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  • HIV – What has Physiotherapy and Rehabilitation got to do with it?

    https://www.physiospot.com/opinion/h...to-do-with-it/

    The Centre of Disease Control (CDC) published the first reports of HIV in 1981, however the advent of combination Antiretroviral Therapy with Protease Inhibitors in 1996 significantly changed the management of HIV/AIDS, with a decline in HIV-related mortality. The healthcare landscape for people living with HIV has improved exponentially over the past 3 decades, whereby treatment has been a spectacular success and now the U=U statement is being endorsed globally; meaning people living with HIV on Antiretroviral Therapy with an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV. Consequently with effective treatment, HIV is considered a chronic condition, and people living with HIV can expect to live normal life expectancies. People are therefore living longer and ageing with HIV or acquiring HIV in older age. With 36.7million people living with HIV globally and over half having access to Antiretroviral Therapy, healthcare services need to prepare for an ageing HIV epidemic, which is largely unchartered territory.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • Dancing or Fitness Sport? The Effects of Two Training Programs on Hippocampal Plasticity and Balance Abilities in Healthy Seniors

      http://journal.frontiersin.org/artic...017.00305/full



      Age-related degenerations in brain structure are associated with balance disturbances and cognitive impairment. However, neuroplasticity is known to be preserved throughout lifespan and physical training studies with seniors could reveal volume increases in the hippocampus (HC), a region crucial for memory consolidation, learning and navigation in space, which were related to improvements in aerobic fitness. Moreover, a positive correlation between left HC volume and balance performance was observed. Dancing seems a promising intervention for both improving balance and brain structure in the elderly. It combines aerobic fitness, sensorimotor skills and cognitive demands while at the same time the risk of injuries is low. Hence, the present investigation compared the effects of an 18-month dancing intervention and traditional health fitness training on volumes of hippocampal subfields and balance abilities. Before and after intervention, balance was evaluated using the Sensory Organization Test and HC volumes were derived from magnetic resonance images (3T, MP-RAGE). Fourteen members of the dance (67.21 ± 3.78 years, seven females), and 12 members of the fitness group (68.67 ± 2.57 years, five females) completed the whole study. Both groups revealed hippocampal volume increases mainly in the left HC (CA1, CA2, subiculum). The dancers showed additional increases in the left dentate gyrus and the right subiculum. Moreover, only the dancers achieved a significant increase in the balance composite score. Hence, dancing constitutes a promising candidate in counteracting the age-related decline in physical and mental abilities.
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • Physical Activity in Midlife is not Associated with Cognitive Health in Later Life Among Cognitively Normal Older Adults

        http://content.iospress.com/articles...ease/jad170290



        Abstract:

        Background:

        Links between physical activity and dementia are based primarily on cross-sectional data or studies with unsatisfactory follow-up.

        Objective:

        We leveraged three decades of follow-up from an established cohort to determine whether physical activity in midlife is associated with late-life cognition and dementia.

        Methods:

        The Johns Hopkins Precursors study (n = 646) enrolled participants from 1948–1964 and administered questions about physical activity, from which we calculated metabolic equivalents (MET h/day), and exercise from 1978-present. Cognitive tests were administered in 2008. Dementia was adjudicated through 2011. To characterize associations with midlife physical activity, we used linear regression for cognitive tests and Cox proportional hazards models for dementia onset. Models adjusted for age, sex, smoking, diabetes, and hypertension.

        Results:

        No physical activity measure from 1978 was associated with late-life cognition or onset of dementia. Both MET h/day (β= 0.007, 95% CI: 0.002, 0.013) and regular exercise (β= 0.357, 95% CI: 0.202, 0.513) in 2006, however, were associated with better cognition in 2008.

        Conclusion:

        Findings from this 30-year cohort study that physical activity measured recently, but not in mid-life, is associated with late-life cognition fits with null findings from randomized trials and other observational studies with extensive follow-up. Cross-sectional findings may be misleading due to reverse causation.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis


          http://journals.plos.org/plosone/art...l.pone.0183945


          Abstract

          Background


          High prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents’ functional disability.

          Methods


          A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data.

          Results


          The prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences.

