Fondazione Mons Arrigo Mazzali

(1) Background: Alzheimer’s Disease (AD) accounts for 70% of dementia cases and with no effective pharmacological treatments, new rehabilitation methods are needed. Motor activities and transcranial direct current stimulation (tDCS) have shown promise in stabilizing and enhancing cognitive functions. Objective: We want to investigate the effects of combined motor or cognitive activity with tDCS on cognitive functions in AD patients. (2) Methods: Patients with mild or moderate AD were randomized into four groups: motor activity or cognitive activity associated with anodic or sham tDCS (MotA, MotS, CogA, CogS). They received two weeks of treatment (45 minutes, 5 days/week), with the first 15 minutes using 2mA tDCS on the dorsolateral prefrontal cortex. Cognitive assessments were conducted pre-treatment (T0), post-treatment (T1), and one week after (T2). (3) Results: Twenty patients were included. Mann-Whitney test showed significant improvements in anodic groups (MotA+CogA) in the global cognitive status (p=.042), in selective attention (p=.012), and sustained attention (p=.012) at T1, but not at T2. In addition, MotA improved in the Picture Recognition Test (p=.027) and in sustained attention (p=.047) at T2. (4) Conclusion: Combined motor or cognitive activity with anodic tDCS could slow cognitive decline in AD patients, with notable improvements in global cognitive state and attention at T1.

PURPOSE: With aging, vascular function (VF) declines. Indeed, a conspicuous number of oldest-old individuals are in chronically bedridden, and literature indicates that chronic immobility exacerbates VF decline. Although studies have suggested that passive mobilization of the limbs (PM) may improve local VF, the effect of PM on nitric oxide (NO)-mediated VF has not been studied yet. Therefore the aims of this study were determine whether PM is effective to counteract VF worsening in bedridden oldest- old. We hypothesized that bedridden patients who underwent a month of PM would have gained significant improvement in NO-mediated VF. METHODS: Twenty bedridden individuals (86±7 yrs) were randomly assigned to PM or control (CT) group, treated with standard therapies only. PM groups underwent a program of 30 min of passive knee (flexo-extension) mobilization (4-week, twice a day/5 days a week) in addition to their standard therapies. Pre and post treatment, NO-mediated VF was measured by means of single passive limb movement (sPLM) test. RESULTS: All PM patients completed all sessions. Concerning sPLM test, PM group improved significantly sPLMpeak (+33%), ΔPLM (+55%), as well as Area Under the Curve (AUC, +200%). CT group did not exhibit any change in VF. CONCLUSIONS: Results suggest that the reduction in VF exhibited in chronically bedridden oldest-old individuals can be reversed by a PM program. PM seems to be an effective strategy to counteract the deleterious effects of bedridden.