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• Both home-based aerobic and resistance exercise programs were feasible. • Two-month exercise intervention tended to improve physical function. • Two-month exercise intervention might be not enough to exert effects on cognitive function. To examine the feasibility and efficacy of home-based aerobic and resistance exercise interventions for geriatric individuals with cognitive impairment. Fourteen participants with cognitive impairment were allocated to either the aerobic group (n = 8) or the resistance group (n = 6), after which they implemented a two-month home-based training program. Feasibility and efficacy outcomes were evaluated. A semi-structured interview was performed after the intervention. All fourteen participants completed the two-month training program. The adherence rate was 0.94 for the aerobic group and 0.96 for the resistance group. No adverse events occurred. The results revealed a trend of group×time interaction effect on delayed recall. Significant group×time interaction effects were revealed on simple physical performance and body composition. Semi-structured interviews identified four motivators for participating in this program, four facilitators for and three barriers to keeping exercising, and some perceived benefits. Home-based aerobic and resistance exercise programs are feasible for geriatric individuals with cognitive impairment. The efficacy needs to be further examined. [ABSTRACT FROM AUTHOR]

Background Nurse-physician collaboration is a critical prerequisite for high-quality care. Previous researchers have addressed multiple factors that influence collaboration. However, little of this research has explored the influence of interactional factors on nurses' perception of nurse-physician collaboration in China. Aims To examine the influence of interactional factors (effective communication, perceived respect and willingness to collaborate) on nurses' perception of nurse-physician collaboration. Methods A cross-sectional survey of 971 registered nurses in nine hospitals was conducted. An author-designed interactional factor questionnaire and the Nurse-Physician Collaboration Scale were used to collect data. Multiple regression analysis was used. Results Nurse-physician collaboration was identified as at a moderate level (mean = 3.93 ± 0.68). Interactional factors (effective communication, perceived respect and willingness to collaborate) were identified as relatively moderate to high (mean = 4.03 ± 0.68, mean = 3.87 ± 0.75, mean = 4.50 ± 0.59, respectively). The results showed that effective communication, perceived respect and willingness to collaborate explained 57.3% of the variance in nurses' perception of nurse-physician collaboration (Adjusted R 2  = 0.573, F = 435.563, P  < 0.001). Perceived respect (β = 0.378) was the strongest factor relevant to nurses' perception of nurse-physician collaboration, second was effective communication (β = 0.315), and the weakest factor among these three factors was willingness to collaborate (β = 0.160). Conclusion Nurses' perceptions of collaboration were relatively positive, mainly in Sharing of patient information ; however, improvements need to be made regarding Joint participation in the cure / care decision-making process . Effective communication, perceived respect and willingness to collaborate significantly affect nurses' perception of nurse-physician collaboration, with perceived respect having greater explanatory power among the three interactional factors. It is necessary for hospital managers to develop strategies to build professional respect for nurses, facilitate effective nurse-physician communication and improve nurses' willingness to collaborate. [ABSTRACT FROM AUTHOR]

Although the health benefits of exercise for older adults are widely recognized, physical inactivity is still common among older adults. Further clarification of the factors affecting exercise adherence is needed to develop more effective exercise interventions in community-dwelling older adults. The purposes of this study were to identify (1) barriers and facilitators of exercise adherence in community-dwelling older adults and (2) behavior change techniques (BCTs) and implementation strategies that are potentially effective in improving adherence. A total of eight databases were searched: PubMed, Web of Science, EMBASE, CENTRAL, PsycINFO, SPORTDiscus, MEDLINE, and Scopus. Studies published from database inception to April 2023 were searched. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Capabilities, Opportunities, Motivations, Behavior (COM-B) model and the Theoretical Domain Framework (TDF) were used to identify potential barriers and facilitators. The BCTs were used to identify potential intervention implementation strategies. A total of 64 studies were included, including 30 qualitative studies, 12 randomized controlled trials, 12 mixed methods studies, 6 quantitative descriptive studies, and 5 non-randomized trials. 54 factors influencing adherence and 38 potentially effective BCTs were identified from the included studies. The 38 BCTs were further categorized into 8 areas of implementation strategies (tailored exercise program, appropriate exercise environment, multidimensional social support, monitoring and feedback, managing emotional experiences and issues, participants education, enhancing self-efficacy, and exerting participants' autonomy). This study identified 54 influential factors affecting exercise adherence and identified 8 areas of intervention strategies (containing 38 BCTs). Further refinement, evaluation, and validation of these factors and strategies are needed in future studies. [ABSTRACT FROM AUTHOR]

