- Email: [email protected]
EFFECTS OF AEROBIC EXERCISE ON THE AGING BRAIN
P1000
Poster Presentations: Tuesday, July 26, 2016
of the translation and equivalence. The cultural equivalence was performed without the need for a second instrument application step. Most respondents (90%) required the interviewer’s help to read the questions, but they have not had difficulty in choosing the answers. Older adults with low education levels have informed more difficulty in understanding the items related to the domain: Depression. Conclusions: With the cross-cultural adaptation of the ANU-ADRI, it is important that the language of the instrument has been described like simple and easy to understand by the Brazilian population. The ANU-ADRI has been undergoing a formal validation process in Brazil so after comparing it with three Cohorts performed in USA and Europe. P3-393
DEVELOPMENT OF A BRAIN HEALTH FOOD GUIDE FOR USE IN MIDDLE-AGED AND OLDER ADULTS
Matthew D. Parrott and Members of the Canadian Consortium on Neurodegeneration in Aging Nutrition, Exercise & Lifestyle Team, Baycrest Health Sciences, Toronto, ON, Canada. Contact e-mail: [email protected] Background: The Alzheimer’s Association, USA, recently argued that ‘there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline’. While results from most epidemiologic studies support diets which emphasize plant-based foods to maintain cognitive function; there is not consensus on best characteristics across all food groups, especially dietary fats. Consequently there remains a need to derive evidence-based recommendations to describe an optimal diet pattern to support cognitive health. As such, we developed a Brain Health Food Guide (BHFG), which could ultimately be used to support dietary change in middle aged and older adults. Methods: A primary consideration in developing the BHFG was to harmonize diet patterns across two RCTs, PREDIMED (Mediterranean-style diet) and ENCORE (DASH diet), which differ markedly in their fat recommendations; both of which demonstrated improved cognitive performance associated with diet change. Relevant data from observational prospective studies exploring a diet-cognition relationship were collated. Conversion factors were developed to enable comparison across studies with different serving size definitions or studies that that expressed serving size as volumes versus those expressed in units of mass. Results: In terms of dietary fat, studies generally supported an intervention that simultaneously targets reductions in SFA consumption while promoting greater contribution of PUFA and MUFA to total fat intake—particularly from plant sources. The evidence supporting targets to increase or decrease total fat intake was equivocal. Translating across all food groups, the BHFG emphasizes vegetables (raw leafy greens, cruciferous vegetables), fruits (berries), nuts, fish, legumes, and low-fat dairy products. It includes whole grains, poultry, and moderate alcohol consumption. It is reduced in red and processed meats, refined grains, commercial sweets, pre-packaged foods, sugared drinks, and high-fat dairy products. Conclusions: A brain healthy eating pattern, based on observational and intervention studies, can be derived from existing literature.
1 Medical University of Lodz, Lodz, Poland; 2Central Teaching Hospital, Lodz, Poland. Contact e-mail: [email protected]
Background: Healthy dietary patterns, such as the Mediterranean diet, are recommended as part of non-pharmacological strategy to prevent or delay the onset of cognitive decline or dementia. Western diet and abnormal body composition (especially increased amount of visceral fat) are postulated as risk factor of cognitive decline in elderly subjects. The aim of this study is to evaluate dietary patterns, nutritional status, anthropometric parameters, body composition, and cognitive performance in community dwelling elderly subjects. Methods: 192 European Caucasian subjects were included into the prospective, observational study. The following data were acquired: detailed medical history, current treatment and clinical status. Data on the presence of vascular risk factors (hypertension, dyslipidemia, diabetes, history of cerebro-vascular incidents) and comorbidity were also collected. The Food Intake Variety Questionnaire (FIVeQ) and a daily diary for 7 days were used for the collecting data on dietary patterns. Body mass index, abdominal, waist and hip circumferences were measured. Body composition (total fat mass, lean body mass, body water, visceral and subcutaneous fat) was assessed using Maltron 920- 2-S bioimpedance analyzer (BIA measurements) and iDXA GE Lunar densitometer (DXA measurements) serving as reference method. Cognitive performance was assessed using set of neuropsychological methods: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Color Trails Test (CTT-2), Verbal Fluency, CANTABeclipse Test Battery. Results: 192 European Caucasian healthy subjects (156 women; mean age, 71,2 years) were included into the first large prospective observational study performed in Poland. Here we present preliminary results of analysis of relationships between dietary patterns, nutritional status, body composition, and cognitive performance in population of community dwelling healthy elders. Abnormal body composition (numerous parameters, including amount of fat depot, and especially significantly increased amount of visceral fat) has been found in the study group. No correlation between cognitive performance (MoCA, MMSE) and BMI, body weight, DXA Fat (kg, %), VAT (g, cm3) has been found in the NutrDem group participants at the baseline visit. Conclusions: No correlation between cognitive performance and nutritional status has been found at the baseline visit. However, a longitudinal assessment of over 200 healthy elderly with preplanned 5 years follow-up is ongoing. P3-395
