Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD

Dyer, Adam H.; Lawlor, Brian; Kennelly, Sean

doi:10.1186/s12877-020-01531-w

Cited by 32 publications

(26 citation statements)

References 34 publications

(42 reference statements)

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“…OH is more common in older adults with dementia 14 and those with dementia may be particularly vulnerable to the adverse effects of medications 15 . Further, those with dementia have an increased risk of falls 16,17 . However, the orthostatic effects of antidepressants has not been explored in this group, who are frequently prescribed antidepressant medication, despite the evidence reporting limited efficacy in this group.…”

Section: Introductionmentioning

confidence: 99%

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Antidepressant use and orthostatic hypotension in older adults living with mild‐to‐moderate Alzheimer disease

Dyer

Murphy

Briggs

et al. 2020

Int J Geriat Psychiatry

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Antidepressant use is often reported as a risk factor for Orthostatic Hypotension (OH), however this relationship has never been explored in those with mild/ moderate Alzheimer Disease (AD), who may represent a particularly vulnerable cohort. Methods: We performed a cross-sectional analysis of baseline data from the NILVAD study. Participants with mild-moderate AD were recruited from 23 centres in nine countries. Systolic and Diastolic Blood Pressure (SBP/DBP) was recorded in the seated position and after both 1 and 5 minutes of standing. OH was defined as a drop of ≥20 mmHg SBP/≥10 mmHg DBP. We examined the relationship between antidepressant use, orthostatic BP drop and the presence of OH, controlling for important covariates. Results: Of 509 participants (72.9 ± 8.3 years, 61.9% female), two-fifths (39.1%; 199/509) were prescribed a regular antidepressant. Antidepressant use was associated with a significantly greater SBP and DBP drop at 5 minutes (β: 1.83, 0.16-3.50, P = .03 for SBP; β: 1.13, 0.02-2.25, P < .05 for DBP). Selective Serotonin Reuptake Inhibitor (SSRI) use was associated with a significantly greater likelihood of OH (OR 2.0, 1.1-3.6, P = .02). Both findings persisted following robust covariate adjustment. Conclusions: In older adults with AD, antidepressants were associated with a significantly greater SBP/DBP drop at 5 minutes. SSRI use in particular may be a risk factor for OH. This emphasises the need to screen older antidepressant users, and particularly those with AD, for ongoing orthostatic symptoms in order to reduce the risk of falls in this vulnerable cohort.

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Section: Introductionmentioning

confidence: 99%

“…15 Further, those with dementia have an increased risk of falls. 16,17 However, the orthostatic effects of antidepressants has not been explored in this group, who are frequently prescribed antidepressant medication, despite the evidence reporting limited efficacy in this group.…”

mentioning

confidence: 99%

Antidepressant use and orthostatic hypotension in older adults living with mild‐to‐moderate Alzheimer disease

Dyer

Murphy

Briggs

et al. 2020

Int J Geriat Psychiatry

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“…Reductions in physical function are also common [ 1 , 5 ]. Characteristic loss of physical function in AD may include experiences of extreme fatigue, reduced gait speed, balance, muscle strength, muscle structure, and dexterity [ 6 , 7 , 8 ]. These changes can make it difficult to participate in daily activity and exercise.…”

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confidence: 99%

“…The use of exercise as medicine has gained recent attention from researchers and clinicians [ 15 , 16 ] given the positive impact of exercise programs on various outcomes in chronic diseases such as cardiovascular diseases, cancer, obesity, depression, as well as in persons living with dementia [ 4 , 17 , 18 , 19 , 20 ]. There is strong evidence that supports the use of exercise in AD; exercise has been demonstrated to improve cognition, quality of life and physical function in persons living with AD [ 8 , 17 , 21 ]. Cardiorespiratory fitness (which improves with exercise) can help increase memory and lower hippocampal atrophy levels, suggesting that exercise can help preserve cognitive function [ 8 , 19 , 22 ].…”

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confidence: 99%

“…There is strong evidence that supports the use of exercise in AD; exercise has been demonstrated to improve cognition, quality of life and physical function in persons living with AD [ 8 , 17 , 21 ]. Cardiorespiratory fitness (which improves with exercise) can help increase memory and lower hippocampal atrophy levels, suggesting that exercise can help preserve cognitive function [ 8 , 19 , 22 ]. Exercise is also associated with improved quality of life and decreased depression in individuals living with AD [ 17 , 21 ].…”

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The Importance of Exercise in Alzheimer’s Disease and the Minds in Motion® Program: An Editorial

