shorter neuromuscular reaction time of the erector spinae than the control group. No significant difference was observed between the Tai Chi and jogging groups. Long-term regular Tai Chi practice enhanced the neuromuscular reaction of the erector spinae and tibialis anterior to lateral perturbation and will help timely posture correction when lateral postural distributions occur.

  13. Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Dafna Merom

    2016-08-01

    Full Text Available The prevention of falls among older people is a major public health challenge. Exercises that challenge balance are recognized as an efficacious fall prevention strategy. Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults, two of the strongest risk factors for falls in older people, this study aimed to determine whether social dance is effective in i reducing the number of falls and ii improving physical and cognitive fall-related risk factors.A parallel two-arm cluster randomized controlled trial was undertaken in 23 self-care retirement villages (clusters around Sydney, Australia. Eligible villages had to have an appropriate hall for dancing, house at least 60 residents, and not be currently offering dance as a village activity. Retirement villages were randomised using a computer generated randomisation method, constrained using minimisation. Eligible participants had to be a resident of the village, be able to walk at least 50 m, and agree to undergo physical and cognitive testing without cognitive impairment. Residents of intervention villages (12 clusters were offered twice weekly one-hour social dancing classes (folk or ballroom dancing over 12 mo (80 h in total. Programs were standardized across villages and were delivered by eight dance teachers. Participants in the control villages (11 clusters were advised to continue with their regular activities.falls during the 12 mo trial and Trail Making Tests.The Physiological Performance Assessment (i.e., postural sway, proprioception, reaction time, leg strength and the Short Physical Performance Battery; health-related physical and mental quality of life from the Short-Form 12 (SF-12 Survey. Data on falls were obtained from 522 of 530 (98% randomised participants (mean age 78 y, 85% women and 424 (80% attended the 12-mo reassessment, which was lower among folk dance participants (71% than ballroom dancing (82% or control

  14. Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.

    Science.gov (United States)

    Sungkarat, Somporn; Boripuntakul, Sirinun; Chattipakorn, Nipon; Watcharasaksilp, Kanokwan; Lord, Stephen R

    2017-04-01

    To examine whether combined center- and home-based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment (a-MCI). Randomized controlled trial. Chiang Mai, Thailand. Adults aged 60 and older who met Petersen's criteria for multiple-domain a-MCI (N = 66). Three weeks center-based and 12 weeks home-based Tai Chi (50 minutes per session, 3 times per week). Cognitive tests, including Logical Memory (LM) delayed recall, Block Design, Digit Span forward and backward, and Trail-Making Test Part B-A (TMT B-A), and fall risk index using the Physiological Profile Assessment (PPA). At the end of the trial, performance on LM, Block Design, and TMT B-A were significantly better for the Tai Chi group than the control group after adjusting for baseline test performance. The Tai Chi group also had significantly better composite PPA score and PPA parameter scores: knee extension strength, reaction time, postural sway, and lower limb proprioception. Combined center- and home-based Tai Chi training three times per week for 15 weeks significantly improved cognitive function and moderately reduced physiological fall risk in older adults with multiple-domain a-MCI. Tai Chi may be particularly beneficial to older adults with this condition. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  15. Outcomes of a Peer Mentor Implemented Fitness Program in Older Adults: A Quasi-Randomized Controlled Trial

    Science.gov (United States)

    Dorgo, Sandor; King, George A.; Bader, Julia O.; Limon, John S.

    2013-01-01

    Objectives To investigate the effectiveness of different applications of mentoring in an older adult exercise program, this study compared the physical fitness scores, the retention and participation rates of older adults trained by student mentors, peer mentors, peer mentors working independently of the researchers, and a non-exercising control group. Methods 106 older adults were recruited and assigned to one of the groups using quasi-randomization. All three experimental groups completed a 14-week intervention. Pre- and post-training assessments of fitness were completed, and retention and participation rates were compared. Results High retention and participation rates, as well as significant improvements in fitness scores from baseline to post-test were observed in all three mentored groups. While the control group showed improvement only in one fitness test, subjects in the mentored groups improved similarly in all measures, regardless of the type of mentoring received. Discussion These findings indicated effectiveness of the peer mentor model and suggested that with adequate preparation peer mentors may be capable of guiding older adult participants effectively without assistance from professional staff. PMID:23279966

  16. Higher Intake of Fruit, but Not Vegetables or Fiber, at Baseline Is Associated with Lower Risk of Becoming Overweight or Obese in Middle-Aged and Older Women of Normal BMI at Baseline123

    Science.gov (United States)

    Rautiainen, Susanne; Wang, Lu; Lee, I-Min; Manson, JoAnn E; Buring, Julie E; Sesso, Howard D

    2015-01-01

    Background: Fruit, vegetable, and dietary fiber intake have been associated with lower risk of cardiovascular disease (CVD); however, little is known about their role in obesity prevention. Objective: Our goal was to investigate whether intake of fruits, vegetables, and dietary fiber is associated with weight change and the risk of becoming overweight and obese. Methods: We studied 18,146 women aged ≥45 y from the Women’s Health Study free of CVD and cancer with an initial body mass index (BMI) of 18.5 to Fruit, vegetable, and dietary fiber intakes were assessed at baseline through a 131-item food-frequency questionnaire, along with obesity-related risk factors. Women self-reported body weight on annual questionnaires. Results: During a mean follow-up of 15.9 y, 8125 women became overweight or obese (BMI ≥25 kg/m2). Intakes of total fruits and vegetables, fruits, and dietary fiber were not associated with the longitudinal changes in body weight, whereas higher vegetable intake was associated with greater weight gain (P-trend: 0.02). In multivariable analyses, controlling for total energy intake and physical activity along with other lifestyle, clinical, and dietary factors, women in the highest vs. lowest quintile of fruit intake had an HR of 0.87 (95% CI: 0.80, 0.94; P-trend: 0.01) of becoming overweight or obese. No association was observed for vegetable or dietary fiber intake. The association between fruit intake and risk of becoming overweight or obese was modified by baseline BMI (P-interaction: fruit, but not vegetables or fiber, by middle-aged and older women with a normal BMI at baseline is associated with lower risk of becoming overweight or obese. PMID:25934663

  17. Higher Intake of Fruit, but Not Vegetables or Fiber, at Baseline Is Associated with Lower Risk of Becoming Overweight or Obese in Middle-Aged and Older Women of Normal BMI at Baseline.

    Science.gov (United States)

    Rautiainen, Susanne; Wang, Lu; Lee, I-Min; Manson, JoAnn E; Buring, Julie E; Sesso, Howard D

    2015-05-01

    Fruit, vegetable, and dietary fiber intake have been associated with lower risk of cardiovascular disease (CVD); however, little is known about their role in obesity prevention. Our goal was to investigate whether intake of fruits, vegetables, and dietary fiber is associated with weight change and the risk of becoming overweight and obese. We studied 18,146 women aged ≥45 y from the Women's Health Study free of CVD and cancer with an initial body mass index (BMI) of 18.5 to Fruit, vegetable, and dietary fiber intakes were assessed at baseline through a 131-item food-frequency questionnaire, along with obesity-related risk factors. Women self-reported body weight on annual questionnaires. During a mean follow-up of 15.9 y, 8125 women became overweight or obese (BMI ≥25 kg/m²). Intakes of total fruits and vegetables, fruits, and dietary fiber were not associated with the longitudinal changes in body weight, whereas higher vegetable intake was associated with greater weight gain (P-trend: 0.02). In multivariable analyses, controlling for total energy intake and physical activity along with other lifestyle, clinical, and dietary factors, women in the highest vs. lowest quintile of fruit intake had an HR of 0.87 (95% CI: 0.80, 0.94; P-trend: 0.01) of becoming overweight or obese. No association was observed for vegetable or dietary fiber intake. The association between fruit intake and risk of becoming overweight or obese was modified by baseline BMI (P-interaction: fruit, but not vegetables or fiber, by middle-aged and older women with a normal BMI at baseline is associated with lower risk of becoming overweight or obese. © 2015 American Society for Nutrition.

  18. A Developmental Study of Static Postural Control and Superimposed Arm Movements in Normal and Slowly Developing Children.

    Science.gov (United States)

    Fisher, Janet M.

    Selected electromyographic parameters underlying static postural control in 4, 6, and 8 year old normally and slowly developing children during performance of selected arm movements were studied. Developmental delays in balance control were assessed by the Cashin Test of Motor Development (1974) and/or the Williams Gross Motor Coordination Test…

  19. Postural control during one-leg stance in active and sedentary older people

    Directory of Open Access Journals (Sweden)

    Leonardo George Victorio Victor

    2014-09-01

    Full Text Available Physical inactivity and aging are functional disability factors for older individuals, causing loss of balance and increasing the risk of falls. The purpose of this study was to compare the balance of physically independent older individuals, both participants and non-participants in a regular exercise program. Fifty six physically independent older participants were divided into G1ACTIVE = 28 individuals who participate in a regular exercise program and G2SEDENTARY = 28 individuals who did not participate in any physical exercise program. All participants underwent an eyes-open during one-leg balance test on a force platform. The postural oscillation parameters included center of pressure (COP; sway mean velocity and frequency of COP oscillations. G2 SEDENTARY showed higher postural instability than G1ACTIVE. Significant differences were observed for the main balance parameters. The results of this study support the concept that participation in regular physical activity is beneficial for postural balance of older individuals.

  20. Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review.

    Science.gov (United States)

    Laufer, Yocheved; Dar, Gali; Kodesh, Einat

    2014-01-01

    Exercise programs that challenge an individual's balance have been shown to reduce the risk of falls among older adults. Virtual reality computer-based technology that provides the user with opportunities to interact with virtual objects is used extensively for entertainment. There is a growing interest in the potential of virtual reality-based interventions for balance training in older adults. This work comprises a systematic review of the literature to determine the effects of intervention programs utilizing the Nintendo Wii console on balance control and functional performance in independently functioning older adults. STUDIES WERE OBTAINED BY SEARCHING THE FOLLOWING DATABASES: PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus, and Google Scholar, followed by a hand search of bibliographic references of the included studies. Included were randomized controlled trials written in English in which Nintendo Wii Fit was used to enhance standing balance performance in older adults and compared with an alternative exercise treatment, placebo, or no treatment. Seven relevant studies were retrieved. The four studies examining the effect of Wii-based exercise compared with no exercise reported positive effects on at least one outcome measure related to balance performance in older adults. Studies comparing Wii-based training with alternative exercise programs generally indicated that the balance improvements achieved by Wii-based training are comparable with those achieved by other exercise programs. The review indicates that Wii-based exercise programs may serve as an alternative to more conventional forms of exercise aimed at improving balance control. However, due to the great variability between studies in terms of the intervention protocols and outcome measures, as well as methodological limitations, definitive recommendations as to optimal treatment protocols and the potential of such an intervention as a safe and effective home-based treatment cannot be made at this

  1. Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review

    Science.gov (United States)

    Laufer, Yocheved; Dar, Gali; Kodesh, Einat

    2014-01-01

    Background Exercise programs that challenge an individual’s balance have been shown to reduce the risk of falls among older adults. Virtual reality computer-based technology that provides the user with opportunities to interact with virtual objects is used extensively for entertainment. There is a growing interest in the potential of virtual reality-based interventions for balance training in older adults. This work comprises a systematic review of the literature to determine the effects of intervention programs utilizing the Nintendo Wii console on balance control and functional performance in independently functioning older adults. Methods Studies were obtained by searching the following databases: PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus, and Google Scholar, followed by a hand search of bibliographic references of the included studies. Included were randomized controlled trials written in English in which Nintendo Wii Fit was used to enhance standing balance performance in older adults and compared with an alternative exercise treatment, placebo, or no treatment. Results Seven relevant studies were retrieved. The four studies examining the effect of Wii-based exercise compared with no exercise reported positive effects on at least one outcome measure related to balance performance in older adults. Studies comparing Wii-based training with alternative exercise programs generally indicated that the balance improvements achieved by Wii-based training are comparable with those achieved by other exercise programs. Conclusion The review indicates that Wii-based exercise programs may serve as an alternative to more conventional forms of exercise aimed at improving balance control. However, due to the great variability between studies in terms of the intervention protocols and outcome measures, as well as methodological limitations, definitive recommendations as to optimal treatment protocols and the potential of such an intervention as a safe and effective home

  2. The Effects of Performance Fatigability on Postural Control and Rehabilitation in the Older Patient

    OpenAIRE

    Papa, Evan V.; Hassan, Mahdi; Bugnariu, Nicoleta

    2016-01-01

    Fatigue is common in older adults and has a significant effect on quality of life. Despite the high prevalence of fatigue in older individuals, several aspects are poorly understood. It is important to differentiate subjective fatigue complaints from fatigability of motor performance because the two are independent constructs with potentially distinct consequences on mobility. Performance fatigability is the magnitude of change in a performance criterion over a given time of task performance....

  3. Home-based exercise program and fall-risk reduction in older adults with multiple sclerosis: phase 1 randomized controlled trial.

    Science.gov (United States)

    Sosnoff, Jacob J; Finlayson, Marcia; McAuley, Edward; Morrison, Steve; Motl, Robert W

    2014-03-01

    To determine the feasibility, safety, and efficacy of a home-based exercise intervention targeting fall risk in older adults with multiple sclerosis. A randomized controlled pilot trial. A home-based exercise program. Participants were randomly allocated to either a home-based exercise intervention group (n = 13) or a waiting list control group (n = 14). The exercise group completed exercises targeting lower muscle strength and balance three times a week for 12 weeks. The control group continued normal activity. Fall risk (Physiological Profile Assessment scores), balance (Berg Balance Scale), and walking testing prior to and immediately following the 12-week intervention. Each outcome measure was placed in an analysis of covariance with group as the between-subject factor and baseline values as the covariate. Effect sizes were calculated. Twelve participants from the control group and ten from the exercise group completed the study. There were no related adverse events. Fall risk was found to decrease in the exercise group following the intervention (1.1 SD 1.0 vs. 0.6 SD 0.6) while there was an increase in fall risk in the control group (1.9 SD 1.5 vs. 2.2 SD 1.9). Effect sizes for most outcomes were large (η(2) > 0.15). Home-based exercise was found to be feasible, safe, and effective for reducing physiological fall risk in older adults with multiple sclerosis. Our findings support the implementation of a larger trial to reduce fall risk in persons with multiple sclerosis.

  4. Cognitive Remediation in Middle-Aged or Older Inpatients with Chronic Schizophrenia: A Randomized Controlled Trial in Korea

    Directory of Open Access Journals (Sweden)

    Kee-Hong Choi

    2018-02-01

    Full Text Available Background: Accumulating evidence indicates that cognitive remediation (CR is effective for improving various cognitive deficits in adult patients with schizophrenia. Although reports of brain plasticity in older adults and the service needs for chronic patients with schizophrenia are increasing, very few randomized controlled trials of CR have been conducted in middle-aged or older inpatients with chronic schizophrenia. We investigated the efficacy of individualized CR on the cognitive impairments of middle-aged or older inpatients with chronic schizophrenia within the context of comprehensive psychiatric rehabilitation (PR by comparing the results obtained with PR only and treatment as usual (TAU.Method: Fifty-seven middle-aged and older individuals with chronic schizophrenia and mild to moderate cognitive deficits were enrolled. Thirty-eight who were undergoing PR were randomly assigned to CR + PR (N = 19 or PR-only (N = 19 groups. Nineteen participants who were undergoing TAU without CR or PR were evaluated pre- and post-treatment.Results: CR was easily provided and well received (drop-out rates = 5.3% by middle-aged or older psychiatric inpatients. Compared to the PR-Only or TAU patients, patients in the CR + PR group showed greater improvement in executive functioning. Compared to TAU patients, CR + PR and PR-only patients showed greater improvement in logical memory. More patients in the CR + PR group improved clinically significantly in executive functioning and logical memory, compared with the PR-only and TAU patients.Conclusions: These results suggested that CR improved some cognitive deficits in middle-aged or older inpatients with chronic schizophrenia and that it was effective as an adjunctive treatment to the usual PR services provided in inpatient settings.Clinical Registration: KCT0002609

  5. White matter hyperintensities and cognitive reserve during a working memory task: a functional magnetic resonance imaging study in cognitively normal older adults.

    Science.gov (United States)

    Fernández-Cabello, Sara; Valls-Pedret, Cinta; Schurz, Matthias; Vidal-Piñeiro, Dídac; Sala-Llonch, Roser; Bargallo, Nuria; Ros, Emilio; Bartrés-Faz, David

    2016-12-01

    Cognitive reserve (CR) models posit that lifestyle factors such as education modulate the relationship between brain damage and cognition. However, the functional correlates of CR in healthy aging are still under investigation. White matter hyperintensities (WMHs) are a common age-associated finding that impacts cognition. In this study, we used functional magnetic resonance imaging to characterize the patterns of brain activation during a working memory task in older participants with high and low levels of education (as a proxy of CR) and high and low WMH volumes. Ninety older volunteers (aged 63-76 years) and 16 young adults (aged 21-27) completed the study. We found that older adults with higher education had better working memory performance than their less educated peers. Among the highly educated participants, those with WMH over-recruited areas engaged by young volunteers and showed activation in additional cortical and subcortical structures. However, those with low WMH differed little with respect to their younger counterparts. Our findings demonstrate that the functional mechanisms subtending the effects of education, as a proxy of CR, are modulated according to the WMH burden. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Maturation of Speech and Language Functional Neuroanatomy in Pediatric Normal Controls

    Science.gov (United States)

    Devous, Michael D., Sr.; Altuna, Dianne; Furl, Nicholas, Cooper, William; Gabbert, Gretchen; Ngai, Wei Tat; Chiu, Stephanie; Scott, Jack M., III; Harris, Thomas S.; Payne, J. Kelly; Tobey, Emily A.

    2006-01-01

    Purpose: This study explores the relationship between age and resting-state regional cerebral blood flow (rCBF) in regions associated with higher order language skills using a population of normal children, adolescents, and young adults. Method: rCBF was measured in 33 normal participants between the ages of 7 and 19 years using single photon…

  7. Control-group feature normalization for multivariate pattern analysis of structural MRI data using the support vector machine.

    Science.gov (United States)

    Linn, Kristin A; Gaonkar, Bilwaj; Satterthwaite, Theodore D; Doshi, Jimit; Davatzikos, Christos; Shinohara, Russell T

    2016-05-15

    Normalization of feature vector values is a common practice in machine learning. Generally, each feature value is standardized to the unit hypercube or by normalizing to zero mean and unit variance. Classification decisions based on support vector machines (SVMs) or by other methods are sensitive to the specific normalization used on the features. In the context of multivariate pattern analysis using neuroimaging data, standardization effectively up- and down-weights features based on their individual variability. Since the standard approach uses the entire data set to guide the normalization, it utilizes the total variability of these features. This total variation is inevitably dependent on the amount of marginal separation between groups. Thus, such a normalization may attenuate the separability of the data in high dimensional space. In this work we propose an alternate approach that uses an estimate of the control-group standard deviation to normalize features before training. We study our proposed approach in the context of group classification using structural MRI data. We show that control-based normalization leads to better reproducibility of estimated multivariate disease patterns and improves the classifier performance in many cases. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial

    Science.gov (United States)

    Ballesteros, Soledad; Prieto, Antonio; Mayas, Julia; Toril, Pilar; Pita, Carmen; Ponce de León, Laura; Reales, José M.; Waterworth, John

    2014-01-01

    Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-h non-action video game training sessions with games selected from a commercially available package (Lumosity) on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended three meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time), attention (reduction of distraction and increase of alertness), immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM) and executive control (shifting strategy) did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others. PMID:25352805

  9. Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial.

    Science.gov (United States)

    Ballesteros, Soledad; Prieto, Antonio; Mayas, Julia; Toril, Pilar; Pita, Carmen; Ponce de León, Laura; Reales, José M; Waterworth, John

    2014-01-01

    Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-h non-action video game training sessions with games selected from a commercially available package (Lumosity) on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended three meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time), attention (reduction of distraction and increase of alertness), immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM) and executive control (shifting strategy) did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others.

  10. [A prospective control study of Saccharomyces boulardii in prevention of antibiotic-associated diarrhea in the older inpatients].

    Science.gov (United States)

    Zhang, D M; Xu, B B; Yu, L; Zheng, L F; Chen, L P; Wang, W

    2017-06-01

    Objective: To study the value of Saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in older inpatients. Methods: A total of 163 older patients who were treated with wide-spectrum antibiotics at least three days during January 2014 to December 2015 were randomly divided into control and study group. In study group, 81 patients were administrated with oral Saccharomyces boulardii 500 mg twice a day for 21 days. The control group was of no intervention. Morbidity rate of antibiotic-associated diarrhea and Clostridium difficile -associated diarrhea, frequency and duration of diarrhea were recorded. Results: The incidence of antibiotic-associated diarrhea in study group was significantly lower than that in control group [14.8%(12/81) vs 28.0%(23/82), P 0.05] in two groups. The frequency and duration of diarrhea in the study group were significantly lower and shorter than those in control group[(4.3±1.7) times/day vs (6.9±2.0) times/day; (3.0±1.1) days vs (5.7±1.8) days, both P Saccharomyces boulardii may reduce the incidence of antibiotic-associated diarrhea therefore improving the symptom of diarrhea in older inpatients.

  11. Evaluation of water balance in a population of older adults. A case control study.

    Science.gov (United States)

    Malisova, Olga; Poulia, Kalliopi-Anna; Kolyzoi, Kleoniki; Lysandropoulos, Athanasios; Sfendouraki, Kalliopi; Kapsokefalou, Maria

    2018-04-01

    Older adults are at risk for dehydration and its' potentially life-threatening consequences. Unrecognized dehydration can complicate chronic medical problems and increase morbidity. The objective of the study was to estimate water balance, intake and loss in elderly people living in Greece using the Water Balance Questionnaire (WBQ). WBQ was administered in winter to 108 independents (65-81yrs) (Group A), 94 independents (82-92yrs) (Group B) and 51 hospitalized (65-92yrs) (Group C). A database from previous study of 335 adults (18-65yrs) (Control Group) used for comparison. Mean estimates of water balance, intake and loss were, respectively, for Group A -749 ± 1386 mL/day, 2571 ± 739 mL/day and 3320 ± 1216 mL/day, for Group B -38 ± 933 mL/day, 2571 ± 739 mL/day and 3320 ± 1216 mL/day, for Group C 64 ± 1399 mL/day, 2586 ± 1071 mL/day and 2522 ± 1048 mL/day and for Control Group -253 ± 1495 mL/day, 2912 ± 1025 mL/day and 3492 ± 2099 mL/day. Significant differences were detected in water balance, intake and loss (p < 0.01). Water balance and water intake in Group A was the lowest. For Groups A, B, C and Control, contribution of solid foods to water intake was 36%, 29%, 32%, 25%, of drinking water was 32%, 48%, 45%, 47%, of beverages was 32%, 23%, 23% and 28% respectively. Significant differences observed in the contribution of drinking water and beverages (p < 0.01). Group A had lower water balance and water intake. Groups B and C had lower water intake from beverages. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  12. [Standard control for diabetes in older adults based on practice guidelines--the target values of blood glucose, blood pressure and lipids].

    Science.gov (United States)

    Sugimoto, Ken; Rakugi, Hiromi

    2013-11-01

    As for standard controls for life style diseases in older adults, the standard control for hypertension in elderly is defined in detail by the guideline for hypertension, however, that for diabetes or dyslipidemia is not clearly defined by each guideline although each has additional descriptions for elderly. The reports about 'Diabetes in Older Adults' and 'Standards of Medical Care in Diabetes 2013' have been published from American Diabetes Association (ADA), and the standard controls for diabetes might be reviewed in the light of these reports in Japan. Here we would like to consider the standard control and recent trends for diabetes in older adults on the basis of the current practice guidelines.

  13. Health-social partnership intervention programme for community-dwelling older adults: a research protocol for a randomized controlled trial.

    Science.gov (United States)

    Wong, Kwan Ching; Wong, Frances Kam Yuet; Chang, Katherine Ka Pik

    2015-11-01

    This paper aims to describe the research protocol that will be used to determine the effectiveness of a health-social partnership intervention programme among community-dwelling older adults. Ageing in place is a preferred option for overcoming challenges of the increasing prevalence of chronic diseases and the risk for hospitalization associated with the ageing population. Nevertheless, our knowledge of how to implement this concept is limited. The integrated efforts of health and social services may help to enable older adults to live with a sense of control over their daily life and to be independent to the fullest extent possible in the community. This is a randomized, controlled trial. Participants are community-dwelling older adults referred from a community centre. Sample size calculation was based on power analysis. The intervention group will receive the programme with the standard protocols guided by a comprehensive assessment-intervention-evaluation framework. Home visits and telephones follow-up will be employed as means of conducting the interventions and monitoring their progress. The customary care group will receive placebo social calls. The duration of the interventions will be 3 months. The study was funded by the School of Nursing in Hong Kong. Research Ethics Committee approval was obtained in September 2014. The results of this research are expected to enable older adults to stay in the community with optimal health and well-being. Health and social sciences are integrated into the practice in this research protocol. The scarce literature on this topic means that this study can also provide an opportunity to bridge the caring gap among older adults. © 2015 John Wiley & Sons Ltd.

  14. Hospital at Home care for older patients with cognitive impairment: a protocol for a randomised controlled feasibility trial.

    Science.gov (United States)

    Pouw, Maaike A; Calf, Agneta H; van Munster, Barbara C; Ter Maaten, Jan C; Smidt, Nynke; de Rooij, Sophia E

    2018-03-27

    An acute hospital admission is a stressful life event for older people, particularly for those with cognitive impairment. The hospitalisation is often complicated by hospital-associated geriatric syndromes, including delirium and functional loss, leading to functional decline and nursing home admission. Hospital at Home care aims to avoid hospitalisation-associated adverse outcomes in older patients with cognitive impairment by providing hospital care in the patient's own environment. This randomised, non-blinded feasibility trial aims to assess the feasibility of conducting a randomised controlled trial in terms of the recruitment, use and acceptability of Hospital at Home care for older patients with cognitive impairment. The quality of care will be evaluated and the advantages and disadvantages of the Hospital at Home care programme compared with usual hospital care. Eligible patients will be randomised either to Hospital at Home care in their own environment or usual hospital care. The intervention consists of hospital level care provided at patients' homes, including visits from healthcare professionals, diagnostics (laboratory tests, blood cultures) and treatment. The control group will receive usual hospital care. Measurements will be conducted at baseline, during admission, at discharge and at 3 and 6 months after the baseline assessment. Institutional ethics approval has been granted. The findings will be disseminated through public lectures, professional and scientific conferences, as well as peer-reviewed journal articles. The study findings will contribute to knowledge on the implementation of Hospital at Home care for older patients with cognitive disorders. The results will be used to inform and support strategies to deliver eligible care to older patients with cognitive impairment. e020313; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

  15. Distinguishing patients with Parkinson's disease subtypes from normal controls based on functional network regional efficiencies.

    Directory of Open Access Journals (Sweden)

    Delong Zhang

    Full Text Available Many studies have demonstrated that the pathophysiology and clinical symptoms of Parkinson's disease (PD are inhomogeneous. However, the symptom-specific intrinsic neural activities underlying the PD subtypes are still not well understood. Here, 15 tremor-dominant PD patients, 10 non-tremor-dominant PD patients, and 20 matched normal controls (NCs were recruited and underwent resting-state functional magnetic resonance imaging (fMRI. Functional brain networks were constructed based on randomly generated anatomical templates with and without the cerebellum. The regional network efficiencies (i.e., the local and global efficiencies were further measured and used to distinguish subgroups of PD patients (i.e., with tremor-dominant PD and non-tremor-dominant PD from the NCs using linear discriminant analysis. The results demonstrate that the subtype-specific functional networks were small-world-organized and that the network regional efficiency could discriminate among the individual PD subgroups and the NCs. Brain regions involved in distinguishing between the study groups included the basal ganglia (i.e., the caudate and putamen, limbic regions (i.e., the hippocampus and thalamus, the cerebellum, and other cerebral regions (e.g., the insula, cingulum, and calcarine sulcus. In particular, the performances of the regional local efficiency in the functional network were better than those of the global efficiency, and the performances of global efficiency were dependent on the inclusion of the cerebellum in the analysis. These findings provide new evidence for the neurological basis of differences between PD subtypes and suggest that the cerebellum may play different roles in the pathologies of different PD subtypes. The present study demonstrated the power of the combination of graph-based network analysis and discrimination analysis in elucidating the neural basis of different PD subtypes.

  16. Long-term effect of physical activity counseling on mobility limitation among older people: a randomized controlled study

    DEFF Research Database (Denmark)

    Mänty, Minna Regina; Heinonen, Ari; Leinonen, Raija

    2009-01-01

    counseling-induced benefits persist after cessation of the intervention. METHODS: In a 2-year, single-blinded, randomized controlled study, 632 sedentary participants aged 75-81 years were randomly assigned into the intervention (n = 318) or control (n = 314) group. The intervention group received a single......BACKGROUND: Physical activity counseling increases physical activity among older people, but its effectiveness on mobility, that is, maintaining the ability to move independently, is unknown. We studied the effect of physical activity counseling on mobility among older people and evaluated whether...... individualized physical activity counseling session with a supportive telephone contact every 4 months for 2 years. The outcome measures-perceived difficulty in advanced (walking 2 km) and basic (walking 0.5 km) mobility-were gathered semiannually during the intervention and the 1.5-year postintervention follow...

