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Purpose Our aim was to compare cerebrovascular and systemic vascular function between older adults with and without mild cognitive impairment (MCI), and to determine which measures of vascular function best predict the presence of MCI. Methods In 41 adults with MCI and 33 adults without MCI (control) we compared middle cerebral artery velocity (MCAv) and cerebrovascular pulsatility index (PI) at rest, cerebrovascular reactivity to CO2, and responsiveness to changes in blood pressure (%∆MCAv/%∆MAP). Systemic vascular function was assessed by flow-mediated dilation (FMD) and stiffness by pulse wave velocity (PWV). Results Cerebrovascular PI was higher in MCI compared with control (mean ± SD: 1.17 ± 0.27 vs. 1.04 ± 0.21), and MCI exhibited a lower %∆MCAv/%∆MAP (1.26 ± 0.44 vs. 1.50 ± 0.55%). Absolute (p = 0.76) and relative cerebrovascular reactivity to CO2 (p = 0.34) was similar between MCI and control. When age was included as a covariate the significant difference in cerebral PI between groups was lost. PWV was higher (13.2 ± 2.2 vs. 11.3 ± 2.5 m s−1) and FMD% (4.41 ± 1.70 vs. 5.43 ± 2.15%) was lower in MCI compared with control. FMD% was positively associated with PI across the cohort. Logistic regression analysis indicated that FMD and PWV significantly discriminated between MCI and controls, independent of age, whereas the inclusion of cerebrovascular measures did not improve the predictive accuracy of the model. Conclusion These findings raise the possibility that early changes in systemic vascular stiffness and endothelial function may contribute to altered cerebrovascular haemodynamics and impaired cognitive function, and present potential targets for prevention and treatment strategies in people with MCI.

Preventive lifestyle strategies have shown promise to slow down or prevent age-related cognitive decline. However, evidence on the reciprocal longitudinal relationships between nutrition biomarkers and cognitive and physical performance is lacking. Studying nutritional, cognitive, and physical profiles over time may help to overcome this knowledge gap.To investigate the relationship of plasma levels of the robust nutritional- and antioxidant defense-related biomarkers carotenoids and tocopherols with both indicators of cognitive and physical performance in persons with mild cognitive impairment (MCI) participating in a structured exercise program.Data from 40 participants with MCI of the NeuroExercise study were analyzed. Participants had undergone a blood withdrawal for the analysis of plasma concentrations of six carotenoids, two tocopherols and retinol prior to and after one-year of structured exercise. All participants had undergone a broad spectrum of cognitive and physical performance tests.Significant associations between lipophilic micronutrients and cognitive/physical measures were observed that were previously found to play a role in cognitive and physical frailty. In particular, lutein, zeaxanthin, and lycopene are confirmed as robust, reliable, and stable indicators of nutritional defense. Importantly, these micronutrients were associated with cognitive measures prior to the physical training program and to a more prominent extent with indicators of motoric function after the physical exercise program.Specific profiles of lipophilic micronutrients are associated to cognitive performance measures and, especially after a structured exercise program, to indicators of physical performance.

The brain's ability to act as an input filter and to suppress actions is crucial to navigate everyday life and impairments in these abilities affect quality of life substantially. Although Parkinson's disease (PD) is primarily known as a movement disorder, recent research has redefined it as a multisystem disorder affecting cognition, in particular inhibitory control and attentional resource allocation. Analysing the neural mechanisms underlying this cognitive deficit provides a better understanding of brain changes observed in patients affected by PD. Therefore, this study aimed to identify resource allocation to relevant and irrelevant stimuli in patients affected by PD. Besides neuropsychological tests, we employed electroencephalographic recordings during an auditory oddball paradigm in 13 patients suffering from idiopathic PD and 11 healthy controls (HC). Participants were instructed to ignore the standard stimulus and to respond as fast as possible to the rarely presented target tone. Event-related potentials (ERP) and time-frequency representations (TFR) were analyzed. Patients affected by PD showed faster response latencies to the task-irrelevant standard tones, but slower response latencies to target tones compared to HC. This observation was prominent at frontal sites during later P3-like processing stages. Reaction time, however, was prolonged in patients with PD, suggesting inefficient resource allocation. Additionally, TFR revealed reduced parietal alpha activity, which is associated with distractor suppression and functional inhibition in patients with PD compared to healthy controls. Thus, our results point towards inefficient resource allocation in patients with PD possibly driven by less functional inhibition through parietal alpha activity.