EFFECTS OF AEROBIC EXERCISE ON THE AGING BRAIN
Silke Matura1, Johannes Fleckenstein2, Valentina A. Tesky1, Ulrich Pilatus3, Elke Hattingen3, Lutz Vogt2, Ralf Deichmann4, Bianca Lienerth4, Winfried Banzer2, Johannes Pantel1, 1Institute of General Practice, Goethe University, Frankfurt am Main, Germany; 2Institute of Sports Sciences, Goethe University, Frankfurt am Main, Germany; 3 Institute of Neuroradiology, Goethe University Hospital, Frankfurt am Main, Germany; 4Brain Imaging Center, Frankfurt am Main, Germany. Contact e-mail: [email protected] Background: There is mounting evidence that exercise has a positive
P3-394
DIETARY PATTERNS, BODY COMPOSITION, AND COGNITIVE PERFORMANCE IN COMMUNITYDWELLING HEALTHY ELDERS (NUTRDEM PROJECT)
Radoslaw Magierski1, Joanna Magierska1, Anna Bogaczewicz1, Krzysztof Pekala1, Anna Lucka2, Jasmina Stanislawska1, Marta Partyka2, Katarzyna Antczak-Domagala1, Iwona Kloszewska1, Tomasz Sobow1,
effect on cognitive functions in older adults. To date, little is known about the neurometabolic and molecular mechanisms underlying this positive effect. The present study used magnetic resonance spectroscopic imaging (MRSI) to systematically explore the effects of physical activity on human brain metabolism in healthy aging. This is the first controlled intervention study which explores the effect of regular exercise on the cerebral metabolism of cognitive
Poster Presentations: Tuesday, July 26, 2016
P1001
healthy, older adults. Methods: 60 participants (mean age: 75.5 years / 33 female) were included in the study. Participants were randomly allocated to a 12-week individualised aerobic exercise program intervention (n ¼30) or a 12 week waiting control group. Assessment included psychometric testing (memory, attention, executive function), assessment of movement-related parameters and a cardiopulmonary exercise test (CPET). 1H MRSI was applied to measure metabolic profiles. Furthermore, structural MRI was used to quantify grey matter volume. Participants successfully passing all assessments were randomised to either receive intervention during the subsequent 12 weeks (intervention group) or after a waiting period of 12 weeks (control group). Twelve weeks after allocation, all participants were reassessed, using identical methods. Results: Multivariate repeated measures ANOVAs did not reveal significant effects of the aerobic exercise intervention on cognitive outcomes (p > 0.5), nor on grey matter volumes (p > 0.5). With regard to the metabolic profiles, there was a trend towards changes induced by active training. The most prominent effect was an increase in NAA/tCho for the intervention group (interaction of group x time: p ¼ 0.037), whereas no changes were observed for the control group (interaction of group x time p ¼ 0.637) Conclusions: Aerobic exercise seems to induce metabolic changes in the brain of older adults. The increase in NAA/tCho following regular aerobic exercise was not associated with improved cognitive function. A possible explanation could be the relatively small sample size (n ¼ 30 in each group), resulting in a lack of statistical power to detect subtle effects of aerobic exercise on cognition. P3-396
IMPROVING TIMELY DIAGNOSIS AND MANAGEMENT OF DEMENTIA IN THE HEALTH CARE SETTING
Cornelya D. Dorbin, Monica W. Parker, Emory University, Atlanta, GA, USA. Contact e-mail: [email protected] Background: Timely evaluation and management of older adult’s
cognitive function in the health care setting has important practice implications. Reports indicate that the population of adults 65 and older will increase dramatically in the next 15 years. Currently, Georgia has nearly 130,000 adults age 65 and older that are diagnosed with Alzheimer’s disease (Alzheimer’s Facts and Figures 2015). More than 14 percent –one in seven –of those aged 60 and over report that they are experiencing confusion or memory loss that is happening more often or is getting worse (BRFSS Cognitive Impairment Module 2015). Methods: We conducted one continuing medical education (CME) training that included lectures and panel discussions with 34 participants recruited from the community, local hospitals, academic institutions and the Georgia Academy of Family Physicians to increase adherence to the guidelines established in the Medicare Annual Wellness Visit. We used the Moore Model of Outcomes Measurements[1] in pre- and post surveys to evaluate the CMEs and to assess changes in knowledge and intent to implement a strategy. Correct responses increased significantly from pre- to post-CME. Results: Results from the live CME training indicate a 31% increase in knowledge with screening guidelines and practices (Figure 1). This increase in knowledge may lead to clinician’s adherence to the Medicare Annual Wellness Visit required elements and their patient’s completing cognitive assessments. Conclusions: Studies show that more than 40% of physicians were unaware of cognitive dysfunction in their patients[2]. It is imperative that we bolster physician training to increase their knowledge and adherence to screening guidelines to improve the diagnosis and treatment of cognitive impairment. CME participants
