The difference between self-reported QoL and family caregivers' ratings of QoL in people with mild dementia indicated that cognitive impairment was not the primary factor that accounted for the differences in the QoL assessments. Our findings suggested that non-cognitive factors, such as awareness of disease and depressive symptoms, played an important role in the differences between the self-reported AD QoL ratings and the caregivers' AD QoL ratings. A major implication is that discrete measures such as cognition or level of function are likely to miss important factors that influence QoL.
Objective: To assess the effect of aerobic exercise on the cognition and functional capacity in Alzheimer's disease (AD) patients. Method: Elderly (n=20) with mild dementia (NINCDS-ADRDA/CDR1) were randomly assigned to an exercise group (EG) on a treadmill (30 minutes, twice a week and moderate intensity of 60% VO 2max ) and control group (GC) 10 patients. The primary outcome measure was the cognitive function using Cambridge Cognitive Examination (CAMCOG). Specifics instruments were also applied to evaluate executive function, memory, attention and concentration, cognitive flexibility, inhibitory control and functional capacity. Results: After 16 weeks, the EG showed improvement in cognition CAMCOG whereas the CG declined. Compared to the CG, the EG presented significant improvement on the functional capacity. The analysis of the effect size has shown a favorable response to the physical exercise in all dependent variables. Conclusion: Walking on treadmill may be recommended as an augmentation treatment for patients with AD.Keywords: Alzheimer's disease, aerobic exercise, physical training, cognitive function, functional capacity. RESUMOObjetivo: Avaliar o efeito do exercício aeróbio na cognição e na capacidade funcional em pacientes com Doença de Alzheimer (DA). Método: Idosos (n=20) com demência leve ((NINCDS-ADRDA/CDR1) foram randomizados em grupo exercício (GE) na esteira (30 minutos, 2 vezes por semana e intensidade moderada de 60% VO 2max )e grupo controle (GC) 10 pacientes. A medida principal foi a função cognitiva através do Cambridge Cognitive Examination (CAMCOG). Instrumentos específicos também foram aplicados para avaliar a função executiva, atenção e concentração, flexibilidade cognitiva, controle inibitório e capacidade funcional. Resultados: Após 16 semanas, o GE mostrou melhora na cognição CAMCOG enquanto o CG declinou. Comparado ao GC, o GE apresentou melhora significativa na capacidade funcional. A análise do tamanho de efeito mostrou resposta favorável do exercício físico em todas as variáveis dependentes. Conclusão: Caminhar na esteira pode ser recomendado como um tratamento adicional para pacientes com doença de Alzheimer.Palavras-chave: doença de Alzheimer, exercício aeróbio, treinamento físico, função cognitiva, capacidade funcional.
Background: Alzheimer's disease (AD) is the most prevalent dementia, being associated with cognitive, behavioral, and functional alterations. However, clarifying the influence of the disease worsening in the decline of these functions is of major relevance. Objective: Compare specific cognitive functions, motor functions and activities of daily living (ADL) of AD patients in different stages of the disease. Methods: Cognitive and motor functions, as well as ADL of 74 AD patients (35 patients CDR1; 20 patients CDR2; 19 patients CDR3) were evaluated. Results: Motor function and independency in the ADL have presented a non-linear decline. While motor function shows a greater decline from the mild to the moderate phase, ADL present a greater decline in the severe stage of the disease. Discussion: Motor function decline is more evident in both moderate and severe stages of AD, associated with losses in physical capacity and increases in risk of falls. The patients' loss of independency to perform instrumental ADL occurs in a non-linear pattern and it is much greater than both physical and cognitive declines when these parameters are objectively evaluated in the three phases of the disease.
-Background:The practice of physical activities has proved to be an efficient strategy in the improvement of independency and cognitive functions in the elderly with Alzheimer's disease (AD). Objective: To evaluate the relation between the practice of physical activity, cognition and activities of daily living (ADL) of patients with AD. Method: The cognitive and physical aspects and ADL were evaluated of 37 elders (19 normal controls, 11 sedentary with AD and 7 active with AD). Results: The variable that best predicts the cognitive state (MMSE) is the duration of disease for the AD sedentary group and Lawton's Scale for the AD active group. We observed a correlation between MMSE score and duration of disease in the sedentary group and between MMSE and ADL in the active group. Conclusion: Our study showed that physical and cognitive stimulation in patients with AD can contribute to decrease cognitive and functional decline.KEy WOrDS: Alzheimer's disease, cognition, ADL, physical exercise, mobility. Papel da atividade física na manutenção da cognição e atividades de vida diária em idosos com doença de alzheimerResumo -Fundamento: A prática de atividade física tem se mostrado uma estratégia eficaz na melhora da independência e das funções cognitivas em idosos com doença de Alzheimer (DA). Objetivo: Avaliar a relação entre a prática de atividade física, a cognição e as atividades de vida diária (AVD) em pacientes com DA. Método: Foram avaliados os aspectos cognitivos, físicos e as AVD de 37 idosos (19 controles normais, 11 com DA sedentários e 7 com DA ativos). Resultados: A variável que melhor prediz o estado cognitivo (MEEM) foi o tempo de doença para o grupo DA sedentários e a Escala de Lawton para o grupo DA ativo. Observou-se correlação entre MEEM e tempo de doença no grupo sedentário e MEEM e AVD no grupo ativo. Conclusão: O nosso estudo mostrou que a estimulação física e cognitiva em pacientes com DA pode contribuir na diminuição do declínio cognitivo e funcional. PALAVrAS-chAVE: doença de Alzheimer, AVD, cognição, exercício físico, mobilidade. The practice of physical activity is associated to a lower prevalence and incidence of dementia and cognitive decline [1][2][3] . A recent study 1 found that healthy elderly who exercised regularly were 32% less prone to developing dementia than a control group of sedentary subjects. Low levels of functional capacity are associated with the risk of dementia whereas a three-day weekly exercise regimen seems to contribute to a protective effect. convincing evidence has also been presented regarding the improvement of the cognitive functioning with aerobic training independently of the type, duration, and intensity of the physical activity, mainly on the executive processes 4 . Activities of daily living (ADL) and cognition in Alzheimer's disease (AD) decline according to a temporal and parallel hierarchy 5 . Furthermore, the impairments on the ADL may be related to motor changes and neurological manifestations which occur along the progression of AD, such as ext...
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