Despite advances in the treatment of Alzheimer’s disease (AD), there is currently no prospect of a cure, and evidence shows that multifactorial interventions can benefit patients. A promising therapeutic alternative is the use of transcranial direct current stimulation (tDCS) simultaneously with cognitive intervention. The combination of these non-pharmacological techniques is apparently a safe and accessible approach. This study protocol aims to compare the efficacy of tDCS and cognitive intervention in a double-blind, randomized and factorial clinical trial. One hundred participants diagnosed with mild-stage AD will be randomized to receive both tDCS and cognitive intervention, tDCS, cognitive intervention, or placebo. The treatment will last 8 weeks, with a 12-month follow-up. The primary outcome will be the improvement of global cognitive functions, evaluated by the AD Assessment Scale, cognitive subscale (ADAS-Cog). The secondary outcomes will include measures of functional, affective, and behavioral components, as well as a neurophysiological marker (Brain-derived neurotrophic factor, BDNF). This study will enable us to assess, both in the short and long term, whether tDCS is more effective than the placebo and to examine the effects of combined therapy (tDCS and cognitive intervention) and isolated treatments (tDCS vs. cognitive intervention) on patients with AD.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02772185—May 5, 2016.
Depression is a disabling mental condition that reduces the quality of life regardless of age and circumstances. Late-life depression may be especially impairing due to its relationship with poor physical and mental health. Repeated or prolonged exposures to stressful events deserve a particular interest among late-life depression risk factors. One factor that may help to cope with these stressful situations is the resilience. The objective of the study was to examine the moderating effect of resilience on the relationship between perceived stress (PS) and depression. A total of 1020 community-dwelling older adults aged from 60 to 101 years (
M
= 68.5,
SD
= 6.99) completed the Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Brief Resilience Scale. A moderation effect has been tested using PROCESS for SPSS. Depressive symptomatology was positively related to PS (
r
= .598;
p
< .001) and inversely related to resilience (
r
= − .444;
p
< .001). Moreover, the negative impact of PS on depressive symptoms was buffered for individuals with higher resilience (
β
= − .014;
p
< .001). The resilience could be an adaptive strategy to cope with stress and reduce depression in community-dwelling older adults.
Objective
The aim of this study was to investigate whether different types of visuoconstructional abilities are useful to distinguish individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) from healthy controls (HCs).
Method
We selected 20 patients with MCI and 14 with AD diagnosis based on standard criteria. The neuropsychological performance of MCI and AD groups were compared with that of a group of 11 HCs using a standard neuropsychological battery and visuoconstructional tasks that differed difficulty and type of implicated skills (graphomotor vs. non-graphomotor): two-dimensional (Clock Drawing Test, CDT; Block Design, BD; and Visual Puzzles, VP) and three-dimensional Block Construction (TBC).
Results
AD group scored significantly lower than HCs in BD, VP and TBC tasks, but no significant differences were found between HCs and MCI. CDT (copy condition) scores did not differ significantly among the groups. The receiver operating characteristic analysis showed that BD [sensitivity (se) = .85, specificity (sp) = .90, Youden index (J) = .76], VP (se = .78 and sp = .72, J = .51) and TBC (se = .71, sp = 100, J = .71) were accurate tasks to discriminate between AD and HCs. Moreover, BD tasks (se = .85, sp = .70, J = .55) and TBC (se = .71, sp = .80, J = .51) showed fair accuracy to differentiate between MCI and AD groups.
Conclusions
These findings indicate that non-graphomotor visuoconstructional tasks are already impaired in the early stages of AD, but are preserved in MCI individuals when compared with HCs.
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