Watson

O'Keeffe

West

2020

JFMK

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Alzheimer’s Disease (AD) and other dementias are prevalent neurodegenerative diseases characterized by decreased cognition, physical function, and quality of life. Currently, millions of people are living with AD and other dementias. With no cure, research has examined the use of non-pharmacological treatment options including exercise. Many high-quality studies demonstrate that physical activity slows the progression of AD’s many outcomes, and is beneficial to overall quality of life in those living with AD. However, creating exercise interventions at the community level that individuals will adhere to is often a challenge. The Alzheimer’s Society of Canada developed a unique program that combines physical activity with cognitive stimulation in a social atmosphere: The Minds in Motion® program. Minds in Motion® addresses many of the barriers often linked to poor physical activity participation in chronic diseases (such as inclusion of the care partner), to ensure the best program uptake. The Minds in Motion® program has anecdotally been successful in helping to increase physical function and social skills in those living with dementia. However, it is important to connect community-driven programs with the academic research community, to create an opportunity for high quality evaluation metrics that can be disseminated at multiple levels: to research audiences, clinical audiences, and to those in the community. With ongoing collaborations between research and community programs, there is a greater opportunity to understand the positive impact of a program, which ultimately increases the chance of funding for the program. In this editorial, we highlight that community-integrated research is an important priority for future collaborations.

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Decreased nesting behavior, selective increases in locomotor activity in a novel environment, and paradoxically increased open arm exploration in Neurogranin knockout mice

Nakajima

Funasaka

Huang

et al. 2020

Neuropsychopharm Rep

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Aims Neurogranin (NRGN) is a postsynaptic protein kinase substrate that binds calmodulin in the absence of calcium. Recent studies suggest that NRGN is involved in neuropsychiatric disorders, including schizophrenia, ADHD, and Alzheimer's disease. Previous behavioral studies of Nrgn knockout (Nrgn KO) mice identified hyperactivity, deficits in spatial learning, impaired sociability, and decreased prepulse inhibition, which suggest that these mice recapitulate some symptoms of neuropsychiatric disorders. To further validate Nrgn KO mice as a model of neuropsychiatric disorders, we assessed multiple domains of behavioral phenotypes in Nrgn KO mice using a comprehensive behavioral test battery including tests of homecage locomotor activity and nesting behavior. Methods Adult Nrgn KO mice (28‐54 weeks old) were subjected to a battery of comprehensive behavioral tests, which examined general health, nesting behavior, neurological characteristics, motor function, pain sensitivity, locomotor activity, anxiety‐like behavior, social behavior, sensorimotor gating, depression‐like behavior, and working memory. Results The Nrgn KO mice displayed a pronounced decrease in nesting behavior, impaired motor function, and elevated pain sensitivity. While the Nrgn KO mice showed increased locomotor activity in the open field test, these mice did not show hyperactivity in a familiar environment as measured in the homecage locomotor activity test. The Nrgn KO mice exhibited a decreased number of transitions in the light‐dark transition test and decreased stay time in the center of the open field test, which is consistent with previous reports of increased anxiety‐like behavior. Interestingly, however, these mice stayed on open arms significantly longer than wild‐type mice in the elevated plus maze. Consistent with previous studies, the mutant mice exhibited decreased prepulse inhibition, impaired working memory, and decreased sociability. Conclusions In the current study, we identified behavioral phenotypes of Nrgn KO mice that mimic some of the typical symptoms of neuropsychiatric diseases, including impaired executive function, motor dysfunction, and altered anxiety. Most behavioral phenotypes that had been previously identified, such as hyperlocomotor activity, impaired sociability, tendency for working memory deficiency, and altered sensorimotor gating, were reproduced in the present study. Collectively, the behavioral phenotypes of Nrgn KO mice detected in the present study indicate that Nrgn KO mice are a valuable animal model that recapitulates a variety of symptoms of neuropsychiatric disorders, such as schizophrenia, ADHD, and Alzheimer's disease.

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Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD

Cited by 32 publications

References 34 publications

Antidepressant use and orthostatic hypotension in older adults living with mild‐to‐moderate Alzheimer disease

Antidepressant use and orthostatic hypotension in older adults living with mild‐to‐moderate Alzheimer disease

The Importance of Exercise in Alzheimer’s Disease and the Minds in Motion® Program: An Editorial

Decreased nesting behavior, selective increases in locomotor activity in a novel environment, and paradoxically increased open arm exploration in Neurogranin knockout mice

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