  17. Cancer and frailty in older adults: a nested case-control study of the Mexican Health and Aging Study

    Science.gov (United States)

    Pérez-Zepeda, Mario Ulises; Cárdenas-Cárdenas, Eduardo; Cesari, Matteo; Navarrete-Reyes, Ana Patricia; Gutiérrez-Robledo, Luis Miguel

    2016-01-01

    Purpose Understanding how the convergence between chronic and complex diseases—such as cancer—and emerging conditions of older adults—such as frailty—takes place would help in halting the path that leads to disability in this age group. The objective of this manuscript is to describe the association between a past medical history of cancer and frailty in Mexican older adults. Methods This is a nested in cohort case-control study of the Mexican Health and Aging Study. Frailty was categorized by developing a 55-item frailty index that was also used to define cases in two ways: incident frailty (incident >0.25 frailty index score) and worsening frailty (negative residuals from a regression between 2001 and 2012 frailty index scores). Exposition was defined as self-report of cancer between 2001 and 2012. Older adults with a cancer history were further divided into recently diagnosed (10 years from the initial diagnosis). Odds ratios were estimated by fitting a logistic regression adjusted for confounding variables. Results Out of a total of 8022 older adults with a mean age of 70.6 years, the prevalence of a past medical history of cancer was 3.6 % (n = 288). Among these participants, 45.1 % had been diagnosed with cancer more than 10 years previously. A higher risk of incident frailty compared to controls [odds ratio (OR) 1.53 (95 % confidence interval (CI) 1.04–2.26, p = 0.03); adjusted model OR 1.74 (95 % CI 1.15–2.61, p = 0.008)] was found in the group with a recent cancer diagnosis. Also, an inverse association between a remote cancer diagnosis and worsening frailty was found [OR = 0.56 (95 % CI 0.39–0.8), p = 0.002; adjusted model OR 0.61 (95 % CI 0.38–0.99, p = 0.046)]. Conclusions Cancer is associated with a higher frailty index, with a potential relevant role of the time that has elapsed since the cancer diagnosis. Implications for cancer survivors Cancer survivors may be more likely to develop frailty or worsening of the health status at an

  18. A positive association between active lifestyle and hemispheric lateralization for motor control and learning in older adults.

    Science.gov (United States)

    Wang, Jinsung; D'Amato, Arthur; Bambrough, Jennifer; Swartz, Ann M; Miller, Nora E

    2016-11-01

    Physical activity (PA) is well known to have general health benefits for older adults, but it is unclear whether it can also positively affect brain function involved in motor control and learning. We have previously shown that interlimb transfer of visuomotor adaptation occurs asymmetrically in young adults, while that occurs symmetrically in older adults, which suggests that the lateralized function of each hemisphere during motor tasks is diminished with aging. Here, we investigated the association between the level of PA and hemispheric motor lateralization by comparing the pattern of interlimb transfer following visuomotor adaptation between physically active and inactive older adults. Subjects were divided into two groups based on their PA level (active, inactive). They were further divided into two groups, such that a half of the subjects in each group adapted to a 30° rotation during targeted reaching movements with the left arm first, then with the right arm; and the other half with the right arm first, then with the left arm. Results indicated asymmetrical transfer (from left to right only) in the active subjects, whereas symmetrical transfer (from left to right, and vice versa) was observed in the inactive subjects. These findings suggest that older adults who maintain active lifestyle have a central nervous system that is more intact in terms of its lateralized motor function as compared with those who are inactive. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial.

    Science.gov (United States)

    Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

    2011-01-01

    Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Participants (N = 34) were generally healthy, obese, older adult women (age range 55-79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle

  20. The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults.

    Science.gov (United States)

    Barnes, Deborah E; Santos-Modesitt, Wendy; Poelke, Gina; Kramer, Arthur F; Castro, Cynthia; Middleton, Laura E; Yaffe, Kristine

    2013-05-13

    The prevalence of cognitive impairment and dementia are projected to rise dramatically during the next 40 years, and strategies for maintaining cognitive function with age are critically needed. Physical or mental activity alone result in relatively small, domain-specific improvements in cognitive function in older adults; combined interventions may have more global effects. To examine the combined effects of physical plus mental activity on cognitive function in older adults. Randomized controlled trial with a factorial design. San Francisco, California. A total of 126 inactive, community-residing older adults with cognitive complaints. All participants engaged in home-based mental activity (1 h/d, 3 d/wk) plus class-based physical activity (1 h/d, 3 d/wk) for 12 weeks and were randomized to either mental activity intervention (MA-I; intensive computer) or mental activity control (MA-C; educational DVDs) plus exercise intervention (EX-I; aerobic) or exercise control (EX-C; stretching and toning); a 2 × 2 factorial design was used so that there were 4 groups: MA-I/EX-I, MA-I/EX-C, MA-C/EX-1, and MA-C/EX-C. Global cognitive change based on a comprehensive neuropsychological test battery. Participants had a mean age of 73.4 years; 62.7% were women, and 34.9% were Hispanic or nonwhite. There were no significant differences between the groups at baseline. Global cognitive scores improved significantly over time (mean, 0.16 SD; P mental activity, P = .74), or across all 4 randomization groups (P = .26). In inactive older adults with cognitive complaints, 12 weeks of physical plus mental activity was associated with significant improvements in global cognitive function with no evidence of difference between intervention and active control groups. These findings may reflect practice effects or may suggest that the amount of activity is more important than the type in this subject population. clinicaltrials.gov Identifier: NCT00522899.

  1. The Effects of Pilates Training on Balance Control and Self-Reported Health Status in Community-Dwelling Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Gabizon, Hadas; Press, Yan; Volkov, Ilia; Melzer, Itshak

    2016-07-01

    To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults. A single-blind, randomized, controlled trial. General community. A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44). The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention. Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period. Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status. The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

  2. Plasticity of attentional functions in older adults after non-action video game training: a randomized controlled trial.

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    Mayas, Julia; Parmentier, Fabrice B R; Andrés, Pilar; Ballesteros, Soledad

    2014-01-01

    A major goal of recent research in aging has been to examine cognitive plasticity in older adults and its capacity to counteract cognitive decline. The aim of the present study was to investigate whether older adults could benefit from brain training with video games in a cross-modal oddball task designed to assess distraction and alertness. Twenty-seven healthy older adults participated in the study (15 in the experimental group, 12 in the control group. The experimental group received 20 1-hr video game training sessions using a commercially available brain-training package (Lumosity) involving problem solving, mental calculation, working memory and attention tasks. The control group did not practice this package and, instead, attended meetings with the other members of the study several times along the course of the study. Both groups were evaluated before and after the intervention using a cross-modal oddball task measuring alertness and distraction. The results showed a significant reduction of distraction and an increase of alertness in the experimental group and no variation in the control group. These results suggest neurocognitive plasticity in the old human brain as training enhanced cognitive performance on attentional functions. ClinicalTrials.gov NCT02007616.

  3. Plasticity of attentional functions in older adults after non-action video game training: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Julia Mayas

    Full Text Available A major goal of recent research in aging has been to examine cognitive plasticity in older adults and its capacity to counteract cognitive decline. The aim of the present study was to investigate whether older adults could benefit from brain training with video games in a cross-modal oddball task designed to assess distraction and alertness. Twenty-seven healthy older adults participated in the study (15 in the experimental group, 12 in the control group. The experimental group received 20 1-hr video game training sessions using a commercially available brain-training package (Lumosity involving problem solving, mental calculation, working memory and attention tasks. The control group did not practice this package and, instead, attended meetings with the other members of the study several times along the course of the study. Both groups were evaluated before and after the intervention using a cross-modal oddball task measuring alertness and distraction. The results showed a significant reduction of distraction and an increase of alertness in the experimental group and no variation in the control group. These results suggest neurocognitive plasticity in the old human brain as training enhanced cognitive performance on attentional functions.ClinicalTrials.gov NCT02007616.

  4. Influence of visual control, conduction, and central integration on static and dynamic balance in healthy older adults.

    Science.gov (United States)

    Perrin, P P; Jeandel, C; Perrin, C A; Béné, M C

    1997-01-01

    Aging is associated with decreased balance abilities, resulting in an increased risk of fall. In order to appreciate the visual, somatosensory, and central signals involved in balance control, sophisticated methods of posturography assessment have been developed, using static and dynamic tests, eventually associated with electromyographic measurements. We applied such methods to a population of healthy older adults in order to appreciate the respective importance of each of these sensorial inputs in aging individuals. Posture control parameters were recorded on a force-measuring platform in 41 healthy young (age 28.5 +/- 5.9 years) and 50 older (age 69.8 +/- 5.9 years) adults, using a static test and two dynamic tests performed by all individuals first with eyes open, then with eyes closed. The distance covered by the center of foot pressure, sway area, and anteroposterior oscillations were significantly higher, with eyes open or closed, in older people than in young subjects. Significant differences were noted in dynamic tests with longer latency responses in the group of old people. Dynamic recordings in a sinusoidal test had a more regular pattern when performed eyes open in both groups and evidenced significantly greater instability in old people. These data suggest that vision remains important in maintaining postural control while conduction and central integration become less efficient with age.

  5. Effects of the anchor system on postural control in older Adults

    Directory of Open Access Journals (Sweden)

    Eliane Mauerberg de Castro

    2012-03-01

    Full Text Available Falls are common during aging, and can have drastic consequences. Within this context, maintaining the ability to balance plays an essential role in enabling older adults to continue to perform their daily activities. Therefore, the use of interventional and treatment tools for development of balance becomes essential. The objective of this study was to analyze the anchor system as a potential tool for decreasing body sway in older and young adults. Older adults had more postural sway than their young counterparts. The absence of visual information led to larger instability in both groups. The anchor system improved postural stability of both groups. Thus, it may be a useful tool for posture stabilization in old and young adults.

  6. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

    Science.gov (United States)

    Hughes, Carmel; Smith, Michael; Tunney, Michael; Bradley, Marie C

    2011-12-07

    Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2011, Issue 2), the Cochrane Wounds Group Specialised Register (searched May 27th, 2011). We also searched Ovid MEDLINE (from 1950 to April Week 2 2011), OVID MEDLINE (In-process and Other Non-Indexed Citations, April 26th 2011) Ovid EMBASE (1980 to 2011 Week 16), EBSCO CINAHL (1982 to April 21st 2011), DARE (1992 to 2011, week 16), Web of Science (1981 to May 2011), and the Health Technology Assessment (HTA) website (1988 to May 2011). Research in progress was sought through Current Clinical Trials (www.controlled-trials.com), Medical Research Council Research portfolio, and HSRPRoj (current USA projects). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this second update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection

  7. A randomised controlled intervention trial evaluating the efficacy of a Mediterranean dietary pattern on cognitive function and psychological wellbeing in healthy older adults: the MedLey study.

    Science.gov (United States)

    Knight, Alissa; Bryan, Janet; Wilson, Carlene; Hodgson, Jonathan; Murphy, Karen

    2015-04-28

    The incidence of age-related cognitive decline is rising considerably around the world. There is evidence from a number of recent cross-sectional and prospective studies indicating positive associations between the Mediterranean dietary pattern (MedDiet) and improved cognitive outcomes among the elderly including, reduced age-related cognitive decline and enhanced age-related cognitive performance. However, to date no study has validated these associations in healthy older adult populations (≥65 years and above) with randomised evidence. The main aim of the present study is to provide justified evidence regarding the efficacy of a MedDiet approach to safely reduce the onset of cognitive decline, and promote optimal cognitive performance among healthy older adults using rigorous, randomised intervention methodology. MedLey is a 6-month, randomised controlled 2-cohort parallel group intervention trial, with initial assessment at baseline and repeated every three months. A sample of 166 healthy Australian men and women aged 65 years and above, with normal cognitive function and proficient in English language were recruited from metropolitan Adelaide, South Australia for the study. Participants randomly allocated to the experimental group are required to maintain an intervention dietary pattern based from the traditional Cretan MedDiet (i.e. vegetables, fruits, olive oil, legumes, fish, whole grain cereals, nuts and seeds and low consumption of processed foods, dairy products, red meat and vegetable oils) for six months, while those participants allocated to the control group are asked to maintain their customary lifestyle and diet. The primary outcome of interest is the quantitative difference in age-related cognitive performance, as measured by latent variables (cognitive constructs) sensitive to normal ageing and diet (i.e. speed of processing, memory, attention, executive functions, visual spatial and visuomotor ability). Secondary outcomes include change in

  8. Effect of tailored on-road driving lessons on driving safety in older adults: A randomised controlled trial.

    Science.gov (United States)

    Anstey, Kaarin J; Eramudugolla, Ranmalee; Kiely, Kim M; Price, Jasmine

    2018-06-01

    We evaluated the effectiveness of individually tailored driving lessons compared with a road rules refresher course for improving older driver safety. Two arm parallel randomised controlled trial, involving current drivers aged 65 and older (Mean age 72.0, 47.4% male) residing in Canberra, Australia. The intervention group (n = 28) received a two-hour class-based road rules refresher course, and two one-hour driving lessons tailored to improve poor driving skills and habits identified in a baseline on-road assessment. The control group (n = 29) received the road rules refresher course only. Tests of cognitive performance, and on-road driving were conducted at baseline and at 12-weeks. Main outcome measure was the Driver safety rating (DSR) on the on-road driving test. The number of Critical Errors made during the on-road was also recorded. 55 drivers completed the trial (intervention group: 27, control group: 28). Both groups showed reduction in dangerous/hazardous driver errors that required instructor intervention. From baseline to follow-up there was a greater reduction in the number of critical errors made by the intervention group relative to the control group (IRR = 0.53, SE = 0.1, p = .008). The intervention group improved on the DSR more than the control group (intervention mean change = 1.07 SD = 2.00, control group mean change = 0.32 SD = 1.61). The intervention group had 64% remediation of unsafe driving, where drivers who achieved a score of 'fail' at baseline, 'passed' at follow-up. The control group had 25% remediation. Tailored driving lessons reduced the critical driving errors made by older adults. Longer term follow-up and larger trials are required. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Acute effects of muscle fatigue on anticipatory and reactive postural control in older individuals: a systematic review of the evidence.

    Science.gov (United States)

    Papa, Evan V; Garg, Hina; Dibble, Leland E

    2015-01-01

    Falls are the leading cause of traumatic brain injury and fractures and the No. 1 cause of emergency department visits by older adults. Although declines in muscle strength and sensory function contribute to increased falls in older adults, skeletal muscle fatigue is often overlooked as an additional contributor to fall risk. In an effort to increase awareness of the detrimental effects of skeletal muscle fatigue on postural control, we sought to systematically review research studies examining this issue. The specific purpose of this review was to provide a detailed assessment of how anticipatory and reactive postural control tasks are influenced by acute muscle fatigue in healthy older individuals. An extensive search was performed using the CINAHL, Scopus, PubMed, SPORTDiscus, and AgeLine databases for the period from inception of each database to June 2013. This systematic review used standardized search criteria and quality assessments via the American Academy for Cerebral Palsy and Developmental Medicine Methodology to Develop Systematic Reviews of Treatment Interventions (2008 version, revision 1.2, AACPDM, Milwaukee, Wisconsin). A total of 334 citations were found. Six studies were selected for inclusion, whereas 328 studies were excluded from the analytical review. The majority of articles (5 of 6) utilized reactive postural control paradigms. All studies incorporated extrinsic measures of muscle fatigue, such as declines in maximal voluntary contraction or available active range of motion. The most common biomechanical postural control task outcomes were spatial measures, temporal measures, and end-points of lower extremity joint kinetics. On the basis of systematic review of relevant literature, it appears that muscle fatigue induces clear deteriorations in reactive postural control. A paucity of high-quality studies examining anticipatory postural control supports the need for further research in this area. These results should serve to heighten

  10. Role of cellular oxalate in oxalate clearance of patients with calcium oxalate monohydrate stone formation and normal controls.

    Science.gov (United States)

    Oehlschläger, Sven; Fuessel, Susanne; Meye, Axel; Herrmann, Jana; Froehner, Michael; Albrecht, Steffen; Wirth, Manfred P

    2009-03-01

    To examine the cellular, plasma, and urinary oxalate and erythrocyte oxalate flux in patients with calcium oxalate monohydrate (COM) stone formation vs normal controls. Pathologic oxalate clearance in humans is mostly integrated in calcium oxalate stone formation. An underlying cause of deficient oxalate clearance could be defective transmembrane oxalate transport, which, in many tissues, is regulated by an anion exchanger (SLC26). We studied 2 groups: 40 normal controls and 41 patients with COM stone formation. Red blood cells were divided for cellular oxalate measurement and for resuspension in a buffered solution (pH 7.40); 0.1 mmol/L oxalate was added. The supernatant was measured for oxalate immediately and 1 hour after incubation. The plasma and urinary oxalate were analyzed in parallel. The mean cellular oxalate concentrations were significantly greater in the normal controls (5.25 +/- 0.47 micromol/L) than in those with COM stone formation (2.36 +/- 0.28 micromol/L; P stone formation (0.31 +/- 0.02 mmol/L) than in the controls (0.24 +/- 0.02 mmol/L; P r = 0.49-0.63; P r = -0.29-0.41; P r = -0.30; P r = 0.25; P stone formation. Our data implicate the presence of a cellular oxalate buffer to stabilize plasma and urinary oxalate concentrations in normal controls.

  11. "Doctor, Make My Decisions": Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults.

    Science.gov (United States)

    Chiu, Catherine; Feuz, Mariko A; McMahan, Ryan D; Miao, Yinghui; Sudore, Rebecca L

    2016-01-01

    Culturally diverse older adults may prefer varying control over medical decisions. Decision control preferences (DCPs) may profoundly affect advance care planning (ACP) and communication. To determine the DCPs of diverse, older adults and whether DCPs are associated with participant characteristics, ACP, and communication satisfaction. A total of 146 participants were recruited from clinics and senior centers in San Francisco. We assessed DCPs using the control preferences scale: doctor makes all decisions (low), shares with doctor (medium), makes own decisions (high). We assessed associations between DCPs and demographics; prior advance directives; ability to make in-the-moment goals of care decisions; self-efficacy, readiness, and prior asked questions; and satisfaction with patient-doctor communication (on a five-point Likert scale), using Chi-square and Kruskal-Wallis analysis of variance. Mean age was 71 ± 10 years, 53% were non-white, 47% completed an advance directive, and 70% made goals of care decisions. Of the sample, 18% had low DCPs, 33% medium, and 49% high. Older age was the only characteristic associated with DCPs (low: 75 ± 11 years, medium: 69 ± 10 years, high: 70 ± 9 years, P = 0.003). DCPs were not associated with ACP, in-the-moment decisions, or communication satisfaction. Readiness was the only question-asking behavior associated (low: 3.8 ± 1.2, medium: 4.1 ± 1.2, high: 4.3 ± 1.2, P = 0.05). Nearly one-fifth of diverse, older adults want doctors to make their medical decisions. Older age and lower readiness to ask questions were the only demographic variables significantly associated with low DCPs. Yet, older adults with low DCPs still engaged in ACP, asked questions, and reported communication satisfaction. Clinicians can encourage ACP and questions for all patients, but should assess DCPs to provide the desired amount of decision support. Copyright © 2016 American Academy of Hospice and Palliative Medicine. All

  12. Body image and weight control in South Africans 15 years or older: SANHANES-1.

    Science.gov (United States)

    Mchiza, Zandile J; Parker, Whadi-Ah; Makoae, Mokhantso; Sewpaul, Ronel; Kupamupindi, Takura; Labadarios, Demetre

    2015-09-30

    South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa. A cross-sectional survey and a secondary analyses of data were undertaken for 6 411 South Africans (15+ years) participating in the first South African National Health and Nutrition Examination Survey. Body image was investigated in relation to weight status and attempts to lose or gain weight. Data were analysed using STATA version 11.0. Descriptive statistics are presented as counts (numbers), percentages, means, standard error of means, and 95 % confidence intervals. Any differences in values were considered to be significantly different if the confidence intervals did not overlap. Overall, 84.5 % participants had a largely distorted body image and 45.3 % were highly dissatisfied about their body size. Overweight and obese participants under estimated their body size and desired to be thinner. On the other hand, normal- and under-weight participants over estimated their body size and desired to be fatter. Only 12.1 and 10.1 % of participants attempted to lose or gain weight, respectively, mainly by adjusting dietary intake and physical activity. Body mass index appears to influence body image and weight adjustment in South Africa. South Africans at the extreme ends of the body mass index range have a largely distorted body image and are highly dissatisfied by it. This suggests a need for health education and beneficial weight control strategies to halt the obesity epidemic in the country.

  13. Delayed postural control during self-generated perturbations in the frail older adults

    Directory of Open Access Journals (Sweden)

    Kubicki A

    2012-02-01

    Full Text Available Alexandre Kubicki1–3, François Bonnetblanc1,2, Geoffroy Petrement3, Yves Ballay1,2, France Mourey2,4¹UFR STAPS, Université de Bourgogne, Dijon, France; ²Motricité et Plasticité, Institut National de la Santé et de la Recherche Médicale (INSERM, Dijon, France; ³SARL Fovea Interactive, Campus Industriel – Espace Entreprises, Chalon sur Saône, France; 4UFR Médecine, Université de Bourgogne, Dijon, FrancePurpose: The aim of this study was to investigate the coordination between posture and movement in pathological aging (frailty in comparison with normal aging, with the hypothesis that in pathological aging, postural control evolves towards a more reactive mode for which the perturbation induced by the movement is not anticipated and leads to delayed and late postural adjustments.Methods: Elderly subjects performed rapid focal arm-raising movements towards a target, from an upright standing position in two stimuli conditions: simple reaction time and choice reaction time (CRT. Hand and center of pressure (CoP kinematics were compared between a control group and a frail group of the same age.Results: In frail individuals, the entire movement was impaired and slowed down. In addition, postural adjustments that classically precede and accompany the focal arm movement were delayed and reduced, especially in the CRT condition in which the motor prediction is more limited. Finally, a correlation between the time to CoP maximal velocity and the timed up-and-go score was observed.Conclusion: In these patients, it was concluded that the control of the CoP displacement evolved from a proactive mode in which the perturbation associated with the arm movement is anticipated toward a more reactive mode in which the perturbation is compensated by late and delayed adjustments.Keywords: frailty, anticipatory postural adjustments, backward disequilibrium

  14. Survival in Malnourished Older Patients Receiving Post-Discharge Nutritional Support; Long-Term Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Neelemaat, F; van Keeken, S; Langius, J A E; de van der Schueren, M A E; Thijs, A; Bosmans, J E

    2017-01-01

    Previous analyses have shown that a post-discharge individualized nutritional intervention had positive effects on body weight, lean body mass, functional limitations and fall incidents in malnourished older patients. However, the impact of this intervention on survival has not yet been studied. The objective of this randomized controlled study was to examine the effect of a post-discharge individualized nutritional intervention on survival in malnourished older patients. Malnourished older patients, aged ≥ 60 years, were randomized during hospitalization to a three-months post-discharge nutritional intervention group (protein and energy enriched diet, oral nutritional supplements, vitamin D3/calcium supplement and telephone counseling by a dietitian) or to a usual care regimen (control group). Survival data were collected 4 years after enrollment. Survival analyses were performed using intention-to-treat analysis by Log-rank tests and Cox regression adjusted for confounders. The study population consisted of 94 men (45%) and 116 women with a mean age of 74.5 (SD 9.5) years. There were no statistically significant differences in baseline characteristics. Survival data was available in 208 out of 210 patients. After 1 and 4 years of follow-up, survival rates were respectively 66% and 29% in the intervention group (n=104) and 73% and 30% in the control group (n=104). There were no statistically significant differences in survival between the two groups 1 year (HR= 0.933, 95% CI=0.675-1.289) and 4 years after enrollment (HR=0.928, 95% CI=0.671-1.283). The current study failed to show an effect of a three-months post-discharge multi-component nutritional intervention in malnourished older patients on long-term survival, despite the positive effects on short-term outcome such as functional limitations and falls.

  15. The Happy Older Latinos are Active (HOLA) health promotion and prevention study: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Jimenez, Daniel E; Reynolds, Charles F; Alegría, Margarita; Harvey, Philip; Bartels, Stephen J

    2015-12-18

    Results of previous studies attest to the greater illness burden of common mental disorders (anxiety and depression) in older Latinos and the need for developing preventive interventions that are effective, acceptable, and scalable. Happy Older Latinos are Active (HOLA) is a newly developed intervention that uses a community health worker (CHW) to lead a health promotion program in order to prevent common mental disorders among at-risk older Latinos. This pilot study tests the feasibility and acceptability of delivering HOLA to older, at-risk Latinos. HOLA is a multi-component, health promotion intervention funded by the National Institute of Mental Health (NIMH). This prevention approach will be tested against a fotonovela, an enhanced psychoeducation control condition, in a sample of Latino elderly with minor or subthreshold depression or anxiety. A total of 60 older Latinos (aged 60+) will be randomized to receive HOLA or the fotonovela. The primary outcomes of interest are recruitment, adherence, retention, and acceptability. Data will also be collected on: preemption of incident and recurrent major depression, generalized anxiety, and social phobia; reduction in depression and anxiety symptom severity; physical functioning; sedentary behaviors; social engagement; and self-efficacy. The results of this study could have implications for other high-risk, highly disadvantaged populations. The development of a health promotion intervention designed to prevent common mental disorders could be a means of addressing multiple disparities (for example, mental health outcomes, mental health service use, stigma) among racial/ethnic minority elderly. CLINICALTRIALS. NCT02371954 . Date of registration: 21 January 2015.

  16. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

    Science.gov (United States)

    Hughes, Carmel; Tunney, Michael; Bradley, Marie C

    2013-11-19

    Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. In August 2013, for this third update, we searched the Cochrane Wounds Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Database of Abstracts of Reviews of Effects (DARE, The Cochrane Library), Ovid MEDLINE, OVID MEDLINE (In-process and Other Non-Indexed Citations), Ovid EMBASE, EBSCO CINAHL, Web of Science and the Health Technology Assessment (HTA) website. Research in progress was sought through Current Clinical Trials, Gateway to Reseach, and HSRProj (Health Services Research Projects in Progress). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this third update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection control audit scores which measured adherence to infection control standards. At the end of the 12 month study, there was no change in MRSA

  17. Control of glycemia and other cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: data from the Adult Diabetes Control and Management.

    Science.gov (United States)

    Sazlina, Shariff-Ghazali; Mastura, Ismail; Ahmad, Zaiton; Cheong, Ai-Theng; Adam, Bujang-Mohamad; Jamaiyah, Haniff; Lee, Ping-Yein; Syed-Alwi, Syed-Abdul-Rahman; Chew, Boon-How; Sriwahyu, Taher

    2014-01-01

    The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia. A cross-sectional study was carried out using cases notified to the Adult Diabetes Control and Management database between 1 January and 31 December 2009. A total of 10 363 people aged over 60 years with type 2 diabetes mellitus were included in the analyses. A standard online case report form was used to record demographic data, clinical factors (diabetes duration, comorbid condition and treatment modalities), cardiovascular disease risk factors, diabetes complications and laboratory assessments. The cardiovascular disease risk factors controls assessed included glycosylated hemoglobin (HbA(1c)) control of cardiovascular disease risk factors was suboptimal in older adults with type 2 diabetes. The oldest elderly were more likely to achieve target HbA(1c) (<7.0%) and triglycerides (<1.7 mmol/L) than older adults aged 60-69 years. © 2013 Japan Geriatrics Society.

  18. A comparative study on distressful events in affective disorder and normal control

    Directory of Open Access Journals (Sweden)

    Sushma Rathee

    2017-01-01

    Full Text Available Background: Life events’ stresses are concerned with situational encounters and the meaning that a person attaches to such encounters. It refers to our feeling; it is something of importance to us and is being jeopardised by events in our daily life, and the stressful life events are causally linked to a variety of undesirable effects which influence our performance and health. Aim: This study was planned for assessment and comparison of stressful life events between mood disorder and normal people. Materials and methods: In this study, total 90 participants (30 manic patients, 30 depressive patients, and 30 normal participants were recruited and severity of symptoms was assessed by Young Mania Rating Scale and Beck Depression Inventory. Normal participants were screened by General Health Questionnaire. Presumptive Stressful Life Events Scale was used for both groups for assessment of stressful life events. Findings and conclusion: The present study results revealed that clinical group had higher score on stressful life events as compared to normal participants. Patients with depression had more stressful life events as compared to the mania and normal population. Overall, life events precede the mood symptoms’ occurrence.

