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  • Depressive symptoms as a barrier to engagement in physical activity in older adults with and without Alzheimer’s disease

    https://journals.plos.org/plosone/ar...l.pone.0208581

    Older adults spend 65–80% of waking time in sedentary activities [1,2], and individuals with Alzheimer’s disease (AD) are even less active [3,4]. Physical activity shows promise for reduced risk of AD and protection against cognitive decline among individuals with and without AD [5,6]. However, older adults face many barriers to adoption of physically active lifestyles. In one study, 87% of older adults reported one or more barriers to exercise [7]. In addition to the barriers to physical activity faced by most people, (e.g., perceived effort, discomfort of sweating, muscle soreness), older adults face unique barriers such as chronic health problems, fear of falling, inadequate environmental support, and lack of self-efficacy about exercise [7,8].

    People with AD likely face even further challenges to engaging in physical activity. Aside from a few small qualitative studies [911], there is little research addressing the barriers to physical activity specific to individuals with dementia [7]. The barriers reported in qualitative studies fall into several categories including physical, social, emotional, environmental, and cognitive. The physical barriers are likely similar to those reported in older adults without dementia such as decreased energy and impaired body function [11]. Malthouse and Fox [9] reported that people with AD generally had positive attitudes about the benefits of physical activity, however few of them were willing to push themselves hard enough to sweat and did not like the feeling of being forced to exercise.

    However, barriers due to cognitive disability and socio-emotional factors are more unique to persons with AD. For example, a hallmark cognitive symptom of AD is disorientation to place. This makes it difficult and unsafe for individuals with AD to walk for exercise without a companion or in an unfamiliar environment. A key social-emotional barrier to physical activity is the need to have a caregiver to arrange for transportation, accompaniment, and assurance of safety. AD patients reported feeling a loss of freedom and safety in their inability to exercise unsupervised and loss of identity in their inability to continue with activities they previously enjoyed [11]. The development of “dementia-friendly” communities would be beneficial for allowing people to regain some sense of independence.

    Individuals with AD have been found to have a reduced ability to accurately perceive bodily states that impact effort during physically demanding activity [12]. This may result in over- or under- exertion during exercise leading to unsafe conditions or insufficient effort to achieve benefits of exercise.
    I see several who over-exert due to wandering. This may, in combination with other co-morbidities, lead to significant weight loss. Some can be persuaded to try journal keeping, list making and other forms of documentation. One turned up yesterday with a note book in a very fetching shade of pink! He is a long term asthmatic and COPD patient of mine, and definately needs pacing with regards to activity.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • Age-related immunity loss

      https://www.sciencedaily.com/release...1213141534.htm

      The elderly suffer more serious complications from infections and benefit less from vaccination than the general population. Scientists have long known that a weakened immune system is to blame but the exact mechanisms behind this lagging immunity have remained largely unknown.

      Now research led by investigators at Harvard Medical School suggests that weakened metabolism of immune T cells may be partly to 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


      • Treatment of humerus fractures in the elderly: A systematic review covering effectiveness, safety, economic aspects and evolution of practice

        https://journals.plos.org/plosone/ar...l.pone.0207815

        Although non-surgical treatment is a reasonable treatment option for the majority of humerus fractures [46], there is an increasing interest in surgical intervention [7, 8]. New technical possibilities for fracture fixation in the elderly were evident after the introduction of angle stable implants at the turn of the 21st century [9]. The use of shoulder arthroplasties as fracture treatment has undergone a rapid development during the 21st century [10]. Only few comparing studies have been performed investigating effectiveness and complications after fracture surgery, and the need for prospective randomized trials has been advocated [11]. New surgical methods for humerus fracture care have been introduced and widespread before they have been scientifically evaluated [10]. There are no evidence-based treatment recommendations, thus permitting large local variation in treatment preferences [7, 1012]. Moreover, societal costs are increasing for osteoporosis fracture health care [13], and there is reason to believe that more sophisticated surgical methods for treatment of humerus fractures will add more expenses in the future. However, to the best of our knowledge, health economic assessments of humerus fractures are largely lacking.
        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 may help older women maintain the ability to perform daily tasks

          https://www.sciencedaily.com/release...1219075832.htm
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • Nutrients in Blood Linked to Better Cognition and Brain Connectivity in Older Adults

            https://neurosciencenews.com/aging-b...trients-10385/
            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 we improve cognitive function among adults with osteoarthritis by increasing moderate-to-vigorous physical activity and reducing sedentary behaviour? Secondary analysis of the MONITOR-OA study

              https://bmcmusculoskeletdisord.biome...891-018-2369-z
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • What helps people live well with dementia

                https://www.sciencedaily.com/release...1221123727.htm

                My father was brought up with formal good manners which have served him well into extreme old age and massive cognitive decline. He loves a party and few who meet him can tell that there is anything amiss.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • The Mysteries of the Super-Ager Revealed

                  https://neurosciencenews.com/super-ager-mystery-10428/

                  It was the kind of case no traditional medical textbook could explain. The subject – let’s call him Peter Green – was a white male in his late 80s, enrolled in longitudinal studies of the elderly at the UCSF Memory and Aging Center. Green’s brain scans “were not pretty,” recalls Joel Kramer, PsyD, who directs the center’s neuropsychology program. His brain had begun to atrophy, and its white matter – composed of long bundles of nerve cells that carry signals from one area to another – were shot through with dead patches, suggesting that Green had suffered the kind of ministrokes often associated with cognitive decline.

