Physical activity and neuropsychiatric symptoms in elderly with Alzheimer's dementia

Is common the presence of neuropsychiatric symptoms in Alzheimer's disease (AD), this is resulted of anatomical and biochemical changes in the brain. The objective of present study was to look for papers relating physical activity and neuropsychiatric symptoms through a systematic review. The following data bases was accessed: Academic Search Premier, Biological Abstracts, Medline, PsycINFO, Pubmed, Scielo, Science direct on line, Sport Discus and Web of Science, using the following key-words: (Neuropsychiatric disturbances OR Neuropsychiatric symptoms OR Neuropsychological disturbances OR Aberrant behavior OR Aberrant behaviour OR Behavior disturbances OR Behaviour disturbances OR Behavior management OR Behaviour management OR Disruptive behavior OR Disruptive behaviour) AND (Alzheimer) AND (Exercise OR Motor intervention OR training OR Physical activity OR fitness), besides crossing the references in the selected articles. Eight studies had filled the inclusion criteria. It was possible to conclude there are evidences of positive results for agitation and sleep disturbances in patients with AD. However, there's no consensus of what kind of activity is better for these patients.17353354

Effects of physical activity on cognitive functions, balance and risk of falls in elderly patients with Alzheimer's dementia

Objective: To analyze the effects of regular, systematic and supervised activity on the cognitive functions, balance and risk of falls of elderly patients with Alzheimer's Dementia (AD). Methods: Sixteen elderly patients (mean age 78.5 +/- 6.8 years) were divided into two groups: intervention group (IG; n=9) and routine group (AG; n=7). The IG exercised systematically for six months, and both groups were submitted to the following tests: Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) and the agility/dynamic balance (AGIBAL) item of the American Alliance for Health, Physical Education, Recreation and Dance (AAHPFRD) test battery. Results: There was a statistically significant interaction (two-way ANOVA; F(1,14)=32.07; p=0.01) between groups and moments for the AGIBAL. The Mann Whitney U test indicated significant differences between groups (p=0.03), only at the post-intervention moment for the TUG measured in steps and for BBS. Therefore, no significant intergroup differences were found for the TUG, BBS and MMSE at the pre-intervention moment or at post-intervention moment for the TUG measured in seconds and MMSE. The intragroup analysis by means of the Wilcoxon test showed a significant decline in the TUG, BBS and MMSE for the AG, but not for the IG. Spearman's coefficient showed a significant correlation between the results of the MMSE and AGIBAL. Conclusions: Physical activity may be an important non-pharmacological approach that can benefit cognitive functions and balance and reduce the risk of falls. Moreover, agility and balance are associated with cognitive functions in elderly patients with AD.141687

Effects of resistance training on the performance of activities of daily living in patients with Alzheimer's disease

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Aim: The objective of this study was to investigate the effects of resistance training in activities of daily living performance in Alzheimer's disease (AD) patients. Methods: An exploratory and longitudinal study, lasting for 16weeks, with the participation of 34 patients divided equally in: the training group (TG), who participated in a resistance training protocol (three sets of 20 repetitions in five exercises); and the social gathering group (SGG), who participated in a social interaction protocol (i.e. group dynamics, writing and reading activities). Results: We observed significant differences between the groups in moving around the house, climbing stairs, standing up from the floor and putting on socks tests. Conclusion: This study showed that resistance training improves agility, lower limb strength, balance and flexibility in AD patients, while SGG protocol is important to improve the agility. Geriatr Gerontol Int 2013; 13: 322328.132322328Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Physical Activity and Aging Lab (LAFE)Programa de Cinesioterapia Funcional e Cognitiva em Idosos com Doenca de Alzheimer (PRO-CDA)Pro-Reitoria de Extensao Universitaria (PROEX-UNESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [2010/00543-6

Depressive symptoms and level of physical activity in patients with Alzheimer's disease