  19. Anodal Transcranial Direct Current Stimulation Shows Minimal, Measure-Specific Effects on Dynamic Postural Control in Young and Older Adults: A Double Blind, Sham-Controlled Study.

    Science.gov (United States)

    Craig, Chesney E; Doumas, Michail

    2017-01-01

    We investigated whether stimulating the cerebellum and primary motor cortex (M1) using transcranial direct current stimulation (tDCS) could affect postural control in young and older adults. tDCS was employed using a double-blind, sham-controlled design, in which young (aged 18-35) and older adults (aged 65+) were assessed over three sessions, one for each stimulatory condition-M1, cerebellar and sham. The effect of tDCS on postural control was assessed using a sway-referencing paradigm, which induced platform rotations in proportion to the participant's body sway, thus assessing sensory reweighting processes. Task difficulty was manipulated so that young adults experienced a support surface that was twice as compliant as that of older adults, in order to minimise baseline age differences in postural sway. Effects of tDCS on postural control were assessed during, immediately after and 30 minutes after tDCS. Additionally, the effect of tDCS on corticospinal excitability was measured by evaluating motor evoked potentials using transcranial magnetic stimulation immediately after and 30 minutes after tDCS. Minimal effects of tDCS on postural control were found in the eyes open condition only, and this was dependent on the measure assessed and age group. For young adults, stimulation had only offline effects, as cerebellar stimulation showed higher mean power frequency (MPF) of sway 30 minutes after stimulation. For older adults, both stimulation conditions delayed the increase in sway amplitude witnessed between blocks one and two until stimulation was no longer active. In conclusion, despite tDCS' growing popularity, we would caution researchers to consider carefully the type of measures assessed and the groups targeted in tDCS studies of postural control.

  20. Comparison of rCBF between patients with medial temporal lobe epilepsy and normal controls using H215O PET

    International Nuclear Information System (INIS)

    Kang, Eun Joo; Lee, Jae Sung; Nam, Hyun Woo; Lee, Sang Kun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

    2002-01-01

    The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using H 2 15 O-PET. 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was performed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Duirng the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal regions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal regions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Epilepsy induced changes were found not only in relative increase/ decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period

  1. Internet cognitive behaviour therapy for depression in older adults with knee osteoarthritis : A randomized controlled trial

    NARCIS (Netherlands)

    O'Moore, K.A.; Newby, J.M.; Andrews, G.; Hunter, D.J.; Bennell, K.; Smith, J.; Williams, A.D.

    2018-01-01

    Objective To determine the efficacy of an internet-based cognitive behavioural therapy (iCBT) program for depression in older adults with osteoarthritis of the knee and comorbid major depressive disorder (MDD). We conducted a RCT in sixty-nine adults (≥ 50 years) meeting criteria for MDD and

  2. A Placebo-Controlled Test of Cognitive-Behavioral Therapy for Comorbid Insomnia in Older Adults

    Science.gov (United States)

    Rybarczyk, Bruce; Stepanski, Edward; Fogg, Louis; Lopez, Martita; Barry, Paulette; Davis, Andrew

    2005-01-01

    The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW,…

  3. Stepped care for depression and anxiety in visually impaired older adults: multicentre randomised controlled trial

    NARCIS (Netherlands)

    van der Aa, H.P.A.; van Rens, G.H.M.B.; Comijs, H.C.; Margrain, T.H.; Galindo Garre, F.; Twisk, J.W.R.; van Nispen, R.M.A.

    2015-01-01

    Study question Is stepped care compared with usual care effective in preventing the onset of major depressive, dysthymic, and anxiety disorders in older people with visual impairment (caused mainly by age related eye disease) and subthreshold depression and/or anxiety? Methods 265 people aged ?50

  4. Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial

    Science.gov (United States)

    Wollesen, Bettina; Mattes, Klaus; Schulz, Sören; Bischoff, Laura L.; Seydell, L.; Bell, Jeffrey W.; von Duvillard, Serge P.

    2017-01-01

    Background: Dual-task (DT) training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions. Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group) in gait performance compared to a single task (ST) strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years) participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task) were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h-1). Specific gait variables, cognitive performance, and fear of falling were compared between all groups. >Results: Training improved gait performance for step length (p changes in cognitive performance. Both interventions reduced fear of falling (p management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals. Trial registration: German register of clinical trials DRKS00012382. PMID:29326581

  5. Hearing Loss is Associated With Risk of Alzheimer’s Disease: A Case-Control Study in Older People

    OpenAIRE

    Shih-Chang Hung; Kuan-Fu Liao; Chih-Hsin Muo; Shih-Wei Lai; Chia-Wei Chang; Hung-Chang Hung

    2015-01-01

    Background: It remains unknown whether hearing loss increases the risk of Alzheimer’s disease. This study aimed to examine the association between hearing loss and risk of Alzheimer’s disease in older people in Taiwan. Methods: Analyzing the database from Taiwan’s National Health Insurance Program, this case-control study enrolled 488 subjects ≥65 years old with newly diagnosed Alzheimer’s disease as a case group and 1952 subjects without Alzheimer’s disease as a control group from 1998–20...

  6. Decision making in pathological gambling: A comparison between pathological gamblers, alcohol dependents, persons with Tourette syndrome, and normal controls

    NARCIS (Netherlands)

    Goudriaan, Anna E.; Oosterlaan, Jaap; de Beurs, Edwin; van den Brink, Wim

    2005-01-01

    Decision making deficits play an important role in the definition of pathological gambling (PG). However, only few empirical studies are available regarding decision making processes in PG. This study therefore compares decision making processes in PG and normal controls in detail using three

  7. Gender differences in nigrostriatal dopaminergic innervation are present at young-to-middle but not at older age in normal adults.

    NARCIS (Netherlands)

    Wong, K.K.; Muller, M.L.; Kuwabara, H.; Studenski, S.A.; Bohnen, N.I.

    2012-01-01

    Gender differences in brain dopaminergic activity have been variably reported in the literature. We performed an evaluation for gender effects on striatal dopamine transporter (DAT) binding in a group of normal subjects. Community-dwelling adults (n = 85, 50F/35M, mean age 62.7 +/- 16.2 SD, range

  8. Heel blood flow during loading and off-loading in bedridden older adults with low and normal ankle-brachial pressure index: a quasi-experimental study.

    Science.gov (United States)

    Masaki, Nami; Sugama, Junko; Okuwa, Mayumi; Inagaki, Misako; Matsuo, Junko; Nakatani, Tosio; Sanada, Hiromi

    2013-07-01

    The purpose of this study was to evaluate the differences in heel blood flow during loading and off-loading in bedridden adults older than 65 years. The patients were divided into three groups based on ankle-brachial pressure index (ABI) and transcutaneous oxygen tension (tcPO₂): (1) patients with an ABI ≥ 0.8 (Group A); (2) patients with an ABI < 0.8 and heel tcPO₂ ≥ 10 mmHg (Group B); and (3) patients with an ABI < 0.8 and heel tcPO₂ < 10 mmHg (Group C). Heel blood flow was monitored using tcPO₂ sensors. Data were collected with the heel (1) suspended above the bed surface (preload), (2) on the bed surface for 30 min (loading), and (3) again suspended above the bed surface for 60 min (off-loading). Heel blood flow during off-loading was assessed using three parameters: oxygen recovery index (ORI), total tcPO₂ for the first 10 min, and change in tcPO₂ after 60 min of off-loading. ORI in Group C (n = 8) was significantly shorter than in Groups A (n = 22) and B (n = 15). Total tcPO₂ for the first 10 min of off-loading in Group C was significantly less than that in Groups A and B. Change in tcPO₂ after 60 min of off-loading in Group C was less than in Group A. Based on these findings, additional preventive care against heel blood flow decrease in older adults with an ABI < 0.8 and heel tcPO₂ < 10 mmHg might be necessary after loading.

  9. Amyloid imaging in cognitively normal older adults: comparison between {sup 18}F-flutemetamol and {sup 11}C-Pittsburgh compound B

    Energy Technology Data Exchange (ETDEWEB)

    Adamczuk, Katarzyna; Schaeverbeke, Jolien; Neyens, Veerle; Dupont, Patrick [KU Leuven, Laboratory for Cognitive Neurology, Leuven (Belgium); Leuven Institute of Neuroscience and Disease, Alzheimer Research Centre KU Leuven, Leuven (Belgium); Nelissen, Natalie [KU Leuven, Laboratory for Cognitive Neurology, Leuven (Belgium); Oxford University, Department of Psychiatry, Oxford (United Kingdom); Vandenbulcke, Mathieu [University Hospitals Leuven, Old Age Psychiatry Department, Leuven (Belgium); Goffin, Karolien [KU Leuven and University Hospitals Leuven, Nuclear Medicine and Molecular Imaging Department, Leuven (Belgium); Lilja, Johan [GE Healthcare, Uppsala (Sweden); Department of Surgical Sciences, Radiology, Uppsala University Hospital, Uppsala University, Uppsala (Sweden); Hilven, Kelly [KU Leuven, Laboratory for Neuroimmunology, Leuven (Belgium); Laere, Koen van [Leuven Institute of Neuroscience and Disease, Alzheimer Research Centre KU Leuven, Leuven (Belgium); KU Leuven and University Hospitals Leuven, Nuclear Medicine and Molecular Imaging Department, Leuven (Belgium); Vandenberghe, Rik [KU Leuven, Laboratory for Cognitive Neurology, Leuven (Belgium); Leuven Institute of Neuroscience and Disease, Alzheimer Research Centre KU Leuven, Leuven (Belgium); University Hospitals Leuven, Neurology Department, Leuven (Belgium)

    2016-01-15

    Preclinical, or asymptomatic, Alzheimer's disease (AD) refers to the presence of positive AD biomarkers in the absence of cognitive deficits. This research concept is being applied to define target populations for clinical drug development. In a prospective community-recruited cohort of cognitively intact older adults, we compared two amyloid imaging markers within subjects: {sup 18}F-flutemetamol and {sup 11}C-Pittsburgh compound B (PIB). In 32 community-recruited cognitively intact older adults aged between 65 and 80 years, we determined the concordance between binary classification based on {sup 18}F-flutemetamol versus {sup 11}C-PIB according to semiquantitative assessment (standardized uptake value ratio in composite cortical volume, SUVR{sub comp}) and, alternatively, according to visual reads. We also determined the correlation between {sup 18}F-flutemetamol and {sup 11}C-PIB SUVR and evaluated how this was affected by the reference region chosen (cerebellar grey matter versus pons) and the use of partial volume correction (PVC) in this population. Binary classification based on semiquantitative assessment was concordant between {sup 18}F-flutemetamol and {sup 11}C-PIB in 94 % of cases. Concordance of blinded binary visual reads between tracers was 84 %. The Spearman correlation between {sup 18}F-flutemetamol and {sup 11}C-PIB SUVR{sub comp} with cerebellar grey matter as reference region was 0.84, with a slope of 0.98. Correlations in neocortical regions were significantly lower with the pons as reference region. PVC improved the correlation in striatum and medial temporal cortex. For the definition of preclinical AD based on {sup 18}F-flutemetamol, concordance with {sup 11}C-PIB was highest using semiquantitative assessment with cerebellar grey matter as reference region. (orig.)

  10. Automatic Camera Control System for a Distant Lecture with Videoing a Normal Classroom.

    Science.gov (United States)

    Suganuma, Akira; Nishigori, Shuichiro

    The growth of a communication network technology enables students to take part in a distant lecture. Although many lectures are conducted in universities by using Web contents, normal lectures using a blackboard are still held. The latter style lecture is good for a teacher's dynamic explanation. A way to modify it for a distant lecture is to…

  11. Psychosocial Functioning of Adult Epileptic and MS Patients and Adult Normal Controls on the WPSI.

    Science.gov (United States)

    Tan, Siang-Yang

    1986-01-01

    Psychosocial functioning of adult epileptic outpatients as assessed by the Washington Psychosocial Seizure Inventory (WPSI) was compared to that of adult multiple sclerosis (MS) outpatients and normal subjects. When only valid WPSI profiles were considered, the only significant finding was that the epilepsy group and the MS group had more…

  12. Healthy younger and older adults control foot placement to avoid small obstacles during gait primarily by modulating step width

    Directory of Open Access Journals (Sweden)

    Schulz Brian W

    2012-10-01

    Full Text Available Abstract Background Falls are a significant problem in the older population. Most falls occur during gait, which is primarily regulated by foot placement. Variability of foot placement has been associated with falls, but these associations are inconsistent and generally for smooth, level flooring. This study investigates the control of foot placement and the associated gait variability in younger and older men and women (N=7/group, total N=28 while walking at three different speeds (slow, preferred, and fast across a control surface with no obstacles and surfaces with multiple (64 small (10cm long ×13mm high visible and hidden obstacles. Results Minimum obstacle distance between the shoe and nearest obstacle during each footfall was greater on the visible obstacles surface for older subjects because some of them chose to actively avoid obstacles. This obstacle avoidance strategy was implemented primarily by modulating step width and to a lesser extent step length as indicated by linear regressions of step width and length variability on minimum obstacle distance. Mean gait speed, step length, step width, and step time did not significantly differ by subject group, flooring surface, or obstacle avoidance strategy. Conclusions Some healthy older subjects choose to actively avoid small obstacles that do not substantially perturb their gait by modulating step width and, to a lesser extent, step length. It is not clear if this obstacle avoidance strategy is appropriate and beneficial or overcautious and maladaptive, as it results in fewer obstacles encountered at a consequence of a less efficient gait pattern that has been shown to indicate increased fall risk. Further research is needed on the appropriateness of strategy selection when the environmental demands and/or task requirements have multiple possible completion strategies with conflicting objectives (i.e. perceived safety vs. efficiency.

  13. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial.

    Science.gov (United States)

    Martínez-Amat, Antonio; Hita-Contreras, Fidel; Lomas-Vega, Rafael; Caballero-Martínez, Isabel; Alvarez, Pablo J; Martínez-López, Emilio

    2013-08-01

    The purpose of this study was to evaluate the effect of a 12-week-specific proprioceptive training program on postural stability, gait, balance, and fall prevention in adults older than 65 years. The present study was a controlled clinical trial. Forty-four community dwelling elderly subjects (61-90 years; mean age, 78.07 ± 5.7 years) divided into experimental (n = 20) and control (n = 24) groups. The participants performed the Berg balance test before and after the training program, and we assessed participants' gait, balance, and the risk of falling, using the Tinetti scale. Medial-lateral plane and anterior-posterior plane displacements of the center of pressure, Sway area, length and speed, and the Romberg quotient about surface, speed, and distance were calculated in static posturography analysis (EPS pressure platform) under 2 conditions: eyes open and eyes closed. After a first clinical evaluation, patients were submitted to 12 weeks proprioception training program, 2 sessions of 50 minutes every week. This program includes 6 exercises with the BOSU and Swiss ball as unstable training tools that were designed to program proprioceptive training. The training program improved postural balance of older adults in mediolateral plane with eyes open (p 0.05). After proprioception training, gait (Tinetti), and balance (Berg) test scores improved 14.66% and 11.47% respectively. These results show that 12 weeks proprioception training program in older adults is effective in postural stability, static, and dynamic balance and could lead to an improvement in gait and balance capacity, and to a decrease in the risk of falling in adults aged 65 years and older.

  14. Making working memory work: a meta-analysis of executive-control and working memory training in older adults.

    Science.gov (United States)

    Karbach, Julia; Verhaeghen, Paul

    2014-11-01

    This meta-analysis examined the effects of process-based executive-function and working memory training (49 articles, 61 independent samples) in older adults (> 60 years). The interventions resulted in significant effects on performance on the trained task and near-transfer tasks; significant results were obtained for the net pretest-to-posttest gain relative to active and passive control groups and for the net effect at posttest relative to active and passive control groups. Far-transfer effects were smaller than near-transfer effects but were significant for the net pretest-to-posttest gain relative to passive control groups and for the net gain at posttest relative to both active and passive control groups. We detected marginally significant differences in training-induced improvements between working memory and executive-function training, but no differences between the training-induced improvements observed in older adults and younger adults, between the benefits associated with adaptive and nonadaptive training, or between the effects in active and passive control conditions. Gains did not vary with total training time. © The Author(s) 2014.

  15. Effect of Volume of Fluid Resuscitation on Metabolic Normalization in Children Presenting in Diabetic Ketoacidosis: A Randomized Controlled Trial.

    Science.gov (United States)

    Bakes, Katherine; Haukoos, Jason S; Deakyne, Sara J; Hopkins, Emily; Easter, Josh; McFann, Kim; Brent, Alison; Rewers, Arleta

    2016-04-01

    The optimal rate of fluid administration in pediatric diabetic ketoacidosis (DKA) is unknown. Our aim was to determine whether the volume of fluid administration in children with DKA influences the rate of metabolic normalization. We performed a randomized controlled trial conducted in a tertiary pediatric emergency department from December 2007 until June 2010. The primary outcome was time to metabolic normalization; secondary outcomes were time to bicarbonate normalization, pH normalization, overall length of hospital treatment, and adverse outcomes. Children between 0 and 18 years of age were eligible if they had type 1 diabetes mellitus and DKA. Patients were randomized to receive intravenous (IV) fluid at low volume (10 mL/kg bolus + 1.25 × maintenance rate) or high volume (20 mL/kg bolus + 1.5 × maintenance rate) (n = 25 in each). After adjusting for initial differences in bicarbonate levels, time to metabolic normalization was significantly faster in the higher-volume infusion group compared to the low-volume infusion group (hazard ratio [HR] = 2.0; 95% confidence interval [CI] 1.0-3.9; p = 0.04). Higher-volume IV fluid infusion appeared to hasten, to a greater extent, normalization of pH (HR = 2.5; 95% CI 1.2-5.0; p = 0.01) than normalization of serum bicarbonate (HR = 1.2; 95% CI 0.6-2.3; p = 0.6). The length of hospital treatment HR (0.8; 95% CI 0.4-1.5; p = 0.5) and time to discharge HR (0.8; 95% CI 0.4-1.5; p = 0.5) did not differ between treatment groups. Higher-volume fluid infusion in the treatment of pediatric DKA patients significantly shortened metabolic normalization time, but did not change overall length of hospital treatment. ClinicalTrials.gov ID NCT01701557. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Controlling the magic and normal sizes of white CdSe quantum dots

    Science.gov (United States)

    Su, Yu-Sheng; Chung, Shu-Ru

    2017-08-01

    In this study, we have demonstrated a facile chemical route to prepare CdSe QDs with white light emission, and the performance of white CdSe-based white light emitting diode (WLED) is also exploded. An organic oleic acid (OA) is used to form Cd-OA complex first and hexadecylamine (HDA) and 1-octadecene (ODE) is used as surfactants. Meanwhile, by varying the reaction time from 1 s to 60 min, CdSe QDs with white light can be obtained. The result shows that the luminescence spectra compose two obvious emission peaks and entire visible light from 400 to 700 nm, when the reaction time less than 10 min. The wide emission wavelength combine two particle sizes of CdSe, magic and normal, and the magic-CdSe has band-edge and surface-state emission, while normal size only possess band-edge emission. The TEM characterization shows that the two different sizes with diameter of 1.5 nm and 2.7 nm for magic and normal size CdSe QDs can be obtained when the reaction time is 4 min. We can find that the magic size of CdSe is produced when the reaction time is less than 3 min. In the time ranges from 3 to 10 min, two sizes of CdSe QDs are formed, and with QY from 20 to 60 %. Prolong the reaction time to 60 min, only normal size of CdSe QD can be observed due to the Ostwald repining, and its QYs is 8 %. Based on the results we can conclude that the two emission peaks are generated from the coexistence of magic size and normal size CdSe to form the white light QDs, and the QY and emission wavelength of CdSe QDs can be increased with prolonging reaction time. The sample reacts for 2 (QY 30 %), 4 (QY 32 %) and 60 min (QY 8 %) are choosing to mixes with transparent acrylic-based UV curable resin for WLED fabrication. The Commission International d'Eclairage (CIE) chromaticity, color rendering index (CRI), and luminous efficacy for magic, mix, and normal size CdSe are (0.49, 0.44), 81, 1.5 lm/W, (0.35, 0.30), 86, 1.9 lm/W, and (0.39, 0.25), 40, 0.3 lm/W, respectively.

  17. Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review

    Directory of Open Access Journals (Sweden)

    Laufer Y

    2014-10-01

    Full Text Available Yocheved Laufer, Gali Dar, Einat Kodesh Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel Background: Exercise programs that challenge an individual’s balance have been shown to reduce the risk of falls among older adults. Virtual reality computer-based technology that provides the user with opportunities to interact with virtual objects is used extensively for entertainment. There is a growing interest in the potential of virtual reality-based interventions for balance training in older adults. This work comprises a systematic review of the literature to determine the effects of intervention programs utilizing the Nintendo Wii console on balance control and functional performance in independently functioning older adults.Methods: Studies were obtained by searching the following databases: PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus, and Google Scholar, followed by a hand search of bibliographic references of the included studies. Included were randomized controlled trials written in English in which Nintendo Wii Fit was used to enhance standing balance performance in older adults and compared with an alternative exercise treatment, placebo, or no treatment.Results: Seven relevant studies were retrieved. The four studies examining the effect of Wii-based exercise compared with no exercise reported positive effects on at least one outcome measure related to balance performance in older adults. Studies comparing Wii-based training with alternative exercise programs generally indicated that the balance improvements achieved by Wii-based training are comparable with those achieved by other exercise programs.Conclusion: The review indicates that Wii-based exercise programs may serve as an alternative to more conventional forms of exercise aimed at improving balance control. However, due to the great variability between studies in terms of the intervention protocols and outcome measures, as

  18. A randomized controlled pilot study of home-based step training in older people using videogame technology.

    Directory of Open Access Journals (Sweden)

    Daniel Schoene

    Full Text Available BACKGROUND: Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people. PURPOSE: To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people. DESIGN: Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention. SETTING/PARTICIPANTS: Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia. INTERVENTION: Intervention group (IG participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2-3 sessions per week for 15-20 minutes each for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT task once each week. MAIN OUTCOME MEASURES: CSRT, the Physiological Profile Assessment (PPA, neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up. RESULTS: Thirty-two participants completed the study (86.5%. IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F31,1 = 18.203, p<.001, PPA composite scores (F31,1 = 12.706, p = 0.001, as well as the postural sway (F31,1 = 4.226, p = 0.049 and contrast sensitivity (F31,1 = 4.415, p = 0.044 PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F31,1 = 4.226, p = 0.049. CONCLUSIONS: Step pad training can

  19. Bright and dark solitons in the normal dispersion regime of inhomogeneous optical fibers: Soliton interaction and soliton control

    International Nuclear Information System (INIS)

    Liu Wenjun; Tian Bo; Xu Tao; Sun Kun; Jiang Yan

    2010-01-01

    Symbolically investigated in this paper is a nonlinear Schroedinger equation with the varying dispersion and nonlinearity for the propagation of optical pulses in the normal dispersion regime of inhomogeneous optical fibers. With the aid of the Hirota method, analytic one- and two-soliton solutions are obtained. Relevant properties of physical and optical interest are illustrated. Different from the previous results, both the bright and dark solitons are hereby derived in the normal dispersion regime of the inhomogeneous optical fibers. Moreover, different dispersion profiles of the dispersion-decreasing fibers can be used to realize the soliton control. Finally, soliton interaction is discussed with the soliton control confirmed to have no influence on the interaction. The results might be of certain value for the study of the signal generator and soliton control.

  20. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children.

    Science.gov (United States)

    Buitelaar, J K; van der Wees, M; Swaab-Barneveld, H; van der Gaag, R J

    1999-01-01

    The hypothesis was tested that weak theory of mind (ToM) and/or emotion recognition (ER) abilities are specific to subjects with autism. Differences in ToM and ER performance were examined between autistic (n = 20), pervasive developmental disorder-not otherwise specified (PDD-NOS) (n = 20), psychiatric control (n = 20), and normal children (n = 20). The clinical groups were matched person-to-person on age and verbal IQ. We used tasks for the matching and the context recognition of emotional expressions, and a set of first- and second-order ToM tasks. Autistic and PDD-NOS children could not be significantly differentiated from each other, nor could they be differentiated from the psychiatric controls with a diagnosis of ADHD (n = 9). The psychiatric controls with conduct disorder or dysthymia performed about as well as normal children. The variance in second-order ToM performance contributed most to differences between diagnostic groups.

  1. Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Soledad eBallesteros

    2014-10-01

    Full Text Available Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-hr non-action video game training sessions with games selected from a commercially available package (Lumosity on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended three meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time, attention (reduction of distraction and increase of alertness, immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM and executive control (shifting strategy did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others. Trial Registration: ClinicalTrials.gov identifier NCT02007616http://clinicaltrials.gov/show/NCT02007616

  2. Cognitive Flexibility Training: A Large-Scale Multimodal Adaptive Active-Control Intervention Study in Healthy Older Adults

    Directory of Open Access Journals (Sweden)

    Jessika I. V. Buitenweg

    2017-11-01

    Full Text Available As aging is associated with cognitive decline, particularly in the executive functions, it is essential to effectively improve cognition in older adults. Online cognitive training is currently a popular, though controversial method. Although some changes seem possible in older adults through training, far transfer, and longitudinal maintenance are rarely seen. Based on previous literature we created a unique, state-of-the-art intervention study by incorporating frequent sessions and flexible, novel, adaptive training tasks, along with an active control group. We created a program called TAPASS (Training Project Amsterdam Seniors and Stroke, a randomized controlled trial. Healthy older adults (60–80 y.o. were assigned to a frequent- (FS or infrequent switching (IS experimental condition or to the active control group and performed 58 half-hour sessions over the course of 12 weeks. Effects on executive functioning, processing- and psychomotor speed, planning, verbal long term memory, verbal fluency, and reasoning were measured on four time points before, during and after the training. Additionally, we examined the explorative question which individual aspects added to training benefit. Besides improvements on the training, we found significant time effects on multiple transfer tasks in all three groups that likely reflected retest effects. No training-specific improvements were detected, and we did not find evidence of additional benefits of individual characteristics. Judging from these results, the therapeutic value of using commercially available training games to train the aging brain is modest, though any apparent effects should be ascribed more to expectancy and motivation than to the elements in our training protocol. Our results emphasize the importance of using parallel tests as outcome measures for transfer and including both active and passive control conditions. Further investigation into different training methods is advised

  3. Efficacy of Wii-Fit on Static and Dynamic Balance in Community Dwelling Older Veterans: A Randomized Controlled Pilot Trial

    Directory of Open Access Journals (Sweden)

    Kalpana P. Padala

    2017-01-01

    Full Text Available Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7 years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9 compared to the control group (0.5; 95% CI, −0.3–1.3 at 8 weeks (average intergroup difference (95% CI, 5.5 (4.3–6.7, p < 0.001 after adjusting for baseline. Conclusion. This study establishes that the Wii-Fit exercise program is efficacious in improving balance in community dwelling older Veterans. This trial is registered with ClinicalTrials.gov Identifier NCT02190045.

  4. Protein-enriched familiar foods and drinks improve protein intake of hospitalized older patients: A randomized controlled trial.

    Science.gov (United States)

    Beelen, Janne; Vasse, Emmelyne; Janssen, Nancy; Janse, André; de Roos, Nicole M; de Groot, Lisette C P G M

    2017-05-18

    Adequate protein intake is important in preventing and treating undernutrition. Hospitalized older patients are recommended to consume 1.2-1.5 g of protein per kg body weight per day (g/kg/d) but most of them fail to do so. Therefore, we investigated whether a range of newly developed protein-enriched familiar foods and drinks were effective in increasing protein intake of hospitalized older patients. This randomized controlled trial involved 147 patients of ≥65 years (mean age: 78.5 ± 7.4 years). The control group (n = 80) received the standard energy and protein rich hospital menu. The intervention group (n = 67) received the same menu with various protein-enriched intervention products replacing regular products or added to the menu. Macronutrient intake on the fourth day of hospitalization, based on food ordering data, was compared between the two groups by using Independent T-tests and Mann Whitney U-tests. In the intervention group 30% of total protein was provided by the intervention products. The intervention group consumed 105.7 ± 34.2 g protein compared to 88.2 ± 24.4 g in the control group (p intervention group than in the control group reached a protein intake of 1.2 g/kg/d (79.1% vs 47.5%). Protein intake was significantly higher in the intervention group at breakfast, during the morning between breakfast and lunch, and at dinner. This study shows that providing protein-enriched familiar foods and drinks, as replacement of regular products or as additions to the hospital menu, better enables hospitalized older patients to reach protein intake recommendations. This trial is registered on ClinicalTrials.gov, Identifier: NCT02213393. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  5. Control survey of normal reference ranges adopted for serum thyroxine binding globulin, thyroxine, triiodothyronine in Japan

    International Nuclear Information System (INIS)

    Sugisaki, Hajime; Kameyama, Mayumi; Shibata, Kyoko

    1985-01-01

    A survey using questionnaires was made on 152 facilities from July through September 1984 to examine normal reference ranges of serum thyroxine binding globulin (TBG), thyroxine (TT 4 ), and triiodothyronine (TT 3 ). Normal reference ranges of TBG were in good agreement with each other, with the exception of four facilities showing high upper limits. An average value of the upper and lower limits in 83 facilities was 13.7 +- 1.9 μg/ml; and the standard deviation was 28.6 +- 2.8 μg/ml. Differences (approximately 10 %) in coefficient of variation were comparable to those (5.7-9.6 %) obtained from the previous survey. There were approximately 10 % differences in coefficient of variation for both TT 4 and TT 3 . (Namekawa, K.)