          Conclusions


          In line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • Combination of measures of handgrip strength and red cell distribution width can predict in-hospital complications better than the ASA grade after hip fracture surgery in the elderly

            https://bmcmusculoskeletdisord.biome...891-017-1738-3

            Abstract

            Background


            Early detection of a high-risk patient following hip fracture surgery is of paramount clinical importance. American Society of Anesthesiologists (ASA) grading is an easy and efficient index in predicting a worse outcome. The red cell distribution width (RDW) and handgrip strength, are gaining interest as a prediction tool as well. Accordingly, the objective of this study was to investigate the potential association between ASA, RDW and grip strength and detect the effects of combining RDW and grip strength for predicting early complication after hip fracture surgery in the elderly.

            Methods


            Eighty-three consecutive patients operated with hip fracture surgeries were identified retrospectively. Age, gender, diagnosis, RDW, handgrip strength and ASA grade were recorded. Admission to the intensive care unit (ICU), length of ICU stay, transfer to other departments, in-hospital death, and readmission were investigated as early complications. Logistic regression analysis was applied to evaluate the estimates in predicting complications, and receiver operating characteristics curves were constructed to compare the estimates and decide which method is more accurate.

            Results


            After the surgery, 52% of the patients were admitted to the ICU. From the analyses, RDW and grip strength had no significant relation with each other. However, the ICU stay was correlated with RDW and grip strength but not for the ASA grade. A higher ASA grade and grip strength could independently predict ICU admission. The combination of RDW with grip strength outweighed the ASA grade in predictive ability.

            Conclusions


            The current study indicated that combining RDW and grip strength measures can be efficient and clinically relevant in predicting early postoperative complications after fragility hip fracture in the elderly. Due to the objectivity and availability of those two approaches, patient care, and functional outcomes are expected to be improved by adopting these measures in the clinical setting.

            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • There is nothing inevitable or natural about chronic disease

              https://aeon.co/ideas/there-is-nothi...75cfe-69418129



              The hope of academic medicine is that research *– especially in molecular biology and pharmaceuticals – will save us. As we zero in on the elusive, primordial mechanisms of disease, we can design ever more precise pharmaceuticals, or even cures.

              But rather than producing any outright cures for chronic disease, decades of basic science research seem to have yielded a different kind of truth – that the human body is an incredibly, devilishly complex system. The deeper we dig, the more convoluted becomes the pathophysiology of chronic disease. What has become clear is that these chronic diseases – high blood pressure, diabetes, cardiovascular disease – are manifestations of aberrant metabolisms, rather than a lone faulty switch buried somewhere within our cells.

              There seem to be no silver bullets. Causation at the molecular level, deep inside the body, appears to be beyond our current reach. But what about pushing against the ultimate cause – not within us, but in the outside world? Are we fated to follow the New Zealanders’ folly, causing damage with every effort to treat? Or, can we learn what external forces have made us so chronically ill, and push back there?

              Perhaps we can. It turns out that traditional cultures across the globe, from hunter-gatherers to pastoralists to horticulturists, have shown little evidence of chronic disease. It’s not because they don’t live long enough – recent analysis has found a common lifespan of up to 78 years among hunter-gatherers, once the bottlenecks of high mortality in infancy and young adulthood are bypassed. We can’t blame genes, since many of these groups appear to be more genetically susceptible to chronic disease than those of European descent.

              Evidence suggests it is how they live. Though traditional cultures span an immensely diverse gamut of lifestyles, they share a common denominator defined by the absence of modern banes: absence of processed foodstuffs, absence of sedentary lifestyle, and likely absence of chronic stressors.

              Indeed, evidence suggests that lack of chronic disease in these groups flows from how they live, how they move, how they eat. Diet looks to be an especially powerful driver – adoption of a Western diet, rich in processed foods, has mirrored the development of chronic disease worldwide, and prospective studies with healthy and diabetic subjects have documented the powerful influence of food on health. Physical exercise, long touted as merely a means to calorie disposal, turns out to have complex endocrine and metabolic effects on insulin signalling, stress response, sleep, mental health, and even neuronal function in the brain. What the science seems to say is that an ancestral way of life aligns the machinery of our metabolisms toward good health.