Subjective cognitive decline is one of the first symptoms of dementia. With increasing awareness of brain health and a rising prevalence of dementia, a growing number of individuals seek medical assistance for purely subjective cognitive decline. However, only individuals with specific characteristics tend to experience clinical progression. This study aims to summarize the predictors of objective cognitive impairment in individuals with subjective cognitive decline and to identify those at higher risk of clinical progression. Systematic review and meta-analysis. We systematically searched 11 electronic databases from inception to February 1, 2023, for longitudinal studies investigating factors associated with the clinical progression of subjective cognitive decline. Effect sizes were pooled using fixed-effects and random-effects models. Leveraging the results of the meta-analysis, we developed two risk prediction models for objective cognitive impairment. Forty-six cohort studies were included in the systematic review, of which 28 met the meta-analysis criteria. Fifteen predictors were identified, including 4 biomarkers (amyloid β deposition, lower Hulstaert Formula scores, apolipoprotein e4, and hippocampus atrophy), four epidemiological factors (older age at baseline, impaired instrumental activity of daily living, depression, and anxiety), and seven neuropsychological factors (participants in clinical settings, older age at onset, stable symptom, concerns, cognitive decline confirmed by informant, severe symptoms, and poor performance on Trail Making Test B). Based on the meta-analysis results, we developed two risk prediction models. The first model (Model 1) incorporates epidemiological and neuropsychological factors, distinguishing individuals with low and medium risk. The second model (Model 2) includes additional biomarkers to enhance predictive performance and identify individuals at high risk. This study provides a comprehensive characterization of individuals undergoing clinical progression from subjective cognitive decline to mild cognitive impairment or dementia. The developed models support the prediction of progression risk in both memory clinic and community settings, aiding in the early identification of individuals at risk of disease conversion and facilitating the translation of evidence into clinical practice. The systematic review and meta-analysis have been registered in PROSPERO (CRD 42023392476). Factors for predicting progression from subjective cognitive decline to objective cognitive impairment: evidence from longitudinal studies. [ABSTRACT FROM AUTHOR]

To summarize the biomarkers for evaluating the effects of exercise interventions in patients with cognitive impairment associated with aging, as well as their responses to exercise interventions. A systematic review and meta-analysis We systematically searched different electronic database, including PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, PsycINFO, SPORTDiscus up to April 2020. Clinical controlled trials with exercise interventions in patients with cognitive impairment were included. The main outcomes included all the biomarkers used to evaluate the effects of exercise interventions. If data for certain biomarkers was enough (more than 2 studies), meta-analyses would be performed to estimate the effect sizes by calculating the standard mean differences (SMDs) and 95% confidence intervals (CIs). Finally, we included 33 articles from 26 trials. The biomarkers included neurotrophic factors, inflammatory factors, oxidative stress markers, neuropathological hallmarks, metabolic biomarkers and genotypes. The meta-analyses indicated that exercise significantly decreased the levels of IL-6 (SMD = −0.45; 95% CI: −0.72, −0.18) and low-density lipoprotein (SMD = −0.26; 95% CI: −0.50, −0.01). Subgroup analyses showed that aerobic exercise also could decrease the levels of TNF-α (SMD = −1.21; 95% CI: −2.29, −0.14). There were some important cognition-related biomarkers which were rarely measured, such as Aβ, tau and IGF-1. Regular exercise showed positive effects on reducing inflammation and regulating lipid metabolism. But the available evidence is limited and more studies with different exercise interventions should be conducted to test the effects of exercise on other important cognition-related biomarkers in patients with cognitive dysfunction. • This study summarized the changes of biomarkers induced by exercise in patients with MCI and dementia. • Exercise significantly decreased the levels of IL-6 and low-density lipoprotein. • Aerobic exercise could decrease the levels of TNF-α. • The evidence for some important cognition-related biomarkers was limited. [ABSTRACT FROM AUTHOR]