                  Yet by all behavioral measures, Green was thriving. His cognitive test scores were impeccable and his ability to function in the world remained high.

                  “If you look at his cognition and level of functioning, it not only remains high – it hasn’t changed at all in years,” Kramer says. What was it about Green, Kramer wondered, that set him apart from his peers with similar brain scans, who seemed to have been waylaid by the ravages of time?

                  When Kramer finally met the study subject in person, the neurologist was struck by Green’s dynamism and sunny outlook on life. He told Kramer he volunteered in the community, was constantly busy with projects and organizations, and remained close to his family. He shared how grateful he was for what he had and really seemed to be enjoying his golden years.

                  “He talked about how his attitude toward life is one of embracing it – not getting stressed out by the little things and valuing the importance of relationships,” Kramer says. “I was so impressed. It was inspiring.”
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                • The Number of People with Dementia Has Doubled in Sixteen Years

                  https://www.thelancet.com/journals/l...403-4/fulltext

                  Had I decided to specialize, it would have been in care of the elderly. I started with Victorians, several of whom had lived through two World Wars. As a student, I treated a patient who had lost a leg in the South African Wars, I also treated a suffragette. Some of my Victorian patients had survived childhood rickets. I thought that with increased awareness of smoking related harms, general health would improve. I didn't foresee morbid obesity and recreational drug use as diseases of poverty, or the marked increase in the number of women with coronary heart disease. On the positive side, I treat people who continue to work and take part in sport into their 90's. With regards to complex pain, I haven't noticed much change in the numbers, but there has been marked ongoing improvement in understanding and management. Louis Gifford and Mick Thacker's work has had a profound influence in the UK. Anecdotally, I find complex pain to be a major aggravating factor in progression of dementia in my older patients.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • Preventing dementia: do vitamin and mineral supplements have a role?

                    http://www.evidentlycochrane.net/preventing-dementia/

                    No

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

                    Comment


                    • Exercise Hormone May Slow Alzheimer’s Progression

                      https://neurosciencenews.com/hormone...ression-10468/
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • Emergency and Urgent Hospitalizations Linked to Accelerated Cognitive Decline in Older Adults

                        https://neurosciencenews.com/cogniti...ization-10521/

                        This work expands upon previous research which has shown that after being hospitalized, older adults are at high risk for memory and other cognitive problems, including both transient (temporary) delirium and long-term changes in cognition, including dementia. According to the Healthcare Cost and Utilization Project in October 2010, 40 percent of all hospitalized patients in U.S. are age 65 and older. Therefore, hospitalization may be an under-recognized risk factor for cognitive decline and dementia for a large number of older adults that deserves more attention.
                        In my experience, this is often aggravated by poor nutrition. Sometimes younger generations will take up the suggestion that the very old get home cooked family meals once or twice a week.
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • Dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis

                          https://journals.plos.org/plosone/ar...l.pone.0210036

                          I get my London elders to walk up the escalators on the London Underground and keep a count of how many steps they can do before it reaches the top. Same goes for complex pain patients.
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • Blood-Brain Barrier Breakdown an Early Driver of Dementia

                            https://neurosciencenews.com/blood-b...ementia-10531/

                            “The fact that we’re seeing the blood vessels leaking, independent of tau and independent of amyloid, when people have cognitive impairment on a mild level, suggests it could be a totally separate process or a very early process,” said senior author Berislav Zlokovic, director of the Zilkha Neurogenetic Institute at the Keck School of Medicine of USC. “That was surprising that this blood-brain barrier breakdown is occurring independently.”
                            “The results were really kind of eye-opening,” said first author Daniel Nation, an assistant professor of psychology at the USC Dornsife College of Letters, Arts and Sciences. “It didn’t matter whether people had amyloid or tau pathology; they still had cognitive impairment.”

                            The researchers cautioned that their findings represent a snapshot in time. In future studies, they hope to get a better sense of how soon cognitive problems occur after blood vessel damage appears. Zlokovic said it’s unlikely that scientists will soon abandon amyloid and tau as Alzheimer’s biomarkers, “but we should be adding some vascular biomarkers to our toolkit.”
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • Investigation of frailty as a moderator of the relationship between neuropathology and dementia in Alzheimer's disease: a cross-sectional analysis of data from the Rush Memory and Aging Project

                              https://www.thelancet.com/journals/l...371-5/fulltext
                              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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