indicated a 38% increase in knowledge of risk factors and diagnostic tests associated with cognitive dysfunction (Figure 2). While the U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults, there are important reasons to identify early cognitive impairment. Patient and family members advise they can better plan for future problems when cognitive impairment is diagnosed early[3]. P3-397
MILD COGNITIVE IMPAIRMENT: THE EFFECT OF KIRTAN KRIYA MEDITATION ON PSYCHOLOGICAL AND COGNITIVE STATUS
MaGloria Borras-Boneu1,2,3, Toni Ca~n1,2, Judit Castella2, Silvia Ramos4, Nuria Pimpinela4, Dharma Singh Khalsa3,5, 1GRDMedic Health Inst, Barcelona, Spain; 2AEKY, Barcelona, Spain; 3Alzheimer’s Research and Prevention Foundation, Tucson, AZ, USA; 4AVAN, Terrassa, Spain; 5University of New Mexico School of Medicine, Albuquerque, NM, USA. Contact e-mail: [email protected] Background: Mild cognitive impairment (MCI) involves a high risk of developing Alzheimer’s dementia. For this reason, the early therapeutic approach to cognitive impairment is crucial to prevent the progression of the disease. Meditation, a non-pharma Mind-Body approach, in conjunction with other modalities such as diet, exercise and socialization, presents us with an opportunity to impact dementia risk factors. Objective: To evaluate the cognitive function and psychological status after the Kirtan Kriya Meditation program (KKM) and Kundalini Yoga (KY), on our population diagnosed with MCI while following their standard memory training program. Methods: Fifteen adults (10 women and 5 men with a mean age of
Poster Presentations: Tuesday, July 26, 2016
of the translation and equivalence. The cultural equivalence was performed without the need for a second instrument application step. Most respondents (90%) required the interviewer’s help to read the questions, but they have not had difficulty in choosing the answers. Older adults with low education levels have informed more difficulty in understanding the items related to the domain: Depression. Conclusions: With the cross-cultural adaptation of the ANU-ADRI, it is important that the language of the instrument has been described like simple and easy to understand by the Brazilian population. The ANU-ADRI has been undergoing a formal validation process in Brazil so after comparing it with three Cohorts performed in USA and Europe. P3-393
DEVELOPMENT OF A BRAIN HEALTH FOOD GUIDE FOR USE IN MIDDLE-AGED AND OLDER ADULTS
Matthew D. Parrott and Members of the Canadian Consortium on Neurodegeneration in Aging Nutrition, Exercise & Lifestyle Team, Baycrest Health Sciences, Toronto, ON, Canada. Contact e-mail: [email protected] Background: The Alzheimer’s Association, USA, recently argued that ‘there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline’. While results from most epidemiologic studies support diets which emphasize plant-based foods to maintain cognitive function; there is not consensus on best characteristics across all food groups, especially dietary fats. Consequently there remains a need to derive evidence-based recommendations to describe an optimal diet pattern to support cognitive health. As such, we developed a Brain Health Food Guide (BHFG), which could ultimately be used to support dietary change in middle aged and older adults. Methods: A primary consideration in developing the BHFG was to harmonize diet patterns across two RCTs, PREDIMED (Mediterranean-style diet) and ENCORE (DASH diet), which differ markedly in their fat recommendations; both of which demonstrated improved cognitive performance associated with diet change. Relevant data from observational prospective studies exploring a diet-cognition relationship were collated. Conversion factors were developed to enable comparison across studies with different serving size definitions or studies that that expressed serving size as volumes versus those expressed in units of mass. Results: In terms of dietary fat, studies generally supported an intervention that simultaneously targets reductions in SFA consumption while promoting greater contribution of PUFA and MUFA to total fat intake—particularly from plant sources. The evidence supporting targets to increase or decrease total fat intake was equivocal. Translating across all food groups, the BHFG emphasizes vegetables (raw leafy greens, cruciferous vegetables), fruits (berries), nuts, fish, legumes, and low-fat dairy products. It includes whole grains, poultry, and moderate alcohol consumption. It is reduced in red and processed meats, refined grains, commercial sweets, pre-packaged foods, sugared drinks, and high-fat dairy products. Conclusions: A brain healthy eating pattern, based on observational and intervention studies, can be derived from existing literature.