              Thus it appears that our bodies aren’t, after all, destined for chronic disease as they age – rather, it is the environment we’ve put them in that should bear the blame.
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?


                http://onlinelibrary.wiley.com/doi/1...3D2CB61.f03t03

                Abstract

                Objectives


                To determine whether lifestyle factors, measured late in life, could compress the disabled period toward the end of life.Design


                Community-based cohort study of older adults followed from 1989 to 2015.Setting


                Four U.S. communities.

                Participants


                Community-living men and women aged 65 and older (N = 5,248, mean age 72.7 ± 5.5, 57% female, 15.2% minority) who were not wheelchair dependent and were able to give informed consent at baseline.

                Measurements


                Multiple lifestyle factors, including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks, and social support, were measured at baseline. Activities of daily living (ADLs) were assessed at baseline and throughout follow-up. Years of life (YoL) was defined as years until death. Years of able life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression or expansion of the disabled period.

                Results


                The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity was associated with 7.3 percentage points (95% confidence interval (CI) = 5.4–9.2) lower YAL/YoL% than normal weight. Scores in the lowest quintile of the Alternate Healthy Eating Index were associated with a 3.7% (95% CI = 1.6–5.9) lower YAL/YoL% than scores in the highest quintile. Every 25 blocks walked in a week was associated with 0.5 percentage points (95% CI = 0.3–0.8) higher YAL/YoL%.

                Conclusion


                The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • Post-fatigue recovery of power, postural control and physical function in older women


                  http://journals.plos.org/plosone/art...l.pone.0183483

                  Abstract


                  Low muscle power, particularly at high velocities, has been linked to poor physical function in older adults. Any loss in muscle power following fatiguing exercise or daily activities could impact physical function and postural control until power has fully recovered. To test the overall hypothesis that a common task such as walking can result in prolonged power loss and decreased physical function and balance, 17 healthy older (66–81 years) women completed a 32-min walking test (32MWT) designed to induce neuromuscular fatigue, followed by 60min of recovery (60R). Fatigue and recovery of knee extensor muscle power (3 velocities) were quantified by dynamometry. Function was quantified by chair rise time and postural control by measures of center of pressure (COP) range (mm) and velocity (mm·s-1) during quiet stance. Power declined at all velocities by 8–13% 2min following the 32MWT (p≤0.02) and remained depressed by 8–26% at 60R (p≤0.04). Postural control decreased following the 32MWT, indicated by increased COP range in the anterior-posterior (AP, p<0.01) direction and a trend in the medial-lateral (ML) direction (p = 0.09), and returned to baseline by 60R (p≥0.10). COP velocity was unchanged immediately following the 32MWT, but at 60R was lower in ML (p = 0.03) and tended to be reduced in AP (p = 0.07). Changes in high-velocity power (270°·s-1) were associated with altered postural control (p = 0.02) and chair rise performance (p≤0.03). These results provide evidence of long-duration neuromuscular changes following fatigue in healthy older women that may place them at increased risk for functional deficits during everyday mobility tasks.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • Differential diagnosis of Alzheimer’s disease using spectrochemical analysis of blood


                    http://www.pnas.org/content/early/20...701517114.full

                    Significance


                    Vibrational spectroscopy is an ideal technique for analysis of biofluids, as it provides a “spectral fingerprint” of all of the molecules present within a biological sample, thus generating a holistic picture of the sample’s status. Neurodegenerative diseases lack early and accurate diagnosis, and tests currently used for their detection are either invasive or expensive and time-consuming. This study used blood plasma to diagnose and differentiate various neurodegenerative diseases; the achieved sensitivities and specificities are equal to, or even higher than, the ones obtained by clinical/molecular methods. Herein, we show that spectroscopy could provide a simple and robust diagnostic test. Additional work should include asymptomatic individuals for an early screening test and exploration of neurodegenerative diseases at all stages of severity.
                    Abstract