ZusammenfassungNeben den motorischen Symptomen wie Rigor, Tremor, Bradykinese und posturale Instabilität führt Morbus Parkinson oftmals auch zu einer Beeinträchtigung der kognitiven Leistungsfähigkeit. Um dem kognitiven Abbau vorzubeugen, gewinnen Sport und Bewegung an Bedeutung. Allerdings sind ihre Effekte auf die Kognition bei Morbus Parkinson noch wenig erforscht. In diesem Beitrag wird eine Übersichtsarbeit vorgestellt, die die bisher durchgeführten wissenschaftlichen Studien zusammengefasst und analysiert. Das Potenzial von gezieltem Sporttraining, einem kognitiven Abbau vorzubeugen, wird in diesen Studien deutlich. Allerdings kann keine eindeutige Empfehlung ausgesprochen werden, welche Form von Sporttraining am besten geeignet erscheint, um die kognitive Leistungsfähigkeit bei Parkinson aufrecht zu erhalten. Hierfür bedarf es weiterer wissenschaftlicher Studien, aus denen klare Empfehlungen zur Trainingsgestaltung abgeleitet werden können.

Background and purpose Exercise is an adjunctive treatment in the management of Parkinson's disease (PD), but barriers such as health status, fear of overexertion, and lack of transportation to the location prevent regular exercise participation. Disease‐inclusive exercise classes may offer an opportunity to make exercise more accessible for older adults with and without diseases. However, the efficacy of such heterogenous exercise classes is still widely unknown. Therefore, it was the aim of this study to analyze the feasibility of disease‐inclusive exercise classes in older adults with and without PD. Methods Twenty‐one older adults (healthy older adults (HOA): n = 13; PD: n = 8) completed an 8‐week multimodal exercise intervention in supervised group sessions. Exercise classes lasted 60 min with the goal of two participations a week. We assessed physical fitness (timed up and go test [TUG], 6‐minute walking test [6MWT], single leg stance), depressive symptoms and cognitive functions, and we determined growth factors (BDNF & IGF‐1) before and after the intervention to determine the effects and by that, the feasibility of a disease‐inclusive exercise program. Repeated measures ANOVA were used to establish changes. Results TUG and 6MWT improved significantly after the training in both HOA (p = .008; p, Older adults with and without Parkinson's disease benefit from disease‐inclusive exercise classes by reducing depressive symptoms and increasing physical fitness. Further, these classes may set an example for an open and inclusive society.

Aim The aim of this pilot study was to examine the acute effect of a psychomotor intervention (PMI) on auditory-verbal memory, emotional state, and electrocortical activity recorded by electroencephalography on subjectively healthy older adults (sHE) and older adults diagnosed with mild cognitive impairment (MCIs). Methods Eleven MCIs and 11 sHE underwent a single 45-min PMI. Resting state electroencephalography, the Rey Auditory-Verbal Learning Test, MoodMeter®, and the Positive and Negative Affect Schedule were compared between groups and pre- and post-PMI. Results Electroencephalography current source density and activity within the theta frequency band were higher in MCIs than in sHE at baseline, and brain frequency had a tendency to decrease in MCIs after training. Both groups showed improvement on the auditory-verbal memory test. Only among MCIs were there increases in perceived physical state and psychological strain and an improvement in negative affect. Conclusions Our findings suggest that acute psychomotor activity may be more effective for MCIs than for sHE. It supports the notion that PMI does have functional influences on the central nervous level and therefore might prevent and treat cognitive, psychological, and psychiatric symptoms of people with mild cognitive impairment.