  6. Memory-guided force control in healthy younger and older adults.

    Science.gov (United States)

    Neely, Kristina A; Samimy, Shaadee; Blouch, Samantha L; Wang, Peiyuan; Chennavasin, Amanda; Diaz, Michele T; Dennis, Nancy A

    2017-08-01

    Successful performance of a memory-guided motor task requires participants to store and then recall an accurate representation of the motor goal. Further, participants must monitor motor output to make adjustments in the absence of visual feedback. The goal of this study was to examine memory-guided grip force in healthy younger and older adults and compare it to performance on behavioral tasks of working memory. Previous work demonstrates that healthy adults decrease force output as a function of time when visual feedback is not available. We hypothesized that older adults would decrease force output at a faster rate than younger adults, due to age-related deficits in working memory. Two groups of participants, younger adults (YA: N = 32, mean age 21.5 years) and older adults (OA: N = 33, mean age 69.3 years), completed four 20-s trials of isometric force with their index finger and thumb, equal to 25% of their maximum voluntary contraction. In the full-vision condition, visual feedback was available for the duration of the trial. In the no vision condition, visual feedback was removed for the last 12 s of each trial. Participants were asked to maintain constant force output in the absence of visual feedback. Participants also completed tasks of word recall and recognition and visuospatial working memory. Counter to our predictions, when visual feedback was removed, younger adults decreased force at a faster rate compared to older adults and the rate of decay was not associated with behavioral performance on tests of working memory.

  7. The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD.

    Science.gov (United States)

    Hall, Katherine S; Morey, Miriam C; Beckham, Jean C; Bosworth, Hayden B; Pebole, Michelle M; Pieper, Carl F; Sloane, Richard

    2018-03-15

    Posttraumatic stress disorder (PTSD) affects up to 30% of military veterans. Older veterans, many of whom have lived with PTSD symptoms for several decades, report a number of negative health outcomes. Despite the demonstrated benefits of regular exercise on physical and psychological health, no studies have explored the impact of exercise in older veterans with PTSD. This paper describes the development, design, and implementation of the Warrior Wellness exercise pilot study for older veterans with PTSD. Veterans aged ≥60 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis of PTSD will be recruited and randomized to (a) Warrior Wellness, a 12-week supervised, facility-based exercise intervention, or (b) usual care for 12 weeks. Warrior Wellness is a theory- and evidence-based behavioral intervention that involves 3 sessions per week of multi-component exercise training that targets strength, endurance, balance, and flexibility. Warrior Wellness focuses on satisfaction with outcomes, self-efficacy, self-monitoring, and autonomy. Factors associated with program adherence, defined as the number of sessions attended during the 12 weeks, will be explored. Primary outcomes include PTSD symptoms and cardiovascular endurance, assessed at baseline and 12 weeks. Compared to those in usual care, it is hypothesized that those in the Warrior Wellness condition will improve on these efficacy outcomes. The Warrior Wellness study will provide evidence on whether a short-term exercise intervention is feasible, acceptable, and effective among older veterans with PTSD, and explore factors associated with program adherence. ClinicalTrials.gov Identifier : NCT02295995.

  8. Postural changes versus balance control and falls in community-living older adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Viviane Lemos Silva Fernandes

    2018-06-01

    Full Text Available Abstract Introduction: Since falls are considered to be a public health problem, it is important to identify whether postural changes over time contribute to the risk of falls in older adults. Objective: To investigate whether postural changes increase fall risk and/or postural imbalance in healthy, community-dwelling older adults. Methods: In April 2016, two reviewers independently searched the PubMed, Web of Science, SPORTDiscus, and CINAHL databases for studies in English published in the previous 10 years, using the following combined keywords: “posture” or (“kyphosis”,“lumbar lordosis”,“flexed posture”,“spinal curvature”,“spinal sagittal contour” AND “elderly” AND “fall”. Study quality was assessed according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology guidelines for observational studies. Results: The search retrieved 1,734 articles. Only observational studies that assessed posture, balance, and/or falls in older adults were considered eligible for review. The final sample included 17 articles: reliability and reproducibility of the instruments were not reported in five studies, while two studies offered a questionable description of the instruments used. Fourteen articles analyzed postural changes at the trunk level and three articles assessed them at the ankles and feet. Most studies found a positive association between postural changes and an increased risk for loss of balance and falls. Conclusion: Thoracic hyperkyphosis, loss of lumbar lordosis, and decreased plantar arch seem to contribute to greater postural instability, and thus to a higher risk of falls in community-living older adults.

  9. Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia

    Directory of Open Access Journals (Sweden)

    Cheong Ai Theng

    2015-07-01

    Full Text Available Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD. This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.

  10. Proteoglycans in Leiomyoma and Normal Myometrium: Abundance, Steroid Hormone Control, and Implications for Pathophysiology.

    Science.gov (United States)

    Barker, Nichole M; Carrino, David A; Caplan, Arnold I; Hurd, William W; Liu, James H; Tan, Huiqing; Mesiano, Sam

    2016-03-01

    Uterine leiomyoma are a common benign pelvic tumors composed of modified smooth muscle cells and a large amount of extracellular matrix (ECM). The proteoglycan composition of the leiomyoma ECM is thought to affect pathophysiology of the disease. To test this hypothesis, we examined the abundance (by immunoblotting) and expression (by quantitative real-time polymerase chain reaction) of the proteoglycans biglycan, decorin, and versican in leiomyoma and normal myometrium and determined whether expression is affected by steroid hormones and menstrual phase. Leiomyoma and normal myometrium were collected from women (n = 17) undergoing hysterectomy or myomectomy. In vitro studies were performed on immortalized leiomyoma (UtLM) and normal myometrial (hTERT-HM) cells with and without exposure to estradiol and progesterone. In leiomyoma tissue, abundance of decorin messenger RNA (mRNA) and protein were 2.6-fold and 1.4-fold lower, respectively, compared with normal myometrium. Abundance of versican mRNA was not different between matched samples, whereas versican protein was increased 1.8-fold in leiomyoma compared with myometrium. Decorin mRNA was 2.4-fold lower in secretory phase leiomyoma compared with proliferative phase tissue. In UtLM cells, progesterone decreased the abundance of decorin mRNA by 1.3-fold. Lower decorin expression in leiomyoma compared with myometrium may contribute to disease growth and progression. As decorin inhibits the activity of specific growth factors, its reduced level in the leiomyoma cell microenvironment may promote cell proliferation and ECM deposition. Our data suggest that decorin expression in leiomyoma is inhibited by progesterone, which may be a mechanism by which the ovarian steroids affect leiomyoma growth and disease progression. © The Author(s) 2015.

  11. Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

    International Nuclear Information System (INIS)

    Sugano, Shigeo; Yamamoto, Kunihiro; Sasao, Ken-ichiro; Watanabe, Manabu

    1999-01-01

    In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3±0.2 l/min in controls vs 1.0±0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0±0.2 l/min in controls vs 0.9±0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5±0.2 l/min in controls vs 1.1±0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6±8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5±4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8±9.4% vs +5.9±11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly physiologic conditions

  12. Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

    Energy Technology Data Exchange (ETDEWEB)

    Sugano, Shigeo; Yamamoto, Kunihiro; Sasao, Ken-ichiro; Watanabe, Manabu [Saiseikai Wakakusa Hospital, Yakohama (Japan)

    1999-07-01

    In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3{+-}0.2 l/min in controls vs 1.0{+-}0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0{+-}0.2 l/min in controls vs 0.9{+-}0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5{+-}0.2 l/min in controls vs 1.1{+-}0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6{+-}8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5{+-}4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8{+-}9.4% vs +5.9{+-}11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly

  13. Individual differences in brainstem and basal ganglia structure predict postural control and balance loss in young and older adults.

    Science.gov (United States)

    Boisgontier, Matthieu P; Cheval, Boris; Chalavi, Sima; van Ruitenbeek, Peter; Leunissen, Inge; Levin, Oron; Nieuwboer, Alice; Swinnen, Stephan P

    2017-02-01

    It remains unclear which specific brain regions are the most critical for human postural control and balance, and whether they mediate the effect of age. Here, associations between postural performance and corticosubcortical brain regions were examined in young and older adults using multiple structural imaging and linear mixed models. Results showed that of the regions involved in posture, the brainstem was the strongest predictor of postural control and balance: lower brainstem volume predicted larger center of pressure deviation and higher odds of balance loss. Analyses of white and gray matter in the brainstem showed that the pedunculopontine nucleus area appeared to be critical for postural control in both young and older adults. In addition, the brainstem mediated the effect of age on postural control, underscoring the brainstem's fundamental role in aging. Conversely, lower basal ganglia volume predicted better postural performance, suggesting an association between greater neural resources in the basal ganglia and greater movement vigor, resulting in exaggerated postural adjustments. Finally, results showed that practice, shorter height and heavier weight (i.e., higher body mass index), higher total physical activity, and larger ankle active (but not passive) range of motion were predictive of more stable posture, irrespective of age. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Well-being among older adults with OA: direct and mediated patterns of control beliefs, optimism and pessimism.

    Science.gov (United States)

    Sherman, Aurora M; Cotter, Kelly A

    2013-01-01

    To assess the contribution of important psychological resources (i.e. optimism, pessimism, control beliefs) to the psychological well-being of older adults with Osteoarthritis (OA); to assess the direct and mediated association of these psychosocial resources to outcomes (depressive symptoms, life satisfaction, and self-esteem). These objectives are important because OA is a significant stressor, treatments are limited, and psychological functioning is at risk for those coping with the condition, even compared to other chronic illnesses. A cross-sectional survey of 160 community-dwelling older adults with OA (81% women). Participants were not randomly selected, but nonetheless reflected the demographic makeup of the selection area. Ordinary least squares regression analyses using the PROCESS macro revealed that optimism and pessimism were associated with higher depressive symptoms and lower self-esteem indirectly through constraints beliefs. The analysis of life satisfaction showed that optimism and pessimism were each partially mediated through mastery and constraints beliefs. These results suggest that prior research, which has assessed these psychological resources as having singular relationships to outcomes, may have underestimated the importance of the relationship between these variables. We discuss possible points of intervention for older adults with OA who may experience increasing constraints beliefs over time.

  15. Effects of Exercise Intervention on Vascular Risk Factors in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Kazuki Uemura

    2012-10-01

    Full Text Available Aims: The purpose of this study is to clarify the effects of exercise intervention on vascular risk factors in older adults with mild cognitive impairment (MCI. Methods: Community-dwelling older adults who met the definition of MCI using the Petersen criteria (n = 100; mean age = 75.3 years were randomly allocated to the exercise (n = 50 or education control group (n = 50. Participants in the exercise group exercised under the supervision of physiotherapists for 90 min/day, 2 days/week, 80 times for 12 months. Anthropometric profiles, blood markers, blood pressure, and physical fitness (the 6-min walking test were measured. Total cholesterol (TC, high-density lipoprotein cholesterol (HDL-C, and TC/HDL-C risk ratio measurements were taken from blood samples. Results: The exercise group showed significantly reduced TC and TC/HDL-C risk ratio after training compared with baseline levels (p Conclusion: Exercise intervention was associated with positive changes in important vascular risk factors related to cognitive decline and vascular disease in older adults with MCI.

  16. Individually tailored internet-based cognitive behaviour therapy for older adults with anxiety and depression: a randomised controlled trial.

    Science.gov (United States)

    Silfvernagel, Kristin; Westlinder, Anna; Andersson, Stina; Bergman, Kajsa; Diaz Hernandez, Rosario; Fallhagen, Line; Lundqvist, Ida; Masri, Nicole; Viberg, Linda; Forsberg, Marie-Louise; Lind, Maria; Berger, Thomas; Carlbring, Per; Andersson, Gerhard

    2018-07-01

    Mixed anxiety and depression is common among older adults. The aim of the study was to compare the effects of an eight-week-long tailored internet-supported cognitive behaviour therapy (ICBT) programme and to compare against the provision of weekly general support. A second aim was to investigate if pre-treatment cognitive flexibility and self-reported cognitive problems would predict outcome. We included 66 older adults (aged over 60 years) with mixed anxiety/depression following media recruitment and randomised them into treatment and control groups. We also included a one-year follow-up. As a measure of executive function, we used the Wisconsin Card Sorting Test (perseverative errors) and the Cognitive Failures Questionnaire during the pre-treatment phase. Results showed a moderate between-group effect on the main outcome measure, the Beck Anxiety Inventory (BAI) (d= .50), favouring the treatment group. Nearly half (45.5%) of that group were classified as responders. One person (3%) in the treatment group deteriorated. There were significant correlations between perseverative errors and outcome (on the BAI r = -.45), but not among self-reported cognitive function. We conclude that guided, tailored ICBT may be effective for some older adults and that the role of cognitive function needs to be investigated further.

  17. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial.

    Science.gov (United States)

    Witham, Miles D; Price, Rosemary J G; Struthers, Allan D; Donnan, Peter T; Messow, Claudia-Martina; Ford, Ian; McMurdo, Marion E T

    2013-10-14

    Observational data link low 25-hydroxyvitamin D levels to both prevalent blood pressure and incident hypertension. No clinical trial has yet examined the effect of vitamin D supplementation in isolated systolic hypertension, the most common pattern of hypertension in older people. To test whether high-dose, intermittent cholecalciferol supplementation lowers blood pressure in older patients with isolated systolic hypertension. Parallel group, double-blind, placebo-controlled randomized trial. Primary care clinics and hospital clinics. Patients 70 years and older with isolated systolic hypertension (supine systolic blood pressure >140 mm Hg and supine diastolic blood pressure blood pressure, 24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, insulin resistance, and b-type natriuretic peptide level during 12 months. A total of 159 participants were randomized (mean age, 77 years). Mean baseline office systolic blood pressure was 163/78 mm Hg. Mean baseline 25-hydroxyvitamin D level was 18 ng/mL. 25-Hydroxyvitamin D levels increased in the treatment group compared with the placebo group (+8 ng/mL at 1 year, P blood pressure (−1 [−6 to 4]/−2 [−4 to 1] mm Hg at 3 months and 1 [−2 to 4]/0 [−2 to 2] mm Hg overall treatment effect). No significant treatment effect was evident for any of the secondary outcomes (24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, glucose level, and walking distance). There was no excess of adverse events in the treatment group, and the total number of falls was nonsignificantly lower in the group receiving vitamin D (36 vs 46, P = .24). Vitamin D supplementation did not improve blood pressure or markers of vascular health in older patients with isolated systolic hypertension. isrctn.org Identifier: ISRCTN92186858.

  18. Tractography of the corticospinal tracts in infants with focal perinatal injury: comparison with normal controls and to motor development

    International Nuclear Information System (INIS)

    Roze, Elise; Harris, Polly A.; Ball, Gareth; Braga, Rodrigo M.; Allsop, Joanna M.; Counsell, Serena J.; Elorza, Leire Zubiaurre; Merchant, Nazakat; Arichi, Tomoki; Edwards, A.D.; Cowan, Frances M.; Porter, Emma; Rutherford, Mary A.

    2012-01-01

    Our aims were to (1) assess the corticospinal tracts (CSTs) in infants with focal injury and healthy term controls using probabilistic tractography and (2) to correlate the conventional magnetic resonance imaging (MRI) and tractography findings in infants with focal injury with their later motor function. We studied 20 infants with focal lesions and 23 controls using MRI and diffusion tensor imaging. Tract volume, fractional anisotropy (FA), apparent diffusion coefficient (ADC) values, axial diffusivity and radial diffusivity (RD) of the CSTs were determined. Asymmetry indices (AIs) were calculated by comparing ipsilateral to contralateral CSTs. Motor outcome was assessed using a standardized neurological examination. Conventional MRI was able to predict normal motor development (n = 9) or hemiplegia (n = 6). In children who developed a mild motor asymmetry (n = 5), conventional MRI predicted a hemiplegia in two and normal motor development in three infants. The AIs for tract volume, FA, ADC and RD showed a significant difference between controls and infants who developed a hemiplegia, and RD also showed a significant difference in AI between controls and infants who developed a mild asymmetry. Conventional MRI was able to predict subsequent normal motor development or hemiplegia following focal injury in newborn infants. Measures of RD obtained from diffusion tractography may offer additional information for predicting a subsequent asymmetry in motor function. (orig.)

  19. Effects of multicomponent exercise on cognitive function in older adults with amnestic mild cognitive impairment: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Suzuki Takao

    2012-10-01

    Full Text Available Abstract Background To examine the effects of a multicomponent exercise program on the cognitive function of older adults with amnestic mild cognitive impairment (aMCI. Methods Design: Twelve months, randomized controlled trial; Setting: Community center in Japan; Participants: Fifty older adults (27 men with aMCI ranging in age from 65 to 93 years (mean age, 75 years; Intervention: Subjects were randomized into either a multicomponent exercise (n = 25 or an education control group (n = 25. Subjects in the multicomponent exercise group exercised under the supervision of physiotherapists for 90 min/d, 2 d/wk, for a total of 80 times over 12 months. The exercises included aerobic exercises, muscle strength training, and postural balance retraining, and were conducted using multiple conditions to stimulate cognitive functions. Subjects in the control group attended three education classes regarding health during the 12-month period. Measurements were administered before, after the 6-month, and after the 12-month intervention period; Measurements: The performance measures included the mini-mental state examination, logical memory subtest of the Wechsler memory scale-revised, digit symbol coding test, letter and categorical verbal fluency test, and the Stroop color word test. Results The mean adherence to the exercise program was 79.2%. Improvements of cognitive function following multicomponent exercise were superior at treatment end (group × time interactions for the mini-mental state examination (P = 0.04, logical memory of immediate recall (P = 0.03, and letter verbal fluency test (P = 0.02. The logical memory of delayed recall, digit symbol coding, and Stroop color word test showed main effects of time, although there were no group × time interactions. Conclusions This study indicates that exercise improves or supports, at least partly, cognitive performance in older adults with aMCI.

  20. Effects of a DVD-delivered exercise program on patterns of sedentary behavior in older adults: a randomized controlled trial.

    Science.gov (United States)

    Fanning, J; Porter, G; Awick, E A; Wójcicki, T R; Gothe, N P; Roberts, S A; Ehlers, D K; Motl, R W; McAuley, E

    2016-06-01

    In the present study, we examined the influence of a home-based, DVD-delivered exercise intervention on daily sedentary time and breaks in sedentary time in older adults. Between 2010 and 2012, older adults (i.e., aged 65 or older) residing in Illinois (N = 307) were randomized into a 6-month home-based, DVD-delivered exercise program (i.e., FlexToBa; FTB) or a waitlist control. Participants completed measurements prior to the first week (baseline), following the intervention period (month 6), and after a 6 month no-contact follow-up (month 12). Sedentary behavior was measured objectively using accelerometers for 7 consecutive days at each time point. Differences in daily sedentary time and breaks between groups and across the three time points were examined using mixed-factor analysis of variance (mixed ANOVA) and analysis of covariance (ANCOVA). Mixed ANOVA models revealed that daily minutes of sedentary time did not differ by group or time. The FTB condition, however, demonstrated a greater number of daily breaks in sedentary time relative to the control condition (p = .02). ANCOVA models revealed a non-significant effect favoring FTB at month 6, and a significant difference between groups at month 12 (p = .02). While overall sedentary time did not differ between groups, the DVD-delivered exercise intervention was effective for maintaining a greater number of breaks when compared with the control condition. Given the accumulating evidence emphasizing the importance of breaking up sedentary time, these findings have important implications for the design of future health behavior interventions.

  1. An evaluation of the effectiveness of a community mentoring service for socially isolated older people: a controlled trial

    Directory of Open Access Journals (Sweden)

    Green Colin

    2011-04-01

    Full Text Available Abstract Background Social isolation affects a significant proportion of older people and is associated with poor health outcomes. The current evidence base regarding the effectiveness of interventions targeting social isolation is poor, and the potential utility of mentoring for this purpose has not previously been rigorously evaluated. The purpose of this study was to examine the effectiveness of a community-based mentoring service for improving mental health, social engagement and physical health for socially isolated older people. Methods This prospective controlled trial compared a sample of mentoring service clients (intervention group with a matched control group recruited through general practice. One hundred and ninety five participants from each group were matched on mental wellbeing and social activity scores. Assessments were conducted at baseline and at six month follow-up. The primary outcome was the Short Form Health Survey v2 (SF-12 mental health component score (MCS. Secondary outcomes included the SF-12 physical health component score (PCS, EuroQol EQ-5D, Geriatric Depression Score (GDS-10, social activity, social support and morbidities. Results We found no evidence that mentoring was beneficial across a wide range of participant outcomes measuring health status, social activity and depression. No statistically significant between-group differences were observed at follow-up in the primary outcome (p = 0.48 and in most secondary outcomes. Identifying suitable matched pairs of intervention and control group participants proved challenging. Conclusions The results of this trial provide no substantial evidence supporting the use of community mentoring as an effective means of alleviating social isolation in older people. Further evidence is needed on the effectiveness of community-based interventions targeting social isolation. When using non-randomised designs, there are considerable challenges in the recruitment of suitable

  2. Normalized performance and load data for the deepwind demonstrator in controlled conditions

    DEFF Research Database (Denmark)

    Battisti, L.; Benini, E.; Brighenti, A.

    2016-01-01

    , derived from real scale measurements on a three-bladed Troposkien vertical-axis wind turbine, are manipulated in a convenient form to be easily compared with the typical outputs provided by simulation codes. The here proposed data complement and support the measurements already presented in "Wind Tunnel......Performance and load normalized coefficients, deriving from an experimental campaign of measurements conducted at the large scale wind tunnel of the Politecnico di Milano (Italy), are presented with the aim of providing useful benchmark data for the validation of numerical codes. Rough data...... Testing of the DeepWind Demonstrator in Design and Tilted Operating Conditions" (Battisti et al., 2016) [1]....

  3. Normal Bone Microstructure and Density But Worse Physical Function in Older Women Treated with Selective Serotonin Reuptake Inhibitors, a Cross-Sectional Population-Based Study.

    Science.gov (United States)

    Larsson, Berit; Mellström, Dan; Johansson, Lisa; Nilsson, Anna G; Lorentzon, Mattias; Sundh, Daniel

    2018-05-05

    Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women. From an ongoing population-based study, 1057 women (77.7 ± 1.5 years) were included. Validated questionnaires were used to assess information regarding medical history, medications, smoking, mental and physical health, and physical activity. Physical function was measured using clinically used tests: timed up and go, walking speed, grip strength, chair stand test, and one leg standing. Bone mineral density (BMD) was measured at the hip and spine with dual-energy X-ray absorptiometry (Hologic Discovery A). Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT). Treatment with SSRIs was associated with higher BMD at the femoral neck, total hip, and lumbar spine, whereas no associations were found for any HR-pQCT-derived measurements. The use of SSRIs was associated with lower grip strength, walking speed, and fewer chair stand rises. These associations were valid also after adjustments for known risk factors for falls. Treatment with SSRIs was, independently of covariates, associated with worse physical function without any signs of inferior bone geometry and microstructure.

  4. The Moderating Effect of Personality Type on the Relationship between Leisure Activity and Executive Control in Older Adults

    Science.gov (United States)

    Hill, Nikki L.; Lin, Feng Vankee; Parisi, Jeanine M.; Kolanowski, Ann

    2016-01-01

    We examined the moderating effect of personality on the association between leisure activities and executive control in healthy community-dwelling older adults. We found two distinct personality typologies: individuals with a Resilient personality were characterized by emotional stability and self-confidence; whereas, those who resembled an Overcontrolled personality tended to be introverted, but also low on neuroticism. Resilient individuals were more likely than Overcontrolled individuals to demonstrate higher executive function and attention as a result of participation in mental activities. These results suggest that personality might be important to include in studies that test the efficacy of activity interventions for improving cognition. PMID:27087715

  5. Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Anton SD

    2011-06-01

    Full Text Available Stephen D Anton1,2, Todd M Manini1, Vanessa A Milsom2, Pamela Dubyak2, Matteo Cesari3, Jing Cheng4, Michael J Daniels5, Michael Marsiske2, Marco Pahor1, Christiaan Leeuwenburgh1, Michael G Perri21Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; 3Area di Geriatria, Università Campus Bio-Medico, Rome, Italy; 4Division of Oral Epidemiology and Dental Public Health, San Francisco, CA, USA; 5Department of Statistics, University of Florida, Gainesville, FL, USABackground: Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women.Methods: Participants (n = 34 were generally healthy, obese, older adult women (age range 55–79 years with mild to moderate physical impairments (ie, functional limitations. Participants were randomly assigned to one of two groups for 24 weeks: (i weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5] or (ii educational control (n = 17; mean age = 63.7 [6.7]. In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i body weight, (ii walking speed (assessed by 400-meter walk test, (iii the Short Physical Performance Battery (SPPB, and (iv knee extension isokinetic strength.Results: Participants randomized

  6. Effect of Baduanjin exercise on cognitive function in older adults with mild cognitive impairment: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Zheng, Guohua; Huang, Maomao; Li, Shuzhen; Li, Moyi; Xia, Rui; Zhou, Wenji; Tao, Jing; Chen, Lidian

    2016-04-11

    Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and dementia characterised by a reduction in memory and/or other cognitive processes. An increasing number of studies have indicated that regular physical activity/exercise may have beneficial association with cognitive function of older adults with or without cognitive impairment. As a traditional Chinese Qigong exercise, Baduanjin may be even more beneficial in promoting cognitive ability in older adults with MCI, but the evidence is still insufficient. The main purpose of this study is to investigate the effect of Baduanjin exercise on neuropsychological outcomes of community-dwelling older adults with MCI, and to explore its mechanism of action from neuroimaging based on functional MRI (fMRI) and cerebrovascular function. The design of this study is a randomised, controlled trial with three parallel groups in a 1:1:1 allocation ratio with allocation concealment and assessor blinding. A total of 135 participants will be enrolled and randomised to the 24-week Baduanjin exercise intervention, 24-week brisk walking intervention and 24-week usual physical activity control group. Global cognitive function and the specific domains of cognition (memory, processing speed, executive function, attention and verbal learning and memory) will be assessed at baseline and 9, 17, 25 and 37 weeks after randomisation, while the structure and function of brain regions related to cognitive function and haemodynamic variables of the brain will be measured by fMRI and transcranial Doppler, respectively, at baseline and 25 and 37 weeks after randomisation. Ethics approval was given by the Medical Ethics Committee of the Second People's Hospital of Fujian Province (approval number 2014-KL045-02). The findings will be disseminated through peer-reviewed publications and at scientific conferences. ChiCTR-ICR-15005795; Pre-results. Published by the BMJ Publishing Group Limited. For

  7. Design report on the guide box-reactivity and safety control plates for MPR reactor under normal operation conditions

    International Nuclear Information System (INIS)

    Markiewicz, M.

    1999-01-01

    The reactivity control system for the MPR reactor (Multi Purpose Reactor) is a critical component regarding safety, it must ensure a fast shut down, maintaining the reactor in subcritical condition under normal or accidental operation condition. For this purpose, this core component must be designed to maintain its operating capacity during all the residence time and under any foreseen operation condition. The mechanical design of control plates and guide boxes must comply with structural integrity, maintaining its geometric and dimensional stability within the pre-established limits to prevent interferences with other core components. For this, the heat generation effect, mechanical loads and environment and irradiation effects were evaluated during the mechanical design. The reactivity control system is composed of guide boxes, manufactured from Aluminium alloy, located between the fuel elements, and control absorber plates of Ag-In-Cd alloy hermetically enclosed by a cladding of stainless steel sliding inside de guide boxes. The upward-downward movement is transmitted by a rod from the motion device located at the reactor lower part. The design requirements, criteria and limits were established to fulfill with the normal and abnormal operation conditions. The design verifications were performed by analytical method, estimating the guide box and control plates residence time. The result of the analysis performed, shows that the design of the reactivity control system and the material selected, are appropriate to fulfill the functional requirements, with no failures attributed to the mechanical design. (author)

  8. Metachronous colon polyps in younger versus older adults: a case-control study.

    Science.gov (United States)

    Nagpal, Sajan Jiv Singh; Mukhija, Dhruvika; Sanaka, Madhusudhan; Lopez, Rocio; Burke, Carol A

    2018-03-01

    The incidence of colorectal cancer in the United States has decreased substantially in individuals aged 50 and older. In contrast, it is increasing in young adults. The polyp characteristics on baseline and follow-up colonoscopy in young adults are not well characterized. We describe the polyp characteristics on baseline and follow-up colonoscopy in adults 1 polyp removed on colonoscopy followed by a postpolypectomy colonoscopy were eligible. The primary outcome was the occurrence of advanced neoplasia or HR polyp features on follow-up colonoscopy. Secondary endpoints included factors associated with metachronous advanced neoplasia in young adults. The occurrence of metachronous advanced neoplasia in young adults was compared with a cohort of patients aged 50 years and older. Included were 128 patients with a mean age of 34.9 years; 124 patients (97%) had adenomas and 7% had sessile serrated polyps (SSPs). Advanced neoplasia was seen in 35% of patients at baseline. The median follow-up time was 33.6 months. Metachronous advanced neoplasia was identified in 7% of patients on follow-up colonoscopy. Baseline factors associated with metachronous advanced neoplasia included the presence of an SSP (hazard ratio, 7.8; 95% CI, 1.09-56.3; P = .041) with a trend in those with advanced neoplasia (hazard ratio, 3.4; 95% confidence interval, .89-12.8; P = .072). The occurrence of metachronous advanced neoplasia did not differ between the young and older cohorts (7% vs 12.2%, P = .58); however, young adults were less likely to have HR polyp features on follow-up (8.6% vs 20.3%, P = .008). More than 1 in 3 adults <40 years old undergoing colonoscopy had advanced neoplasia on baseline colonoscopy. The occurrence of metachronous advanced neoplasia in young adults is similar to older adults and appears to be associated with the size, pathology, and number of baseline polyps. Our data suggest young polyp-bearing adults may undergo postpolypectomy colonoscopy at intervals

  9. Quantitative nailfold capillaroscopy findings in a population with connective tissue disease and in normal healthy controls.

