Background: Intermittent Claudication symptomatic peripheral arterial disease (ICSPAD) is associated with reduced mobility, functional capacity, and quality of life. Physical exercise is an effective non-pharmacological intervention for the management of ICSPAD. Adherence to exercise programs is challenging, due to the nature of the disease and the complex comorbidities associated with it. This study aimed to determine adherence to three supervised physical exercise programs (a walking intervention, strength intervention, and concurrent intervention) and an unsupervised exercise program (standard advice) in individuals with ICSPAD. Methods: In this clinical trial, 122 patients were divided into four groups based on the type of exercise program they followed: standard advice, walking intervention, strength intervention, and concurrent intervention. Results: The results revealed that while the demographic characteristics were similar, the strength intervention group had a younger mean age, and the walking group had a higher prevalence of hypertension and increased usage of anti-hypertensive drugs. Adherence to physical exercise and pedometer wearing was highest in the standard advice group. Logistic regression analysis showed lower odds of adherence to exercise and pedometer wearing in the intervention groups compared to the standard advice group. Adherence did not significantly vary across ankle-brachial index categories. Furthermore, there was no significant difference in adherence between the severity levels of intermittent claudication, though mild cases tended to exhibit higher adherence. Conclusions: The results show that the standard advice from healthcare professionals positively influences treatment adherence.
Background/Objectives: With rising diabetes rates, early detection of complications such as diabetic retinopathy (DR), a leading cause of visual impairment, is crucial. Incorporating DR screening into primary care has shown positive results, and integrating technological advances and artificial intelligence (AI) into these processes offers promising potential. The overall study aims to evaluate the agreement between primary care physicians, ophthalmologists, and an AI system in DR screening and referral decisions within a real-world primary care setting. Methods: In this brief report, we present the study protocol and provide an initial overview and description of our sample. A total of 1517 retinographies, obtained by a non-mydriatic retinal camera, were retrospectively collected from 301 patients with diabetes. Results: Primary care physicians referred 34.5% of the patients to ophthalmology, primarily due to opacification, suspicion of DR, or other retinal diseases. Overall, 13.62% of the participants were suspected of having DR, with 9.63% having a definitive diagnosis. Conclusions: These initial descriptive findings will be further explored in the next phase of the study through the analysis of concordance between primary care physicians, the AI-based software, and ophthalmology specialists. Future results are expected to provide valuable insights into the reliability of DR screening across different evaluators and support the integration of effective DR screening strategies into real-world clinical practice.
Cognitive aging trajectories differ widely across individuals, and genetic factors such as APOE and BDNF polymorphisms may contribute to this variability. While APOE ε4 has been widely studied, the influence of APOE ε2, particularly in interaction with sex, remains underexplored. This study aims to examine the longitudinal trajectory of APOE ε2 individuals on cognitive performance, and their interactions with sex, age, and BDNF Val66Met polymorphism, in a population-based cohort of older adults with vascular risk. We analyzed data from 386 participants (mean age: 71.8) from the Barcelona-AsIA Neuropsychology Study, followed over a 7-year period. Verbal memory, verbal fluency, and visuospatial domains were assessed. Linear regression models tested associations between cognitive change and genotypes, controlling for age, sex, education, depression, and vascular risk. Interaction terms and permutation testing were applied. Regression to the mean (RTM) effects were assessed. BDNF showed no significant associations with cognitive performance. RTM effects were evident across subgroups, particularly among ε2 carriers, suggesting this phenomenon partly explains the divergent results over time. APOE ε2 does not confer a consistent protective effect on cognition over time. Our results highlight that APOE ε2 may be detrimental to verbal memory in aging males.