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Nicholas Bott
Clinical Excellence Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA

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Journal article
Published: 19 April 2021 in International Journal of Environmental Research and Public Health
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Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. Methods. A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses “pre” and “during” the lockdown period. Participants responded to the Short Warwick–Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. Results. Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20). Conclusion. COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

ACS Style

Khaled Trabelsi; Achraf Ammar; Liwa Masmoudi; Omar Boukhris; Hamdi Chtourou; Bassem Bouaziz; Michael Brach; Ellen Bentlage; Daniella How; Mona Ahmed; Patrick Mueller; Notger Mueller; Hsen Hsouna; Yousri Elghoul; Mohamed Romdhani; Omar Hammouda; Laisa Paineiras-Domingos; Annemarie Braakman-Jansen; Christian Wrede; Sofia Bastoni; Carlos Pernambuco; Leonardo Mataruna-Dos-Santos; Morteza Taheri; Khadijeh Irandoust; Nicola Bragazzi; Jana Strahler; Jad Washif; Albina Andreeva; Stephen Bailey; Jarred Acton; Emma Mitchell; Nicholas Bott; Faiez Gargouri; Lotfi Chaari; Hadj Batatia; Samira Khoshnami; Evangelia Samara; Vasiliki Zisi; Parasanth Sankar; Waseem Ahmed; Gamal Ali; Osama Abdelkarim; Mohamed Jarraya; Kais Abed; Wassim Moalla; Nafaa Souissi; Asma Aloui; Nizar Souissi; Lisette Gemert-Pijnen; Bryan Riemann; Laurel Riemann; Jan Delhey; Jonathan Gómez-Raja; Monique Epstein; Robbert Sanderman; Sebastian Schulz; Achim Jerg; Ramzi Al-Horani; Taysir Mansi; Ismail Dergaa; Mohamed Jmail; Fernando Barbosa; Fernando Ferreira-Santos; Boštjan Šimunič; Rado Pišot; Saša Pišot; Andrea Gaggioli; Jürgen Steinacker; Piotr Zmijewski; Christian Apfelbacher; Jordan Glenn; Aïmen Khacharem; Cain Clark; Helmi Saad; Karim Chamari; Tarak Driss; Anita Hoekelmann; on behalf of the ECLB-COVID19 Consortium. Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey. International Journal of Environmental Research and Public Health 2021, 18, 4329 .

AMA Style

Khaled Trabelsi, Achraf Ammar, Liwa Masmoudi, Omar Boukhris, Hamdi Chtourou, Bassem Bouaziz, Michael Brach, Ellen Bentlage, Daniella How, Mona Ahmed, Patrick Mueller, Notger Mueller, Hsen Hsouna, Yousri Elghoul, Mohamed Romdhani, Omar Hammouda, Laisa Paineiras-Domingos, Annemarie Braakman-Jansen, Christian Wrede, Sofia Bastoni, Carlos Pernambuco, Leonardo Mataruna-Dos-Santos, Morteza Taheri, Khadijeh Irandoust, Nicola Bragazzi, Jana Strahler, Jad Washif, Albina Andreeva, Stephen Bailey, Jarred Acton, Emma Mitchell, Nicholas Bott, Faiez Gargouri, Lotfi Chaari, Hadj Batatia, Samira Khoshnami, Evangelia Samara, Vasiliki Zisi, Parasanth Sankar, Waseem Ahmed, Gamal Ali, Osama Abdelkarim, Mohamed Jarraya, Kais Abed, Wassim Moalla, Nafaa Souissi, Asma Aloui, Nizar Souissi, Lisette Gemert-Pijnen, Bryan Riemann, Laurel Riemann, Jan Delhey, Jonathan Gómez-Raja, Monique Epstein, Robbert Sanderman, Sebastian Schulz, Achim Jerg, Ramzi Al-Horani, Taysir Mansi, Ismail Dergaa, Mohamed Jmail, Fernando Barbosa, Fernando Ferreira-Santos, Boštjan Šimunič, Rado Pišot, Saša Pišot, Andrea Gaggioli, Jürgen Steinacker, Piotr Zmijewski, Christian Apfelbacher, Jordan Glenn, Aïmen Khacharem, Cain Clark, Helmi Saad, Karim Chamari, Tarak Driss, Anita Hoekelmann, on behalf of the ECLB-COVID19 Consortium. Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey. International Journal of Environmental Research and Public Health. 2021; 18 (8):4329.

