Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis

: EPHPP quality rating scores (DOCX 38 kb

Salivary Gland Disorders and Diseases

Saliva plays an important role in maintaining healthy oral mucosa and teeth as well as oral function by continually covering and lubricating the oral tissues. Salivary gland dysfunction designates decreased saliva flow rate (salivary gland hypofunction), increased saliva flow rate (sialorrhea or hypersalivation), and changed saliva composition. Xerostomia (the subjective feeling of oral dryness) is often associated with salivary gland hypofunction and may severely affect nutritional intake, social interaction and quality of life. Local or systemic disorders and diseases are common causes of compromised saliva secretion. Some of these are related to gland pathology or to the pathophysiological conditions of the host, whereas others affect the gland innervation or are an iatrogenic result of treatment of a disease (e.g., radiation therapy for head and neck cancer, side effects of medications). In general, many patients suffering from diseases that influence salivary gland function also undergo treatments that may impair saliva secretion and/or induce xerostomia as an adverse effect. Consequently, it can be difficult to distinguish what can be attributed to the disease per se or what can be induced by treatment (e.g., medication intake). Thus, a thorough diagnostic workup and early diagnosis of salivary gland dysfunction are crucial to provide appropriate evidence-based treatment of salivary gland dysfunction to prevent oral sequelae and to initiate individualized alleviating management strategies of xerostomia.</p

Cognitive Correlates of Timed Up and Go Subtasks in Older People with Preserved Cognition, Mild Cognitive Impairment, and Alzheimer's Disease

Objective To determine whether impaired Timed Up and Go Test (TUG) subtask performances are associated with specific cognitive domains among older people with preserved cognition (PC), mild cognitive impairment (MCI), and mild Alzheimer's disease (AD). Design TUG subtasks performances were assessed by the Qualisys motion system. Cognition was assessed by Addenbrooke's Cognitive Examination and the Frontal Assessment Battery (FAB). Results The highest correlations with transition subtasks were with aspects of executive function, i.e. the fluency domain in the PC group (n = 40), FAB scores in the MCI group (n = 40), and the visuospatial domain in the AD group (n = 38). No significant associations were found between the walking subtasks and cognition in any group. Multivariate linear regression models identified the fluency domain as an independent predictor of turn-to-walk and turn-to-sit measures in the PC group, and the visuospatial domain as an independent predictor of turn-to-walk and turn-to-sit measures in the AD group, adjusted for age and sex. Conclusions Poorer executive functioning was associated with impaired transition mobility in all groups. The significant associations between visuospatial impairment and poor transition mobility in the AD participants may provide insight into why this group has an elevated fall risk

A case management strategy to reduce falls in older people with a history of falls: A randomized controlled trial

The present study aimed to determine whether a remotely delivered intervention, based on an individual case management, can reduce falls and their consequences in community-dwelling older people with a history of multiple falls. In this randomized controlled trial, 32 participants were randomized to the intervention group, which comprised a 16-week case management program involving a multidimensional assessment, targeted interventions according to the identified fall risk factors, and development of individualized care plans. The intervention was performed by trained gerontologists, under weekly supervision of professionals with experience in falls. The control group (n = 30) received usual care. Falls were monitored over 12 months with monthly falls calendars and telephone calls. Remotely delivered case management presented an 82 % uptake of recommendations. There was a trend toward a reduced fall incidence in the intervention vs control group, with lower fall, fall injury and fracture rates in the intervention group compared with the control group at both the 16-week and 12-month time-points, with the difference statistically significant for injurious fall rates at 12 months - IRR=0.18 (95 % CI = 0.04 to 0.74)