    Science.gov (United States)

    Kabasakal, Y; Elvins, D M; Ring, E F; McHugh, N J

    1996-01-01

    OBJECTIVE: To describe and quantify the morphological characteristics of nailfold capillaries that distinguish different forms of connective tissue disease from healthy controls. METHODS: A CCD video microscope with fibreoptic illumination and PC based image processing was used to visualise nailfold capillaries and to quantify findings in 23 patients with systemic sclerosis (SSc), 22 patients with systemic lupus erythematosus (SLE), 21 patients with undifferentiated connective tissue disease (UCTD), and 38 healthy controls. RESULTS: Capillary density was reduced in SSc (5.2 (SD 1.3) capillaries/mm) compared with other patient groups and controls. The average number of enlarged capillaries/finger was high in all disease groups (5.5-6.6) compared with controls (2). However, giant capillaries were most frequent in SSc (43%) and were not present in controls. Mild and moderate avascular areas were present in all groups (35%-68%), but severe avascularity was most frequent in SSc (44%) compared with other patients (18%-19%) and controls (0%). The greatest frequency of extensive haemorrhage was in SSc (35%). CONCLUSIONS: There is a range of abnormal capillary findings in patients with connective tissue disease and healthy controls. However, certain abnormalities such as a reduced number of capillaries, severe avascularity, giant capillaries, and haemorrhage are most commonly associated with SSc. Videomicroscopy with image processing offers many technical advantages that can be exploited in further studies of nailfold capillaries. Images PMID:8774177

  10. False Memory in Adults With ADHD: A Comparison Between Subtypes and Normal Controls.

    Science.gov (United States)

    Soliman, Abdrabo Moghazy; Elfar, Rania Mohamed

    2017-10-01

    To examine the performance on the Deese-Roediger-McDermott task of adults divided into ADHD subtypes and compares their performance to that of healthy controls to examine whether adults with ADHD are more susceptible to the production of false memories under experimental conditions. A total of 128 adults with ADHD (50% females), classified into three Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV-TR) subtypes, were compared with 48 controls. The results indicated that the ADHD participants recalled and recognized fewer studied words than the controls, the ADHD groups produced more false memories than the control group, no differences in either the false positives or the false negatives. The ADHD-combined (ADHD-CT) group recognized significantly more critical words than the control, ADHD-predominantly inattentive (ADHD-IA), and ADHD-predominantly hyperactive-impulsive (ADHD-HI) groups. The ADHD groups recalled and recognized more false positives, were more confident in their false responses, and displayed more knowledge corruption than the controls. The ADHD-CT group recalled and recognized more false positives than the other ADHD groups. The adults with ADHD have more false memories than the controls and that false memory formation varied with the ADHD subtypes.

  11. Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth.

    Science.gov (United States)

    Harmon, Kristin A; Gerard, Lori; Jensen, Dalan R; Kealey, Elizabeth H; Hernandez, Teri L; Reece, Melanie S; Barbour, Linda A; Bessesen, Daniel H

    2011-10-01

    We sought to define 24-h glycemia in normal-weight and obese pregnant women using continuous glucose monitoring (CGM) while they consumed a habitual and controlled diet both early and late in pregnancy. Glycemia was prospectively measured in early (15.7 ± 2.0 weeks' gestation) and late (27.7 ± 1.7 weeks' gestation) pregnancy in normal-weight (n = 22) and obese (n = 16) pregnant women on an ad libitum and controlled diet. Fasting glucose, triglycerides (early pregnancy only), nonesterified fatty acids (FFAs), and insulin also were measured. The 24-h glucose area under the curve was higher in obese women than in normal-weight women both early and late in pregnancy despite controlled diets. Nearly all fasting and postprandial glycemic parameters were higher in the obese women later in pregnancy, as were fasting insulin, triglycerides, and FFAs. Infants born to obese mothers had greater adiposity. Maternal BMI (r = 0.54, P = 0.01), late average daytime glucose (r = 0.48, P fasting insulin (r = 0.49, P fasting triglycerides (r = 0.67, P fasting FFAs (r = 0.54, P obese women without diabetes have higher daytime and nocturnal glucose profiles than normal-weight women despite a controlled diet both early and late in gestation. Body fat in infants, not birth weight, was related to maternal BMI, glucose, insulin, and FFAs, but triglycerides were the strongest predictor. These metabolic findings may explain higher rates of infant macrosomia in obese women, which might be targeted in trials to prevent excess fetal growth.

  12. Distributed hierarchical control architecture for integrating smart grid assets during normal and disrupted operations

    Science.gov (United States)

    Kalsi, Karan; Fuller, Jason C.; Somani, Abhishek; Pratt, Robert G.; Chassin, David P.; Hammerstrom, Donald J.

    2017-09-12

    Disclosed herein are representative embodiments of methods, apparatus, and systems for facilitating operation and control of a resource distribution system (such as a power grid). Among the disclosed embodiments is a distributed hierarchical control architecture (DHCA) that enables smart grid assets to effectively contribute to grid operations in a controllable manner, while helping to ensure system stability and equitably rewarding their contribution. Embodiments of the disclosed architecture can help unify the dispatch of these resources to provide both market-based and balancing services.

  13. Effects of programmed exercise on depressive symptoms in midlife and older women: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Pérez-López, Faustino R; Martínez-Domínguez, Samuel J; Lajusticia, Héctor; Chedraui, Peter

    2017-12-01

    To perform a systematic review and meta-analysis to clarify the effect of programmed exercise on depressive symptoms (DSs) in midlife and older women. We carried out a structured search of PubMed-Medline, Web of Science, Scopus, Embase, Cochrane Library and Scielo, from database inception through June 29, 2017, without language restriction. The search included the following terms: "depression", "depressive symptoms", "exercise", "physical activity", "menopause", and "randomized controlled trial" (RCTs) in midlife and older women. The US, UK and Australian Clinical Trials databases were also searched. We assessed randomized controlled trials (RCTs) that compared the effect of exercise for at least 6 weeks versus no intervention on DSs as the outcome (as defined by trial authors). Exercise was classified according to duration as "mid-term exercise intervention" (MTEI; lasting for 12 weeks to 4 months), and "long-term exercise intervention" (LTEI; lasting for 6-12 months). Mean changes (±standard deviations) in DSs, as assessed with different questionnaires, were extracted to calculate Hedges' g and then used as the effect size for meta-analysis. Standardized mean differences (SMDs) of DSs after intervention were pooled using a random-effects model. Eleven publications were included for analysis related to 1943 midlife and older women (age range 44-55 years minimum to 65.5±4.0 maximum), none of whom was using a hormone therapy. Seven MTEIs were associated with a significant reduction in DSs (SMD=-0.44; 95% CI -0.69, -0.18; p=0.0008) compared with controls. The reduction in DSs was also significant in six LTEIs (SMD=- 0.29; 95% CI -0.49; -0.09; p=0.005). Heterogeneity of effects among studies was moderate to high. Less perceived stress and insomnia (after exercise) were also found as secondary outcomes. Exercise of low to moderate intensity reduces depressive symptoms in midlife and older women. Copyright © 2017. Published by Elsevier B.V.

  14. Assessing control of postural stability in community-living older adults using performance-based limits of stability

    Directory of Open Access Journals (Sweden)

    Boissy Patrick

    2008-03-01

    Full Text Available Abstract Background Balance disability measurements routinely used to identify fall risks in frail populations have limited value in the early detection of postural stability deficits in community-living older adults. The objectives of the study were to 1 measure performance-based limits of stability (LOS in community-living older adults and compare them to theoretical LOS computed from data proposed by the Balance Master® system, 2 explore the feasibility of a new measurement approach based on the assessment of postural stability during weight-shifting tasks at performance-based LOS, 3 quantify intra-session performance variability during multiple trials using the performance-based LOS paradigm. Methods Twenty-four healthy community-living older adults (10 men, 14 women aged between 62 to 85 (mean age ± sd, 71.5 ± 6 yrs participated in the study. Subjects' performance-based LOS were established by asking them to transfer their body weight as far as possible in three directions (forward, right and left without changing their base of support. LOS were computed as the maximal excursion of the COP in each direction among three trials. Participants then performed two experimental tasks that consisted in controlling, with the assistance of visual feedback, their centre of pressure (COP within two predefined targets set at 100% of their performance-based LOS. For each tasks 8 trials were performed. Ground reaction forces and torques during performance-based LOS evaluation and experimental tasks were recorded with a force plate. Sway area and medio-lateral mean COP displacement speed variables were extracted from force plate recordings. Results Significant differences between theoretical LOS computed from maximum leaning angles derived from anthropometric characteristics and performance-based LOS were observed. Results showed that a motor learning effect was present as the participants optimized their weight-shifting strategy through the first three

  15. Short-Term Changes in General and Memory-Specific Control Beliefs and Their Relationship to Cognition in Younger and Older Adults

    Science.gov (United States)

    Bielak, Allison A. M.; Hultsch, David F.; Levy-Ajzenkopf, Judi; MacDonald, Stuart W. S.; Hunter, Michael A.; Strauss, Esther

    2007-01-01

    We examined short-term changes in younger and older adults' control beliefs. Participants completed measures of general and memory-specific competence and locus of control on 10 bi-monthly occasions. At each occasion, participants rated their control beliefs prior to and following completion of a battery of cognitive tasks. Exposure to the set of…

  16. Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Bettina Wollesen

    2017-12-01

    Full Text Available Background: Dual-task (DT training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions.Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group in gait performance compared to a single task (ST strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h-1. Specific gait variables, cognitive performance, and fear of falling were compared between all groups.>Results: Training improved gait performance for step length (p < 0.001 and gait-line (ST: p < 0.01; DT p < 0.05 in both training groups. The BDT training group showed greater improvements in step length (p < 0.001 and gait-line (p < 0.01 during DT walking but did not have changes in cognitive performance. Both interventions reduced fear of falling (p < 0.05.Conclusion: Implementation of task management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals.Trial registration: German register of clinical trials DRKS00012382.

  17. Normalized performance and load data for the deepwind demonstrator in controlled conditions

    Directory of Open Access Journals (Sweden)

    L. Battisti

    2016-09-01

    Full Text Available Performance and load normalized coefficients, deriving from an experimental campaign of measurements conducted at the large scale wind tunnel of the Politecnico di Milano (Italy, are presented with the aim of providing useful benchmark data for the validation of numerical codes. Rough data, derived from real scale measurements on a three-bladed Troposkien vertical-axis wind turbine, are manipulated in a convenient form to be easily compared with the typical outputs provided by simulation codes. The here proposed data complement and support the measurements already presented in “Wind Tunnel Testing of the DeepWind Demonstrator in Design and Tilted Operating Conditions” (Battisti et al., 2016 [1]. Keywords: VAWT, DeepWind Project, Troposkien rotor, Skewed flow, Wind tunnel measurements, Wind turbine benchmark data

  18. Depth of word processing in Alzheimer patients and normal controls: a magnetoencephalographic (MEG) study.

    Science.gov (United States)

    Walla, P; Püregger, E; Lehrner, J; Mayer, D; Deecke, L; Dal Bianco, P

    2005-05-01

    Effects related to depth of verbal information processing were investigated in probable Alzheimer's disease patients (AD) and age matched controls. During word encoding sessions 10 patients and 10 controls had either to decide whether the letter "s" appeared in visually presented words (alphabetical decision, shallow encoding), or whether the meaning of each presented word was animate or inanimate (lexical decision, deep encoding). These encoding sessions were followed by test sessions during which all previously encoded words were presented again together with the same number of new words. The task was then to discriminate between repeated and new words. Magnetic field changes related to brain activity were recorded with a whole cortex MEG.5 probable AD patients showed recognition performances above chance level related to both depths of information processing. Those patients and 5 age matched controls were then further analysed. Recognition performance was poorer in probable AD patients compared to controls for both levels of processing. However, in both groups deep encoding led to a higher recognition performance than shallow encoding. We therefore conclude that the performance reduction in the patient group was independent of depth of processing. Reaction times related to false alarms differed between patients and controls after deep encoding which perhaps could already be used for supporting an early diagnosis. The analysis of the physiological data revealed significant differences between correctly recognised repetitions and correctly classified new words (old/new-effect) in the control group which were missing in the patient group after deep encoding. The lack of such an effect in the patient group is interpreted as being due to the respective neuropathology related to probable AD. The present results demonstrate that magnetic field recordings represent a useful tool to physiologically distinguish between probable AD and age matched controls.

  19. Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Min-Ji Kim

    2016-06-01

    Full Text Available Aims: This study aimed to investigate the effect of 6-month physical exercise with a multicomponent cognitive program (MCP on the cognitive function of older adults with moderate to severe Alzheimer's disease (AD. Methods: We included 33 participants with AD in a 6-month randomized controlled trial. The intervention group participated in physical exercise and received a MCP. The control group received only the MCP. Before and after the intervention, cognitive outcomes were assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog, Mini-Mental State Examination, and the Clock Drawing Test. Physical performance was evaluated by exercise time, the number of pedal rotation, total load, grip strength, and the Berg Balance Scale (BBS. Results: In all cognitive measures, there were no significant improvements between the two groups after 6 months in the baseline value-adjusted primary analysis. However, the ADAS-cog score was significantly lower between the two groups in secondary analysis adjusted for baseline value, age, sex, and education years. All physical outcomes were significantly higher in the intervention group except for total load compared with baseline measurements. Conclusion: This study indicates that it is possible to improve cognitive function in older adults with moderate to severe AD through 6-month physical exercise with a multicomponent cognitive intervention.

  20. Randomized controlled trial comparing tailoring methods of multimedia-based fall prevention education for community-dwelling older adults.

    Science.gov (United States)

    Schepens, Stacey L; Panzer, Victoria; Goldberg, Allon

    2011-01-01

    We attempted to determine whether multimedia fall prevention education using different instructional strategies increases older adults' knowledge of fall threats and their fall prevention behaviors. Fifty-three community-dwelling older adults were randomized to iwo educational groups or a control group. Multimedia-based educational interventions to increase fall threats knowledge and encourage fall prevention behaviors had two tailoring strategies: (1) improve content realism for individual learners (authenticity group) and (2) highlight program goals and benefits while using participants' content selections (motivation group). Knowledge was measured at baseline and 1-mo follow-up. Participants recorded prevention behaviors for 1 mo. Intervention group participants showed greater knowledge gains and posttest knowledge than did control group participants. The motivation group engaged in more prevention behaviors over 1 mo than did the other groups. Tailoring fall prevention education by addressing authenticity and motivation successfully improved fall threats knowledge. Combining motivational strategies with multimedia education increased the effectiveness of the intervention in encouraging fall prevention behaviors.

  1. Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Min-Ji; Han, Chang-Wan; Min, Kyoung-Youn; Cho, Chae-Yoon; Lee, Chae-Won; Ogawa, Yoshiko; Mori, Etsuro; Kohzuki, Masahiro

    2016-01-01

    This study aimed to investigate the effect of 6-month physical exercise with a multicomponent cognitive program (MCP) on the cognitive function of older adults with moderate to severe Alzheimer's disease (AD). We included 33 participants with AD in a 6-month randomized controlled trial. The intervention group participated in physical exercise and received a MCP. The control group received only the MCP. Before and after the intervention, cognitive outcomes were assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Mini-Mental State Examination, and the Clock Drawing Test. Physical performance was evaluated by exercise time, the number of pedal rotation, total load, grip strength, and the Berg Balance Scale (BBS). In all cognitive measures, there were no significant improvements between the two groups after 6 months in the baseline value-adjusted primary analysis. However, the ADAS-cog score was significantly lower between the two groups in secondary analysis adjusted for baseline value, age, sex, and education years. All physical outcomes were significantly higher in the intervention group except for total load compared with baseline measurements. This study indicates that it is possible to improve cognitive function in older adults with moderate to severe AD through 6-month physical exercise with a multicomponent cognitive intervention.

  2. Wii-Workouts on Chronic Pain, Physical Capabilities and Mood of Older Women: A Randomized Controlled Double Blind Trial.

    Science.gov (United States)

    Monteiro-Junior, Renato Sobral; de Souza, Cíntia Pereira; Lattari, Eduardo; Rocha, Nuno Barbosa Ferreira; Mura, Gioia; Machado, Sérgio; da Silva, Elirez Bezerra

    2015-01-01

    Chronic Low Back Pain (CLBP) is a public health problem and older women have higher incidence of this symptom, which affect body balance, functional capacity and behavior. The purpose of this study was to verifying the effect of exercises with Nintendo Wii on CLBP, functional capacity and mood of elderly. Thirty older women (68 ± 4 years; 68 ± 12 kg; 154 ± 5 cm) with CLBP participated in this study. Elderly individuals were divided into a Control Exercise Group (n = 14) and an Experimental Wii Group (n = 16). Control Exercise Group did strength exercises and core training, while Experimental Wii Group did ones additionally to exercises with Wii. CLBP, balance, functional capacity and mood were assessed pre and post training by the numeric pain scale, Wii Balance Board, sit to stand test and Profile of Mood States, respectively. Training lasted eight weeks and sessions were performed three times weekly. MANOVA 2 x 2 showed no interaction on pain, siting, stand-up and mood (P = 0.53). However, there was significant difference within groups (P = 0.0001). ANOVA 2 x 2 showed no interaction for each variable (P > 0.05). However, there were significant differences within groups in these variables (P balance (P > 0.01). Capacity to Sit improved only in Experimental Wii Group (P = 0.04). In conclusion, physical exercises with Nintendo Wii Fit Plus additional to strength and core training were effective only for sitting capacity, but effect size was small.

  3. Normal endothelial function in patients with mild-to-moderate psoriasis: a case-control study

    DEFF Research Database (Denmark)

    Jensen, Peter R; Zachariae, Claus; Hansen, Peter

    2011-01-01

    -dependent and technically demanding ultrasound measurement of brachial artery flow-mediated vasodilation. Therefore, we decided to measure endothelial function and other cardiovascular risk factors in patients with mild-to-moderate psoriasis (n = 30) and controls (n = 30) using a newer and relatively operator......Evidence is increasing that severe psoriasis is an independent cardiovascular risk factor. Results from case-control studies of endothelial dysfunction, a marker of early atherosclerosis, in patients with moderate-to-severe psoriasis have been conflicting and were conducted with operator...... blood pressures, and plasma levels of triglycerides, very-low-density lipoprotein cholesterol and glycated glucose, compared with controls. This indicates that even mild-to-moderate psoriasis may be regarded as a systemic inflammatory disease, and that an increased risk of cardiovascular morbidity may...

  4. Differentiating Patients with Parkinson's Disease from Normal Controls Using Gray Matter in the Cerebellum.

    Science.gov (United States)

    Zeng, Ling-Li; Xie, Liang; Shen, Hui; Luo, Zhiguo; Fang, Peng; Hou, Yanan; Tang, Beisha; Wu, Tao; Hu, Dewen

    2017-02-01

    Parkinson's disease (PD) is one of the most common neurodegenerative disorders in the world. Previous studies have focused on the basal ganglia and cerebral cortices. To date, the cerebellum has not been systematically investigated in patients with PD. In the current study, 45 probable PD patients and 40 age- and gender-matched healthy controls underwent structural magnetic resonance imaging, and we used support vector machines combining with voxel-based morphometry to explore the cerebellar structural changes in the probable PD patients relative to healthy controls. The results revealed that the gray matter alterations were primarily located within the cerebellar Crus I, implying a possible important role of this region in PD. Furthermore, the gray matter alterations in the cerebellum could differentiate the probable PD patients from healthy controls with accuracies of more than 95 % (p cerebellum in the clinical diagnosis of PD.

  5. Circulating Docosahexaenoic Acid Associates with Insulin-Dependent Skeletal Muscle and Whole Body Glucose Uptake in Older Women Born from Normal Weight Mothers

    Directory of Open Access Journals (Sweden)

    Robert M. Badeau

    2017-02-01

    Full Text Available Background: Obesity among pregnant women is common, and their offspring are predisposed to obesity, insulin resistance, and diabetes. The circulating metabolites that are related to insulin resistance and are associated with this decreased tissue-specific uptake are unknown. Here, we assessed metabolite profiles in elderly women who were either female offspring from obese mothers (OOM or offspring of lean mothers (OLM. Metabolic changes were tested for associations with metrics for insulin resistance. Methods: Thirty-seven elderly women were separated into elderly offspring from obese mothers (OOM; n = 17 and elderly offspring from lean/normal weight mothers (OLM; n = 20 groups. We measured plasma metabolites using proton nuclear magnetic resonance (1H-NMR and insulin-dependent tissue-specific glucose uptake in skeletal muscle was assessed. Associations were made between metabolites and glucose uptake. Results: Compared to the OLM group, we found that the docosahexaenoic acid percentage of the total long-chain n-3 fatty acids (DHA/FA was significantly lower in OOM (p = 0.015. DHA/FA associated significantly with skeletal muscle glucose uptake (GU (p = 0.031 and the metabolizable glucose value derived from hyperinsulinemic-euglycemic clamp technique (M-value in the OLM group only (p = 0.050. Conclusions: DHA/FA is associated with insulin-dependent skeletal muscle glucose uptake and this association is significantly weakened in the offspring of obese mothers.

  6. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls

    Energy Technology Data Exchange (ETDEWEB)

    Buchanan, Allison; Kalathingal Sajitha; De Rossi, Scott [Dept. of Oral Health and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta (United States); Cohen, Ruben [Park Avenue Oral and Facial Surgery, New York (United States); Loony, Stephen [Dept. of Biostatistics and Epidemiology, Augusta University Medical College of Georgia, Augusta (United States)

    2016-03-15

    To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixteen control subjects were compared. The average area, average volume, total volume, and total length of the upper airway were computed. Width and anterior-posterior (AP) measurements were obtained on the smallest axial slice. OSA subjects had a significantly smaller average airway area, average airway volume, total airway volume, and mean airway width. OSA subjects had a significantly larger airway length measurement. The mean A-P distance was not significantly different between groups. OSA subjects have a smaller upper airway compared to controls with the exception of airway length. The lack of a significant difference in the mean A-P distance may indicate that patient position during imaging (upright vs. supine) can affect this measurement. Comparison of this study with a future prospective study design will allow for validation of these results.

  7. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls

    International Nuclear Information System (INIS)

    Buchanan, Allison; Kalathingal Sajitha; De Rossi, Scott; Cohen, Ruben; Loony, Stephen

    2016-01-01

    To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixteen control subjects were compared. The average area, average volume, total volume, and total length of the upper airway were computed. Width and anterior-posterior (AP) measurements were obtained on the smallest axial slice. OSA subjects had a significantly smaller average airway area, average airway volume, total airway volume, and mean airway width. OSA subjects had a significantly larger airway length measurement. The mean A-P distance was not significantly different between groups. OSA subjects have a smaller upper airway compared to controls with the exception of airway length. The lack of a significant difference in the mean A-P distance may indicate that patient position during imaging (upright vs. supine) can affect this measurement. Comparison of this study with a future prospective study design will allow for validation of these results

  8. Optimised anaesthesia to reduce post operative cognitive decline (POCD in older patients undergoing elective surgery, a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Clive Ballard

    Full Text Available BACKGROUND: The study determined the one year incidence of post operative cognitive decline (POCD and evaluated the effectiveness of an intra-operative anaesthetic intervention in reducing post-operative cognitive impairment in older adults (over 60 years of age undergoing elective orthopaedic or abdominal surgery. METHODS AND TRIAL DESIGN: The design was a prospective cohort study with a nested randomised, controlled intervention trial, using intra-operative BiSpectral index and cerebral oxygen saturation monitoring to enable optimisation of anaesthesia depth and cerebral oxygen saturation in older adults undergoing surgery. RESULTS: In the 52 week prospective cohort study (192 surgical patients and 138 controls, mild (χ(2 = 17.9 p<0.0001, moderate (χ(2 = 7.8 p = 0.005 and severe (χ(2 = 5.1 p = 0.02 POCD were all significantly higher after 52 weeks in the surgical patients than among the age matched controls. In the nested RCT, 81 patients were randomized, 73 contributing to the data analysis (34 intervention, 39 control. In the intervention group mild POCD was significantly reduced at 1, 12 and 52 weeks (Fisher's Exact Test p = 0.018, χ(2 = 5.1 p = 0.02 and χ(2 = 5.9 p = 0.015, and moderate POCD was reduced at 1 and 52 weeks (χ(2 = 4.4 p = 0·037 and χ(2 = 5.4 p = 0.02. In addition there was significant improvement in reaction time at all time-points (Vigilance Reaction Time MWU Z = -2.1 p = 0.03, MWU Z = -2.7 p = 0.004, MWU Z = -3.0 p = 0.005, in MMSE at one and 52 weeks (MWU Z = -2.9 p = 0.003, MWU Z = -3.3 p = 0.001, and in executive function at 12 and 52 weeks (Trail Making MWU Z = -2.4 p = .0.018, MWU Z = -2.4 p = 0.019. CONCLUSION: POCD is common and persistent in older adults following surgery. The results of the nested RCT indicate the potential benefits of intra-operative monitoring of anaesthetic depth and cerebral oxygenation as a pragmatic intervention to reduce post-operative cognitive impairment. TRIAL REGISTRATION

  9. Promoting Active Transport in Older Adolescents Before They Obtain Their Driving Licence: A Matched Control Intervention Study.

    Science.gov (United States)

    Verhoeven, Hannah; Simons, Dorien; Van Cauwenberg, Jelle; Van Dyck, Delfien; Vandelanotte, Corneel; de Geus, Bas; De Bourdeaudhuij, Ilse; Clarys, Peter; Deforche, Benedicte

    2016-01-01

    Active transport has great potential to increase physical activity in older adolescents (17-18 years). Therefore, a theory- and evidence-based intervention was developed aiming to promote active transport among older adolescents. The intervention aimed to influence psychosocial factors of active transport since this is the first step in order to achieve a change in behaviour. The present study aimed to examine the effect of the intervention on the following psychosocial factors: intention to use active transport after obtaining a driving licence, perceived benefits, perceived barriers, subjective norm, self-efficacy, habit and awareness towards active transport. A matched control three-arm study was conducted and consisted of a pre-test post-test design with intervention and control schools in Flanders (northern part of Belgium). A lesson promoting active transport was implemented as the last lesson in the course 'Driving Licence at School' in intervention schools (intervention group 1). Individuals in intervention group 2 received this active transport lesson and, in addition, they were asked to become a member of a Facebook group on active transport. Individuals in the control group only attended the regular course 'Driving Licence at School'. Participants completed a questionnaire assessing socio-demographics and psychosocial variables at baseline, post (after one week) and follow-up (after eight weeks). To assess intervention effects, multilevel linear mixed models analyses were performed. A sample of 441 older adolescents (56.8% female; 17.4 (0.7) years) was analysed. For awareness regarding the existence of car sharing schemes, a significant increase in awareness from baseline to post measurement was found within intervention group 1 (p = 0.001) and intervention group 2 (p = 0.030) compared to the control group in which no change was found. In addition, a significant increase in awareness from baseline to follow-up measurement was found within intervention

  10. Promoting Active Transport in Older Adolescents Before They Obtain Their Driving Licence: A Matched Control Intervention Study.

