JOURNAL OF GERONTOLOGY AND GERIATRICS

Effect of vestibular therapy as an adjunct to cognitive therapy to improve cognition in elderly with mild cognitive impairment (MCI): A Randomized Controlled Trial

Abhishek Goswami — 2024-11-15

Background and aims. The rate of population aging is drastically accelerating globally, having significant social, economic, and health repercussions. The prevalence of aging-related illnesses, such as mild cognitive impairment (MCI), will rise in elderly population as they get older, highlighting necessity of developing new treatment methods to stop MCI. This study aimed to determine effect of vestibular therapy as an adjunct to cognitive therapy to improve cognition in elderly with MCI.
Methods. This was a three-armed, randomized controlled trial. The study was conducted with an estimated sample size of 36. After eligibility screening, participants were randomly assigned to vestibular therapy as an adjunct to cognitive therapy (VT+CT), cognitive therapy (CT) alone, and a control group. Participants in VT+CT group received vestibular therapy and computerized brain program. The CT alone group received a computerized brain program only. Primary outcome measures were ERP-P300, and Digit Symbol Substitution Test (DSST), and secondary outcomes included Stroop Color Word Test (SCWT) and Trail Making Test. Data was collected at baseline, 8th week, and 2 weeks after intervention.
Results. VT+CT resulted in greater improvement in measures of cognition including ERP-P300 latency (p < 0.03) and its amplitude (p < 0.04), DSST (p < 0.00), and TMT-B (p < 0.00) as compared to CT alone, and control group.
Conclusions. Given the superior effects in favor of VT+CT, It could reliably be argued that incorporating vestibular therapy in intervention regimen may yield greater improvements in cognition as evident in present study on measures of cognition like ERP-P300, DSST, and TMT-B in elderly with MCI.

Correlation between muscle masses measured by chest computed tomography and bioelectrical impedance analysis in older adults

Serdar Ceylan — 2024-11-15

Background and aims. There is a scarcity of research investigating the relationship between thoracic muscles and bioelectrical impedance analysis (BIA)-measured muscle mass specifically in older adults. Thus, the objective of this study is to assess the association between muscle measurements obtained from chest computed tomography (CT) scans and BIA in older adults.
Methods. The retrospective study included outpatients who previously applied to the geriatrics outpatient clinic of a university hospital, who were evaluated with BIA and who had a chest CT for any reason within 3 months before or after the BIA. Cross-sectional muscle area at Th10 and Th12 was obtained from chest CT images.
Results. The median age of the 83 patients was 73.0 (25p-75p: 69- 79), and 51.8% (n = 43) were female. By CT, from Th10 median for cross-sectional area (CSA) was 81.7 cm² (25p-75p: 61.5-95.3); from Th12, median for CSA was 93.1 cm² (25p-75p: 70-107.6). At both thoracic vertebrae levels, muscle masses were correlated with muscle mass obtained by BIA in all participants, those with normal handgrip strength, those who were obese and non-obese, and those with normal SMI.
Conclusions. Muscle masses measured with BIA and CT correlated in older adults. It should be noticed that the thoracic muscles will also diminish if muscle mass measured by BIA decreases in older adults. Since BIA offers significant advantages in terms of non-invasiveness, portability, cost, time efficiency, ease of use and safety profile it can be a valid alternative to CT scans for thoracic muscle mass measurement.

Long-term survival in frail older adults sustaining a hip fracture: does the perioperative period really matter?

Alessandra Gerosa — 2024-12-17

Purpose. Hip fractures in older adults are a major challenge for public health, it is associated with increased morbidity and mortality, especially in frailty older adults. An accurate evaluation of preventable perioperative risk factors is essential to optimize care pathways and clinical outcomes. This study aims to gauge evidence on the predictive accuracy of perioperative variables, including the Nottingham Hip Fracture Score (NHFS), on overall long-term survival (OS) in frail, hospitalized hip-fractured older adults.
Methods. From March 2020 to September 2021, 433 elderly patients with hip fractures received multidisciplinary orthogeriatric care in Policlinic San Martino Hospital (Genova, Italy). Enrolled patients received geriatric assessment (CGA) within 24 hours from hospital admission and their medical conditions were assessed alongside post-operative complications and survival rates. Statistical analyses, including Cox models, evaluated factor influencing overall survival.
Results. The patients’ most prevalent clinical phenotype was frailty, sustained by loss of muscle strength, malnutrition and functional disability. This phenotype reflects the unique demographic of the Liguria region (Italy) with the highest proportion of oldest-old (≥ 85 years) and frail individuals in the nation. Results showed NHFS > 5, vitamin D deficiency and delayed verticalization as key predictive determinants of long-term mortality (up to 21 months). Resilience to perioperative stressors in frail hip-fractured patients is crucial to the success of treatments aimed at improving their physical recovery.
Conclusions. Our research showed that targeting preventable factors during surgery can greatly impact the functional reserve of frail elderly patients, influencing their recovery and long-term outcomes, including mortality rates.

Exergames in neurocognitive disease management in elderly: a narrative review of therapeutic benefits and applications

Annalisa D'Ermo — 2024-11-15

Objective. Recent advancements in understanding neurodegenerative diseases highlight their global impact, affecting about 55 million individuals. Mild Neurocognitive disorder (MND) underscores the urgency for early intervention. Nonpharmacological approaches, including exergames, show promise in enhancing cognitive and physical functions. This review explores exergames’ potential in Neurocognitive disorder intervention.
Methods. The review covered publications from 2012 to December 2023, from PubMed, Scopus, Google Scholar, Web of Science, and PEdro. Papers were selected using key words like “exergame”, “dementia”,” neurocognitive disorder” “Alzheimer’s Disease”, “cognitive function”, “balance”, and “walking”.
Results. This study focused on identifying studies using exergames in Neurocognitive disorder (NCD) support. Most studies (22/28) included control group comparisons. Some focused on cognitive function (3/27), physical abilities like balance and walking (4/27), or both (12/27). A study investigated cognitive function and electroencephalogram (EEG). Additionally, a pilot study examined cognitive functions and oxidative stress (OxS). The Nintendo Wii and Microsoft Kinect were commonly used, alongside iPACES, iPACES 2.0, Physiomat, Bike and Fiets Labyrint, IREX, LegSys, BioSensics, Cosmed EuroBike 320, Dividat Senso, Valve Index (HMD), and Hexer Heart.
Conclusions. Exergames emerge as a viable alternative to traditional physical exercise, offering easy accessibility and active participant engagement, thus promoting greater adherence. Utilizing low-cost devices, these games are readily available and applicable in specialized centers and at home with caregiver assistance, highlighting their adaptability during circumstances such as pandemics.