Objective: To examine the impact of cardiovascular and motor fitness on cognitive performance in subjects interested in the prevention and early recognition of Alzheimer’s dementia (AD). Methods: The data of 388 participants of a respective project aged between 50 and 85 years were evaluated. Classification of the participants into the groups of “no cognitive impairment” (NCI), “mild cognitive impairment of the amnestic type” (MCIa), and “mild AD” (mAD) was performed by neuropsychological assessment, history of third party, and further clinical, laboratory, or imaging investigations. Subjective memory impairment (SMI) and cognitive blackouts were recorded. Cardiorespiratory fitness (CRF) was assessed by means of the 2-min step test and motor fitness (MF) by means of the 30-s chair-stand test. Results: CRF and MF were reduced in participants with MCIa and mAD. They were negatively correlated with the score for cognitive blackouts. In the group of 50- to 60-year-old nondemented participants those with low CRF and MF performed poorer in various cognitive domains, had a higher score for cognitive blackouts, and more frequently SMI. Conclusion: Low CRF and MF are associated with cognitive impairment. This applies even in 50- to 60-year-old nondemented subjects without marked physical morbidity. These findings support the potential usefulness of physical exercise for dementia prevention.
Objective: Hyperglycemia and type 2 diabetes mellitus have been shown to have a negative impact on cognitive performance in older adults. In order to assess the relevance of this effect in memory clinic patients, we examined the relationship between hyperglycemia and cognition in an unselected out-patient sample. Design:In a cross-sectional study in memory clinic patients, glycosylated hemoglobin (HbA1c) was determined and related to cognitive performance, subjective memory impairment, and self-perceived cognitive blackouts. Results:The frequency of mild cognitive impairment or mild dementia of the Alzheimer type was increased 1.7-fold in subjects with hyperglycemia. The HbA1c value was negatively correlated with global cognitive performance as well as with orientation, short-term memory and visuospatial capabilities. The frequency of cognitive blackouts was positively correlated with HbA1c levels and it was increased in hyperglycemic subjects.Conclusions: Hyperglycemia could be confirmed as a major risk factor for cognitive impairment. This could be shown even in a non-representative cross-sectional memory clinic sample. Thus, the HbA1c determination may be recommended for a routine diagnostic memory clinic work-up. KeywordsDiabetes mellitus, Hyperglycemia, HbA1c, Mild cognitive impairment, Dementia, Alzheimer, Subjective memory impairment, Cognitive blackouts, Memory clinic [7]. Even prediabetes and insulin resistance are associated with cognitive decline and brain atrophy [8].Diabetes may compromise cognitive function by various mechanisms, such as brain vascular lesions, insulin resistance, oxidative stress, the accumulation of advanced glycilation end products, inflammation or a competition of insulin and β-amyloid on the insulin-degrading enzyme [9].This may also apply to subjects with prediabetes as reflected by a moderately increased HbA1c level. Accordingly, it has been shown that the HbA1c value correlates with the rate of brain atrophy [10] and that it predicts conversion to dementia and mild cognitive impairment [11]. Glycosilated hemoglobin (HbA1c) is a measure of blood glucose concentration over the past two to three months and is used both for the diagnosis of diabetes and the assessment of diabetes management [12].We studied the effects of diabetes and hyperglycemia as determined by elevated HbA1c values on cognitive performance, subjective memory impairment and self-perceived cognitive blackouts in a group of patients of our memory clinic. Subjects and MethodsThe analyses were carried out in 113 patients consecutively presenting for the first time for memory assessment at our memory clinic. They were 70 women (61.9%) and 43 men (38.1%) at ages between 50 and 87 years (mean ± SD: 61.2 ± 9.1 years). Subjects with a history of neurological disorder, with an actual neurological or psychiatric disorder, or with a medication that may compromise cognitive performance were not
Background: Cognitive blackouts, e.g. moments of amnesia, disorientation, or perplexity may be an early sign of incipient Alzheimer’s dementia (AD). A short questionnaire, the checklist for cognitive blackouts (CCB), was evaluated cross-sectionally in users of a memory clinic. Methods: The CCB was performed in 130 subjects, who further underwent a neuropsychological and clinical examination. Subjective memory impairment and depressive symptoms were assessed. Differences in the CCB score between diagnostic groups and relationships with cognitive performance, depression, and subjective memory impairment were analyzed. Results: The CCB score was increased in mild cognitive impairment of the amnestic type or mild AD and correctly predicted 69.2% of the respective subjects. It was negatively correlated with cognitive performance, positively correlated with depressive symptoms, and substantially increased in subjects who estimated their memory poorer than that of other persons of their age. Discussion: The CCB may be a helpful screening tool for the early recognition of AD.
Integration wurde in den letzten Jahren auch in Deutschland zum zentralen Schlagwort in der Migrationsdebatte. Während das Konzept einerseits positiv »Teilhabe« verspricht, fungiert es in der deutschen Migrationspolitik potentiell als Exklusionsmechanismus. Dieses Buch nimmt aus Perspektiven der Politik, Wissenschaft, Kunst und des Aktivismus das Integrationsparadigma kritisch unter die Lupe. Entgegen der öffentlichen Integrationsforderung an hier lebende Migranten nehmen die Beiträge die Perspektive der Migration ein und loten in verschiedenen Praxisfeldern aus, was dies hinsichtlich politischer und wissenschaftlicher Konzepte in einem Europa der Migration bedeutet.
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