    Directory of Open Access Journals (Sweden)

    Hannah Verhoeven

    Full Text Available Active transport has great potential to increase physical activity in older adolescents (17-18 years. Therefore, a theory- and evidence-based intervention was developed aiming to promote active transport among older adolescents. The intervention aimed to influence psychosocial factors of active transport since this is the first step in order to achieve a change in behaviour. The present study aimed to examine the effect of the intervention on the following psychosocial factors: intention to use active transport after obtaining a driving licence, perceived benefits, perceived barriers, subjective norm, self-efficacy, habit and awareness towards active transport.A matched control three-arm study was conducted and consisted of a pre-test post-test design with intervention and control schools in Flanders (northern part of Belgium. A lesson promoting active transport was implemented as the last lesson in the course 'Driving Licence at School' in intervention schools (intervention group 1. Individuals in intervention group 2 received this active transport lesson and, in addition, they were asked to become a member of a Facebook group on active transport. Individuals in the control group only attended the regular course 'Driving Licence at School'. Participants completed a questionnaire assessing socio-demographics and psychosocial variables at baseline, post (after one week and follow-up (after eight weeks. To assess intervention effects, multilevel linear mixed models analyses were performed.A sample of 441 older adolescents (56.8% female; 17.4 (0.7 years was analysed. For awareness regarding the existence of car sharing schemes, a significant increase in awareness from baseline to post measurement was found within intervention group 1 (p = 0.001 and intervention group 2 (p = 0.030 compared to the control group in which no change was found. In addition, a significant increase in awareness from baseline to follow-up measurement was found within

  11. Comparison of Well-being of Older Adult Choir Singers and the General Population in Finland: A Case-Control Study.

    Science.gov (United States)

    Johnson, Julene K; Louhivuori, Jukka; Siljander, Eero

    2017-06-01

    Previous research suggests that singing in a choir as an older adult is associated with better quality of life (QOL). However, the degree to which sociodemographic variables and level of engagement in hobbies contribute to this relationship is largely unknown. The aim of the study was to compare quality of life (QOL) of older adult choir singers with a matched sample of older adults from the general population in Finland, taking into consideration sociodemographic, satisfaction with health, and level of engagement in hobbies (active, inactive). Case-control methods were used to match a sample of 109 older adult singers with a sample of 307 older adults from the general population. Tobit regression analysis with sociodemographic covariates was used to explore observed group differences in QOL as measured by two WHOQOL-Bref domains (psychological and physical). Probit regression analysis was used to examine the effect of sociodemographic variables and engagement in hobbies and on overall QOL and satisfaction with health. As expected, sociodemographic variables were strongly associated with physical and psychological QOL. After controlling for sociodemographic variables, the older choir singers reported significantly higher ratings on physical QOL, but not psychological QOL, compared to matched controls. Additional adjustment for satisfaction for health attenuated the results. When considering level of engagement in hobbies, older adult choir singers reported significantly higher overall QOL and satisfaction with health when compared to either controls who were either actively engaged in hobbies or not active in hobbies. These results suggest that singing in a choir as an older adult may promote well-being, even after accounting for sociodemographic and level of engagement in hobbies.

  12. Balance, Falls-Related Self-Efficacy, and Psychological Factors amongst Older Women with Chronic Low Back Pain: A Preliminary Case-Control Study

    OpenAIRE

    Champagne, Annick; Prince, François; Bouffard, Vicky; Lafond, Danik

    2012-01-01

    Objective. To investigate balance functions in older women and evaluate the association of the fear-avoidance beliefs model (FABM) factors with balance and mobility performance. Participants. Fifteen older women with CLBP was compared with age-matched pain-free controls (n = 15). Main Outcome Measures. Pain intensity, falls-related self-efficacy and intrinsic constructs in the FABM were evaluated. Postural steadiness (centre of pressure (COP)) and mobility functions were assessed. Linear rela...

  13. Aerobic Glycolysis Is Essential for Normal Rod Function and Controls Secondary Cone Death in Retinitis Pigmentosa.

    Science.gov (United States)

    Petit, Lolita; Ma, Shan; Cipi, Joris; Cheng, Shun-Yun; Zieger, Marina; Hay, Nissim; Punzo, Claudio

    2018-05-29

    Aerobic glycolysis accounts for ∼80%-90% of glucose used by adult photoreceptors (PRs); yet, the importance of aerobic glycolysis for PR function or survival remains unclear. Here, we further established the role of aerobic glycolysis in murine rod and cone PRs. We show that loss of hexokinase-2 (HK2), a key aerobic glycolysis enzyme, does not affect PR survival or structure but is required for normal rod function. Rods with HK2 loss increase their mitochondrial number, suggesting an adaptation to the inhibition of aerobic glycolysis. In contrast, cones adapt without increased mitochondrial number but require HK2 to adapt to metabolic stress conditions such as those encountered in retinitis pigmentosa, where the loss of rods causes a nutrient shortage in cones. The data support a model where aerobic glycolysis in PRs is not a necessity but rather a metabolic choice that maximizes PR function and adaptability to nutrient stress conditions. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  14. Hormonal enzymatic systems in normal and cancerous human breast: control, prognostic factors, and clinical applications.

    Science.gov (United States)

    Pasqualini, Jorge R; Chetrite, Gérard S

    2012-04-01

    The bioformation and transformation of estrogens and other hormones in the breast tissue as a result of the activity of the various enzymes involved attract particular attention for the role they play in the development and pathogenesis of hormone-dependent breast cancer. The enzymatic process concerns the aromatase, which transforms androgens into estrogens; the sulfatase, which hydrolyzes the biologically inactive sulfates to the active hormone; the 17β-hydroxysteroid dehydrogenases, which are involved in the interconversion estradiol/estrone or testosterone/androstenedione; hydroxylases, which transform estrogens into mitotic and antimitotic derivatives; and sulfotransferases and glucuronidases, which, respectively convert into the biologically inactive sulfates and glucuronides. These enzymatic activities are more intense in the carcinoma than in the normal tissue. Concerning aromatase, the application of antiaromatase agents has been largely developed in the treatment of breast cancer patients, with very positive results. Various studies have shown that the activity levels of these enzymes and their mRNA can be involved as interesting prognostic factors for breast cancer. In conclusion, the application of new antienzymatic molecules can open attractive perspectives in the treatment of hormone-dependent breast cancer.

  15. Effect of a social intervention of choice vs. control on depressive symptoms, melancholy, feeling of loneliness, and perceived togetherness in older Finnish people: a randomized controlled trial.

    Science.gov (United States)

    Pynnönen, Katja; Törmäkangas, Timo; Rantanen, Taina; Tiikkainen, Pirjo; Kallinen, Mauri

    2018-01-01

    This study examined effects of a social intervention on depressive symptoms, melancholy, loneliness, and perceived togetherness in community-dwelling Finnish older people. Promotion of mental well-being in older people (GoodMood; ISRCTN78426775) was a single-blinded randomized control trial lasting 1.5 years. Two hundred and twenty-three persons aged 75-79 years reporting symptoms of loneliness or melancholy were randomized into intervention and control groups. The intervention group was allowed to choose among supervised exercise, social activity, or personal counseling. Follow-up measurements were conducted at the end of 6-month intervention, and at 3, 6, and 12 months post intervention. Number of depressive symptoms remained unchanged, while loneliness and melancholy decreased in both the intervention and control groups during the study (p Social integration increased in the intervention group but not in controls (p = 0.041). Attachment and guidance increased in both groups (p intervention did not alleviate depressed mood. Positive changes over time were observed in loneliness, feelings of melancholy, attachment, and guidance but these occurred independently of the intervention. Our secondary analysis suggests that the intervention increased perceived social integration. In sum, the effects of the intervention were moderate only and did not expedite further overcoming depressive mood or loneliness.

  16. Validation of Tuba1a as Appropriate Internal Control for Normalization of Gene Expression Analysis during Mouse Lung Development

    Directory of Open Access Journals (Sweden)

    Aditi Mehta

    2015-02-01

    Full Text Available The expression ratio between the analysed gene and an internal control gene is the most widely used normalization method for quantitative RT-PCR (qRT-PCR expression analysis. The ideal reference gene for a specific experiment is the one whose expression is not affected by the different experimental conditions tested. In this study, we validate the applicability of five commonly used reference genes during different stages of mouse lung development. The stability of expression of five different reference genes (Tuba1a, Actb Gapdh, Rn18S and Hist4h4 was calculated within five experimental groups using the statistical algorithm of geNorm software. Overall, Tuba1a showed the least variability in expression among the different stages of lung development, while Hist4h4 and Rn18S showed the maximum variability in their expression. Expression analysis of two lung specific markers, surfactant protein C (SftpC and Clara cell-specific 10 kDA protein (Scgb1a1, normalized to each of the five reference genes tested here, confirmed our results and showed that incorrect reference gene choice can lead to artefacts. Moreover, a combination of two internal controls for normalization of expression analysis during lung development will increase the accuracy and reliability of results.

  17. Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Kronborg, Christian; Puggaard, Lis

    2008-01-01

    and health-related quality of life. METHODS: Communitydwelling frail women >/=75 yrs, receiving public home care, were randomized into a training group (n=30) and a control group (n=31). Participants exercised for 26 minutes, three times per week for five months. Both groups received a bi-weekly telephone...... call. The effect of intervention was evaluated by the physical performance test, mobility-tiredness score, maximal isometric handgrip and biceps strength, lower limb explosive power, repeated chair rise (5 times), 10-m maximal walking-speed, semi-tandem balance, and health-related quality of life......, handgrip, biceps strength, chair rise, and 10-m maximal walking-speed in the training group, and for walking-speed and self-rated health in the control group. CONCLUSIONS: These results suggest that homebased training for frail older women using an exercise video induces lasting health-related quality...

  18. Older teen attitudes toward birth control access in pharmacies: a qualitative study.

    Science.gov (United States)

    Wilkinson, Tracey A; Miller, Courtney; Rafie, Samantha; Landau, Sharon Cohen; Rafie, Sally

    2018-03-01

    To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are

  19. Normal Pubertal Development in Daughters of Women With PCOS: A Controlled Study.

    Science.gov (United States)

    Legro, Richard S; Kunselman, Allen R; Stetter, Christy M; Gnatuk, Carol L; Estes, Stephanie J; Brindle, Eleanor; Vesper, Hubert W; Botelho, Julianne C; Lee, Peter A; Dodson, William C

    2017-01-01

    Daughters of women with polycystic ovary syndrome (PCOS) are thought to be at increased risk for developing stigmata of the syndrome, but the ontogeny during puberty is uncertain. We phenotyped daughters (n = 76) of mothers with PCOS and daughters (n = 80) from control mothers for reproductive and metabolic parameters characteristic of PCOS. We performed a matched case/control study at Penn State Hershey Medical Center that included non-Hispanic, white girls 4 to 17 years old. We obtained birth history, biometric, ovarian ultrasounds, whole-body dual-energy X-ray absorptiometry scan for body composition, 2-hour glucose challenged salivary insulin levels, and two timed urinary collections (12 hours overnight and 3 hours in the morning) for gonadotropins and sex steroids. We measured integrated urinary levels of adrenal (dehydroepiandrosterone sulfate) and ovarian [testosterone (TT)] steroids. Other endpoints included integrated salivary insulin levels and urinary luteinizing hormone levels. There were no differences in detection rates or mean levels for gonadotropins and sex steroids in timed urinary collections between PCOS daughters and control daughters, nor were there differences in integrated salivary insulin levels. Results showed that 69% of Tanner 4/5 PCOS daughters vs 31% of control daughters had hirsutism defined as a Ferriman-Gallwey score >8 (P = 0.04). There were no differences in body composition as determined by dual-energy X-ray absorptiometry between groups in the three major body contents (i.e., bone, lean body mass, and fat) or in ovarian volume between groups. Matched for pubertal stage, PCOS daughters have similar levels of urinary androgens and gonadotropins as well as glucose-challenged salivary insulin levels. Copyright © 2017 by the Endocrine Society

  20. Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in wards for older people.

    Science.gov (United States)

    Drahota, Amy Kim; Ward, Derek; Udell, Julie E; Soilemezi, Dia; Ogollah, Reuben; Higgins, Bernard; Dean, Taraneh P; Severs, Martin

    2013-09-01

    falls disproportionately affect older people, who are at increased risk of falls and injury. This pilot study investigates shock-absorbing flooring for fall-related injuries in wards for frail older people. we conducted a non-blinded cluster randomised trial in eight hospitals in England between April 2010 and August 2011. Each site allocated one bay as the 'study area', which was randomised via computer to intervention (8.3-mm thick Tarkett Omnisports EXCEL) or control (2-mm standard in situ flooring). Sites had an intervention period of 1 year. Anybody admitted to the study area was eligible. The primary outcome was the fall-related injury rate. Secondary outcomes were injury severity, fall rate and adverse events. during the intervention period, 226 participants were recruited to each group (219 and 223 were analysed in the intervention and control group, respectively). Of 35 falls (31 fallers) in the intervention group, 22.9% were injurious, compared with 42.4% of 33 falls (22 fallers) in the control group [injury incident rate ratio (IRR) = 0.58, 95% CI = 0.18-1.91]. There were no moderate or major injuries in the intervention group and six in the control group. The fall IRR was 1.07 (95% CI = 0.64-1.81). Staff at intervention sites raised concerns about pushing equipment, documenting one pulled back. future research should assess shock-absorbing flooring with better 'push/pull' properties and explore increased faller risk. We estimate a future trial will need 33,480-52,840 person bed-days per arm.

  1. More automation and less cognitive control of imagined walking movements in high versus low fit older adults

    Directory of Open Access Journals (Sweden)

    Ben Godde

    2010-09-01

    Full Text Available Using motor imagery, we investigated brain activation in simple and complex walking tasks (walking forward and backward on a treadmill and analyzed if the motor status of older adults influenced these activation patterns. 51 older adults (64-79 years of age were trained in motor execution and imagery and then performed the imagination task and two control tasks (standing, counting backward in a horizontal position within a 3T MRI scanner (first person perspective, eyes closed. Walking backward as compared to walking forward required larger activations in the primary motor cortex, supplementary motor area, parietal cortex, thalamus, putamen, and caudatum, but less activation in the cerebellum and brainstem. Motor high-fit individuals showed more activations and larger BOLD signals in motor-related areas compared to low-fit participants but demonstrated lower activity in the dorsolateral prefrontal cortex. Moreover, parietal activation in high-fit participants remained stable throughout the movement period whereas low-fit participants revealed an early drop in activity in this area accompanied by increasing activity in frontal brain regions. Overall, walking forward seemed to be more automated (more activation in cerebellum and brainstem, whereas walking backward required more resources, e.g. for visual-spatial processing and sensorimotor control. Low-fit subjects in particular seemed to require more cognitive resources for planning and controlling. High-fit subjects, on the contrary, revealed more movement automation and a higher “attention span.” Our results support the hypothesis that high fitness corresponds with more automation and less cognitive control of complex motor tasks, which might help to free up cognitive resources.

  2. Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people.

    Science.gov (United States)

    Barker, Anna L; Talevski, Jason; Bohensky, Megan A; Brand, Caroline A; Cameron, Peter A; Morello, Renata T

    2016-10-01

    To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Pilot Randomized controlled trial. Community physiotherapy clinic. A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61-84). A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks. Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P fall injury rates. A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820). © The Author(s) 2015.

  3. Confirmatory factor analysis reveals a latent cognitive structure common to bipolar disorder, schizophrenia, and normal controls.

    Science.gov (United States)

    Schretlen, David J; Peña, Javier; Aretouli, Eleni; Orue, Izaskun; Cascella, Nicola G; Pearlson, Godfrey D; Ojeda, Natalia

    2013-06-01

    We sought to determine whether a single hypothesized latent factor structure would characterize cognitive functioning in three distinct groups. We assessed 576 adults (340 community controls, 126 adults with bipolar disorder, and 110 adults with schizophrenia) using 15 measures derived from nine cognitive tests. Confirmatory factor analysis (CFA) was conducted to examine the fit of a hypothesized six-factor model. The hypothesized factors included attention, psychomotor speed, verbal memory, visual memory, ideational fluency, and executive functioning. The six-factor model provided an excellent fit for all three groups [for community controls, root mean square error of approximation (RMSEA) schizophrenia, RMSEA = 0.06 and CFI = 0.98]. Alternate models that combined fluency with processing speed or verbal and visual memory reduced the goodness of fit. Multi-group CFA results supported factor invariance across the three groups. Confirmatory factor analysis supported a single six-factor structure of cognitive functioning among patients with schizophrenia or bipolar disorder and community controls. While the three groups clearly differ in level of performance, they share a common underlying architecture of information processing abilities. These cognitive factors could provide useful targets for clinical trials of treatments that aim to enhance information processing in persons with neurological and neuropsychiatric disorders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Normal endothelial function in patients with mild-to-moderate psoriasis: a case-control study

    DEFF Research Database (Denmark)

    Jensen, Peter R; Zachariae, Claus; Hansen, Peter

    2011-01-01

    Evidence is increasing that severe psoriasis is an independent cardiovascular risk factor. Results from case-control studies of endothelial dysfunction, a marker of early atherosclerosis, in patients with moderate-to-severe psoriasis have been conflicting and were conducted with operator-dependen......Evidence is increasing that severe psoriasis is an independent cardiovascular risk factor. Results from case-control studies of endothelial dysfunction, a marker of early atherosclerosis, in patients with moderate-to-severe psoriasis have been conflicting and were conducted with operator......-dependent and technically demanding ultrasound measurement of brachial artery flow-mediated vasodilation. Therefore, we decided to measure endothelial function and other cardiovascular risk factors in patients with mild-to-moderate psoriasis (n = 30) and controls (n = 30) using a newer and relatively operator......-independent technique. No difference was detected between the groups with regards to endothelial function. However, despite the patients experiencing rather mild psoriasis they did exhibit higher levels of certain cardiovascular risk factors, including waist circumference, resting heart rate, systolic and diastolic...

  5. Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

    International Nuclear Information System (INIS)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2003-01-01

    Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD

  6. Stiffness control of balance during dual task and prospective falls in older adults: the MOBILIZE Boston Study.

    Science.gov (United States)

    Kang, Hyun Gu; Quach, Lien; Li, Wenjun; Lipsitz, Lewis A

    2013-09-01

    Outdoor fallers differ from indoor fallers substantially in demographics, lifestyle, health condition and physical function. Biomechanical predictors of outdoor falls have not been well characterized. Current validated measures of postural deficits, which describe only the overall postural behavior, are predictive of indoor falls but not outdoor falls. We hypothesized that a model-based description of postural muscle tone and reflexes, particularly during dual tasking, would predict outdoor falls. We tested whether postural stiffness and damping from an inverted pendulum model were predictive of future indoor and outdoor falls among older adults from the MOBILIZE Boston Study. The center of pressure data during standing were obtained from 717 participants aged 77.9±5.3 years. Participants stood barefoot with eyes open for 30s per trial, in two sets of five standing trials. One set included a serial subtractions task. Postural stiffness and damping values were determined from the postural sway data. After the postural measurements, falls were monitored prospectively using a monthly mail-in calendar over 6-36 months. Associations of postural measures with fall rates were determined using negative binomial regressions. After covariate adjustments, postural stiffness (p=0.02-0.05) and damping (p=0.007-0.1) were associated with lower outdoor falls risk, but not with indoor falls. Results were invariant by direction (anteroposterior versus mediolateral) or by condition (quiet standing versus dual task). Outdoor fall risk may be tied to postural control more so than indoor falls. Dual tasking is likely related to fall risk among older and sicker older adults, but not those relatively healthy. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Motivational characteristics and resistance training in older adults: a randomized controlled trial and 1-year follow-up.

    Science.gov (United States)

    Kekäläinen, Tiia; Kokko, Katja; Tammelin, Tuija; Sipilä, Sarianna; Walker, Simon

    2018-06-07

    The aim of this study was to investigate the effects of a nine-month supervised resistance training intervention on motivational and volitional characteristics related to exercise, and whether the absolute level and/or intervention-induced change in these characteristics predict self-directed continuation of resistance training one year after the intervention. Community-dwelling older adults aged 65-75, who did not fulfill physical activity recommendations, were randomized into resistance training intervention groups: training once- (n=26), twice- (n=27), three-times-a-week (n=28) or non-training control group (n=25). Training groups participated in supervised resistance training for nine months: during months 1-3 all groups trained twice-a-week and then with allocated frequencies during months 4-9. Exercise-related motivation, self-efficacy and planning were measured with questionnaires at baseline, month-3 and month-9. The continuance of resistance training was determined by interviews six and twelve months after the end of the intervention. The intervention improved action and coping planning as well as intrinsic motivation (group×time p<.05). During one-year follow-up, 54% of participants did not continue self-directed regular resistance training, 22% continued regular resistance training once-a-week and 24% twice-a-week. Increases in exercise self-efficacy and intrinsic motivation related to training during the intervention predicted continuation of resistance training twice-a-week. Resistance training improved exercise-related motivational and volitional characteristics in older adults. These improvements were linked to continuing resistance training one year after the supervised intervention. The role of these characteristics should be taken into account when promoting long-term resistance training participation among older adults. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Acute effects of exergames on cognitive function of institutionalized older persons: a single-blinded, randomized and controlled pilot study.

    Science.gov (United States)

    Monteiro-Junior, Renato Sobral; da Silva Figueiredo, Luiz Felipe; Maciel-Pinheiro, Paulo de Tarso; Abud, Erick Lohan Rodrigues; Braga, Ana Elisa Mendes Montalvão; Barca, Maria Lage; Engedal, Knut; Nascimento, Osvaldo José M; Deslandes, Andrea Camaz; Laks, Jerson

    2017-06-01

    Improvements on balance, gait and cognition are some of the benefits of exergames. Few studies have investigated the cognitive effects of exergames in institutionalized older persons. To assess the acute effect of a single session of exergames on cognition of institutionalized older persons. Nineteen institutionalized older persons were randomly allocated to Wii (WG, n = 10, 86 ± 7 year, two males) or control groups (CG, n = 9, 86 ± 5 year, one male). The WG performed six exercises with virtual reality, whereas CG performed six exercises without virtual reality. Verbal fluency test (VFT), digit span forward and digit span backward were used to evaluate semantic memory/executive function, short-term memory and work memory, respectively, before and after exergames and Δ post- to pre-session (absolute) and Δ % (relative) were calculated. Parametric (t independent test) and nonparametric (Mann-Whitney test) statistics and effect size were applied to tests for efficacy. VFT was statistically significant within WG (-3.07, df = 9, p = 0.013). We found no statistically significant differences between the two groups (p > 0.05). Effect size between groups of Δ % (median = 21 %) showed moderate effect for WG (0.63). Our data show moderate improvement of semantic memory/executive function due to exergames session. It is possible that cognitive brain areas are activated during exergames, increasing clinical response. A single session of exergames showed no significant improvement in short-term memory, working memory and semantic memory/executive function. The effect size for verbal fluency was promising, and future studies on this issue should be developed. RBR-6rytw2.

  9. A Randomized Controlled Study on the Effects of a Documentary on Students' Empathy and Attitudes towards Older Adults.

    Science.gov (United States)

    Laganá, Luciana; Gavrilova, Larisa; Carter, Delwin B; Ainsworth, Andrew T

    2017-01-01

    Despite the rapid increase in the size of the geriatric population, no current published literature is available based on the effects of viewing a documentary covering medical and psychosocial issues concerning older adults influencing young people's empathy and ageism. The aim of the current study was to test whether participants who viewed an original documentary about older adults experiencing physical pain would report lower ageism and higher empathy scores when compared to participants who watched a neutral documentary. Seventy-seven students (ages 18-29 years) were randomized to either the experimental (pain documentary) or the control (neutral documentary) conditions and given pre- and post-test measures of empathy and ageism. The results of a series of Profile Analyses (Multivariate Mixed ANOVAs) showed a significant interaction (Wilk's λ=0.933, F (1,75)=5.389, p =0.023, partial η 2 =0.067) between treatment and time (pre- vs . post-viewing the film) for the empathy measure that was confirmed by follow-up t -tests. The latter showed a significant increase in empathy scores for only the experimental group, t (37)=-2.999, p =0.005. However, contrary to the original prediction, this same treatment by time effect was not observed for ageism (Wilk's λ=0.994, F (1,75)=0.482, p =0.490, partial η 2 =0.006), as the experimental participants did not significantly reduce their ageism scores, t (38)=0.725, p =0.473. The results of these analyses, as well as those obtained by using the subscales of each questionnaire, have been discussed. The findings of this preliminary study indicate that showing a pain-based, anti-bias documentary feature film has the potential to significantly improve empathy towards older adults in university students.

  10. A Randomized Controlled Study on the Effects of a Documentary on Students’ Empathy and Attitudes towards Older Adults

    Science.gov (United States)

    Laganá, Luciana; Gavrilova, Larisa; Carter, Delwin B.; Ainsworth, Andrew T.

    2017-01-01

    Background Despite the rapid increase in the size of the geriatric population, no current published literature is available based on the effects of viewing a documentary covering medical and psychosocial issues concerning older adults influencing young people’s empathy and ageism. The aim of the current study was to test whether participants who viewed an original documentary about older adults experiencing physical pain would report lower ageism and higher empathy scores when compared to participants who watched a neutral documentary. Method Seventy-seven students (ages 18–29 years) were randomized to either the experimental (pain documentary) or the control (neutral documentary) conditions and given pre- and post-test measures of empathy and ageism. Results The results of a series of Profile Analyses (Multivariate Mixed ANOVAs) showed a significant interaction (Wilk’s λ=0.933, F(1,75)=5.389, p=0.023, partial η2=0.067) between treatment and time (pre- vs. post-viewing the film) for the empathy measure that was confirmed by follow-up t-tests. The latter showed a significant increase in empathy scores for only the experimental group, t(37)=−2.999, p=0.005. However, contrary to the original prediction, this same treatment by time effect was not observed for ageism (Wilk’s λ=0.994, F(1,75)=0.482, p=0.490, partial η2=0.006), as the experimental participants did not significantly reduce their ageism scores, t(38)=0.725, p=0.473. The results of these analyses, as well as those obtained by using the subscales of each questionnaire, have been discussed. Conclusions The findings of this preliminary study indicate that showing a pain-based, anti-bias documentary feature film has the potential to significantly improve empathy towards older adults in university students. PMID:29399638

  11. Efficacy of memory training in healthy community-dwelling older people: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Pérez, Anna; Roqué, Marta; Domènech, Sara; Monteserín, Rosa; Soriano, Núria; Blancafort, Xavier; Bosom, Maria; Vidal, Cristina; Petit, Montse; Hortal, Núria; Gil, Carles; Espelt, Albert; López, Maria José

    2015-10-01

    There is limited evidence on the efficacy and social utility of cognitive training. To address this, we have designed a randomized controlled trial to assess the effectiveness of memory training workshops for healthy older people in terms of their short- and long-term impact on cognitive function, health-related quality of life, and functionality. A randomized controlled trial will be performed in health care centers in Barcelona (Spain) through comparison of a group of individuals participating in memory training workshops (experimental group) with another group with similar characteristics not participating in the workshops (control group). The intervention will consist of twelve 90-minute group sessions imparted once a week by a psychologist specialized in memory training. The groups will each comprise approximately 15 people, for a total number of 230 patients involved in the study. Each session has its own objectives, materials and activities. The content of the intervention is based on memory training from different perspectives, including cognitive and emotional aspects and social and individual skills. Data will be collected at baseline, at 3-4 months and at 6 months. To assess the efficacy of the intervention on cognitive function, health-related quality of life and functionality, a statistical analysis will be performed by fitting a repeated-measures mixed effects model for each main outcome: Self-perceived memory, measured by a Subjective Self-reported Memory Score (from 0 to 10) and by the Memory Failures in Everyday life questionnaire (MFE); Everyday memory, measured using the Rivermead Behavioural Memory Test-3 (RBMT-3) and Executive control abilities, measured in terms of visual-perceptual ability, working memory and task-switching ability with the Trail Making Test (TMT) and with the digit span scale of the Wechsler Adult Intelligence Scale III (WAIS III). The results of this study will be highly useful for social and public health policies related

  12. The association between Western and Prudent dietary patterns and fasting blood glucose levels in type 2 diabetes and normal glucose metabolism in older Australian adults.

    Science.gov (United States)

    Walsh, Erin I; Jacka, Felice N; Butterworth, Peter; Anstey, Kaarin J; Cherbuin, Nicolas

    2017-06-01

    High blood glucose and type 2 diabetes are associated with a range of adverse health and cognitive outcomes. One factor that contributes to high blood glucose and type 2 diabetes is dietary intake. This study investigated the relationship between dietary patterns, fasting blood glucose and diabetes status in a sample of 209 participants aged 60-65. Blood plasma glucose was measured from venous blood samples. Individual Prudent and Western dietary patterns were estimated from a self-completed food frequency questionnaire. The relationship between dietary patterns, diabetes, and blood glucose was assessed via general linear model analyses controlling for age, sex, height, and total caloric intake. Results indicated that there was no association between Prudent diet and fasting blood glucose levels, or type 2 diabetes. In contrast, an individual in the upper tertile for Western dietary score had a significantly higher risk of having diabetes than an individual in the lower tertile for Western dietary score. However, there was no significant association between Western diet and fasting blood glucose. Western diet may be associated with type 2 diabetes through mechanisms beyond impacting blood plasma glucose directly. The fact that the association between Western diet and type 2 diabetes remained even when total caloric intake was controlled for highlights the need for policy and population health interventions targeting the reduction of unhealthy food consumption.