                    The progressive aging of the world’s population makes a higher prevalence of neurodegenerative diseases inevitable. The necessity for an accurate, but at the same time, inexpensive and minimally invasive, diagnostic test is urgently required, not only to confirm the presence of the disease but also to discriminate between different types of dementia to provide the appropriate management and treatment. In this study, attenuated total reflection FTIR (ATR-FTIR) spectroscopy combined with chemometric techniques were used to analyze blood plasma samples from our cohort. Blood samples are easily collected by conventional venepuncture, permitting repeated measurements from the same individuals to monitor their progression throughout the years or evaluate any tested drugs. We included 549 individuals: 347 with various neurodegenerative diseases and 202 age-matched healthy individuals. Alzheimer’s disease (AD; n = 164) was identified with 70% sensitivity and specificity, which after the incorporation of apolipoprotein ε4 genotype (APOE ε4) information, increased to 86% when individuals carried one or two alleles of ε4, and to 72% sensitivity and 77% specificity when individuals did not carry ε4 alleles. Early AD cases (n = 14) were identified with 80% sensitivity and 74% specificity. Segregation of AD from dementia with Lewy bodies (DLB; n = 34) was achieved with 90% sensitivity and specificity. Other neurodegenerative diseases, such as frontotemporal dementia (FTD; n = 30), Parkinson’s disease (PD; n = 32), and progressive supranuclear palsy (PSP; n = 31), were included in our cohort for diagnostic purposes. Our method allows for both rapid and robust diagnosis of neurodegeneration and segregation between different dementias.
                    Jo Bowyer
                    Chartered Physiotherapist Registered Osteopath.
                    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                    Comment


                    • Frailty is associated with objectively assessed sedentary behaviour patterns in older adults: Evidence from the Toledo Study for Healthy Aging (TSHA)

                      http://journals.plos.org/plosone/art...l.pone.0183911

                      Abstract

                      Objective


                      The aim of this study was to examine the association of sedentary behaviour patterns with frailty in older people.

                      Setting


                      Clinical setting.

                      Design


                      Cross-sectional, observational study.

                      Participants and measurements


                      A triaxial accelerometer was used in a subsample from the Toledo Study for Healthy Aging (519 participants, 67–97 years) to assess several sedentary behaviour patterns including sedentary time per day, the number and duration (min) of breaks in sedentary time per day, and the proportion of the day spent in sedentary bouts of 10 minutes or more. Frailty was assessed using the Frailty Trait Scale (FTS). Regression analysis was used to ascertain the associations between sedentary behaviour patterns and frailty.

                      Results


                      Sedentary time per day and the proportion of the day spent in sedentary bouts of 10 minutes or more, were positively associated with frailty in the study sample. Conversely, the time spent in breaks in sedentary time was negatively associated with frailty.

                      Conclusion


                      In summary, breaking up sedentary time and time spent in sedentary behaviour are associated with frailty in older people.

                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • Brain Halves Increase Communication to Compensate for Aging

                        http://neurosciencenews.com/aging-br...nication-7498/

                        The aged brain tends to show more bilateral communication than the young brain. While this finding has been observed many times, it has not been clear whether this phenomena is helpful or harmful and no study has directly manipulated this effect, until now.

                        “This study provides an explicit test of some controversial ideas about how the brain reorganizes as we age,” said lead author Simon Davis, PhD. “These results suggest that the aging brain maintains healthy cognitive function by increasing bilateral communication.”

                        Simon Davis and colleagues used a brain stimulation technique known as transcranial magnetic stimulation (TMS) to modulate brain activity of healthy older adults while they performed a memory task. When researchers applied TMS at a frequency that depressed activity in one memory region in the left hemisphere, communication increased with the same region in the right hemisphere, suggesting the right hemisphere was compensating to help with the task.

                        In contrast, when the same prefrontal site was excited, communication was increased only in the local network of regions in the left hemisphere. This suggested that communication between the hemispheres is a deliberate process that occurs on an “as needed” basis.
                        brain-communication-aging-neurosciencnews-public.jpg?w=750.jpg



                        These results suggest that greater bilaterality in the prefrontal cortex might be the result of the aging brain adapting to the damage endured over the lifespan, in an effort to maintain normal function.
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • Why we did not evolve to live forever: Unveiling the mystery of why we age

                          https://www.sciencedaily.com/release...0915144151.htm

                          Getting old, it's something that happens to everyone and nearly every species on this planet, but the question is, should it? In a recent publication in the journal Genes & Development titled "Neuronal inhibition of the autophagy nucleation complex extends lifespan in post-reproductive C. elegans," the laboratory of Dr Holger Richly at IMB, has found some of the first genetic evidence that may put this question to rest.