Background: Recent research suggests using an imaginary version of the Timed Up and Go test (TUG) for a first assessment of cognitive impairment. By using the time difference between a real (TUGr) and an imagined (TUGi) TUG task, the objective of this study was to examine the effect of cognitive impairment on motor imagery ability. Methods: Fifty-two participants (mean age 69.3 ± 4.0 years) with mild cognitive impairment or subjective cognitive impairment were included in this study. The time difference between the TUGr and the TUGi was used as the main outcome. The Trail Making Test part B (TMT B), the ratio between TMT A and TMT B, and the Montreal Cognitive Assessment (MoCA) battery were the main independent variables. Results: The difference between TUGr and TUGi performance time and the TMT B performance time increased with decreasing cognitive function (p < 0.01). There was no relationship between TUGr and TUGi performance time and TMT B/A ratio. There were significant correlations between TUG time differences and the MoCA score (r = -0.489, p < 0.01), the TMT B (r = 0.364, p < 0.01), and the TMT B/A ratio (r = 0.377, p < 0.01). Conclusion: The combination of TUGr and TUGi may have added value in assessing cognitive impairment, which is a possible pre-stage of dementia.

Activity tracking devices gain popularity in research, which is due to their multiple features (e.g. heart rate monitor, step count) and easy handling. Nevertheless, many devices used for research are lacking validation of specific features. This study aimed to assess the validity of the Polar M400© activity tracker to count steps in older adults and, therefore, compared it to a previously validated pedometer (Omron Walking Style©) and observed step count. 32 older adults (mean age: 74.8 ± 5.9 years) walked at a self-selected, normal gait speed on a tartan track for 200 meters while wearing the activity tracker and the pedometer. Additionally, steps were counted manually. Data was analysed using Kruskal-Wallis test and Lin's concordance coefficient. Furthermore, Bland Altman plots were employed to evaluate accuracy of the activity tracker. Kruskal-Wallis test revealed significant differences between the step count of the activity tracker and the pedometer (p = 0.011) but no further differences were observed. Lin's concordance showed a moderate correlation between activity tracker and pedometer (rc = 0.561) and between pedometer and observed step count (rc = 0.690). A high correlation was detected between activity tracker and observed step count (rc = 0.802). Bland Altman plots revealed good accuracy of the activity tracker. The Polar M400© activity tracker accurately assesses steps during walking in older adults. Nevertheless, a slight overestimation compared to the pedometer was observed, which should be considered when using the activity tracker for tracking steps over a longer period of time.

BACKGROUND Supervised exercise training alleviates motor symptoms in people with Parkinson's disease (PD). However, the efficacy of exercise to improve nonmotor symptoms such as cognitive function is less well known. OBJECTIVE To systematically review evidence on the efficacy of different exercise modes (coordination exercise, resistance exercise, aerobic exercise) on domain-specific cognitive function in patients with PD. METHODS Parallel-group randomized controlled trials published before March 2018 were included. Primary outcome measures included global cognitive function and its subdomains, and the Unified Parkinson's Disease Rating Scale was included as a secondary outcome. Methodological quality was assessed using the Physiotherapy Evidence Database scale. RESULTS The literature search yielded 2,000 articles, of which 11 met inclusion criteria. 508 patients (mean age 68±4 years) were included with a disease severity from 1 to 4 on the Hoehn & Yahr stage scale. Overall study quality was modest (mean 6±2, range 3-8/10). In 5 trials a significant between-group effect size (ES) was identified for tests of specific cognitive domains, including a positive effect of aerobic exercise on memory (ES = 2.42) and executive function (ES = 1.54), and of combined resistance and coordination exercise on global cognitive function (ES = 1.54). Two trials found a significant ES for coordination exercise (ES = 0.84-1.88), which led to improved executive function compared with that of non-exercising control subjects. CONCLUSION All modes of exercise are associated with improved cognitive function in individuals with PD. Aerobic exercise tended to best improve memory; however, a clear effect of exercise mode was not identified.

Age-associated cognitive impairment in general and dementia in particular are a global concern. Preventive lifestyle strategies are highly used but there is a lack of information on the reciprocal relationships between nutrition biomarkers and measures of both cognitive and physical performance. To fill this gap of knowledge, the relationship between plasma levels of the robust nutrition- and antioxidant defense-related biomarkers carotenoid and tocopherols and both indicators of cognitive and physical performance was investigated in a group of persons with mild cognitive impairment participating in the NeuroExercise Study at the German Sport University in Cologne, Germany. In 56 participants with full dataset, significant correlations independently of fruit and vegetable intake were found between plasma levels of &beta, cryptoxanthin and Timed Up&amp, Go test (p &lt, 0.05), &gamma, tocopherol and number of daily steps (p &lt, 0.01), as well as between four out of six measured carotenoids&mdash, lutein, zeaxanthin, &beta, cryptoxanthin and &beta, carotene&mdash, and the computerized CogState International Shopping List subtest (p &lt, 0.01). In light of the increasing attention towards the nutritional cognitive neuroscience of carotenoids, computerized measures of cognitive performance might be further implemented in future studies investigating the effects of lifestyle interventions against cognitive and physical impairment.

