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Aims To investigate the effect of mild cognitive impairment (MCI) on unplanned readmission in patients with coronary artery disease (CAD). Methods and results From 2132 CAD patients, MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in 243 non-dementia patients who met the study criteria. The primary outcome was unplanned hospital readmission after discharge. The incidence of MCI in this cohort was 33.3%, and 51 patients (21.0%) had unplanned readmission during a mean follow-up period of 418.6 ± 203.5 days. After adjusting for the covariates, MCI (hazard ratio, 2.28; 95% confidence interval: 1.09–4.76; P = 0.03) was independently associated with unplanned readmission in the multivariable Cox proportional hazard regression analysis. In the Kaplan–Meier analysis, the cumulative incidence of unplanned readmission for the MCI group was significantly higher than that for the non-MCI group (log-rank test, P < 0.001). Even after exclusion of the patients readmitted within 30 days of discharge, the main results did not change (log-rank test, P < 0.001). Conclusion Mild cognitive impairment was independently associated with unplanned readmission after adjustment for many independent variables in CAD patients. In addition to its short-term effects, the adverse effects of MCI had a persistent, long-term impact on CAD patients. Assessment of cognitive function should be conducted by health professionals prior to hospital discharge and during follow-up. To prevent readmission of CAD patients, it will be necessary to support solutions to the problems that inhibit secondary prevention behaviours based on the assessment of the patients' cognitive function. [ABSTRACT FROM AUTHOR]

Background/objectives: Aquatic exercise is attracting attention as a method of rehabilitation for children with cerebral palsy (CP). The purpose of this systematic review was to evaluate whether aquatic exercise for children with CP improves their walking ability and quality of life (QOL) and is enjoyable for them., Methods: A literature search was conducted on 2 August 2024 using three databases: PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials through Evidence-Based Medicine Reviews. Studies included in the review focused on aquatic exercise interventions for children with CP, with outcomes related to walking ability, QOL, or enjoyment. Studies that did not isolate the effects of aquatic exercise (except when combined with conventional interventions) were excluded. Two reviewers independently conducted screening and risk of bias assessments., Results: Seven studies involving 94 participants in total were included in the review. Three of these studies had a control group. All four studies reported improvements in walking ability, including walking endurance and efficiency. One of two studies showed improvement in health-related QOL (HRQOL) compared to the control group, whereas the other did not show significant differences between groups. All three studies that assessed enjoyment reported high levels of enjoyment of aquatic exercise. However, all studies were at risk of bias., Conclusions: The reviewed studies suggest that aquatic exercise for children with CP may be enjoyable and may improve walking ability. Further research is needed to accurately assess the effects of aquatic exercise and compare it to other interventions.

Background: Body mass index (BMI) of patients with ischemic stroke (IS) has been associated with prognosis and disability in studies in the United States. Although the Asian population is leaner, the optimal BMI for stroke-related disability remains unknown., Objectives: To clarify the association between BMI and disability in patients with IS from a national database in Japan., Methods: The present study included 522,421 patients with IS identified in the JROAD-DPC database from April 2016 to March 2020. We used the WHO classification of BMI, which divides Asia-Pacific patients into five groups, to categorize BMI and the modified Rankin Scale (mRS) to assess stroke-related disability at admission and discharge. After multiple imputation for missing values, we conducted a multiple mixed-effect logistic regression analysis for poor mRS score (>2) in September 2023. In addition, we created a restricted cubic spline model between the odds ratio (OR) for poor mRS and BMI., Results: The mRS score worsened during hospitalization in 60.1% of the patients with IS, and 45.7% had a poor mRS score at discharge. Overweight patients had the lowest OR of having a poor mRS score (OR: 0.898, 95% confidence interval: 0.895-0.902). The spline curve for the OR for poor mRS score was U-shaped with a BMI of 24.7 kg/m 2 as the apex value., Conclusion: The present study revealed a U-shaped relationship between BMI and stroke-related disability, with overweight patients having the lowest OR for disability at discharge.