  13. The effect of backpack weight on the standing posture and balance of schoolgirls with adolescent idiopathic scoliosis and normal controls.

    Science.gov (United States)

    Chow, Daniel H K; Kwok, Monica L Y; Cheng, Jack C Y; Lao, Miko L M; Holmes, Andrew D; Au-Yang, Alexander; Yao, Fiona Y D; Wong, M S

    2006-10-01

    Concerns have been raised regarding the effect of carrying a backpack on adolescent posture and balance, but the effect of backpack loading combined with other factors affecting balance, such as adolescent idiopathic scoliosis (AIS), has not been determined. This study examines the effects of backpack load on the posture and balance of schoolgirls with AIS and normal controls. The standing posture of 26 schoolgirls with mild AIS (mean age 13, Cobb angle 10-25 degrees ) and 20 age-matched normal schoolgirls were recorded without a backpack and while carrying a standard dual-strap backpack loaded at 7.5%, 10%, 12.5% and 15% of the subject's bodyweight (BW). Kinematics of the pelvis, trunk and head were recorded using a motion analysis system and centre of pressure (COP) data were recorded using a force platform. Reliable COP data could only be derived for 13 of the subjects with AIS. Increasing backpack load causes a significantly increased flexion of the trunk in relation to the pelvis and extension of the head in relation to the trunk, as well as increased antero-posterior range of COP motion. While backpack load appears to affect balance predominantly in the antero-posterior direction, differences between groups were more evident in the medio-lateral direction, with AIS subjects showing poor balance in this direction. Overall, carrying a backpack causes similar sagittal plane changes in posture and balance in both normal and AIS groups. Load size or subject group did not influence balance, but the additive effect of backpack carrying and AIS on postural control alters the risk of fall in this population. Therefore, load limit recommendations based on normal subjects should not be applicable to subjects with AIS.

  14. Comparative analysis of contrast between hepatic vein and hepatic parenchyma with controlled velocity of ultrasound in normal and fatty liver

    International Nuclear Information System (INIS)

    Yun, Eun Joo; Choi, Byung Jin; Han, Joon Koo; Cha, Joo Hee; Kim, Seung Hyup; Lee, Dong Hyuk

    2000-01-01

    To evaluate the contrast between hepatic vein and hepatic parenchyma with controlled velocities of ultrasound in normal and fatty liver. 31 patient with normal liver and 39 patients with moderate degree of fatty liver were studies with sonography with controlled velocities of ultrasound (1,580 m/sec, 1,540 m/sec, 1,500 m/sec, 1,460 m/sec). Sonographic images were captured with picture grabbing (Sono-PACS) and were recalled with visual C++(Microsoft Redmond. WA, USA). The contrast between hepatic vein and parenchyma was measured and analyzed on each sonographic image. The number of patients with the highest contrast between hepatic vein and hepatic parenchyma among the 31 patients with normal liver were 5 (16.1%) with 1,580 m/sec, 12 (38.8%) with 1,540 m/sec, 9 (29.0%) with 1,500 m/sec, and 5 (16.1%) with 1,460 m/sec. The number of patients with highest contrast between hepatic vein and hepatic parenchyma among the 39 patients with fatty liver were 3 (7.7%) with 1,580 m/sec, 7 (17.9%) with 1,540 m/sec, 12 (30.8%) with 1,500 m/sec and 17 (43.6%) with 1,460 m/sec. The velocity of ultrasound for the highest contrast between hepatic vein and hepatic parenchyma in normal liver was 1,540 m/sec, and 1,460 m/sec in fatty liver.

  15. Protein-enriched 'regular products' and their effect on protein intake in acute hospitalized older adults; a randomized controlled trial

    NARCIS (Netherlands)

    Stelten, S.; Dekker, I.M.; Ronday, E.M.; Thijs, A.; Boelsma, E.; Peppelenbos, H.W.; van Bokhorst-de van der Schueren, M.A.E.

    2015-01-01

    Background & aims: Especially in older adults, maintaining muscle mass is essential to perform activities of daily living. This requires a sufficient protein intake. However, protein intake in hospitalized older adults is often insufficient. Thus far different nutrition intervention strategies have

  16. Synthesis of controllable and normal sublanguages for discrete-event systems using a coordinator

    Czech Academy of Sciences Publication Activity Database

    Komenda, Jan; Masopust, Tomáš; van Schuppen, J. H.

    2011-01-01

    Roč. 60, č. 7 (2011), s. 492-502 ISSN 0167-6911 R&D Projects: GA ČR(CZ) GAP103/11/0517; GA ČR(CZ) GPP202/11/P028 Grant - others:European Commission(XE) EU.ICT.DISC 224498 Institutional research plan: CEZ:AV0Z10190503 Keywords : discrete-event system * coordination control * coordinator Subject RIV: BA - General Mathematics Impact factor: 1.222, year: 2011 http://www.sciencedirect.com/science/article/pii/S0167691111000739

  17. Synthesis of controllable and normal sublanguages for discrete-event systems using a coordinator

    Czech Academy of Sciences Publication Activity Database

    Komenda, Jan; Masopust, Tomáš; van Schuppen, J. H.

    2011-01-01

    Roč. 60, č. 7 (2011), s. 492-502 ISSN 0167-6911 R&D Projects: GA ČR(CZ) GAP103/11/0517; GA ČR(CZ) GPP202/11/P028 Grant - others:European Commission(XE) EU. ICT .DISC 224498 Institutional research plan: CEZ:AV0Z10190503 Keywords : discrete-event system * coordination control * coordinator Subject RIV: BA - General Mathematics Impact factor: 1.222, year: 2011 http://www.sciencedirect.com/science/article/pii/S0167691111000739

  18. Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial.

    Science.gov (United States)

    Goertz, Christine M; Salsbury, Stacie A; Long, Cynthia R; Vining, Robert D; Andresen, Andrew A; Hondras, Maria A; Lyons, Kevin J; Killinger, Lisa Z; Wolinsky, Fredric D; Wallace, Robert B

    2017-10-13

    Low back pain is a debilitating condition for older adults, who may seek healthcare from multiple providers. Few studies have evaluated impacts of different healthcare delivery models on back pain outcomes in this population. The purpose of this study was to compare clinical outcomes of older adults receiving back pain treatment under 3 professional practice models that included primary medical care with or without chiropractic care. We conducted a pilot randomized controlled trial with 131 community-dwelling, ambulatory older adults with subacute or chronic low back pain. Participants were randomly allocated to 12 weeks of individualized primary medical care (Medical Care), concurrent medical and chiropractic care (Dual Care), or medical and chiropractic care with enhanced interprofessional collaboration (Shared Care). Primary outcomes were low back pain intensity rated on the numerical rating scale and back-related disability measured with the Roland-Morris Disability Questionnaire. Secondary outcomes included clinical measures, adverse events, and patient satisfaction. Statistical analyses included mixed-effects regression models and general estimating equations. At 12 weeks, participants in all three treatment groups reported improvements in mean average low back pain intensity [Shared Care: 1.8; 95% confidence interval (CI) 1.0 to 2.6; Dual Care: 3.0; 95% CI 2.3 to 3.8; Medical Care: 2.3; 95% CI 1.5 to 3.2)] and back-related disability (Shared Care: 2.8; 95% CI 1.6 to 4.0; Dual Care: 2.5; 95% CI 1.3 to 3.7; Medical Care: 1.5; 95% CI 0.2 to 2.8). No statistically significant differences were noted between the three groups on the primary measures. Participants in both models that included chiropractic reported significantly better perceived low back pain improvement, overall health and quality of life, and greater satisfaction with healthcare services than patients who received medical care alone. Professional practice models that included primary care and

  19. Development and Pilot Randomized Control Trial of a Drama Program to Enhance Well-being Among Older Adults.

    Science.gov (United States)

    Moore, Raeanne C; Straus, Elizabeth; Dev, Sheena I; Parish, Steven M; Sueko, Seema; Eyler, Lisa T

    2017-02-01

    Develop a novel theatre-based program and test its feasibility, tolerability, and preliminary efficacy for improving empathy/compassion and well-being among older adults. Thirteen older adults were randomized to a 6-week Drama Workshop (DW) program or time-equivalent Backstage Pass (BP) control condition. Pre- and post-treatment measures included empathy, compassion, and mood scales. Additional post-treatment measures included self-rated change in empathy/compassion, confidence, and affect. Participants also rated their mood/affect after each session. The program was successfully completed and well-liked. No pre-to-post-treatment changes in empathy/compassion or mood symptoms were found in either group. Compared to BP, DW weekly ratings indicated higher levels of anxiety and lower happiness; however, the DW program had higher self-ratings of positive change in self-esteem, confidence, and happiness post-treatment. While the DW may not promote empathy/compassion and was personally challenging during the program, engagement in dramatic exercises and rehearsing and performing a dramatic piece was seen by participants as a positive growth experience, as indicated by the post-treatment ratings of enhanced self-esteem, confidence and happiness. Thus, such a program might be useful for counteracting some of the potential negative aspects of aging, including reduced self-efficacy due to physical limitations and negative affect due to losses.

  20. The Effects of Four-Week Multivitamin Supplementation on Mood in Healthy Older Women: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Helen Macpherson

    2016-01-01

    Full Text Available Objective. Nutritional deficiencies have been associated with cognitive decline and mood disturbances. Vitamin intake can influence mood and randomized controlled trials have demonstrated that multivitamin supplements are capable of reducing mild symptoms of mood dysfunction. However, few studies have focussed on healthy older women. Methods. This study investigated the effects of four weeks’ multivitamin supplementation on mood in 76 healthy women aged 50–75 years. Mood was assessed before and after intervention in the laboratory using measures of current mood and retrospective experiences of mood over the past week or longer. Mobile phones were used to assess changes in real-time mood ratings, twice weekly in the home. Results. There were no multivitamin-related benefits identified for measures of current mood or reflections of recent mood when measured in the laboratory. In-home assessments, where mood was rated several hours after dose, revealed multivitamin supplementation improved ratings of stress, with a trend to reduce mental fatigue. Conclusions. Over four weeks, subtle changes to stress produced by multivitamin supplementation in healthy older women may not be detected when only pre- and posttreatment mood is captured. In-home mobile phone-based assessments may be more sensitive to the effects of nutritional interventions compared to traditional in-laboratory assessments.

  1. Church-based social marketing to motivate older adults to take balance classes for fall prevention: cluster randomized controlled trial.

    Science.gov (United States)

    DiGuiseppi, Carolyn G; Thoreson, Sallie R; Clark, Lauren; Goss, Cynthia W; Marosits, Mark J; Currie, Dustin W; Lezotte, Dennis C

    2014-10-01

    Determine whether a church-based social marketing program increases older adults' participation in balance classes for fall prevention. In 2009-10, 51 churches (7101 total members aged ≥ 60) in Colorado, U.S.A. were randomized to receive no intervention or a social marketing program. The program highlighted benefits of class participation (staying independent, building relationships), reduced potential barriers (providing convenient, subsidized classes), and communicated marketing messages through church leaders, trained "messengers," printed materials and church-based communication channels. Between-group differences in balance class enrollment and marketing message recall among congregants were compared using Wilcoxon Two-Sample Test and regression models. Compared to 25 control churches, 26 churches receiving the social marketing program had a higher median proportion (9.8% vs. 0.3%; psocial marketing effectively disseminated messages about preventing falls through balance classes and, by emphasizing benefits and reducing barriers and costs of participation, successfully motivated older adults to enroll in the classes. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. A controlled trial of envelope colour for increasing response rates in older women.

    Science.gov (United States)

    Mitchell, Natasha; Hewitt, Catherine E; Torgerson, David J

    2011-06-01

    Postal questionnaires are widely used in health research to provide measurable outcomes in areas such as quality of life. Participants who fail to return postal questionnaires can introduce non-response bias. Previous studies within populations over the age of 65 years have shown that response rates amongst older people can be 60% or less. The current study sought to investigate whether envelope colour affected response rates in a study about the effectiveness of screening older women for osteoporosis. A total of 2803 eligible female participants aged between 70 and 85 were sent an invitation pack from their GP practice. The invitation was either in a brown or white envelope and contained a matching pre-paid reply envelope. A study questionnaire was also sent out in brown or white envelopes 1 week after consenting to participate in the trial. The overall response rate was 78%. There was little evidence of an effect of envelope colour on response to the invitation to participate in the trial (OR 1.04, 95% CI 0.87-1.24). Similarly, there was no influence of envelope colour on the number of participants returning their questionnaires (OR 0.99, 95% CI 0.60-1.63). There was weak evidence of an effect of envelope colour on the response rates of the consent process (OR 0.86, 95% CI 0.74-1.00). When we updated a recent meta-analysis with the results of this study, there was a non-statistically- significant trend for greater response rates with brown envelopes compared with white envelopes (OR 1.19, 95% CI 0.86-1.64, I2=92%). However, the results where influenced by one study and when this study was excluded the pooled estimate was 0.98 (95% CI 0.89-1.08, I2=0%). This study found no evidence to suggest envelope colour has an effect on response to participate in a trial or questionnaire returns. There is weak evidence to suggest envelope colour may affect consent into a trial.

  3. Chronic Effects of a Wild Green Oat Extract Supplementation on Cognitive Performance in Older Adults: A Randomised, Double-Blind, Placebo-Controlled, Crossover Trial

    Directory of Open Access Journals (Sweden)

    Narelle M. Berry

    2012-05-01

    Full Text Available Background and aim: Preliminary evaluation of a wild green oat extract (WGOE (Neuravena® ELFA®955, Frutarom, Switzerland revealed an acute cognitive benefit of supplementation. This study investigated whether regular daily WGOE supplementation would result in sustained cognitive improvements. Method: A 12-week randomised, double-blind, placebo-controlled cross-over trial of WGOE supplementation (1500 mg/day versus placebo was undertaken in 37 healthy adults aged 67 ± 0.8 years (mean ± SEM. Cognitive assessments included the Stroop colour-word test, letter cancellation, the rule-shift task, a computerised multi-tasking test battery and the trail-making task. All assessments were conducted in Week 12 and repeated in Week 24 whilst subjects were fasted and at least 18 h after taking the last dose of supplement. Result: Chronic WGOE supplementation did not affect any measures of cognition. Conclusion: It appears that the cognitive benefit of acute WGOE supplementation does not persist with chronic treatment in older adults with normal cognition. It remains to be seen whether sustained effects of WGOE supplementation may be more evident in those with mild cognitive impairment.

  4. Effects of Mat Pilates on Physical Functional Performance of Older Adults: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Bueno de Souza, Roberta Oliveira; Marcon, Liliane de Faria; Arruda, Alex Sandro Faria de; Pontes Junior, Francisco Luciano; Melo, Ruth Caldeira de

    2018-06-01

    The present meta-analysis aimed to examine evidence from randomized controlled trials to determine the effects of mat Pilates on measures of physical functional performance in the older population. A search was conducted in the MEDLINE/PubMed, Scopus, Scielo, and PEDro databases between February and March 2017. Only randomized controlled trials that were written in English, included subjects aged 60 yrs who used mat Pilates exercises, included a comparison (control) group, and reported performance-based measures of physical function (balance, flexibility, muscle strength, and cardiorespiratory fitness) were included. The methodological quality of the studies was analyzed according to the PEDro scale and the best-evidence synthesis. The meta-analysis was conducted with the Review Manager 5.3 software. The search retrieved 518 articles, nine of which fulfilled the inclusion criteria. High methodological quality was found in five of these studies. Meta-analysis indicated a large effect of mat Pilates on dynamic balance (standardized mean difference = 1.10, 95% confidence interval = 0.29-1.90), muscle strength (standardized mean difference = 1.13, 95% confidence interval = 0.30-1.96), flexibility (standardized mean difference = 1.22, 95% confidence interval = 0.39-2.04), and cardiorespiratory fitness (standardized mean difference = 1.48, 95% confidence interval = 0.42-2.54) of elderly subjects. There is evidence that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility, and cardiovascular endurance in elderly individuals. Furthermore, high-quality studies are necessary to clarify the effects of mat Pilates on other physical functional measurements among older adults.

  5. Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.

    Science.gov (United States)

    Anson, Eric; Ma, Lei; Meetam, Tippawan; Thompson, Elizabeth; Rathore, Roshita; Dean, Victoria; Jeka, John

    2018-05-01

    Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes. To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems. 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk. There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest. Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Participant-selected music and physical activity in older adults following cardiac rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Clark, Imogen N; Baker, Felicity A; Peiris, Casey L; Shoebridge, Georgie; Taylor, Nicholas F

    2017-03-01

    To evaluate effects of participant-selected music on older adults' achievement of activity levels recommended in the physical activity guidelines following cardiac rehabilitation. A parallel group randomized controlled trial with measurements at Weeks 0, 6 and 26. A multisite outpatient rehabilitation programme of a publicly funded metropolitan health service. Adults aged 60 years and older who had completed a cardiac rehabilitation programme. Experimental participants selected music to support walking with guidance from a music therapist. Control participants received usual care only. The primary outcome was the proportion of participants achieving activity levels recommended in physical activity guidelines. Secondary outcomes compared amounts of physical activity, exercise capacity, cardiac risk factors, and exercise self-efficacy. A total of 56 participants, mean age 68.2 years (SD = 6.5), were randomized to the experimental ( n = 28) and control groups ( n = 28). There were no differences between groups in proportions of participants achieving activity recommended in physical activity guidelines at Week 6 or 26. Secondary outcomes demonstrated between-group differences in male waist circumference at both measurements (Week 6 difference -2.0 cm, 95% CI -4.0 to 0; Week 26 difference -2.8 cm, 95% CI -5.4 to -0.1), and observed effect sizes favoured the experimental group for amounts of physical activity (d = 0.30), exercise capacity (d = 0.48), and blood pressure (d = -0.32). Participant-selected music did not increase the proportion of participants achieving recommended amounts of physical activity, but may have contributed to exercise-related benefits.

  7. Eating Disorder Inventory-3, validation in Swedish patients with eating disorders, psychiatric outpatients and a normal control sample.

    Science.gov (United States)

    Nyman-Carlsson, Erika; Engström, Ingemar; Norring, Claes; Nevonen, Lauri

    2015-02-01

    The Eating Disorder Inventory-3 (EDI-3) is designed to assess eating disorder psychopathology and the associated psychological symptoms. The instrument has been revised and has not yet been validated for Swedish conditions in its current form. The aim of this study was to investigate the validity and reliability of this inventory and present national norms for Swedish females. Data from patients with eating disorders (n = 292), psychiatric outpatients (n = 140) and normal controls (n = 648), all females, were used to study the internal consistency, the discriminative ability, and the sensitivity and specificity of the inventory using preliminary cut-offs for each subscale and diagnosis separately. Swedish norms were compared with those from Denmark, USA, Canada, Europe and Australian samples. The reliability was acceptable for all subscales except Asceticism among normal controls. Analysis of variance showed that the EDI-3 discriminates significantly between eating disorders and normal controls. Anorexia nervosa was significantly discriminated from bulimia nervosa and eating disorder not otherwise specified on the Eating Disorder Risk Scales. Swedish patients scored significantly lower than patients from other countries on the majority of the subscales. Drive for Thinness is the second best predictor for an eating disorder. The best predictor for anorexia nervosa was Interoceptive Deficits and Bulimia for the other diagnoses. Conclusions/clinical implications: The EDI-3 is valid for use with Swedish patients as a clinical assessment tool for the treatment planning and evaluation of patients with eating-related problems. However, it still exist some uncertainty regarding its use as a screening tool.

  8. Prevention of Hospital-Acquired Adverse Drug Reactions in Older People Using Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment Criteria: A Cluster Randomized Controlled Trial.

    Science.gov (United States)

    O'Connor, Marie N; O'Sullivan, David; Gallagher, Paul F; Eustace, Joseph; Byrne, Stephen; O'Mahony, Denis

    2016-08-01

    To determine whether use of the Screening Tool of Older Persons' Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START) criteria reduces incident hospital-acquired adverse drug reactions (ADRs), 28-day medication costs, and median length of hospital stay in older adults admitted with acute illness. Single-blind cluster randomized controlled trial (RCT) of unselected older adults hospitalized over a 13-month period. Tertiary referral hospital in southern Ireland. Consecutively admitted individuals aged 65 and older (N = 732). Single time point presentation to attending physicians of potentially inappropriate medications according to the STOPP/START criteria. The primary outcome was the proportion of participants experiencing one or more ADRs during the index hospitalization. Secondary outcomes were median length of stay (LOS) and 28-day total medication cost. One or more ADRs occurred in 78 of the 372 control participants (21.0%; median age 78, interquartile range (IQR) 72-84) and in 42 of the 360 intervention participants (11.7%; median age 80, IQR 73-85) (absolute risk reduction = 9.3%, number needed to treat = 11). The median LOS in the hospital was 8 days (IQR 4-14 days) in both groups. At discharge, median medication cost was significantly lower in the intervention group (€73.16, IQR €38.68-121.72) than in the control group (€90.62, IQR €49.38-162.53) (Wilcoxon rank test Z statistic = -3.274, P older adults but did not affect median LOS. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  9. 1H-MR-spectroscopy in Anorexia nervosa; characteristic differences between patients and normal controls

    International Nuclear Information System (INIS)

    Hentschel, F.; Moeckel, R.; Schlemmmer, H.P.; Gueckel, F.; Koepke, J.; Georgi, M.; Markus, A.; Goepel, C.; Schmidt, M.H.

    1999-01-01

    Results: The ratio of NAA/PCr in both voxels were not significantly different when comparing patients vs. controls. Patients showed significantly higher ratios of choline-containing components (Cho) or, respectively Cho/PCr and NAA/PCr in the white matter. Distinct, but not significant differences were detected both for m-Ino and m-Ino/PCr in the parieto-occipital region and for the Cho- and m-Ino cotained ratios in the thalamus. Conclusion: AN is not associated with neuronal damage. The ratio of Cho/PCr and NAA/Cho may reflect the disturbance of membrane-turnover. It is possible that the increase of membrane catabolism leads to a hyperosmolar state. The change of m-Ino/PCr ratio may reflect the regulation of osmolarity. (orig.) [de

  10. A behavioral medicine intervention for community-dwelling older adults with chronic musculoskeletal pain: protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cederbom S

    2017-04-01

    Full Text Available Sara Cederbom,1 Eva Denison,2 Astrid Bergland1 1Department of Physiotherapy, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; 2Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden Background: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The aim of the planned study is to evaluate the effect of an individually tailored integrated physical therapy intervention based on a behavioral medicine approach compared with the effect of standard care.Methods/design: The planned study is an RCT that will include one intervention and one control group involving a total of 150 adults aged ≥75 years with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The intervention will involve a 12-week home-based individually tailored intervention that will be designed to enhance the participants’ ability to perform everyday activities by improving physical function and reducing pain-related disability and beliefs. The control group will be given standard care, including general advice about physical activity. The participants will be assessed at baseline and at 3 and 6 months after baseline. The primary outcome will be pain

  11. Differences in the Tongue Features of Primary Dysmenorrhea Patients and Controls over a Normal Menstrual Cycle

    Directory of Open Access Journals (Sweden)

    Jihye Kim

    2017-01-01

    Full Text Available Background. The aims of this study were to investigate the relationships between tongue features and the existence of menstrual pain and to provide basic information regarding the changes in tongue features during a menstrual cycle. Methods. This study was conducted at the Kyung Hee University Medical Center. Forty-eight eligible participants aged 20 to 29 years were enrolled and assigned to two groups according to their visual analogue scale (VAS scores. Group A included 24 females suffering from primary dysmenorrhea (PD caused by qi stagnation and blood stasis syndrome with VAS ≥ 4. In contrast, Group B included 24 females with few premenstrual symptoms and VAS < 4. All participants completed four visits (menses-follicular-luteal-menses phases, and the tongue images were taken by using a computerized tongue image analysis system (CTIS. Results. The results revealed that the tongue coating color value and the tongue coating thickness in the PD group during the menstrual phase were significantly lower than those of the control group (P=0.031 and P=0.029, resp.. Conclusions. These results suggest that the tongue features obtained from the CTIS may serve as a supplementary means for the differentiation of syndromes and the evaluation of therapeutic effect and prognosis in PD. Trial Registration. This trial was registered with Clinical Research Information Service, registration number KCT0001604, registered on 27 August 2015.

  12. 'You don't show everyone your weakness': Older adults' views on using Family Group Conferencing to regain control and autonomy.

    Science.gov (United States)

    Metze, Rosalie N; Kwekkeboom, Rick H; Abma, Tineke A

    2015-08-01

    Family Group Conferencing (FGC), a model in which a person and his or her social network make their own 'care' plan, is used in youth care and might also be useful in elderly care to support older persons living at home. In Amsterdam, the Netherlands, FGC was implemented for older adults but they showed resistance. Reasons for this resistance have been researched and are described in this article. We examine existing views and attitudes of older adults concerning the use of FGC, and report on how older adults see the possibility to regain control over their lives using FGC. To do this, focus group sessions, duo interviews and individual interviews were held with older adults with varying characteristics: living at home, in sheltered housing, or in a home for the elderly; and living in urban, suburban or rural areas. Themes were: views on and contentment with the control and autonomy that they experience in their lives, and the willingness to use FGC to improve this. The main reasons for our respondents to resist FGC were: expecting people to be there for them without a FGC, not feeling ready yet for a FGC, feeling embarrassed when asking for help, being reluctant to open up about their problems, and having the fear of losing control when organizing a FGC. We conclude that, for this generation of older adults, FGC means losing control and autonomy rather than gaining it. To be appealing to older adults, a relational empowerment strengthening model should most likely be focused on reciprocity, peer-to-peer support, and solutions instead of problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Dextrose saline compared with normal saline rehydration of hyperemesis gravidarum: a randomized controlled trial.

    Science.gov (United States)

    Tan, Peng Chiong; Norazilah, Mat Jin; Omar, Siti Zawiah

    2013-02-01

    To compare 5% dextrose-0.9% saline against 0.9% saline solution in the intravenous rehydration of hyperemesis gravidarum. Women at their first hospitalization for hyperemesis gravidarum were enrolled on admission to the ward and randomly assigned to receive either 5% dextrose-0.9% saline or 0.9% saline by intravenous infusion at a rate 125 mL/h over 24 hours in a double-blind trial. All participants also received thiamine and an antiemetic intravenously. Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being (by 10-point visual numerical rating scale) at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours. Persistent ketonuria rates after the 24-hour study period were 10 of 101 (9.9%) compared with 11 of 101 (10.9%) (P>.99; relative risk 0.9, 95% confidence interval 0.4-2.2) and median (interquartile range) well-being scores at 24 hours were 9 (8-10) compared with 9 (8-9.5) (P=.73) in the 5% dextrose-0.9% saline and 0.9% saline arms, respectively. Repeated measures analysis of variance of the nausea visual numerical rating scale score as assessed every 8 hours during the 24-hour study period showed a significant difference in favor of the 5% dextrose-0.9% saline arm (P=.046) with the superiority apparent at 8 and 16 hours, but the advantage had dissipated by 24 hours. Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different. Intravenous rehydration with 5% dextrose-0.9% saline or 0.9% saline solution in women hospitalized for hyperemesis gravidarum produced similar outcomes. ISRCTN Register, www.controlled-trials.com/isrctn, ISRCTN65014409. I.

  14. [High-grade pressure sores in frail older high-risk persons. A retrospective postmortem case-control-study].

    Science.gov (United States)

    Von Renteln-Kruse, W; Krause, T; Anders, J; Kühl, M; Heinemann, A; Püschel, K

    2004-04-01

    Some old persons at risk do develop, but others, at comparable risk, do not develop high-grade pressure sores. To evaluate potentially different risk factors, we performed a post mortem case-control study in old persons who developed high-grade pressure sores within six months until 14 days before death. Consecutive cases with pressure sores grade >/=3 and potential controls at comparably high risk for pressure sores were examined before cremation. After written informed consent had been obtained by the next relatives, all available nursing and medical records of the deceased were thoroughly evaluated. Cases and controls were matched according to age, gender, immobility, and cachexia.A total of 100 cases with 71 pressure sores grade 3 and 29 pressure sores grade 4 were compared to 100 controls with 27 pressure sores grade pressure sores in frail older high-risk persons. Sedative drug effects and impaired patient compliance with preventive and therapeutic measures may also be associated with the development of high-grade pressure sores in old persons at high risk.