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Aim: The purpose of this study was to determine the presence of depressive symptoms in patients with Alzheimer's disease, to assess whether there was an association between physical activity level and depressive symptoms in this population, and to assess whether more active patients had lower rates of depressive symptoms when compared with less active patients. Methods: The study included 37 patients with Alzheimer's disease and used the following instruments: the Geriatric Depression Scale, the Cornell Scale for Depression in Dementia and the Baecke Questionnaire Modified for the Elderly. The ShapiroWilk test was used to determine whether the data were normally distributed. The Spearman correlation test and the MannWhitney U-test was used. P-values less than 5% were considered statistically significant. Results and discussion: The prevalence of depressive symptoms in the sample was 35.13%. The Spearman correlation test verified the relationship between level of physical activity and depressive symptoms (rho = -0,4), and between the sports activities domain and depressive symptoms (rho = -0,4). Patients who were more active had lower depressive symptoms. Conclusions: The prevalence of depressive symptoms in the sample was 35.13%. Patients who were more active had lower rates of depressive symptoms. Geriatr Gerontol Int 2012; : .124637642Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Physical Activity and Aging Lab (LAFE)Programa de Cinesioterapia Funcional e Cognitiva em Idosos com Doenca de Alzheimer (PRO-CDA)Fundação para o Desenvolvimento da UNESP (FUNDUNESP)Pro-Reitoria de Extensao Universitaria (PROEX-UNESP)Nucleo UNESP-UNATI-Universidade Aberta a Terceira IdadeFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Validation of the Brazilian version of the Apathy Inventory

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: Apathy is a frequent neuropsychiatric condition in neurodegenerative disorders, depression, and often in mild cognitive impairment. The Apathy Inventory (AI) is a reliable instrument for improving the accuracy of the apathy diagnosis. The aim was to establish the validity of the Apathy Inventory for the Brazilian community. Methods: We established the concurrent validity, internal consistency, inter-rater reliability, and the sensitivity and specificity of AI for the Brazilian community in a cohort of 175 individuals with Alzheimer's disease, Parkinson's disease, depression, mild cognitive impairment, and healthy controls. The three dimensions of the AI (emotional blunting, lack of initiative, and lack of interest) were compared with the Apathy domain of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C) in an independent scheme. Results: The analyses demonstrated high correlation coefficients in AI's individual dimensions and in AI-total score (F = 0.965). Concerning the NPI-C/Apathy domain, intra-class correlation coefficients were also high (F = 0.977). Concurrent validity was high according to both raters on AI dimensions x NPI-C/Apathy domain and regarding total score (rater 1: rho = 0.956 vs. rater 2: rho = 0.970). The internal consistency of the AI was also high concerning the AI's individual dimensions and total score (rater 1: 0.945 vs. rater 2: 0.958). Conclusion: We observed high internal consistency, high concurrent validity, and inter-rater reliability of the Apathy Inventory. In addition, we found that its sensitivity and specificity were high. We suggest that the Brazilian version of the Apathy Inventory would be an appropriate instrument to identify the apathy syndrome in Brazilian patients. Copyright (c) 2013 John Wiley & Sons, Ltd.289979986Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Influence of physical exercise on the functional capacity in institutionalized elderly

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Introduction: With the rapid increase in life expectancy, systematic physical exercise programs can have a good influence on the functional capacity of the elderly, especially in relation to institutionalization. Objective: To analyze the association between a systematic physical exercise program and functional capacity in institu-tionalized elderly. Methods: The sample included 30 elderly subjects (16 women and 14 men) aged 60 years or older (mean age = 74.43), divided into a control group (n=16) and a training group (n=14), residents in a long-stay institution. A training protocol of 12 weeks, two weekly sessions, was applied, and functional capa-city was assessed before and after the intervention, through chair lift tests (lower limb strength), upper limb strength, timed up and go and handgrip dynamometry. The analysis pre and post-training of intervention and control groups was performed using paired Student t test and the ANOVA test for repeated measures. The level of significance was set at 5%. Results: The main statistical significance were found for the following functional tests: upper limb strength (training 15.6±4.1 x control 10.7±6.6 rep, p<0.05) and chair lift test (training 11.0±4.0 x control 8.0±3.1 rep, p<0.05). Conclusion: The protocol used proved to be effective in improving some of the functional capabilities of the institutionalized elderly

Effects of weight training on cognitive functions in elderly with Alzheimer's disease

Deterioration in cognitive functions is characteristic in Alzheimer's disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life. Objective: To analyze weight training effects on cognitive functions in elderly with AD. Subjects: 34 elderly with AD were allocated into two groups: Training Group (TG) and Social Gathering Group (SGG). Methods: Global cognitive status was determined using the Mini-Mental State Exam. Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test. The protocols were performed three times a week, one hour per session. The weight training protocol consisted of three sets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the U Mann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of 0.05. Results: There were no significant differences associated to the effects of the practice of weight training on cognition in AD patients. Conclusion: In this study, no improvement in cognitive functions was evident in elderly with AD who followed a low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs