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Background Cognitive deficits have been reported in older cardiac patients. An underlying mechanism for these findings may be reduced cardiac function. The relationship between cardiac function as represented by different echocardiographic measures and different cognitive function domains in older cardiac patients remains unknown. Methods An older (≥70 years) heterogeneous group of 117 community-dwelling cardiac patients under medical supervision by a cardiologist underwent thorough echocardiographic assessment including left ventricular ejection fraction, cardiac index, left atrial volume index, left ventricular mass index, left ventricular diastolic function, and valvular calcification. During a home visit, a neuropsychological assessment was performed within 7.1 ± 3.8 months after echocardiographic assessment; the neuropsychological assessment included three subtests of a word-learning test (encoding, recall, recognition) to examine one memory function domain and three executive function tests, including digit span backwards, Trail Making Test B minus A, and the Stroop colour–word test. Results Regression analyses showed no significant linear or quadratic associations between any of the echocardiographic functions and the cognitive function measures. Conclusions None of the echocardiographic measures as representative of cardiac function was correlated with memory or executive function in this group of community-dwelling older cardiac patients. These findings contrast with those of previous studies.

Objective The objective of this study was to ascertain if cognition helps to predict functional outcome in older comorbid stroke patients with severe loss of independence. Design This is a cross-sectional study. Subjects The subjects of this study are patients who have suffered a stroke and who rehabilitated in the nursing homes' rehabilitation units and patients (n = 160) (mean age: 77; SD: 9.5) with a mean Barthel Index of 11.02. Method Demographic, illness-related, functional and cognitive data were selected at baseline. Main Assessment Measures Functional abilities were tested using the Barthel Index. Cognitive functions were assessed using a wide variety of neuropsychological tests. Results Patients faced cognitive impairments especially in executive functioning and memory. Stepwise linear regression analysis shows that executive functioning (p = 0.050) and memory (p = 0.000; confidence interval −1.255, −0.403) are significantly associated with functional outcome. Conclusion From a clinical point of view, we suggest combining physical and cognitive training from the very early phase of recovery.

Aims. The goal of this brief review is to address studies examining the relationship between physical inactivity and pain in aging and dementia. Background. A decrease in the level of physical activity is characteristic of older persons, both with and without dementia. Passive behaviour is often considered to be part of the apathy frequently observed in patients with dementia, although it could also be a sign of pain. Design. Literature review. Method. Searches were performed in PubMed and Embase. A total of 15 studies concerning the relationship between physical inactivity and pain in older persons with and without dementia were identified (older persons without dementia: 12; with dementia: 3). Results. In older persons without dementia, a positive relationship between physical inactivity and pain has been demonstrated. In older persons with dementia, pain may cause physical inactivity and physical inactivity may cause pain. Conclusions. In older persons, a positive relationship between physical inactivity and pain was demonstrated. More specifically, pain may cause physical inactivity. In older persons with dementia pain may cause physical inactivity and vice versa. Relevance to clinical practice. Nurses' awareness of physical inactivity as an indication of pain in older persons with and without dementia may reduce the risk of underdiagnosis and subsequent undertreatment of pain. © 2012 Blackwell Publishing Ltd.

Background There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and healthy lifestyles.The present study compares the motor skills of children with intellectual disability (ID) to the abilities observed in typically developing chil- dren. It also aimed to determine whether there is an association between degree of ID and motor performance. Methods A total of 170 children between 7 and 12 years old with MID or BIF, who attended schools for special education, were examined on the test component of the Movement Assessment Battery for Children (MABC) test. Both groups were com- pared with the norm scores of the total score, sub- scale scores and individual items of the MABC test. Results Of the children, 81.8% with MID and 60.0% with BIF performed below the 16th percen- tile on the total score of the MABC. Both groups demonstrated a relative weakness in the area of manual dexterity. Comparisons between both groups showed small to moderate effect sizes on the total score of the MABC, as well as for all three sub-scales, favouring the children with BIF. Conclusions Children with ID had significantly more borderline and definite motor problems than the normative sample and there was an association between degree of ID and performance of manual dexterity, ball skills and balance skills.This study highlights the importance of improving motor skill performance in both children with borderline and mild ID, and the results support the notion that the level of motor and cognitive functioning are related in children with ID.