1 Medical University of Lodz, Lodz, Poland; 2Central Teaching Hospital, Lodz, Poland. Contact e-mail: [email protected]
Background: Healthy dietary patterns, such as the Mediterranean diet, are recommended as part of non-pharmacological strategy to prevent or delay the onset of cognitive decline or dementia. Western diet and abnormal body composition (especially increased amount of visceral fat) are postulated as risk factor of cognitive decline in elderly subjects. The aim of this study is to evaluate dietary patterns, nutritional status, anthropometric parameters, body composition, and cognitive performance in community dwelling elderly subjects. Methods: 192 European Caucasian subjects were included into the prospective, observational study. The following data were acquired: detailed medical history, current treatment and clinical status. Data on the presence of vascular risk factors (hypertension, dyslipidemia, diabetes, history of cerebro-vascular incidents) and comorbidity were also collected. The Food Intake Variety Questionnaire (FIVeQ) and a daily diary for 7 days were used for the collecting data on dietary patterns. Body mass index, abdominal, waist and hip circumferences were measured. Body composition (total fat mass, lean body mass, body water, visceral and subcutaneous fat) was assessed using Maltron 920- 2-S bioimpedance analyzer (BIA measurements) and iDXA GE Lunar densitometer (DXA measurements) serving as reference method. Cognitive performance was assessed using set of neuropsychological methods: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Color Trails Test (CTT-2), Verbal Fluency, CANTABeclipse Test Battery. Results: 192 European Caucasian healthy subjects (156 women; mean age, 71,2 years) were included into the first large prospective observational study performed in Poland. Here we present preliminary results of analysis of relationships between dietary patterns, nutritional status, body composition, and cognitive performance in population of community dwelling healthy elders. Abnormal body composition (numerous parameters, including amount of fat depot, and especially significantly increased amount of visceral fat) has been found in the study group. No correlation between cognitive performance (MoCA, MMSE) and BMI, body weight, DXA Fat (kg, %), VAT (g, cm3) has been found in the NutrDem group participants at the baseline visit. Conclusions: No correlation between cognitive performance and nutritional status has been found at the baseline visit. However, a longitudinal assessment of over 200 healthy elderly with preplanned 5 years follow-up is ongoing. P3-395
EFFECTS OF AEROBIC EXERCISE ON THE AGING BRAIN
Silke Matura1, Johannes Fleckenstein2, Valentina A. Tesky1, Ulrich Pilatus3, Elke Hattingen3, Lutz Vogt2, Ralf Deichmann4, Bianca Lienerth4, Winfried Banzer2, Johannes Pantel1, 1Institute of General Practice, Goethe University, Frankfurt am Main, Germany; 2Institute of Sports Sciences, Goethe University, Frankfurt am Main, Germany; 3 Institute of Neuroradiology, Goethe University Hospital, Frankfurt am Main, Germany; 4Brain Imaging Center, Frankfurt am Main, Germany. Contact e-mail: [email protected] Background: There is mounting evidence that exercise has a positive
P3-394
DIETARY PATTERNS, BODY COMPOSITION, AND COGNITIVE PERFORMANCE IN COMMUNITYDWELLING HEALTHY ELDERS (NUTRDEM PROJECT)
Radoslaw Magierski1, Joanna Magierska1, Anna Bogaczewicz1, Krzysztof Pekala1, Anna Lucka2, Jasmina Stanislawska1, Marta Partyka2, Katarzyna Antczak-Domagala1, Iwona Kloszewska1, Tomasz Sobow1,
effect on cognitive functions in older adults. To date, little is known about the neurometabolic and molecular mechanisms underlying this positive effect. The present study used magnetic resonance spectroscopic imaging (MRSI) to systematically explore the effects of physical activity on human brain metabolism in healthy aging. This is the first controlled intervention study which explores the effect of regular exercise on the cerebral metabolism of cognitive
Poster Presentations: Tuesday, July 26, 2016
P1001
