Geriatrics, Volume 1, Issue 2 (June 2016) – 5 articles

Contemporary research findings indicate that in older persons (typically 64 > years) there are functional decrements in the ability to mentally represent and effectively plan motor actions. Actions, if poorly planned, can result in falling, a major health concern for the elderly. Whereas a number of factors may contribute to falls, over- or underestimation of reach abilities may lead to loss of postural control (balance) and pose a higher risk of falling. Our intent with this paper was to provide: (1) a brief background of the problem, (2) suggest strategies for mental (motor) imagery practice in the context of reach planning, and (3) describe general guidelines and a sample practice format of a training program for clinical use. Mental (motor) imagery practice of reach planning has potential for improving motor performance in reach-related everyday activities and reducing the risk of falls in older persons. Full article

Background: Intra-individual (IIV) of reaction time (RT), as the short-term fluctuations of RT-based performance, has been reported to be susceptible to cognitive ageing. The current study aimed to examine IIV of RT and its relationships with cognitive performance in cognitively normal senior adults. Methods: We evaluated 137 community-dwelling elderly (mean age: 72.41 ± 3.99) with a comprehensive neuropsychological battery and a RT-based test. Intraindividual coefficient of variation of reaction time (ICV-RT) was used to evaluate the IIV. Pearson’s correlation and hierarchical multiple regression analyses were employed to assess the relationships between IIV and the scores of cognitive function. Results: Advancing age was accompanied with declined cognitive function and increased IIV. ICV-RT was negatively correlated with the score of Montreal Cognitive Assessment Hong Kong version (HK MoCA) across three types of flanker. Hierarchical multiple regression showed that ICV-RT was a significant predictor of HK MoCA (β = −0.294, p = 0.001). Conclusion: Increased IIV is consistently associated with and contributed to the age-related decline of cognitive performance in senior adults. The utility of IIV in predicting further deterioration should be carefully postulated with prospective studies. Full article

With the increasing aging of the population, the number of older drivers is rising. Driving is a significant factor for quality of life and independence concerning social and working life. On the other hand, driving is a complex task involving visual, motor, and cognitive skills that experience age-related changes even in healthy aging. In this review we summarize different age-related functional changes with relevance for driving concerning sensory, motor, and cognitive functions. Since these functions have great interindividual variability, it is necessary to apply methods that help to identify older drivers with impaired driving abilities in order to take appropriate measures. We discuss three different methods to assess driving ability, namely the assessment of (i) functions relevant for driving; (ii) driving behavior in real traffic; and (iii) behavior in a driving simulator. We present different measures to improve mobility in older drivers, including information campaigns, design of traffic and car environment, instructions, functional training, and driving training in real traffic and in a driving simulator. Finally, we give some recommendations for assessing and improving the driving abilities of older drivers with multi-modal approaches being most promising for enhancing individual and public safety. Full article

Background: Despite having the same histopathological characteristics, early-onset and late-onset Alzheimer’s disease (AD) patients show some distinct clinical and neuropsychological profiles. Early Onset Mild Cognitive Impairment (EOMCI) is a less characterized group. The aim of this study is to characterize MCI probably due to AD in terms of the clinical, genetic, Cerebrospinal fluid (CSF) biomarkers profile and conversion rate of EOMCI, compared to the late-onset form (LOMCI). Methods: 159 MCI patients were divided in two groups: 52 EOMCI (onset < 65 years) and 107 LOMCI (onset ≥ 65 years). We investigated differences in neuropsychological scores, clinical variables, ApoE genotype, CSF biomarkers (Aβ42, t-Tau and p-Tau) in both groups. Conversion was ascertained during follow-up. Results: EOMCI showed a longer duration of symptoms prior to the first evaluation (EOMCI = 4.57 vs. LOMCI = 3.31, p = 0.008) and scored higher on the subjective memory complaints scale (9.91 vs. 7.85, p = 0.008), but performed better in brief cognitive tests (27.81 vs. 26.51, p < 0.001 in Mini-Mental State Examination; 19.84 vs. 18.67, p = 0.005 in Montreal Cognitive Assessment) than LOMCI. ApoE genotype distribution and CSF biomarker profile were similar in both groups, as was the conversion risk. Lower Aβ42 (Hazard ratio (HR): 0.998, 95% Confidence Interval (CI) = [0.996–1.000], p = 0.042), higher t-Tau levels (HR: 1.003, 95%CI = [1.000–1.005], p = 0.039) and higher scores in the Alzheimer Disease Assessment Scale-Cognitive (HR: 1.186, 95%CI = [1.083–1.299], p = 0.002) increased the risk of conversion. Discussion: Despite differences in memory performance and memory complaints, EOMCI and LOMCI seem to represent indistinct biological groups that do not have a higher risk of conversion to AD or differ in risk factors for conversion. Full article

In an in vitro study, it was found that aspirin might decrease neopterin production and tryptophan degradation. The aim of the present study was to evaluate the possible association between aspirin use and mean neopterin and tryptophan levels in patients with and without a delirium and whether the use of aspirin is associated with a decreased prevalence of delirium. Neopterin and tryptophan levels were determined previously in acutely ill admitted patients aged ≥65 years. The possible influence of aspirin on mean levels of neopterin and tryptophan was investigated with univariate analysis of variance in adjusted models. Eighty-three patients were included; 22 had a delirium. In patients without a delirium (no aspirin (n = 31) versus aspirin (n = 27)), mean neopterin levels were 47.0 nmol/L versus 43.6 nmol/L (p = 0.645) and tryptophan levels were 33.1 µmol/L versus 33.9 µmol/L (p = 0.816). In patients with a delirium (no aspirin (n = 13) versus aspirin (n = 9)), mean neopterin levels were 77.8 nmol/L versus 71.1 nmol/L (p = 0.779) and tryptophan levels were 22.4 µmol/L versus 27.3 µmol/L (p = 0.439). No difference was found in the distribution of aspirin users between patients with and without a delirium. In this study, we found that the use of aspirin had no significant effect on mean levels of neopterin and tryptophan. However, the raw data suggest that there might be a potential influence in patients with a delirium. Aspirin use was not associated with a decreased prevalence of delirium. Full article