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(3) Emerging PT Practice > New Trends in Cognitive Rehabilitation > Flashcards

New Trends in Cognitive Rehabilitation Flashcards

1
Q

Intermediary state of cognitive decline between normal aging process and dementia

A

Mild cognitive impairment

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2
Q

T/F

Cognitive function in MCI is higher compared to that expected for one’s chronological age and educational attainment.

A

FALSE.

Cognitive function in MCI is lower compared to that expected for one’s chronological age and educational attainment.

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3
Q

T/F

Mild Cognitive Impairment affects ADLs, unlike dementia

A

FALSE.

Mild Cognitive Impairment does NOT affect ADLs, unlike dementia.

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4
Q

When was MCI initially introduced in literature?

A

1982

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5
Q

T/F

The incidence of falls among persons with cognitive impairment is 8 times compared to healthy persons.

A

TRUE

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6
Q

Having mild cognitive impairment is normal in old age.

A

FALSE

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7
Q

Combining physical and cognitive training showed improvement in overall fall risk.

A

TRUE

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8
Q

T/F

The global prevalence of mild cognitive impairment is 16-20%.

A

FALSE

The global prevalence of mild cognitive impairment is 14-18%.

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9
Q

Memory loss is the reason for persons with cognitive impairment to experience a fall.

A

FALSE

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10
Q

T/F

Criteria for dx of MCI

  1. Reports cognitive deficits without evidence of deterioration over time on objective cognitive data
  2. Cognitive function is classified as normal or demented
  3. Basic ADLs are preserved with only slight impairment in complex instrumental ADLs
A
  1. FALSE - Reports cognitive deficits with evidence of deterioration over time on objective cognitive data
  2. FALSE - Cognitive function cannot be classified as normal nor demented
  3. TRUE
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11
Q

What is the global prevalence rate of MCI

A

14-18%

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11
Q

MCI is a ________ phase of dementia

A

MCI is a PRODROMAL phase of dementia

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11
Q

The annual conversion rate to dementia is
10-13% in community settings
3-5% in clinical settings

A

FALSE.

3-5% in community settings
10-13% in clinical settings

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12
Q

According to doc D1’s research, what is the prevalence of MCI in manila?

A

80+% MCI in Manila

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13
Q

T/F

The incidence of MCI is 8-68 per 1000 older persons/year

A

FALSE.

8-58 per 1000 older persons/year

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14
Q

MODIFIED T/F

Prevalence: 7X compared to normal.
Incidence: 8X compared to normal.

A

FT

Prevalence: 2X compared to normal.
Incidence: 8X compared to normal.

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15
Q

T/F

Motor planning for daily activities may be altered by impaired executive functioning resulting in increased falls risk.

A

TRUE

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16
Q

T/F

Faulty perceptual-motor integration (related to executive function) leads to instability in automatic tasks like walking, and eventual fall.

A

TRUE

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17
Q

T/F

Better outcomes are also expected for older people with cognitive impairment compared to those without.

A

FALSE

Poorer outcomes are also expected for older people with cognitive impairment compared to those without.

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18
Q

T/F

Mild Cognitive Impairment (MCI) has been considered a predictor and also a fall risk factor in older persons living in the community, particularly among older men

A

FALSE

Mild Cognitive Impairment (MCI) has been considered a predictor and also a fall risk factor in older persons living in the community particularly among older women

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19
Q

T/F

Cognitive training may also be an effective preventive strategy in the onset of any cognitive decline among older persons.

A

TRUE

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19
Q

T/F

Cognitive training is effective in improving cognitive functioning in demented older adults.

A

FALSE

Cognitive training is effective in improving cognitive functioning in healthy older adults.

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20
Q

T/F

By targeting specifically executive dysfunction, cognitive training has been recommended to decrease falls rates in older persons with Alzheimer’s disease

A

TRUE

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21
Q

T/F

Physical exercise and cognitive training may have additive effect on neurogenesis

A

TRUE

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22
Q

T/F

Sensory and cognitive processes in our brain share similar developmental evolution

A

FALSE

Motor and cognitive processes in our brain share similar developmental evolution

23
Q

This enhanced neurogenesis through priming of the neurogenic region of the dentate gyrus (Fabel et al. 2009) or increased length and complexity of dendrites in the dentate gyrus

