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Thais R.S. Paulo, Sheilla Tribess, Jeffer Eidi Sasaki, Joilson Meneguci, Cristiane A. Martins, Ismael F. Freitas Jr., Vicente Romo-Perez and Jair S. Virtuoso Jr.

The aim of this study was to examine the association of physical activity with depression and cognition deficit, separately and combined, in Brazilian older adults. We analyzed data from 622 older adults. Physical activity was assessed using the International Physical Activity Questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale, while cognitive deficit was assessed using the Mini-Mental State Examination. Multinomial logistic regressions were used to assess associations of depression and cognitive deficit with sociodemographic, health, and behavioral variables. Prevalence of physical inactivity (< 150 min of moderate-to-vigorous physical activity/week), depression, and cognitive deficit were 35.7%, 37.4%, and 16.7%. Physical inactivity was associated with depression (OR: 1.83, 95% CI: 1.14–2.94) and with depression and cognitive deficit combined (OR: 4.23, 95% CI: 2.01–8.91). Physically inactive participants were also more likely to present limitations in orientation and language functions. Physical inactivity was associated with depression and also with depression and cognitive deficit combined in older adults.

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Nicole L. Hoffman, Hannes Devos and Julianne D. Schmidt

Key Points ▸ Individualized driving performance prior to and postconcussion is not commonly available. ▸ Subtle driving performance and cognitive deficits were evident despite being symptom-free. ▸ Awareness is needed to determine readiness to return to driving postconcussion. Symptom severity and

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Roya Saffary, Lawrence S. Chin and Robert C. Cantu

Sports-related activities account for an estimated 10% of head and spinal cord injuries. In recent years, concussion in particular has garnered more interest in the medical field as well as the media. Reports of athletes suffering from long-term cognitive deficits and Parkinsonian symptoms have sparked concern in a disease process that has often been underestimated or ignored. As more reports surface, the desperate need for a better understanding of the neuropathology has been made clear. In addition to the concern for acute injury, long-term sequelae such as chronic traumatic encephalopathy (CTE) are feared consequences of concussive injuries. Research studies have shown significant overlap in the neuropathology between CTE and chronic neurodegenerative processes such as Alzheimer’s disease (AD). In particular, tau protein deposition has been found to be present in both disease processes and may play an important part in the clinical findings observed. The present review discusses concussion and our current understanding of pathological findings that may underlie the clinical features associated with concussive injuries and resulting chronic traumatic encephalopathy.

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Alon Eliakim

The Pediatric Exercise Science Year That Was section aims to highlight the most important (to the author’s opinion) manuscripts that were published in 2016 in the field of endocrinology and pediatric exercise science. This year’s selection includes studies showing that 1) Induction of T4 to T3 conversion by type 2 deiodinase following aerobic exercise in skeletal muscles was associated with concomitant increase in peroxisome proliferatoractivated receptor-γ coactivator-1α, and mitochondrial oxidative capacity and therefore plays an important mechanistic role in the muscle adaptation to exercise training. 2) Hypothyroidism in fetal and early postnatal life was associated with impaired spatial learning and memory and with reduced hippocampal brain-derived neurotrophic factor in male and female rat pups. Forced (treadmill) and voluntary (wheel) exercise alleviated all these biochemical and neuro-cognitive deficits. 3) The relationship between different exercise intensities and carbohydrate requirements to maintain euglycemia at basal insulin levels among adolescent and young adults with Type 1 diabetes are nonlinear but rather inverted- U with no exogenous glucose required to maintain stable glucose level at high-intensity exercise (80%). The implication of these studies to the pediatric population, their importance and the new research avenues that were opened by these studies is emphasized.

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Joseph J. Crisco, Bethany J. Wilcox, Jason T. Machan, Thomas W. McAllister, Ann-Christine Duhaime, Stefan M. Duma, Steven Rowson, Jonathan G. Beckwith, Jeffrey J. Chu and Richard M. Greenwald

The purpose of this study was to quantify the severity of head impacts sustained by individual collegiate football players and to investigate differences between impacts sustained during practice and game sessions, as well as by player position and impact location. Head impacts (N = 184,358) were analyzed for 254 collegiate players at three collegiate institutions. In practice, the 50th and 95th percentile values for individual players were 20.0 g and 49.5 g for peak linear acceleration, 1187 rad/s2 and 3147 rad/s2 for peak rotational acceleration, and 13.4 and 29.9 for HITsp, respectively. Only the 95th percentile HITsp increased significantly in games compared with practices (8.4%, p = .0002). Player position and impact location were the largest factors associated with differences in head impacts. Running backs consistently sustained the greatest impact magnitudes. Peak linear accelerations were greatest for impacts to the top of the helmet, whereas rotational accelerations were greatest for impacts to the front and back. The findings of this study provide essential data for future investigations that aim to establish the correlations between head impact exposure, acute brain injury, and long-term cognitive deficits.

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Nicholas M. Hattrup, Rebekah L. Gardiner, Hannah Gray, Cailee E. Welch Bacon and Tamara C. Valovich McLeod

Key Points ▸ When a baseline assessment is performed appropriately, individualized baseline data may provide a more accurate way to assess cognitive deficits following a concussion when compared to normative data. ▸ When choosing preseason baseline assessments, the clinician, patient history, and

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Jian Chen, Bruce Oddson and Heather C. Gilbert

concussions. The results of neuropsychological testing have indicated that cognitive deficits may linger long after symptoms have resolved. 15 – 18 Progressive changes in a concussed brain may lead to chronic traumatic encephalopathy (CTE) that results in manifestation of symptoms years even decades after

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Hanan Khalil, Mahmoud A. Alomari, Omar Khabour, Aya Al-Hieshan and Jawad A. Bajwa

-Gray, Foltynie, Brayne, Robbins, & Barker, 2007 ). The most common cognitive deficits in PD are executive dysfunctions which include problems with planning, cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions, inhibiting inappropriate actions, and selecting relevant sensory

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Carla Elane Silva dos Santos, Sofia Wolker Manta, Guilherme Pereira Maximiano, Susana Cararo Confortin, Tânia Rosane Bertoldo Benedetti, Eleonora d’Orsi and Cassiano Ricardo Rech

dependency was defined as difficulty in performing 4 or more activities of daily living. The cognitive state of the participants was evaluated with the Mini-Mental State Examination and was classified either as no cognitive deficit or probable deficit, considering the educational level of the subjects (<19

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Christine C. Center, Samuel J. Wilkins, Ross Mathiasen and Adam B. Rosen

intensive care unit. Comparative Outcome After being weaned off of sedation and extubated, he initially showed signs of posttraumatic amnesia and moderate cognitive deficits. The patient had an oculomotor (third) cranial nerve palsy with right-sided ptosis noted. He continued to make significant