Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, April 28, 2017

Lifestyle Program May Slow Cognitive Decline

I bet this could be adapted for stroke survivors. It will never occur, we have such absolute stupidity in stroke with NO STRATEGY AND NO LEADERSHIP.
http://www.medpagetoday.com/meetingcoverage/aan/64800

At-risk seniors seem to benefit from nutritional guidance, vigorous exercise

  • by
    Contributing Writer, MedPage Today

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
BOSTON -- A program that provides elderly people at risk for dementia with dietary guidance, exercise, cognitive training, and vascular risk monitoring could prevent cognitive decline, researchers said here.
Prevention has been highlighted "as a key element in managing dementia, said Miia Kivipelto, PhD, of the Center for Alzheimer Research and Aging Research Center, Karolinska Insitutet in Stockholm in a presentation at the American Academy of Neurology annual meeting.
"At the same time it is increasingly clear that it is very difficult to find new drug treatments for Alzheimer's disease and dementia," she noted.
While there has been evidence in observational studies that modifiable vascular and lifestyle-related risk factors are associated with dementia risk, what has been lacking has been evidence from randomized control trials showing that modifying these risk factors can prevent cognitive decline, she noted.
The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study is a proof-of-concept randomized control trial designed to assess a "multidomain" approach to preventing cognitive decline in at-risk elderly persons. The results of the study were originally published in the Lancet.
In this trial conducted from 2009-2011, researchers enrolled individuals between the ages of 60-77, with 631 randomly assigned to the multidomain intervention group, and 629 to the control group. Inclusion criteria include CAIDE (Cardiovascular Risk Factors, Aging, and Incidence of Dementia) Dementia Risk Scores of at least 6 points, and cognition at mean level or slightly lower than expected for age.
Individuals in the intervention group were given nutrition guidance, put on increasingly vigorous exercise regimens, and provided with cognitive training. Their metabolic and vascular risk factors were also monitored and managed. The control group was provided with general health advice.
"As expected, both groups improved over the 2 years, but the intervention group improved much more," Kivipelto said.
The primary outcome was cognitive change as measured through a comprehensive neuropsychological test battery Z score.
The impact of the intervention on global cognition was significantly higher, said Kivipelto, with the intervention group showing a 25% greater improvement over baseline scores compared with the control group.
That pattern also held for outcomes such as executive functioning (83% improvement), processing speed (150%), and complex memory tasks (40%).
"We also saw that the control group had a 30% increased risk of cognitive decline [versus the intervention group] over the 2 years," she said.
Kivipelto added that new data from the trial also indicated that the intervention was beneficial regardless of sociodemographic factors, baseline cognition, or cardiovascular risk factors. "This indicates that the selection of the target group was successful and that this type of intervention may be implemented in a wider population."
The intervention also had positive effects on secondary outcomes such as activities of daily life (ADL) function, mobility, and quality of life. For example, the intervention group had a 30% lower risk of a decline in ADL function versus the control group.
While adverse events occurred in 46 (7%) of the people in the intervention group, compared with six (1%) in the control group, "there were no serious adverse events," Kivipelto said, adding that most adverse events involved slight muscular pain related to exercise.
As for future research in this area, "I think it will be very important in the future to have even larger multidomain, multinational studies, with tailored interventions, and pragmatic prevention programs," Kivipelto said.
Kivipelto disclosed no relevant relationships with industry.

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