The use of self-reported data to estimate the prevalence of hypertension and diabetes may lead to underestimated prevalence estimates and biased associations with risk factors due to differential misclassification. Adding biometrical measurements to self-reported questionnaire information will assure the validity of the data. The magnitude of the additional value of biometrical data depends on the condition studied and the characteristics of the population under investigation.

Consecutive and integrated dual-task training led to similar and sustained improvements in dual-task gait velocity without increasing fall risk. These novel findings support adoption of dual-task training in clinical practice. © 2017 International Parkinson and Movement Disorder Society.

OBJECTIVE -The purpose of this study was to assess the relationship between lifestyle factors and abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in a community-based setting.RESEARCH DESIGN AND METHODS -Cross-sectional associations between lifestyle factors (dietary quality, physical activity, smoking, and alcohol consumption) and SAT and VAT volumes were examined in 2,926 Framingham Heart Study participants (48.6% women, aged 50 Ϯ 10 years). RESULTS -Diets consistent with the 2005 Dietary GuidelinesAdherence Index and greater physical activity were inversely associated with SAT and VAT (P Ͻ 0.0001-0.002). In men, former smoking was associated with higher SAT (2,743 Ϯ 56 cm3 ) compared with current smokers (2,629 Ϯ 88 cm 3 ) or those who never smoked (2,538 Ϯ 44 cm 3 ; P ϭ 0.02). Both former and current smoking was associated with higher VAT (P ϭ 0.03 [women]; P ϭ 0.005 [men]). Women with high amounts of alcohol intake (Ͼ7 drinks/week) had lower SAT (2,869 Ϯ 106 cm 3 ) than those who consumed less alcohol (3,184 Ϯ 44 cm 3 , P ϭ 0.006); significant differences in VAT were not observed (P ϭ 0.18). In men, high amounts of alcohol intake (Ͼ14 drinks/ week) were associated with higher VAT (2,272 Ϯ 59 cm 3 ) compared with intake of Յ14 drinks/week (2,139 Ϯ 25 cm 3 , P ϭ 0.04), whereas SAT did not differ (P ϭ 0.91). An increasing number of healthy lifestyle factors were associated with lower SAT and VAT volumes (all P Ͻ 0.003).CONCLUSIONS -Adherence to recommended dietary guidelines and physical activity are associated with lower SAT and VAT volumes. However, both smoking and high alcohol intake are differentially associated with VAT volumes. Further research to uncover the putative mechanisms is warranted. Diabetes Care 32:505-510, 2009A bdominal adiposity is strongly associated with metabolic and cardiovascular disease (CVD) risk (1) and all-cause mortality (2). Visceral adipose tissue (VAT) in particular may be a pathogenic fat compartment (3). Numerous studies have demonstrated that central obesity is associated with lifestyle factors (4 -6). However, the majority of these studies used waist circumference as a proxy for abdominal obesity, which does not allow for the differentiation between subcutaneous adipose tissue (SAT) and VAT. As VAT is more strongly associated with metabolic risk factors than SAT (3), it is important to identify whether VAT is more correlated with lifestyle factors. This information may provide more understanding of the relationship between a healthy lifestyle and VAT and the contribution of individual lifestyle factors to cardiometabolic risk.Thus, the aim of the present study was to examine the relation between lifestyle factors (dietary quality, physical activity, smoking, and alcohol consumption) and SAT and VAT volumes, as assessed by multidetector computed tomography (MDCT), in a large populationbased cohort of women and men free of CVD.RESEARCH DESIGN AND METHODS -Participants for this study were part of the Framingham Heart Study MDCT Study, a substudy ...

Dual-task (DT) circumstances aggravate gait disorders in Parkinson's disease (PD) and are associated with an increased risk of falling and reduced functional mobility. Clinical rehabilitation guidelines for PD consider DT interventions as potentially hazardous and recommend avoiding them in daily life. The current article challenges this notion and addresses the necessity of implementing DT training in PD. First, underlying reasons for DT interference in PD and current theoretical models are discussed. Subsequently, different training approaches to tackle DT difficulties are put forward. Finally, the effectiveness and limitations of DT training in PD are reviewed. We conclude that there is a need for DT interventions in PD and recommend randomized, power-based studies to further test their efficacy.

