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cog aging and dementia > interventions > Flashcards

interventions Flashcards

1
Q

Factors to consider in intervention studies

A
  • Group being tested (e.g., healthy older adults, MCI, mild/moderate dementia)
  • Outcome measures (e.g., IADL, QOL, cognition)
  • Control condition (what is the intervention being compared to?)
  • Timeline of intervention & when outcomes are measured
  • Generalizability
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2
Q

cognitive interventions

A

(1) cognitive training,
(2) cognitive rehabilitation, and
(3) cognitive stimulation

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3
Q

cognitive outcome measures

A
  • Cognitive performance - e.g., on memory tests
  • Instrumental activities of daily living (IADL)
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4
Q

ACTIVE

A

Advanced Cognitive Training for Independent and Vital Elderly

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5
Q

what did the active trial test?

A

memory, reasoning, and visual speed of processing in maintaining cognitive health

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6
Q

what was the MMSE score on the participants

A

> 22 (dementia cutoff is 24)

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7
Q

ACTIVE trial: major findings

A
  • Immediate improvement in the trained cognitive ability
  • Significant improvements in IADL
  • less QOL decline
  • driving effects
  • reduced traffic accidents
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8
Q

overall conclusion ACTIVE

A

“Results support the effectiveness of cognitive intervention in maintaining cognitive health over the long-term and indicate modest but detectable far transfer to instrumental activities of daily living, health-related quality of life, and driving outcomes.”

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9
Q

Challenges With Studies Of Physical Activity

A
  • definitions vary
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10
Q

findings physical activity studies

A

reduced risk of cognitive decline & dementia
- mixed results aerobic vs resistance training

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11
Q

WHO recommendations physical activity

A

For adults aged 65+, the WHO recommends:
* 150 minutes or more of moderate- intensity aerobic physical activity/week, OR
* 75 minutes or more of vigorous- intensity aerobic physical activity/week, OR
a combo

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12
Q

Diet and cognition: what are the findings?

A

associated with larger brain volumes and better cognitive performance

  • Memory (delayed recognition, long-term and working memory), executive function, and visual constructs

MeDi, fish, meat
higher brain activation in MeDi on scans

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13
Q

Diet and cognition: WHO Recommendations

A
  • recommends a Mediterranean-like diet
  • does not recommend taking supplements
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14
Q

social factors

A

Social isolation and low social participation

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15
Q

Epidemiological/Cohort Studies advantages

A
  • Large number of subjects
  • Data on multiple factors
  • Longitudinal follow-up over many years
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16
Q

Epidemiological/Cohort Studies disadvantages

A
  • association not causation
  • hard determination of ‘direction’ of cause/effect for exposure/outcome (reverse causality problem)
  • influence of unidentified factors
  • Uncertainty about whether an intervention aimed at an identified factor would have an impact on biological or
    clinical outcome
17
Q

Basic science/animal studies advantages

A
  • highly controlled conditions
  • Determination of underlying mechanisms
  • Identification of intervening variables that help explain clinical outcomes (e.g., changes in brain structure, neurotransmitters, growth factors, inflammatory markers, etc.)
18
Q

Basic science/animal studies disadvantages

A
  • Reduction of complex issues into simple ones
  • Need to translate to humans
  • Elucidating underlying mechanisms does not signify that manipulating an identified factor will alter clinical outcome
19
Q

Human “Proof-of- Concept” Studies advantages

A
  • Opportunity to examine markers of cerebral plasticity, reserve, efficiency, and neural compensation
  • utilization of tools of cognitive neuroscience to elucidate underlying mechanism
  • Opportunity for further hypothesis testing and generation
  • Often considered the “gold standard”
20
Q

Human “Proof-of- Concept” Studies disadvantages

A
  • similar to limitations of basic science/animal studies noted above
21
Q

what is sleep hygiene?

A
  • sleep ritual before you fall asleep
22
Q

Additional factors: what is the evidence?

A
  • Avoid medications with anticholinergic properties
  • Limit alcohol use
  • Protect the brain from physical and toxic injuries
23
Q

Sense of purpose: what is it?

A

refers to the feeling that one’s life is goal- oriented & has a direction

24
Q

Sense of purpose: what is associated with?

A

It is associated with:
* better cognitive function
* less age-related cognitive decline
* lower risk of incident dementia

25
Q

Sense of purpose: what are the findings in SCD?

A

Sense of purpose was negatively related to SCD
* Conclusion: sense of purpose may help mitigate the cognitive decrements associated with loneliness

26
Q

Depression and loneliness were ______ related to SCD

A

positively

27
Q

For loneliness, this association was ________ by sense of purpose:

A

moderated

cog aging and dementia (6 decks)

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