A

Animal Studies

24
Q

T/F

HUMAN STUDIES
1. Decreased cerebral blood flow in the parahippocampal area in the medial temporal lobe of the brain
2. Lesser neural resources utilized or better neural efficiency for the same behavioral activities
3. Positive effect on the functional plasticity of the brain, including cognitive-motor coupling and cross-modality transfer effect, and that there is evidence for brain plasticity even in old age

A
  1. FALSE- Increased cerebral blood flow in the parahippocampal area in the medial temporal lobe of the brain
  2. TRUE
  3. TRUE
25
Q

T/F
Effect of exercise and cognitive training on falls and fall-related factors in older adults with mild cognitive impairment: A systematic review

This systemic review found that
1. Combined interventions improved balance in MCI
2. Physical exercise improved fall-related factors such as walking speed and global cognitive function in MCI
3. Cognitive training alone improved cognitive outcomes in MCI.
4. None of the included RCTs reported falls rate or incidence, and the number of fallers.

A
  1. TRUE
  2. TRUE
  3. FALSE - Cognitive training alone did not improve cognitive outcomes in MCI.
  4. TRUE
26
Q

What was used to assess the physiological risks for falls in “Fall-related physiological and physical risk factors of community-dwelling older adults with and without mild cognitive impairment: A cross-sectional study”?

A

The short-form Physiological Profile Assessment (PPA)

27
Q

It is a valid, reliable and objective series of tests used to differentiate persons who are at risk for falls (fallers) from those who are not at risk for falls (nonfallers).

A

The short-form Physiological Profile Assessment (PPA)

28
Q

This test was used to examine dynamic balance and functional mobility.

A

Time Up and Go Test (TUGT)

29
Q

This test was used to assess gait speed

A

10-Meter Walk Test (10MWT)

30
Q

T/F

The cross-sectional study found that:
1. Aside from old age and cognitive impairment, older adults with MCI are at higher risk for falls as shown by significantly higher composite PPA scores
2. There were no significant differences in dynamic balance and gait speed between those with and those without MCI, after considering age as a confounding factor

A

BOTH ARE TRUE

31
Q

Meaning of

PACT
PT
CT

A

PACT - physical and cognitive training
PT - physical training
CT - cognitive training

31
Q

How long was the duration of interventions in the “Fall prevention and risk reduction with combined physical and cognitive training (falls PACT) in older adults with mild cognitive impairment: A randomized controlled study”

A

Delivered for 60-90 minutes, 1-3 times per week for 12 weeks.

31
Q

T/F

To successfully reduce falls incidence in older people, a minimum of three hours every week (Sherrington et al., 2016) for at least 40 hours of exercise over the course of interventions is needed (Power & Clifford, 2013). The optimal exercise frequency is purported to be three times per week (Power & Clifford, 2013).

A

TRUE

32
Q

T/F

In order to achieve the recommended 50 hours of exercise to prevent falls, incorporating also the prescribed frequency of three times per week of 1-1.5 hours per session, the calculated number of weeks is 12.

A

FALSE

In order to achieve the recommended 40 hours of exercise to prevent falls, incorporating also the prescribed frequency of three times per week of 1-1.5 hours per session, the calculated number of weeks is 12.

33
Q

T/F

A multicomponent (balance, strength, endurance and flexibility) programme with at least one-fourth is focused on balance training was recommended.

A

FALSE

Multicomponent (balance, strength, endurance and flexibility) programme with at least one-third is focused on balance training was recommended.

34
Q

Identify the exercise:

Pt stands every time to answer questions about orientation to person, place and time

A

Sit to stand: c cognitive training on orientation

35
Q

Identify the exercise:

From a mixed set of objects (30 pieces) on a table at the start of the line, bring one object at a time walking over 10 meters towards another table to sort the objects properly in 3-4 separate groups. Walking is done forward, backward, sideward, in the figure of 8, or tandem.