                          As Charles Darwin explained, natural selection results in the fittest individuals for a given environment surviving to breed and pass on their genes to the next generation. The more fruitful a trait is at promoting reproductive success, the stronger the selection for that trait will be. In theory, this should give rise to individuals with traits which prevent ageing as their genes could be passed on nearly continuously. Thus, despite the obvious facts to the contrary, from the point of evolution ageing should never have happened. This evolutionary contradiction has been debated and theorised on since the 1800s. It was only in 1953 with his hypothesis of antagonistic pleiotropy (AP) that George C. Williams gave us a rational explanation for how ageing can arise in a population through evolution. Williams proposed that natural selection enriches genes promoting reproductive success but consequently ignores their negative effects on longevity. Importantly, this is only true when those negative effects occur after the onset of reproduction. Essentially, if a gene mutation results in more offspring but shortens life that's fine. This is because there can be more descendants carrying on the parent's genes in a shorter time to compensate. Accordingly, over time, these pro-fitness, pro-ageing mutations are actively selected for and the ageing process becomes hard-wired into our DNA. While this theory has been proven mathematically and its implications demonstrated in the real world, actual evidence for genes behaving in such as fashion has been lacking.

                          This evidence has now arrived according to the co-lead author of the paper Jonathan Byrne, "The evolutionary theory of ageing just explains everything so nicely but it lacked real evidence that it was happening in nature. Evolution becomes blind to the effects of mutations that promote ageing as long as those effects only kick in after reproduction has started.
                          The evidence for ageing driven by evolution was not the only surprise the paper had in store, according to Thomas Wilhelm, the other co-lead author on the paper. "What was most surprising was what processes those genes were involved in." Not content to provide just the missing evidence for a 60-year-old puzzle, Wilhelm and his colleagues went on to describe what a subset of these genes do in C. elegans and how they might be driving the ageing process. "This is where the results really get fascinating," says Dr Holger Richly, the principal investigator of the study. "We found a series of genes involved in regulating autophagy, which accelerate the ageing process." These results are surprising indeed, the process of autophagy is a critical recycling process in the cell, and is usually required to live a normal full lifetime. Autophagy is known to become slower with age and the authors of this paper show that it appears to completely deteriorate in older worms. They demonstrate that shutting down key genes in the initiation of the process allows the worms to live longer compared with leaving it running crippled. "This could force us to rethink our ideas about one of the most fundamental processes that exist in a cell," Holger explains. "Autophagy is nearly always thought of as beneficial even if it's barely working. We instead show that there are severe negative consequences when it breaks down and then you are better off bypassing it all together." "It's classic AP," he continues, "In young worms, autophagy is working properly and is essential to reach maturity but after reproduction, it starts to malfunction causing the worms to age."

                          In a final revelation, Richly and his team were able to track the source of the pro longevity signals to a specific tissue, namely the neurons. By inactivating autophagy in the neurons of old worms they were not only able to prolong the worms life but they increased the total health of the worms dramatically. "Imagine reaching the halfway point in your life and getting a drug that leaves you as fit and mobile as someone half your age who you then live longer than, that's what it's like for the worms," says Thomas Wilhelm. "We turn autophagy off only in one tissue and the whole animal gets a boost. The neurons are much healthier in the treated worms and we think this is what keeps the muscles and the rest of the body in good shape. The net result is a 50% extension of life."

