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Updates on Recent Advances in the Therapy of Adult Psoriatic Disease.

Curr Rheumatol Rev

January 2025

University of Toronto, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.

Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease with various joint and skin manifestations and multiple associated comorbidities. The management of PsA is important not only in controlling disease activity and preventing subsequent damage but also in improving the quality of life and reducing mortality. Over the years, numerous drugs have been introduced into the therapeutic armamentarium of the disease.

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Background: Cognitive changes affecting performance are subtle in early stages of Alzheimer's Disease (AD) and may emerge only with more complex tasks. Driving is a highly challenging instrumental activity of daily living, requiring higher order integration of cognitive skills. For example, driving on freeway entrance ramps requires heightened cognitive engagement such as rapid responses to fast-emerging traffic and sudden speed changes, combining sensory processing and manipulative actions.

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Background: Previous literature has highlighted that excessive alcohol use (EAU) is directly linked with permanent neurological damage. Studies have also highlighted gradual improvements in heart rate variability (HRV) after cessation of alcohol use. Moreover, chronic alcohol consumption has also been correlated with reduced HRV and an increase in skin conductance (SC) among healthy adults, leading to a combined decline in cognitive performance.

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Background: Identifying markers for increased risk of cognitive change and early Alzheimer's disease (AD) is key to enhancing the effectiveness of treatments. Changes in instrumental activities of daily living, including the complex task of driving, may serve as potential markers to identify older adults at risk of cognitive decline. This study evaluates driving behaviors and associated physiological signals in older adults with and without elevated brain amyloid burden.

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Background: Early symptoms of Alzheimer's disease (AD) may include subtle performance changes in complex tasks, such as driving, which could be potential markers for identifying those at risk of cognitive decline. In this study, categorical driving behaviors and events as well as related physiological changes were compared in older adults with and without elevated brain amyloid.

Method: Video and physiological data collected from 21 amyloid positive and 21 amyloid negative participants over the age of 65 (range 65-85), who participated in the University of Michigan's Driving and Physiological Responses study were analyzed.

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