Nutritional counselling by a dietician resulted in modest reductions in weight and waist circumference in overweight adults, which were sustained up to 12 months. Adding exercise counselling by a physiotherapist did not significantly enhance the effect on body weight. Exercise counselling may, however, further improve waist circumference.

In people with PD, DT measures proved to be reliable for use in clinical studies and look promising for use in clinical practice to assess improvements after DT training. Large effects, however, are needed to obtain meaningful effect sizes.

Background and Purpose: Dual-task interventions show positive effects in people with Parkinson disease (PD), but it remains unclear which factors determine the size of these benefits. As a secondary analysis of the DUALITY trial, the aim of this study was to assess the determinants of the effect size after 2 types of dual-task practice. Methods: We randomly allocated 121 participants with PD to receive either integrated or consecutive dual-task training. Dual-task walking performance was assessed during (i) a backward digit span task (digit), (ii) an auditory Stroop task (Stroop), and (iii) a functional mobile phone task. Baseline descriptive, motor, and cognitive variables were correlated with the change in dual-task gait velocity after the intervention. Factors correlated with the change in dual-task gait velocity postintervention (P < 0.20) were entered into a stepwise forward multiple linear regression model. Results: Lower dual-task gait velocity and higher cognitive capacity (Scales for Outcomes in Parkinson's Disease-Cognition [ScopaCog]) at baseline were related to larger improvements in dual-task gait velocity after both integrated and consecutive dual-task training for all 3 tasks (β[gait] = −0.45, β[ScopaCog] = 0.34, R 2 = 0.23, P < 0.001, for digit; β[gait] = −0.52, β[ScopaCog] = 0.29, R 2 = 0.26, P < 0.001, for Stroop; and β[gait] = −0.40, β[ScopaCog] = 0.30, R 2 = 0.18, P < 0.001, for mobile phone task). Discussion and Conclusions: Participants with PD who showed a slow dual-task gait velocity and good cognitive functioning at baseline benefited most from the dual-task training, irrespective of the type of training and type of dual-task outcome. Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A242).

BackgroundMultiple tasking is an integral part of daily mobility. Patients with Parkinson’s disease have dual tasking difficulties due to their combined motor and cognitive deficits. Two contrasting physiotherapy interventions have been proposed to alleviate dual tasking difficulties: either to discourage simultaneous execution of dual tasks (consecutive training); or to practice their concurrent use (integrated training). It is currently unclear which of these training methods should be adopted to achieve safe and consolidated dual task performance in daily life. Therefore, the proposed randomized controlled trial will compare the effects of integrated versus consecutive training of dual tasking (tested by combining walking with cognitive exercises).Methods and designHundred and twenty patients with Parkinson’s disease will be recruited to participate in this multi-centered, single blind, randomized controlled trial. Patients in Hoehn & Yahr stage II-III, with or without freezing of gait, and who report dual task difficulties will be included. All patients will undergo a six-week control period without intervention after which they will be randomized to integrated or consecutive task practice. Training will consist of standardized walking and cognitive exercises delivered at home four times a week during six weeks. Treatment is guided by a physiotherapist twice a week and consists of two sessions of self-practice using an MP3 player. Blinded testers will assess patients before and after the control period, after the intervention period and after a 12-week follow-up period. The primary outcome measure is dual task gait velocity, i.e. walking combined with a novel untrained cognitive task to evaluate the consolidation of learning. Secondary outcomes include several single and dual task gait and cognitive measures, functional outcomes and a quality of life scale. Falling will be recorded as a possible adverse event using a weekly phone call for the entire study period.DiscussionThis randomized study will evaluate the effectiveness and safety of integrated versus consecutive task training in patients with Parkinson’s disease. The study will also highlight whether dual task gait training leads to robust motor learning effects, and whether these can be retained and carried-over to untrained dual tasks and functional mobility.Trial registrationClinicaltrials.gov NCT01375413.