Previous studies showed a decrease in reaction time during the weightlessness phase of a parabolic flight. This effect was found to be stronger with increasing task complexity and was independent of previous experience of weightlessness as well as anti-nausea medication. Analysis of event related potentials showed a decreased amplitude of the N100-P200 complex in weightlessness but was not able to distinguish a possible effect of task complexity. The present study aimed to extend this previous work, by comparing behavioral (reaction time) and neurological (event related potentials analysis) performance to a simple (oddball) and a complex (mental arithmetic + oddball) task during weightlessness. 28 participants participated in two experiments. 11 participants performed a simple oddball experiment in the 1G and 0G phases of a parabolic flight. 17 participants were presented a complex arithmetic task in combination with an oddball task during the 1G and 0G phases of a parabolic flight. Reaction time as well as event related potentials (ERP) were assessed. Results revealed a reduced reaction time (p .05) for the complex task during 0G. No gravity effects on reaction time were found for the simple task. In both experiments a reduction of typical ERP amplitudes was noticeable in weightlessness. It is assumed that the weightlessness induced fluid shift to the brain is positively affecting neuro-behavioral performance.

Objective The analysis of event-related potentials (ERPs) is a useful tool to differentiate between healthy older adults, and individuals with mild cognitive impairment (MCI). Less is known about the ERPs’ sensitivity of differentiating between individuals with subjective cognitive impairment (SCI) and MCI, as early evidence indicates similar brain alterations between these two groups. In order, to establish tests that are sensitive to subclinical impairment, this study compared auditory evoked ERPs between individuals with SCI and MCI. Methods Besides assessing cognitive performance in four neuropsychological tests (Trail Making Test A + B, verbal fluency letter and category task), latency and amplitude of ERP components evoked by an auditory oddball paradigm were compared between two groups of either individuals with SCI (n = 13) or MCI (n = 13). Results While individuals with MCI performed significantly worse in all neuropsychological tests (TMT A: p = 0.001, Cohen’s d = 1.5; TMT B: p = 0.030, Cohen’s d = 0.94; verbal fluency letter: p = 0.0011, Cohen’s d = 1.08; verbal fluency category: p = 0.038; Cohen’s d = 0.86), no significant differences (p > 0.05) were found in ERP components with small to moderate effect sizes (Cohen’s d ranged between 0.11 – 0.59). Conclusion ERPs evoked by an auditory oddball paradigm lack sensitivity to differentiate between individuals with SCI and MCI, although significant differences in cognitive performance were detected by neuropsychological tests. Similar pathophysiological brain alterations may limit utility of ERPs as indicated by previous research and results of this study. Cognitively more challenging tasks than the auditory oddball paradigm may be considered by future investigations.

Prevention trials in subjects with mild cognitive impairment (MCI), especially lifestyle interventions, can be difficult to carry out, particularly the recruitment and retention of subjects. We experienced these challenges in our multi-site one-year exercise trial in MCI, NeuroExercise. Trial recruitment rates differed significantly across sites; the non-medical sport university site, providing free access to a range of group exercise in a sports environment, proved far more successful than memory clinics linked to hospitals. This suggests that non-medical settings and a non-medical research community facilitating physical activities may be important factors in recruitment of subjects with MCI for large prevention trials.

