Disentangling Cognitive-Frailty: Results From the Gait and Brain Study.

Background: Cognitive-frailty, defined as the presence of both frailty and cognitive impairment, is proposed as a distinctive entity that predicts dementia. However, it remains controversial whether frailty alone, cognitive-frailty, or the combination of cognitive impairment and slow gait pose different risks of incident dementia.

Methods: Two hundred and fifty-two older adults free of dementia at baseline (mean age 76.

Reduced N-acetylaspartate to creatine ratio in the posterior cingulate correlates with cognition in Alzheimer's disease following four months of rivastigmine treatment.

Aim: To determine whether 4 months of rivastigmine treatment would result in metabolic changes and whether metabolic changes correlate with changes in cognition in people with Alzheimer's disease (AD).

Methods: Magnetic resonance spectra were acquired from the posterior cingulate cortex of subjects with AD at 3 T. Magnetic resonance imaging scans and cognitive tests were performed before and 4 months after the beginning of the treatment.

Examining the construct validity of the Cognitive Competency Test for occupational therapy practice.

Background: Enhancing occupational therapy practice requires critical examination of assessment tools and the conclusions being drawn from their use. When working with cognitively impaired older individuals, judgments about occupational competence are often informed by an assessment of cognitive competence.

Purpose: The Cognitive Competency Test (CCT) is a frequently used measure in Canada to inform predictions of occupational competence.

Components of cognitive competence predictive of occupational competence in persons with dementia: a Delphi study.

Background: Within the area of dementia care, occupational therapists are asked to predict occupational competence in everyday living and often do so by assessing cognitive competence. Considering the cognitive changes that occur with dementia over time, the construct of cognitive competence is a key consideration. Still, a gap exists in the literature examining the relationship between cognitive competence and occupational competence.

Motor cortex and gait in mild cognitive impairment: a magnetic resonance spectroscopy and volumetric imaging study.

Gait disorders are common in the course of dementia, even at the stage of mild cognitive impairment, owing to probable changes in higher levels of motor control. Since motor control message is ultimately supported in the brain by the primary motor cortex and since cortical lesions are frequent in the dementia process, we hypothesized that impairments of the primary motor cortex may explain the early gait disorders observed in mild cognitive impairment. Our purpose was to determine whether the neurochemistry of the primary motor cortex measured with proton magnetic resonance spectroscopy, and its volume, were associated with gait performance while single and dual-tasking in mild cognitive impairment.

Uses of the National Rehabilitation Reporting System: perspectives of geriatric rehabilitation clinicians.

Background: The National Rehabilitation Reporting System (NRS) is a minimum data set for inpatient rehabilitation units. The system was designed to support administrative decision making from the facility to the national level.

Purpose: To conduct a pilot study to explore current and potential clinician uses of NRS data, particularly for hip-fractured clients.

Increased glutamate in the hippocampus after galantamine treatment for Alzheimer disease.

Galantamine is a cholinesterase inhibitor and allosteric potentiating ligand modulating presynaptic nicotinic acetylcholine receptors that is used in the treatment of Alzheimer disease (AD). The purpose of this study was to determine if galantamine treatment would result in detectable hippocampal metabolite changes that correlated with changes in cognition, as measured by the Mini-Mental State Examination (MMSE) and the Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Short echo-time proton magnetic resonance (MR) spectra were acquired from within the right hippocampus of ten patients using a 4 Tesla magnetic resonance imaging (MRI) scanner.

Quantitative gait analysis under dual-task in older people with mild cognitive impairment: a reliability study.

Background: Reliability of quantitative gait assessment while dual-tasking (walking while doing a secondary task such as talking) in people with cognitive impairment is unknown. Dual-tasking gait assessment is becoming highly important for mobility research with older adults since better reflects their performance in the basic activities of daily living. Our purpose was to establish the test-retest reliability of assessing quantitative gait variables using an electronic walkway in older adults with mild cognitive impairment (MCI) under single and dual-task conditions.

Can cognitive enhancers reduce the risk of falls in older people with mild cognitive impairment? A protocol for a randomised controlled double blind trial.

Background: Older adults with cognitive problems have a higher risk of falls, at least twice that of cognitively normal older adults. The consequences of falls in this population are very serious: fallers with cognitive problems suffer more injuries due to falls and are approximately five times more likely to be admitted to institutional care. Although the mechanisms of increased fall risk in cognitively impaired people are not completely understood, it is known that impaired cognitive abilities can reduce attentional resource allocation while walking.

Ventricular enlargement as a possible measure of Alzheimer's disease progression validated using the Alzheimer's disease neuroimaging initiative database.

Ventricular enlargement may be an objective and sensitive measure of neuropathological change associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD), suitable to assess disease progression for multi-centre studies. This study compared (i) ventricular enlargement after six months in subjects with MCI, AD and normal elderly controls (NEC) in a multi-centre study, (ii) volumetric and cognitive changes between Apolipoprotein E genotypes, (iii) ventricular enlargement in subjects who progressed from MCI to AD, and (iv) sample sizes for multi-centre MCI and AD studies based on measures of ventricular enlargement. Three dimensional T(1)-weighted MRI and cognitive measures were acquired from 504 subjects (NEC n = 152, MCI n = 247 and AD n = 105) participating in the multi-centre Alzheimer's Disease Neuroimaging Initiative.

High field (1)H MRS of the hippocampus after donepezil treatment in Alzheimer disease.

The purpose of this study was to measure metabolite level changes in patients with newly diagnosed Alzheimer Disease (AD) following four months of donepezil treatment. A small number of cognitively normal elderly subjects were also scanned longitudinally (twice within one year) to assess the reproducibility. Short echo-time (1)H magnetic resonance spectra were acquired at 4.

Nutrition and aging: assessment and treatment of compromised nutritional status in frail elderly patients.

Nutrition is an important determinant of health in persons over the age of 65. Malnutrition in the elderly is often underdiagnosed. Careful nutritional assessment is necessary for both the successful diagnosis and development of comprehensive treatment plans for malnutrition in this population.

State of the art in geriatric rehabilitation. Part II: clinical challenges.

Objectives: To examine common clinical problems in geriatric rehabilitation and to make recommendations for current practice based on evidence from the literature.

Data Sources: A CINAHL database and 2 MEDLINE searches were conducted for 1980 to 2001. A fourth search was completed by using the Cochrane database.

State of the art in geriatric rehabilitation. Part I: review of frailty and comprehensive geriatric assessment.

Objectives: To increase recognition of geriatric rehabilitation and to provide recommendations for practice and future research.

Data Sources: A CINAHL and 2 MEDLINE searches were conducted for 1980 to 2001. A fourth search used the Cochrane database.

A novel clinical pharmacy experience for third-year medical students.

A novel, clinical curriculum was developed to teach third-year medical students the principles of prescribing for elderly people. The experience involved a didactic session with a community pharmacist and a home visit to assess a senior citizen volunteer who was over age 75 years and was prescribed more than five medications. The medical students completed pre- and postexperience questionnaires to assess knowledge and opinions.