                          While the authors do not yet know the exact mechanism causing the neurons to stay healthier for longer, this finding could have real world implications. "There are many neuronal diseases associated with dysfunctional autophagy such as Alzheimer's, Parkinson's, and Huntington's disease, it is possible that these autophagy genes could represent a good way to help preserve neuronal integrity in these cases," elaborates Thomas Wilhelm. While any such a treatment would be a long way off, assuming such findings could be recapitulated in humans, it does offer a tantalising hope; prevent disease and get younger and healthier while doing it.
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • Differences in aggression among people with dementia


                            https://www.sciencedaily.com/release...0915165048.htm

                            Physical aggression among people with dementia is not unusual. A study from Lund University in Sweden showed that one-third of patients with the diagnosis Alzheimer's disease or frontotemporal dementia were physically aggressive towards healthcare staff, other patients, relatives, animals and complete strangers. This manifestation of disease must be both understood and addressed in the right way.
                            Louis Gifford was one of those who took the hands of an elderly gentleman from around my neck just as I was blacking out. Unfortunately, it mean't that the gentleman couldn't come to the rehab unit any more and he was kept under fairly heavy sedation from then onwards, I always wondered with hindsight, and continue to wonder, if I could have handled the situation better. He had been a prisoner of the Japanese during WW2.
                            Last edited by Jo Bowyer; 17-09-2017, 10:18 PM.
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • Older People’s Experiences of Mobility and Mood in an Urban Environment: A Mixed Methods Approach Using Electroencephalography (EEG) and Interviews

                              http://www.mdpi.com/1660-4601/14/2/151/htm

                              Abstract


                              There are concerns about mental wellbeing in later life in older people as the global population becomes older and more urbanised. Mobility in the built environment has a role to play in improving quality of life and wellbeing, as it facilitates independence and social interaction. Recent studies using neuroimaging methods in environmental psychology research have shown that different types of urban environments may be associated with distinctive patterns of brain activity, suggesting that we interact differently with varying environments. This paper reports on research that explores older people’s responses to urban places and their mobility in and around the built environment. The project aim was to understand how older people experience different urban environments using a mixed methods approach including electroencephalography (EEG), self-reported measures, and interview results. We found that older participants experience changing levels of “excitement”, “engagement” and “frustration” (as interpreted by proprietary EEG software) whilst walking between a busy built urban environment and an urban green space environment. These changes were further reflected in the qualitative themes that emerged from transcribed interviews undertaken one week post-walk. There has been no research to date that has directly assessed neural responses to an urban environment combined with qualitative interview analysis. A synergy of methods offers a deeper understanding of the changing moods of older people across time whilst walking in city settings.
                              Keywords:
                              older adults; mobility; mood; built environment; mixed methods; qualitative; electroencephalography (EEG)
                              Jo Bowyer
                              Chartered Physiotherapist Registered Osteopath.
                              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                              Comment


                              • Prevention of Alzheimer's Disease: Lessons Learned and Applied

                                http://onlinelibrary.wiley.com/doi/1...jgs.14997/full

                                Abstract


                                Alzheimer's disease (AD) affects more than 5 million Americans, with substantial consequences for individuals with AD, families, and society in terms of morbidity, mortality, and healthcare costs. With disease-modifying treatment trials unsuccessful at the present time and only medications to treat symptoms available, an emerging approach is prevention. Advances in diagnostic criteria, biomarker development, and greater understanding of the biophysiological basis of AD make these initiatives feasible. Ongoing pharmacological trials using anti-amyloid therapies are underway in sporadic and genetic forms of AD, although a large number of modifiable risk factors for AD have been identified in observational studies, many of which do not appear to exert effects through amyloid or tau. This suggests that prevention studies focusing on risk reduction and lifestyle modification may offer additional benefits. Rather than relying solely on large-sample, long-duration, randomized clinical trial designs, a precision medicine approach using N-of-1 trials may provide more-rapid information on whether personalized prevention plans can improve person-centered outcomes. Because there appear to be multiple pathways to developing AD, there may also be multiple ways to prevent or delay the onset of AD. Even if these precision approaches alone are not successful in preventing AD, they may greatly improve the likelihood of amyloid- or tau-specific therapies to reach their endpoints by reducing comorbidities. Keeping this in mind, dementia may be a disorder that develops over a lifetime, with individualized ways to build a better brain as we age.
                                Jo Bowyer
                                Chartered Physiotherapist Registered Osteopath.
                                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                                Comment

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