Aim This study compared the gross motor skills of school-age children (mean age 7y 8mo, range 6–9y) with developmental speech and language disorders (DSLDs; n=105; 76 males, 29 females) and typically developing children (n=105; 76 males, 29 females). The relationship between the performance parameters and the children’s age was investigated as well as the role of the type of DSLD. Method The children with DSLDs were classified by their schools’ speech and language therapists into three subgroups: children with speech disorders (n=16), those with language disorders (n=41), or those with both (n=48). They were tested with the Test of Gross Motor Development, 2nd edition. Results Compared with their typically developing peers, all three DSLD subgroups scored lower on the locomotor (all p values

Background It has been suggested that children with intellectual disabilities (ID) have motor prob- lems and higher-order cognitive deficits.The aim of this study was to examine the motor skills and executive functions in school-age children with bor- derline and mild ID.The second aim was to investi- gate the relationship between the two performance domains. Methods Sixty-one children aged between 7 and 12 years diagnosed with borderline ID (33 boys and 28 girls; 71 < IQ < 79) and 36 age peers with mild ID (24 boys and 12 girls; 54 < IQ < 70) were assessed. Their abilities were compared with those of 97 age- and gender-matched typically developing children. Qualitative motor skills, i.e. locomotor ability and object control, were evaluated with the Test of Gross Motor Development (TGMD-2). Executive functioning (EF), in terms of planning ability, stra- tegic decision-making and problem solving, was gauged with the Tower of London (TOL) task. Results Compared with the reference group, the full ID cohort scored significantly lower on all assessments. For the locomotor skills, the children with mild ID scored significantly lower than the children with borderline ID, but for the object control skills and the TOL score, no significant dif- ferences between the two groups were found. Motor performance and EF correlated positively. At the most complex level, the TOL showed decision time to be a mediator between motor performance and EF: the children with the lower motor scores had significantly shorter decision times and lower EF scores. Analogously, the children with the lower object control scores had longer execution times and lower EF scores. Conclusions The current results support the notion that besides being impaired in qualitative motor skills intellectually challenged children are also impaired in higher-order executive functions.The deficits in the two domains are interrelated, so early interventions boosting their motor and cognitive development are recommended.

OBJECTIVES: To determine the relationship between physical activity and cognition, specifically executive function, and the possible mediating role of factors such as cardiovascular disease (CVD) and CVD risk factors, chronic pain, and depressive symptoms. DESIGN: Cross-sectional study. SETTING: Population-based study of individuals aged 70 and older in the Boston area. PARTICIPANTS: Older community-dwelling adults (n 5 544; mean age 78, 62% female). MEASUREMENTS: Presenceof heart disease (self-reported physician diagnosed), pain, and depressive symptomatology were assessed using interviewer-administered questions. Blood pressure was measured. Engagement in physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Cognitive function was measured using a battery of neuropsychological tests. RESULTS: The older adults who engaged in more physical activity had significantly better performance on all cognitive tests, except for Letter Fluency and the memory test of delayed recall, after adjusting for age, sex, education, and total number of medications. With further adjustment for CVD and CVD risk factors (heart disease, diabetes mellitus, stroke, and hypertension), pain, and depressive symptoms, PASE score remained significantly associated with executive function tests. CONCLUSION: Even after multivariate adjustment, neuropsychological tests that were executive in nature were positively associated with physical activity participation in thiscohort ofolder community-dwellingadults. Incontrast, delayed recall of episodic memory was not associated with physical activity, supporting the idea that the relationship with executive function represents a specific biologically determined relationship. J Am Geriatr Soc 57:1750–1756, 2009.