  15. Interactive Cognitive-Motor Step Training Improves Cognitive Risk Factors of Falling in Older Adults - A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Daniel Schoene

    Full Text Available Interactive cognitive-motor training (ICMT requires individuals to perform both gross motor movements and complex information processing. This study investigated the effectiveness of ICMT on cognitive functions associated with falls in older adults.A single-blinded randomized controlled trial was conducted in community-dwelling older adults (N = 90, mean age 81.5±7 without major cognitive impairment. Participants in the intervention group (IG played four stepping games that required them to divide attention, inhibit irrelevant stimuli, switch between tasks, rotate objects and make rapid decisions. The recommended minimum dose was three 20-minute sessions per week over a period of 16 weeks unsupervised at home. Participants in the control group (CG received an evidence-based brochure on fall prevention. Measures of processing speed, attention/executive function (EF, visuo-spatial ability, concerns about falling and depression were assessed before and after the intervention.Eighty-one participants (90% attended re-assessment. There were no improvements with respect to the Stroop Stepping Test (primary outcome in the intervention group. Compared to the CG, the IG improved significantly in measures of processing speed, visuo-spatial ability and concern about falling. Significant interactions were observed for measures of EF and divided attention, indicating group differences varied for different levels of the covariate with larger improvements in IG participants with poorer baseline performance. The interaction for depression showed no change for the IG but an increase in the CG for those with low depressive symptoms at baseline. Additionally, low and high-adherer groups differed in their baseline performance and responded differently to the intervention. Compared to high adherers, low adherers improved more in processing speed and visual scanning while high-adherers improved more in tasks related to EF.This study shows that unsupervised stepping

  16. Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial.

    Science.gov (United States)

    Lam, Freddy Mh; Chan, Philip Fl; Liao, L R; Woo, Jean; Hui, Elsie; Lai, Charles Wk; Kwok, Timothy Cy; Pang, Marco Yc

    2018-04-01

    To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits. A single-blinded randomized controlled trial was conducted. This study was carried out in residential care units. In total, 73 older adults (40 women, mean age: 82.3 ± 7.3 years) were enrolled into this study. Participants were randomly allocated to one of the three groups: strength and balance program combined with whole-body vibration, strength and balance program without whole-body vibration, and social and recreational activities consisting of upper limb exercises only. All participants completed three training sessions per week for eight weeks. Assessment of mobility, balance, lower limb strength, walking endurance, and self-perceived balance confidence were conducted at baseline and immediately after the eight-week intervention. Incidences of falls requiring medical attention were recorded for one year after the end of the training period. A significant time × group interaction was found for lower limb strength (five-times-sit-to-stand test; P = 0.048), with the exercise-only group showing improvement (pretest: 35.8 ± 16.1 seconds; posttest: 29.0 ± 9.8 seconds), compared with a decline in strength among controls (pretest: 27.1 ± 10.4 seconds; posttest: 28.7 ± 12.3 seconds; P = 0.030). The exercise with whole-body vibration group had a significantly better outcome in balance confidence (pretest: 39.2 ± 29.0; posttest: 48.4 ± 30.6) than the exercise-only group (pretest: 35.9 ± 24.8; posttest: 38.2 ± 26.5; P = 0.033). The exercise program was effective in improving lower limb strength among institutionalized older adults but adding whole-body vibration did not enhance its effect. Whole-body vibration may improve balance confidence without enhancing actual balance performance.

  17. Hunger modulates behavioral disinhibition and attention allocation to food-associated cues in normal-weight controls.

    Science.gov (United States)

    Loeber, Sabine; Grosshans, Martin; Herpertz, Stephan; Kiefer, Falk; Herpertz, Sabine C

    2013-12-01

    Overeating, weight gain and obesity are considered as a major health problem in Western societies. At present, an impairment of response inhibition and a biased salience attribution to food-associated stimuli are considered as important factors associated with weight gain. However, recent findings suggest that the association between an impaired response inhibition and salience attribution and weight gain might be modulated by other factors. Thus, hunger might cause food-associated cues to be perceived as more salient and rewarding and might be associated with an impairment of response inhibition. However, at present, little is known how hunger interacts with these processes. Thus, the aim of the present study was to investigate whether hunger modulates response inhibition and attention allocation towards food-associated stimuli in normal-weight controls. A go-/nogo task with food-associated and control words and a visual dot-probe task with food-associated and control pictures were administered to 48 normal-weight participants (mean age 24.5 years, range 19-40; mean BMI 21.6, range 18.5-25.4). Hunger was assessed twofold using a self-reported measure of hunger and a measurement of the blood glucose level. Our results indicated that self-reported hunger affected behavioral response inhibition in the go-/nogo task. Thus, hungry participants committed significantly more commission errors when food-associated stimuli served as distractors compared to when control stimuli were the distractors. This effect was not observed in sated participants. In addition, we found that self-reported hunger was associated with a lower number of omission errors in response to food-associated stimuli indicating a higher salience of these stimuli. Low blood glucose level was not associated with an impairment of response inhibition. However, our results indicated that the blood glucose level was associated with an attentional bias towards food-associated cues in the visual dot probe task

  18. Can a combination of average of normals and "real time" External Quality Assurance replace Internal Quality Control?

    Science.gov (United States)

    Badrick, Tony; Graham, Peter

    2018-03-28

    Internal Quality Control and External Quality Assurance are separate but related processes that have developed independently in laboratory medicine over many years. They have different sample frequencies, statistical interpretations and immediacy. Both processes have evolved absorbing new understandings of the concept of laboratory error, sample material matrix and assay capability. However, we do not believe at the coalface that either process has led to much improvement in patient outcomes recently. It is the increasing reliability and automation of analytical platforms along with improved stability of reagents that has reduced systematic and random error, which in turn has minimised the risk of running less frequent IQC. We suggest that it is time to rethink the role of both these processes and unite them into a single approach using an Average of Normals model supported by more frequent External Quality Assurance samples. This new paradigm may lead to less confusion for laboratory staff and quicker responses to and identification of out of control situations.

  19. Cognitive intervention through a training program for picture book reading in community-dwelling older adults: a randomized controlled trial.

    Science.gov (United States)

    Suzuki, Hiroyuki; Kuraoka, Masataka; Yasunaga, Masashi; Nonaka, Kumiko; Sakurai, Ryota; Takeuchi, Rumi; Murayama, Yoh; Ohba, Hiromi; Fujiwara, Yoshinori

    2014-11-21

    Non-pharmacological interventions are expected to be important strategies for reducing the age-adjusted prevalence of senile dementia, considering that complete medical treatment for cognitive decline has not yet been developed. From the viewpoint of long-term continuity of activity, it is necessary to develop various cognitive stimulating programs. The aim of this study is to examine the effectiveness of a cognitive intervention through a training program for picture book reading for community-dwelling older adults. Fifty-eight Japanese older participants were divided into the intervention and control groups using simple randomization (n =29 vs 29). In the intervention group, participants took part in a program aimed at learning and mastering methods of picture book reading as a form of cognitive training intervention. The control group listened to lectures about elderly health maintenance. Cognitive tests were conducted individually before and after the programs. The rate of memory retention, computed by dividing Logical Memory delayed recall by immediate recall, showed a significant interaction (p < .05) in analysis of covariance. Simple main effects showed that the rate of memory retention of the intervention group improved after the program completion (p < .05). In the participants with mild cognitive impairment (MCI) examined by Japanese version of the Montreal Cognitive Assessment (MoCA-J) (n =14 vs 15), significant interactions were seen in Trail Making Test-A (p < .01), Trail Making Test-B (p < .05), Kana pick-out test (p < .05) and the Mini-Mental State Examination (p < .05). The intervention effect was found in delayed verbal memory. This program is also effective for improving attention and executive function in those with MCI. The short-term interventional findings suggest that this program might contribute to preventing a decline in memory and executive function. UMIN000014712 (Date of ICMJE and WHO compliant trial information

  20. Effectiveness and cost-effectiveness of a proactive, goal-oriented, integrated care model in general practice for older people. A cluster randomised controlled trial: Integrated Systematic Care for older People--the ISCOPE study.

    Science.gov (United States)

    Blom, Jeanet; den Elzen, Wendy; van Houwelingen, Anne H; Heijmans, Margot; Stijnen, Theo; Van den Hout, Wilbert; Gussekloo, Jacobijn

    2016-01-01

    older people often experience complex problems. Because of multiple problems, care for older people in general practice needs to shift from a 'problem-based, disease-oriented' care aiming at improvement of outcomes per disease to a 'goal-oriented care', aiming at improvement of functioning and personal quality of life, integrating all healthcare providers. Feasibility and cost-effectiveness of this proactive and integrated way of working are not yet established. cluster randomised trial. all persons aged ≥75 in 59 general practices (30 intervention, 29 control), with a combination of problems, as identified with a structured postal questionnaire with 21 questions on four health domains. for participants with problems on ≥3 domains, general practitioners (GPs) made an integrated care plan using a functional geriatric approach. Control practices: care as usual. (i) quality of life (QoL), (ii) activities of daily living, (iii) satisfaction with delivered health care and (iv) cost-effectiveness of the intervention at 1-year follow-up. Netherlands trial register, NTR1946. of the 11,476 registered eligible older persons, 7,285 (63%) participated in the screening. One thousand nine hundred and twenty-one (26%) had problems on ≥3 health domains. For 225 randomly chosen persons, a care plan was made. No beneficial effects were found on QoL, patients' functioning or healthcare use/costs. GPs experienced better overview of the care and stability, e.g. less unexpected demands, in the care. GPs prefer proactive integrated care. 'Horizontal' care using care plans for older people with complex problems can be a valuable tool in general practice. However, no direct beneficial effect was found for older persons. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society.

  1. The small Rho GTPase Rac1 controls normal human dermal fibroblasts proliferation with phosphorylation of the oncoprotein c-myc

    International Nuclear Information System (INIS)

    Nikolova, Ekaterina; Mitev, Vanio; Zhelev, Nikolai; Deroanne, Christophe F.; Poumay, Yves

    2007-01-01

    Proliferation of dermal fibroblasts is crucial for the maintenance of skin. The small Rho GTPase, Rac1, has been identified as a key transducer of proliferative signals in various cell types, but in normal human dermal fibroblasts its significance to cell growth control has not been studied. In this study, we applied the method of RNA interference to suppress endogenous Rac1 expression and examined the consequences on human skin fibroblasts. Rac1 knock-down resulted in inhibition of DNA synthesis. This effect was not mediated by inhibition of the central transducer of proliferative stimuli, ERK1/2 or by activation of the pro-apoptotic p38. Rather, as a consequence of the suppressed Rac1 expression we observed a significant decrease in phosphorylation of c-myc, revealing for the first time that in human fibroblasts Rac1 exerts control on proliferation through c-myc phosphorylation. Thus Rac1 activates proliferation of normal fibroblasts through stimulation of c-myc phosphorylation without affecting ERK1/2 activity

  2. Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders

    International Nuclear Information System (INIS)

    Ichinose, M.; Miki, K.; Hayashi, R.; Niwa, H.; Oka, H.; Furihata, C.; Matsushima, T.; Kageyama, T.; Takahashi, K.

    1982-01-01

    A radioimmunoassay (RIA) for human group I pepsinogens (PgI) in serum was developed, using PgI purified from gastric mucosa. The sensitivity (0.7 μg/l) and reproducibility of the assay were satisfactory for clinical use. In normal controls total serum pepsinogen (T-Pg) level was 58.9 +- 31.7 μg/l (mean +- SD) (PgI, 43.6 +- 25.0 μg/l; PgII, 15.3 +- 11.1 μg/l). Peptic ulcer cases had elevated T-Pg levels (gastric ulcer, gastroduodenal ulcer and duodenal ulcer, in increasing order of magnitude). T-Pg levels were not useful for diagnosis of peptic ulcer because of a large overlap with normal controls. T-Pg levels were low in patients with gastric polyp and in aged subjects. In these groups, the decrease of PgI was more marked than that of PgII. (Auth.)

  3. Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders

    Energy Technology Data Exchange (ETDEWEB)

    Ichinose, M.; Miki, K.; Hayashi, R.; Niwa, H.; Oka, H. (Tokyo Univ. (Japan). Faculty of Medicine); Furihata, C.; Matsushima, T. (Tokyo Univ. (Japan). Inst. for Medical Science); Kageyama, T.; Takahashi, K. (Kyoto Univ., Inuyama (Japan). Primate Research Inst.)

    1982-12-09

    A radioimmunoassay (RIA) for human group I pepsinogens (PgI) in serum was developed, using PgI purified from gastric mucosa. The sensitivity (0.7 ..mu..g/l) and reproducibility of the assay were satisfactory for clinical use. In normal controls total serum pepsinogen (T-Pg) level was 58.9 +- 31.7 ..mu..g/l (mean +- SD) (PgI, 43.6 +- 25.0 ..mu..g/l; PgII, 15.3 +- 11.1 ..mu..g/l). Peptic ulcer cases had elevated T-Pg levels (gastric ulcer, gastroduodenal ulcer and duodenal ulcer, in increasing order of magnitude). T-Pg levels were not useful for diagnosis of peptic ulcer because of a large overlap with normal controls. T-Pg levels were low in patients with gastric polyp and in aged subjects. In these groups, the decrease of PgI was more marked than that of PgII.

  4. 'Beyond Milestones': a randomised controlled trial evaluating an innovative digital resource teaching quality observation of normal child development.

    Science.gov (United States)

    Connolly, Anne M; Cunningham, Clare; Sinclair, Adriane J; Rao, Arjun; Lonergan, Amy; Bye, Ann M E

    2014-05-01

    The study aimed to create and evaluate the educational effectiveness of a digital resource instructing paediatric trainees in a systematic approach to critical and quality observation of normal child development. A digital educational resource was developed utilising the skills of an expert developmental paediatrician who was videoed assessing normal early child development at a series of critical stages. Videos illustrated aspects of language, sophistication of play and socialisation, cognition, and motor progress. Expert commentary, teaching text and summaries were used. A randomised controlled trial evaluated the resource. Paediatric trainees were recruited from The Sydney Children's Hospitals Network. Outcome measures were repeated at three time points (pre-teaching, immediate-post and 1 month) and included self-rated attitudes, knowledge of markers of development and observational expertise. Qualitative data on teaching usefulness were obtained through open-ended questions. Fifty-six paediatric trainees (registrar 79%, women 82%; mean age 31 years) completed the pre-assessment, 46 the immediate-post and 45 the 1-month follow-up (20% attrition). Compared with the Control group, the Teaching group scored higher over time on markers of development (P = 0.006), observational expertise (P improves knowledge, increases confidence and is useful, providing a structured approach to developmental assessment. The techniques taught can be applied to every paediatric consultation. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  5. Body image and weight control in South Africans 15 years or older: SANHANES-1

    OpenAIRE

    Mchiza, Zandile J.; Parker, Whadi-ah; Makoae, Mokhantso; Sewpaul, Ronel; Kupamupindi, Takura; Labadarios, Demetre

    2015-01-01

    Background South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa. Methods A cross-sectional survey and a secondary analyses of...

  6. Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial.

    Science.gov (United States)

    Müller, Andre Matthias; Khoo, Selina; Morris, Tony

    2016-01-07

    Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones. The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants' exercise frequency and the effects of the intervention on secondary outcomes. The Malaysian Physical Activity for Health Study (myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity-related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24. In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study

  7. Self-Care for Older People (SCOPE): a cluster randomized controlled trial of self-care training and health outcomes in low-income elderly in Singapore.

    Science.gov (United States)

    Chan, Angelique; Matchar, David B; Tsao, Mary Ann; Harding, Susana; Chiu, Chi-Tsun; Tay, Bryan; Raman, Prassanna; Pietryla, Zachary; Klein, Mara K; Haldane, Victoria Elizabeth

    2015-03-01

    Population aging is associated with a higher prevalence of chronic health conditions. Previous studies have shown that older persons, specifically those with chronic conditions, often lack sufficient knowledge about their condition and thus frequently have poor self-care skills. Efforts to increase general health screenings and improve access to chronic condition management resources are hampered by a lack of disease and health awareness. Self-Care for Older People (SCOPE) study, a cluster randomized controlled trial in Singapore, was designed to evaluate the impact of a self-care program for chronic disease awareness and management of specific health measures and quality of life of older people over eighteen months. SCOPE provided self-care education targeted at older people with low income and low education in order to improve health-related knowledge. A total of 378 low-income older people with no or minimal disability, defined as having difficulty in one or more activities of daily living (ADL), were recruited from senior activity centers. The measurements taken included self-reported health conditions, health and disease knowledge questions, and biomarkers (HbA1c, blood pressure, peak expiratory flow, lipid panel, albumin, and creatinine). SCOPE was also designed to provide information for policy makers on chronic disease burden and healthcare facility utilization among community-dwelling older adults. NCT01672177. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Insomnia in older adults with chronic obstructive pulmonary disease (COPD) in Hong Kong: a case-control study.

    Science.gov (United States)

    Xiang, Yu-Tao; Wong, Tak-Shun; Tsoh, Joshua; Ungvari, Gabor S; Correll, Christoph U; Ko, Fanny W S; Hui, David S C; Chiu, Helen F K

    2014-06-01

    This study aimed to determine the frequency and sociodemographic/clinical correlates of insomnia in Chinese patients aged ≥60 years suffering from chronic obstructive pulmonary disease (COPD). In this case-control study of 142 outpatients with COPD and 218 sex- and age-matched control subjects, COPD patients were recruited from a prospective study sample hospitalized in Hong Kong for acute COPD exacerbation (≥2 major COPD symptoms or >1 major+minor COPD symptoms for ≥2 consecutive days). Controls were recruited from social centres in Hong Kong. Activity of daily living was assessed with the Instrumental Activities of Daily Living Scale, life events were evaluated using the Life Event Scale, depressive symptoms were ascertained with the Geriatric Depression Scale, and quality of life was measured using the Medical Outcomes Study Short Form-12. Early, middle and late insomnia were measured using items 4, 5 and 6 of the Hamilton Rating Scale for Depression. The frequency of ≥1 type of insomnia was 47.2% in patients and 25.7% in controls; frequencies of early, middle and late insomnia in patients were 24.6%, 31.0%, and 26.1%, respectively, compared to 14.7%, 14.7% and 11.9% in controls. Group differences were non-significant after controlling for relevant covariates. However, in multiple logistic regression analysis, more physical illnesses (p = 0.02, OR = 1.3, 95% CI = 1.1-1.7) and more severe depressive symptoms (p = 0.009, OR = 1.1, 95% CI = 1.03-1.3) were independently associated with any type of insomnia in COPD patients, accounting for 21.3% of the variance. A significant proportion of older adult Chinese COPD patients suffer from insomnia that warrants more attention in clinical practice.

  9. Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.

    Science.gov (United States)

    Haas, Marilyn C; Bodner, Eric V; Brown, Cynthia J; Bryan, David; Buys, David R; Keita, Akilah Dulin; Flagg, Lee Anne; Goss, Amy; Gower, Barbara; Hovater, Martha; Hunter, Gary; Ritchie, Christine S; Roth, David L; Wingo, Brooks C; Ard, Jamy; Locher, Julie L

    2014-01-01

    We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), and functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article.

  10. Physiological complexity and system adaptability: evidence from postural control dynamics of older adults.

    Science.gov (United States)

    Manor, Brad; Costa, Madalena D; Hu, Kun; Newton, Elizabeth; Starobinets, Olga; Kang, Hyun Gu; Peng, C K; Novak, Vera; Lipsitz, Lewis A

    2010-12-01

    The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups (P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity (P postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors.

  11. Effects of Vestibular Rehabilitation on Balance Control in Older People with Chronic Dizziness: A Randomized Clinical Trial.

    Science.gov (United States)

    Ricci, Natalia Aquaroni; Aratani, Mayra Cristina; Caovilla, Heloísa Helena; Ganança, Fernando Freitas

    2016-04-01

    The aim of this study was to compare the effects of vestibular rehabilitation protocols on balance control in elderly with dizziness. This is a randomized clinical trial with 3-mo follow-up period. The sample was composed of 82 older individuals with chronic dizziness from vestibular disorders. The control group was treated according to the Conventional Cawthorne & Cooksey protocol (n = 40), and the experimental group was submitted to a Multimodal Cawthorne & Cooksey protocol (n = 42). Measures included Dynamic Gait Index, fall history, hand grip strength, Time Up-and-Go Test, sit-to-stand test, multidirectional reach, and static balance tests. With the exception of history of falls, Forward Functional Reach, Unipedal Right and Left Leg Eyes Closed, and Sensorial Romberg Eyes Open, all outcomes improved after treatments. Such results persisted at follow-up period, with the exception of the Tandem Eyes Open and the Timed Up-and-Go manual. The between-group differences for Sensorial Romberg Eyes Closed (4.27 secs) and Unipedal Left Leg Eyes Open (4.08 secs) were significant after treatment, favoring the Multimodal protocol. Both protocols resulted in improvement on elderly's balance control, which was maintained during a short-term period. The multimodal protocol presented better performance on specific static balance tests.

  12. Functional brain response to food images in successful adolescent weight losers compared with normal-weight and overweight controls.

    Science.gov (United States)

    Jensen, Chad D; Kirwan, C Brock

    2015-03-01

    Research conducted with adults suggests that successful weight losers demonstrate greater activation in brain regions associated with executive control in response to viewing high-energy foods. No previous studies have examined these associations in adolescents. Functional neuroimaging was used to assess brain response to food images among groups of overweight (OW), normal-weight (NW), and successful weight-losing (SWL) adolescents. Eleven SWL, 12 NW, and 11 OW participants underwent functional magnetic resonance imaging while viewing images of high- and low-energy foods. When viewing high-energy food images, SWLs demonstrated greater activation in the dorsolateral prefrontal cortex (DLPFC) compared with OW and NW controls. Compared with NW and SWL groups, OW individuals demonstrated greater activation in the ventral striatum and anterior cingulate in response to food images. Adolescent SWLs demonstrated greater neural activation in the DLPFC compared with OW/NW controls when viewing high-energy food stimuli, which may indicate enhanced executive control. OW individuals' brain responses to food stimuli may indicate greater reward incentive processes than either SWL or NW groups. © 2015 The Obesity Society.

  13. CT volumetry of lumbar vertebral bodies in patients with hypoplasia L5 and bilateral spondylolysis and in normal controls

    International Nuclear Information System (INIS)

    Wilms, Guido E.; Demaerel, Philippe; Keyzer, Frederik de; Willems, Endry

    2012-01-01

    To examine the feasibility and results of calculating the volume of lumbar vertebral bodies in normal patients and patients with suspected hypoplasia of L5. Lumbar multi-detector CT was performed in 38 patients with bilateral spondylolysis and hypoplasia of L5 and in 38 normal patients. Lumbar vertebral body volume of L3, L4 and L5 was measured by CT volumetry with a semi-automated program, created with MeVisLab. In the control group, the average vertebral body volume (in cubic centimeters) of L3 was 35.93 (±7.33), 36.34 (±7.13) for L4 and 34.63 (±6.88) for L5. In patients with suspected hypoplasia L5 the average body volume (in cubic centimeters) of L3 was 36.85 (±7.37), 36.90 (±6.99) for L4 and 33.14 (±6.57) for L5. The difference in mean vertebral body volume for L3, L4 and L5 between both groups was statistically not significant. However, there was a statistically significant difference of the ratio L5/L4 (P < 0.001) between both groups: the mean ratio L5/L4 in the control group was 95.3 ± 3.9%, the ratio for the hypoplastic L5 group was 89.9 ± 6.3%. There was no significant difference in the vertebral body volume for L3, L4 and L5 between both groups due to inter-patient variability. However, the relation between the body volume of L5 and L4 is significantly different between both groups. The volume of the vertebral body of L5 proved to be on average 10.2% smaller than the volume of L4 in the group with hypoplasia L5 versus 4.7% in the control group. (orig.)

  14. CT volumetry of lumbar vertebral bodies in patients with hypoplasia L5 and bilateral spondylolysis and in normal controls

    Energy Technology Data Exchange (ETDEWEB)

    Wilms, Guido E.; Demaerel, Philippe; Keyzer, Frederik de [UZ Leuven, Campus Gasthuisberg, Department of Radiology, Leuven (Belgium); Willems, Endry [ZOL, Department of Radiology, Genk (Belgium)

    2012-08-15

    To examine the feasibility and results of calculating the volume of lumbar vertebral bodies in normal patients and patients with suspected hypoplasia of L5. Lumbar multi-detector CT was performed in 38 patients with bilateral spondylolysis and hypoplasia of L5 and in 38 normal patients. Lumbar vertebral body volume of L3, L4 and L5 was measured by CT volumetry with a semi-automated program, created with MeVisLab. In the control group, the average vertebral body volume (in cubic centimeters) of L3 was 35.93 ({+-}7.33), 36.34 ({+-}7.13) for L4 and 34.63 ({+-}6.88) for L5. In patients with suspected hypoplasia L5 the average body volume (in cubic centimeters) of L3 was 36.85 ({+-}7.37), 36.90 ({+-}6.99) for L4 and 33.14 ({+-}6.57) for L5. The difference in mean vertebral body volume for L3, L4 and L5 between both groups was statistically not significant. However, there was a statistically significant difference of the ratio L5/L4 (P < 0.001) between both groups: the mean ratio L5/L4 in the control group was 95.3 {+-} 3.9%, the ratio for the hypoplastic L5 group was 89.9 {+-} 6.3%. There was no significant difference in the vertebral body volume for L3, L4 and L5 between both groups due to inter-patient variability. However, the relation between the body volume of L5 and L4 is significantly different between both groups. The volume of the vertebral body of L5 proved to be on average 10.2% smaller than the volume of L4 in the group with hypoplasia L5 versus 4.7% in the control group. (orig.)

  15. Model-based analysis and control of a network of basal ganglia spiking neurons in the normal and Parkinsonian states

    Science.gov (United States)

    Liu, Jianbo; Khalil, Hassan K.; Oweiss, Karim G.

    2011-08-01

    Controlling the spatiotemporal firing pattern of an intricately connected network of neurons through microstimulation is highly desirable in many applications. We investigated in this paper the feasibility of using a model-based approach to the analysis and control of a basal ganglia (BG) network model of Hodgkin-Huxley (HH) spiking neurons through microstimulation. Detailed analysis of this network model suggests that it can reproduce the experimentally observed characteristics of BG neurons under a normal and a pathological Parkinsonian state. A simplified neuronal firing rate model, identified from the detailed HH network model, is shown to capture the essential network dynamics. Mathematical analysis of the simplified model reveals the presence of a systematic relationship between the network's structure and its dynamic response to spatiotemporally patterned microstimulation. We show that both the network synaptic organization and the local mechanism of microstimulation can impose tight constraints on the possible spatiotemporal firing patterns that can be generated by the microstimulated network, which may hinder the effectiveness of microstimulation to achieve a desired objective under certain conditions. Finally, we demonstrate that the feedback control design aided by the mathematical analysis of the simplified model is indeed effective in driving the BG network in the normal and Parskinsonian states to follow a prescribed spatiotemporal firing pattern. We further show that the rhythmic/oscillatory patterns that characterize a dopamine-depleted BG network can be suppressed as a direct consequence of controlling the spatiotemporal pattern of a subpopulation of the output Globus Pallidus internalis (GPi) neurons in the network. This work may provide plausible explanations for the mechanisms underlying the therapeutic effects of deep brain stimulation (DBS) in Parkinson's disease and pave the way towards a model-based, network level analysis and closed

  16. Blood pressure control is similar in treated hypertensive patients with optimal or with high-normal albuminuria.

    Science.gov (United States)

    Oliveras, Anna; Armario, Pedro; Lucas, Silvia; de la Sierra, Alejandro

    2014-09-01

    Although elevated urinary albumin excretion (UAE) is associated with cardiovascular prognosis and high blood pressure (BP), it is unknown whether differences in BP control could also exist between patients with different grades of UAE, even in the normal range. We sought to explore the association between different levels of UAE and BP control in treated hypertensive patients. A cohort of 1,200 treated hypertensive patients was evaluated. Clinical data, including 2 office BP measurements and UAE averaged from 2 samples, were recorded. Albuminuria was categorized into 4 groups: G0 (UAE <10mg/g), G1 (UAE 10-29 mg/g), G2 (UAE 30-299 mg/g), and G3 (UAE ≥300 mg/g). Forty-three percent of patients had systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg. Median UAE was significantly higher (20.3 vs. 11.7 mg/g; P < 0.001) in these patients than in controlled hypertensive patients (BP<140/90 mm Hg). When UAE was categorized into the 4 groups, there were differences in BP control among groups (P < 0.001).The proportion of noncontrolled patients in G2 (52.3%) was significantly higher than in G0 (36.8%) and G1 (41.5%) (P < 0.01 and P < 0.05, respectively). Importantly, no significant differences were observed between G0 and G1 (P = 0.18) or between G2 and G3 (P = 0.48). With G0 as the reference group, the odds ratio of lack of BP control for the G2 group after adjustment for confounders was 1.40 (95% confidence interval =1.16-1.68; P < 0.001). Lack of BP control is more prevalent among patients with microalbuminuria than in patients with normoalbuminuria. No significant difference was seen between patients with optimal or high-normal UAE. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. The effect of speaking rate on serial-order sound-level errors in normal healthy controls and persons with aphasia.

    Science.gov (United States)

    Fossett,