Contains fulltext : 193331.pdf (Publisher’s version ) (Closed access) BACKGROUND: By 2030, about 74 million people will be diagnosed with dementia, and many more will experience subjective (SCI) or mild cognitive impairment (MCI). As physical inactivity has been identified to be a strong modifiable risk factor for dementia, exercise and physical activity (PA) may be important parameters to predict the progression from MCI to dementia, but might also represent disease trajectory modifying strategies for SCI and MCI. OBJECTIVE: A better understanding of the relationship between activity, fitness, and cognitive function across the spectrum of MCI and SCI would provide an insight into the potential utility of PA and fitness as early markers, and treatment targets to prevent cognitive decline. METHODS: 121 participants were stratified into three groups, late MCI (LMCI), early MCI (EMCI), and SCI based on the Montreal Cognitive Assessment (MoCA). Cognitive function assessments also included the Trail Making Test A+B, and a verbal fluency test. PA levels were evaluated with an interviewer-administered questionnaire (LAPAQ) and an activity monitor. An incremental exercise test was performed to estimate cardiorespiratory fitness and to determine exercise capacity relative to population normative data. RESULTS: ANCOVA revealed that LMCI subjects had the lowest PA levels (LAPAQ, p = 0.018; activity monitor, p = 0.041), and the lowest exercise capacity in relation to normative values (p = 0.041). Moreover, a modest correlation between MoCA and cardiorespiratory fitness (r = 0.25; p < 0.05) was found. CONCLUSION: These findings suggest that during the earliest stages of cognitive impairment PA and exercise capacity might present a marker for the risk of further cognitive decline. This finding warrants further investigation using longitudinal cohort studies.

Background: By 2030 about 74 million people worldwide will be diagnosed with dementia. This number will pose a tremendous burden for patients, caregivers and health care systems. Physical activity is known to affect cognitive ageing positively and maintain cognitive functions, but its role in the progression of already diagnosed cognitive impairment remains unclear. This study aims to display the relationship between physical activity levels and cognitive functions among older people with prodromal stages of dementia. Methods: 121 participants aged above 60 with memory complaints took part in this study. General cognitive function was analyzed using the Montreal Cognitive Assessment (MoCA). Physical activity levels were evaluated using the self-reported LASA Physical Activity Questionnaire (LAPAQ) and an activity tracker. Physical fitness was determined with an incremental exercise test. On the basis of the results of the MoCA the participants were subdivided into three different groups (Group 1 with a MoCA score of 19–21, Group 2 with a MoCA score between 22–25 Group 2 and Group 3 with a MoCA score of 26). The groups’ physical activity levels (LAPAQ, activity tracker, incremental exercise test) were analyzed using the one-way analysis of variance with the dependent variable group. The relationship between general cognitive function (MoCA) and physical activity levels (LAPAQ, activity tracker, incremental exercise test) was analyzed with Spearman’s correlation. Results: Group 1 showed significantly lower activity levels than Group 2, both, for self-reported activity (p < 0.05) as well as activity measured by the activity tracker (p < 0.001). Furthermore, physical fitness was significantly worse in Group 1 compared to Group 2 (p < 0.05). A negative correlation between the MoCA and the results of the incremental exercise test (p < 0.05; r = −0.24) was found. Discussion: Due to these findings we assume that a reciprocal relationship between physical activity and cognitive functions exists. In contrast to previous studies we were able to show a direct link between physical activity levels – objectively and subjectively measured – physical fitness and cognitive performance even among prodromal stages of dementia. Data of this study supports the idea that an increase in physical activity levels will be reflected by an improvement of cognitive functions even in patients at a prodromal stage of dementia.

Forced exercise training presents a valid method of improving symptoms of Parkinson's disease such as rigor, dyskinesia and gait dysfunctions. Brain imaging data suggest that use of active assistive forced exercise could improve Parkinsonian symptoms more effectively than passive assistive forced exercise. However, the long-term effects of active versus passive assistive forced exercise on the symptoms of Parkinson's disease are unknown. Here, 24 patients showing bilateral effects of Parkinson's disease underwent a 12 week intervention of either passive or active assistive forced exercise. We analyzed tremor scores, gait patterns, and scores on the Unified Parkinson's Disease Rating Scale-III from three timepoints--before beginning the intervention, upon completion of the intervention, and twelve weeks after completion of the intervention. Participation in both passive and active assistive forced exercise increased gait velocity (0.5 km/h), swing phase (2%), monopedal stance phase (2%), elongated stride length (11 cm) and decreased double stance phase (4%). However, with participation in active assistive forced exercise, postural and kinetic tremor were also reduced and gait velocity and stride length were increased long-term. Given these findings, we conclude that future treatment for patients bilaterally affected by Parkinson's disease should carefully consider the type of assistive forced exercise intervention to be used.