healthy, older adults. Methods: 60 participants (mean age: 75.5 years / 33 female) were included in the study. Participants were randomly allocated to a 12-week individualised aerobic exercise program intervention (n ¼30) or a 12 week waiting control group. Assessment included psychometric testing (memory, attention, executive function), assessment of movement-related parameters and a cardiopulmonary exercise test (CPET). 1H MRSI was applied to measure metabolic profiles. Furthermore, structural MRI was used to quantify grey matter volume. Participants successfully passing all assessments were randomised to either receive intervention during the subsequent 12 weeks (intervention group) or after a waiting period of 12 weeks (control group). Twelve weeks after allocation, all participants were reassessed, using identical methods. Results: Multivariate repeated measures ANOVAs did not reveal significant effects of the aerobic exercise intervention on cognitive outcomes (p > 0.5), nor on grey matter volumes (p > 0.5). With regard to the metabolic profiles, there was a trend towards changes induced by active training. The most prominent effect was an increase in NAA/tCho for the intervention group (interaction of group x time: p ¼ 0.037), whereas no changes were observed for the control group (interaction of group x time p ¼ 0.637) Conclusions: Aerobic exercise seems to induce metabolic changes in the brain of older adults. The increase in NAA/tCho following regular aerobic exercise was not associated with improved cognitive function. A possible explanation could be the relatively small sample size (n ¼ 30 in each group), resulting in a lack of statistical power to detect subtle effects of aerobic exercise on cognition. P3-396
IMPROVING TIMELY DIAGNOSIS AND MANAGEMENT OF DEMENTIA IN THE HEALTH CARE SETTING
Cornelya D. Dorbin, Monica W. Parker, Emory University, Atlanta, GA, USA. Contact e-mail: [email protected] Background: Timely evaluation and management of older adult’s
cognitive function in the health care setting has important practice implications. Reports indicate that the population of adults 65 and older will increase dramatically in the next 15 years. Currently, Georgia has nearly 130,000 adults age 65 and older that are diagnosed with Alzheimer’s disease (Alzheimer’s Facts and Figures 2015). More than 14 percent –one in seven –of those aged 60 and over report that they are experiencing confusion or memory loss that is happening more often or is getting worse (BRFSS Cognitive Impairment Module 2015). Methods: We conducted one continuing medical education (CME) training that included lectures and panel discussions with 34 participants recruited from the community, local hospitals, academic institutions and the Georgia Academy of Family Physicians to increase adherence to the guidelines established in the Medicare Annual Wellness Visit. We used the Moore Model of Outcomes Measurements[1] in pre- and post surveys to evaluate the CMEs and to assess changes in knowledge and intent to implement a strategy. Correct responses increased significantly from pre- to post-CME. Results: Results from the live CME training indicate a 31% increase in knowledge with screening guidelines and practices (Figure 1). This increase in knowledge may lead to clinician’s adherence to the Medicare Annual Wellness Visit required elements and their patient’s completing cognitive assessments. Conclusions: Studies show that more than 40% of physicians were unaware of cognitive dysfunction in their patients[2]. It is imperative that we bolster physician training to increase their knowledge and adherence to screening guidelines to improve the diagnosis and treatment of cognitive impairment. CME participants
indicated a 38% increase in knowledge of risk factors and diagnostic tests associated with cognitive dysfunction (Figure 2). While the U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults, there are important reasons to identify early cognitive impairment. Patient and family members advise they can better plan for future problems when cognitive impairment is diagnosed early[3]. P3-397
MILD COGNITIVE IMPAIRMENT: THE EFFECT OF KIRTAN KRIYA MEDITATION ON PSYCHOLOGICAL AND COGNITIVE STATUS
MaGloria Borras-Boneu1,2,3, Toni Ca~n1,2, Judit Castella2, Silvia Ramos4, Nuria Pimpinela4, Dharma Singh Khalsa3,5, 1GRDMedic Health Inst, Barcelona, Spain; 2AEKY, Barcelona, Spain; 3Alzheimer’s Research and Prevention Foundation, Tucson, AZ, USA; 4AVAN, Terrassa, Spain; 5University of New Mexico School of Medicine, Albuquerque, NM, USA. Contact e-mail: [email protected] Background: Mild cognitive impairment (MCI) involves a high risk of developing Alzheimer’s dementia. For this reason, the early therapeutic approach to cognitive impairment is crucial to prevent the progression of the disease. Meditation, a non-pharma Mind-Body approach, in conjunction with other modalities such as diet, exercise and socialization, presents us with an opportunity to impact dementia risk factors. Objective: To evaluate the cognitive function and psychological status after the Kirtan Kriya Meditation program (KKM) and Kundalini Yoga (KY), on our population diagnosed with MCI while following their standard memory training program. Methods: Fifteen adults (10 women and 5 men with a mean age of