A

Walking with executive function training

36
Q

Identify the exercise:

Show a picture; if the picture is heel raise, the pt should do heel raises. If the picture shows toe raises, they have to perform toe raise

A

Physical training (heel and toe raise) c visual attention training

37
Q

Identify the exercise:

PT will give the instructions/cues per action
“Right foot up” or “Left foot up”, instead of the pt finishing a set of 10 step ups c R or L foot

A

Step ups c auditory attention training

38
Q

Identify the exercise:

Ask them to stand; as they stand, the BOS should be narrowed to challenge them; then they will reach in the activities
(a) Table setting activity (arrange plates, utensils, glasses based on picture model)
(b) arrange objects from smallest to largest, or in alternating pattern
(c) copying the drawing (pyramid, cylinder house); dot copy

A

Graded reaching in standing with executive function

39
Q

Identify the exercise:

  • Stepping on a set of specified number and sequence of markers on the floor
  • If PT says “6789”, the pt has to step to those numbers accordingly
A

Stepping in different directions with memory training

40
Q

T/F

1.There is no dose-response relationship between the total training hours and the effectiveness of the intervention on cognitive outcomes.
2. Cognitive training greater than 12 weeks duration showed better outcomes compared to programmes with ≤ 12 weeks duration, where the risk of attrition is also reduced.

A
  1. TRUE
  2. FALSE - cognitive training greater than 12 weeks duration did not show better outcomes compared to programmes with ≤ 12 weeks duration, where the risk of attrition is also reduced.
41
Q

T/F

PACT participants after 12 weeks had no falls

A

TRUE

42
Q

Physical training alone showed increased ________________

A

Physical training alone showed increased fastest walking speed

43
Q

LIMITATIONS OF THE STUDY
T/F

  1. The time point to measure outcomes was limited to 12 and 36 weeks after baseline to establish short-term effects of interventions.
  2. The overall attrition rate at 12 weeks was 29.6% while at 36 weeks, it was 28.3%.
A
  1. TRUE
  2. The overall attrition rate at 12 weeks was 19.6% while at 36 weeks, it was 28.3%.
44
Q

T/F

  1. PT resulted in lower overall fall risk, improved cognitive function and better dynamic balance.
  2. PACT resulted in improved cognitive function, faster walking speed, stronger lower limb muscles.
  3. CT showed no significant improvement in cognitive, physiological and physical outcomes.
A
  1. FALSE - PACT resulted in lower overall fall risk, improved cognitive function and better dynamic balance.
  2. FALSE - PT resulted in improved cognitive function, faster walking speed, stronger lower limb muscles.
  3. TRUE
45
Q

T/F

Based on the systematic review, combined physical and cognitive training have demonstrated better outcomes in reducing the balance risk of falling.

A

TRUE

46
Q

T/F

In the systematic review, MCI was found to be highly prevalent and those with MCI have higher risk of falling based on poorer physiological profile, which was independent of age as a confounding factor.

A

FALSE

In the cross-sectional study, MCI was found to be highly prevalent and those with MCI have higher risk of falling based on poorer physiological profile, which was independent of age as a confounding factor.

47
Q

T/F

In the RCT, combined physical and cognitive training reduced overall fall risk, increased cognitive function and increased balance control in older persons with MCI

A

TRUE

48
Q

T/F

Community-based fall prevention programs for older persons, particularly for those without MCI, need to consider the negative effects of combining physical exercise and cognitive training interventions.

A

FALSE

Community-based fall prevention programs for older persons, particularly for those WITH MCI, need to consider the positive effects of combining physical exercise and cognitive training interventions.

49
Q

T/F

Qunatitative investigation of the interventions also needs to be conducted to gather information on how to improve future implementation of the programme.

A

FALSE

Qualitative investigation of the interventions also needs to be conducted to gather information on how to improve future implementation of the programme.

50
Q

T/F

Mental rehearsal is done by verbally repeating a series of numbers or letters.

A

TRUE

51
Q

T/F

The prevalence of falls among persons with cognitive impairment is 8 times compared to healthy persons.

A

FALSE

The INCIDENCE of falls among persons with cognitive impairment is 8 times compared to healthy persons.

52
Q

T/F

Clapping upon hearing a specified letter is way of training tactile attention.

A

FALSE

Clapping upon hearing a specified letter is way of training auditory attention

53
Q

To assess orientation to place, you can ask the patient about countries in Asia, location of a tourist spot, current address.

A

TRUE

54
Q

Copying a drawing on a high table while standing with narrow base of support is combining physical training with executive functioning.

A

TRUE

55
Q

Those with MCI are at a higher risk of falling because of poorer physiological profile.

A

TRUE

56
Q

Memory loss is the reason for persons with cognitive impairment to experience a fall.

A

FALSE

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