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The imagination of motor actions forms not only a theoretical challenge for cognitive neuroscience but may also be seen as a novel therapeutic tool in neurological rehabilitation, in that it can be used for relearning motor control after damage to the motor system. However, since the majority of rehabilitation patients consist of older individuals it is relevant to know whether the capacity of mental imaging is compromised by age. Scores on the vividness of movement imagery questionnaire were obtained for 333 participants, divided in three age groups. Results showed that elderly participants were slightly worse in motor imagery capacity than younger participants, particularly in relation to motor imagery from an internal (first person) perspective. Furthermore, a possible relation between the level of physical activities and motor imagery capacity is discussed.

Background: Interventions to promote successful aging include psychological and physical activity programs. Identification of determinants of attendance of older persons may be useful to develop strategies to improve attendance. For physical activity programs determinants of attendance have been investigated extensively. For psychological programs hardly any knowledge is available. Determinants of attendance at psychological and physical activity programs have never been investigated simultaneously., Objective: To identify demographic, physical and psychological determinants of attendance of older subjects following multifaceted psychological training - aimed at promoting active social participation - and physical activity training and to compare the variation of these determinants between the two training programs., Method: 118 subjects aged 65-92 years were randomized over psychological and physical activity training. Determinants of attendance were obtained at pretest with questionnaires and performance-based tests., Results: Mean attendance was 62%. Attendance was not related to type of program. Having chronic diseases facilitated attendance in the psychological training group and limited attendance in the physical activity training group. Low and high levels of Activities of Daily Living performance (ADLs) and walking endurance were related to a high attendance in the psychological training group. A low level of activities of daily living (ADL) and a low walking endurance were related to a low attendance in the physical activity training group. For both training groups, persons living with a partner had higher attendance rates than persons living alone, and persons with a low level of anxiety had higher attendance rates than persons with a moderate or a high level of anxiety., Conclusion: Psychological training may be more suitable for frail older persons with chronic diseases, low ADL levels and low walking endurance than physical activity training, and may help to prepare such persons for physical activity., (Copyright (c) 2006 S. Karger AG, Basel.)

Background and Aims: Volunteer bias in intervention studies on successful aging has been poorly explored. This paper investigated differences between participants and non-participants of the Groningen Intervention Study on Successful Aging (GISSA) over a wide range of demographic, physical, psychological and social subject characteristics., Methods: Subjects were recruited among a longitudinal cohort study (Groningen Longitudinal Aging Study) and included 558 men and 711 women, aged 65-96 years, who were invited to participate in the GISSA. Measures were obtained by questionnaires at the moment of invitation and eight years before invitation. Participants were compared with three groups of non-participants: persons who refused to participate, those who did not respond after a reminder, and those who intended to participate but withdrew before pre-test., Results: At the moment of invitation, participants were younger, better educated, and functionally and physically more active than the three groups of non-participants. They also had better scores on the physical functioning subscale of the medical outcome scale, better ADL, iADL and vigorous ADL functions and fewer depressive symptoms, and perceived less social support in everyday and problem situations. Participants reported a less strong rate of decline in physical and psychological functioning in the eight years prior to the invitation than did the other groups., Conclusion: Due to volunteer bias, results of intervention studies on successful aging may have limited generalizability.

Objectives: To determine (1) whether long-term improvement of cognitive function takes place after stroke and (2) which clinical factors influence cognitive recovery., Design: Cohort study with patients who were assessed at 2.3 and 27.7 months after stroke., Setting: Home-based stroke patients., Participants: From a group of 229 stroke patients, 92 were approached to participate. Sixty-five (43 men, 22 women; mean age, 56.4y) agreed, and they were neuropsychologically assessed at 72.2 days after stroke. A group of 33 controls (12 men, 21 women; mean age, 52.4y) was used as a reference sample., Interventions: Not applicable., Main Outcome Measures: Orientation, memory, attention, visuospatial, visuoconstructive, language, and arithmetic abilities were assessed with an extensive neuropsychologic test battery., Results: Significant improvements across time were noted for all cognitive domains. The biggest improvement was found in the attentional domain; the least, in the memory domain. In addition, a small subset of patients accounted for the significant improvement in all cognitive domains; most patients showed no improvement or declined. Factors influencing recovery were side of the stroke and incidence of lowered consciousness on admission. Patients with right-side brain damage performed better than those with left-side brain damage and showed more improvement over time. Patients with lowered consciousness on admission performed worse than patients without lowered consciousness. No significant effect was found for gender, type of stroke, cortical versus subcortical lesions, having 1 stroke or multiple strokes, or the interval between the stroke and the neuropsychologic assessment., Conclusion: There was room for improvement in all cognitive domains, although this improvement was gained by only a small number of patients. Hence, most patients must cope with serious permanent cognitive decline after stroke.

Objectives: To describe the quality of life (QOL) of stroke patients and to distill neuropsychologic predictors for poor QOL., Design: A cohort study in which patients were neuropsychologically assessed at a mean of 72.2 days after stroke, with follow-up at a mean of 9.8 months after stroke., Setting: Research department of a rehabilitation center., Patients: A consecutive sample of 164 stroke patients (mean age, 55.2yr) recruited from a university hospital, a regional hospital, and a rehabilitation center., Interventions: Not applicable., Main Outcome Measures: Orientation, memory, attention and concentration, visuospatial and visuoconstructive functions, language, and arithmetic skills were assessed with neuropsychologic tests. QOL was assessed with the Sickness Impact Profile (SIP)., Results: An overall mean SIP score +/- standard deviation of 20 +/- 11 showed that stroke has a high impact on everyday functioning. Further analyses indicated that QOL is related in particular to tests measuring spatiotemporal and/or sequential aspects of behavior. Forward/backward stepwise regression analysis (n = 106) showed that poor QOL was more likely if patients had a poor result on the Trailmaking Test (TMT) B and/or were women., Conclusion: The predictive value of the TMT is most effective and very useful because the TMT is a short and economical procedure. However, the gender-related aspects of recovery deserve more attention, as does the possible bias that can be caused by the composition of a measurement. Further research is needed to refine predictive models that are needed to facilitate the development of more adequate, individual rehabilitation programs., (Copyright 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation)

Objective: To find out what the late implications of a stroke were for patients and relatives and whether specific requests for help existed., Design: Cross sectional study., Setting: Academic Hospital Nijmegen, department of Neurology and Sint Maartenskliniek (rehabilitation centre), The Netherlands., Method: Patients who had sustained a cerebrovascular accident (CVA) in the last five years were asked, using the sickness impact profile (SIP), about their subjective functioning and the effect of the CVA on daily life. They were also asked about the degree to which they experienced their complaints as a problem, and whether they needed help., Results: In this study 165 patients and their close relatives filled out the SIP. Stroke had a very high impact on everyday functioning as indicated by a total SIP score of 20. The results further showed that psychosocial problems arise independently of the degree of physical problems, that these problems were chronic, and that psychosocial problems hindered 52% of the patients often to always. The physical problems hindered 60% of them often to always. A third of the patients wanted help for their physical problems, a quarter for their psychosocial problems., Conclusion: The impact of stroke on both patients and their relatives was extensive and appeared chronic. There was need for physical and psychosocial help in a third or quarter of the cases.