Contains fulltext : 71056.pdf (Publisher’s version ) (Closed access) Tactile defensiveness (TD) is a disturbance in sensory processing and is observed in some children with attention-deficit-hyperactivity disorder (ADHD). TD has been examined in male children with ADHD and in children with ADHD without differentiating by sex. As males and females with ADHD may differ in the clinical expression of the disorder and associated deficits, the aim of this study was to examine sex differences in TD in males and females with ADHD. Non-affected siblings were also examined to investigate familiality of TD. The Touch Inventory for Elementary-School-Aged Children was administered to 47 children with ADHD (35 males, 12 females; mean age 9y 8mo [SD 1y 11mo]), 36 non-affected siblings (21 males, 15 females; mean age 8y 10mo [SD 2y 4mo]), and 35 control children (16 males, 19 females; mean age 9y 5mo [SD 6mo]). Results indicated that females with ADHD displayed higher levels of TD than males with ADHD (who did not differ from control males). This suggests that TD is sex specific and may contribute to the identification of ADHD in females, thus improving diagnostic and therapeutic strength in this under-referred group. Non-affected siblings were unimpaired, regardless of sex, which suggests that TD is specific to the disorder and not part of a familial risk for ADHD.

Aim. This paper reports on a study examining the level of agreement between the pain perceptions of nursing assistants, older people without dementia and patients with Alzheimer's dementia. It was hypothesized that nursing assistants would overestimate the pain experience of patients with Alzheimer's dementia.Background. There is now increasing evidence that, in contrast to other subtypes of dementia, patients with Alzheimer's disease might experience a decrease in pain. It is unfortunate that these latest insights into the complex relationship between subtypes of dementia and pain are not always included in education programmes for nursing assistants.Method. Twenty patients with Alzheimer's disease and 17 older people with arthrosis and/or osteoporosis but no dementia and their personal nursing assistants participated in the study. Pain experience was assessed using the Coloured Analogue Scale for the assessment of Pain Intensity and Pain Affect, the Faces Pain Scale, and the Checklist of Non-verbal Pain Indicators. The data were collected in 2002-2003.Results. Before and after walking, the absolute difference in pain evaluation between nursing assistants and older people without dementia was statistically significantly less than the difference in pain evaluation between nursing assistants and patients with Alzheimer's disease on the Coloured Analogue Scale for Pain Intensity ( P 0 007 and P 0 04, respectively) and on the Coloured Analogue Scale for Pain Affect ( P 0 009 and P 0 01, respectively). Conclusion. Nursing assistants may overestimate the extent of suffering from pain of patients with Alzheimer's disease. They might be very well able to estimate this pain, provided they were educated about new insights into the influence of the various subtypes of dementia on pain.

Tasks relying on (pre)frontal functioning are performed disproportionally worse with aging. There is also an intriguing relation of frontal functioning to sleep. EEG delta activity predominates in the frontal derivations during the first two sleep cycles, and is enhanced especially in these derivations after sleep deprivation. Sleep deprivation also disproportionally attenuates frontal functioning, as shown e.g. on a verbal fluency task. In animals, disruption of the circadian rhythm furthermore affects memory retrieval processes. Since disturbances in the sleepwake cycle frequently occur in healthy elderly, and even more demented elderly, we hypothesized that these disturbances might contribute to the worsening of frontal function at high age. We investigated the relation between frontal functioning and the circadian sleepwake cycle in 66 demented elderly by assessing their verbal fluency (animals) and an actigraphic recording for two weeks continuously (Actiwatch-L, Cambridge Neurotechnology). Sleep duration was calculated using the SleepWatch software (Cambridge Neurotechnology) and the stability, fragmentation and amplitude of the rest-activity rhythm were quantified nonparametrically. Stepwise regression analysis was used to assess the association of the sleep-wake variables with fluency. Two likely contributors to the fluency performance were included in the analysis as covariates: the general cognitive functional level (MMSE) and the use of psychotropic drugs. In the present sample of demented elderly (MMSE mean±SD 16±7), fluency was positively associated only with the MMSE (beta=0.68, p