Chicago/Turabian Style

Khaled Trabelsi; Achraf Ammar; Liwa Masmoudi; Omar Boukhris; Hamdi Chtourou; Bassem Bouaziz; Michael Brach; Ellen Bentlage; Daniella How; Mona Ahmed; Patrick Mueller; Notger Mueller; Hsen Hsouna; Yousri Elghoul; Mohamed Romdhani; Omar Hammouda; Laisa Paineiras-Domingos; Annemarie Braakman-Jansen; Christian Wrede; Sofia Bastoni; Carlos Pernambuco; Leonardo Mataruna-Dos-Santos; Morteza Taheri; Khadijeh Irandoust; Nicola Bragazzi; Jana Strahler; Jad Washif; Albina Andreeva; Stephen Bailey; Jarred Acton; Emma Mitchell; Nicholas Bott; Faiez Gargouri; Lotfi Chaari; Hadj Batatia; Samira Khoshnami; Evangelia Samara; Vasiliki Zisi; Parasanth Sankar; Waseem Ahmed; Gamal Ali; Osama Abdelkarim; Mohamed Jarraya; Kais Abed; Wassim Moalla; Nafaa Souissi; Asma Aloui; Nizar Souissi; Lisette Gemert-Pijnen; Bryan Riemann; Laurel Riemann; Jan Delhey; Jonathan Gómez-Raja; Monique Epstein; Robbert Sanderman; Sebastian Schulz; Achim Jerg; Ramzi Al-Horani; Taysir Mansi; Ismail Dergaa; Mohamed Jmail; Fernando Barbosa; Fernando Ferreira-Santos; Boštjan Šimunič; Rado Pišot; Saša Pišot; Andrea Gaggioli; Jürgen Steinacker; Piotr Zmijewski; Christian Apfelbacher; Jordan Glenn; Aïmen Khacharem; Cain Clark; Helmi Saad; Karim Chamari; Tarak Driss; Anita Hoekelmann; on behalf of the ECLB-COVID19 Consortium. 2021. "Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey." International Journal of Environmental Research and Public Health 18, no. 8: 4329.

Journal article
Published: 27 August 2020 in International Journal of Environmental Research and Public Health
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Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses “before” and “during” confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (−58%), friends/neighbors (−44.9%), or entertainment (−46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (−30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. Conclusion: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.

ACS Style

Achraf Ammar; Hamdi Chtourou; Omar Boukhris; Khaled Trabelsi; Liwa Masmoudi; Michael Brach; Bassem Bouaziz; Ellen Bentlage; Daniella How; Mona Ahmed; Patrick Mueller; Notger Mueller; Hsen Hsouna; Asma Aloui; Omar Hammouda; Laisa Paineiras-Domingos; Annemarie Braakman-Jansen; Christian Wrede; Sophia Bastoni; Carlos Pernambuco; Leonardo Mataruna-Dos-Santos; Morteza Taheri; Khadijeh Irandoust; Aïmen Khacharem; Nicola Bragazzi; Jana Strahler; Jad Washif; Albina Andreeva; Samira Khoshnami; Evangelia Samara; Vasiliki Zisi; Parasanth Sankar; Waseem Ahmed; Mohamed Romdhani; Jan Delhey; Stephen Bailey; Nicholas Bott; Faiez Gargouri; Lotfi Chaari; Hadj Batatia; Gamal Ali; Osama Abdelkarim; Mohamed Jarraya; Kais Abed; Nizar Souissi; Lisette Gemert-Pijnen; Bryan Riemann; Laurel Riemann; Wassim Moalla; Jonathan Gómez-Raja; Monique Epstein; Robbert Sanderman; Sebastian Schulz; Achim Jerg; Ramzi Al-Horani; Taiysir Mansi; Mohamed Jmail; Fernando Barbosa; Fernando Ferreira-Santos; Boštjan Šimunič; Rado Pišot; Saša Pišot; Andrea Gaggioli; Piotr Zmijewski; Christian Apfelbacher; Jürgen Steinacker; Helmi Saad; Jordan Glenn; Karim Chamari; Tarak Driss; Anita Hoekelmann; on behalf of the ECLB-COVID19 Consortium. COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study. International Journal of Environmental Research and Public Health 2020, 17, 6237 .

AMA Style

Achraf Ammar, Hamdi Chtourou, Omar Boukhris, Khaled Trabelsi, Liwa Masmoudi, Michael Brach, Bassem Bouaziz, Ellen Bentlage, Daniella How, Mona Ahmed, Patrick Mueller, Notger Mueller, Hsen Hsouna, Asma Aloui, Omar Hammouda, Laisa Paineiras-Domingos, Annemarie Braakman-Jansen, Christian Wrede, Sophia Bastoni, Carlos Pernambuco, Leonardo Mataruna-Dos-Santos, Morteza Taheri, Khadijeh Irandoust, Aïmen Khacharem, Nicola Bragazzi, Jana Strahler, Jad Washif, Albina Andreeva, Samira Khoshnami, Evangelia Samara, Vasiliki Zisi, Parasanth Sankar, Waseem Ahmed, Mohamed Romdhani, Jan Delhey, Stephen Bailey, Nicholas Bott, Faiez Gargouri, Lotfi Chaari, Hadj Batatia, Gamal Ali, Osama Abdelkarim, Mohamed Jarraya, Kais Abed, Nizar Souissi, Lisette Gemert-Pijnen, Bryan Riemann, Laurel Riemann, Wassim Moalla, Jonathan Gómez-Raja, Monique Epstein, Robbert Sanderman, Sebastian Schulz, Achim Jerg, Ramzi Al-Horani, Taiysir Mansi, Mohamed Jmail, Fernando Barbosa, Fernando Ferreira-Santos, Boštjan Šimunič, Rado Pišot, Saša Pišot, Andrea Gaggioli, Piotr Zmijewski, Christian Apfelbacher, Jürgen Steinacker, Helmi Saad, Jordan Glenn, Karim Chamari, Tarak Driss, Anita Hoekelmann, on behalf of the ECLB-COVID19 Consortium. COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study. International Journal of Environmental Research and Public Health. 2020; 17 (17):6237.

Chicago/Turabian Style

Achraf Ammar; Hamdi Chtourou; Omar Boukhris; Khaled Trabelsi; Liwa Masmoudi; Michael Brach; Bassem Bouaziz; Ellen Bentlage; Daniella How; Mona Ahmed; Patrick Mueller; Notger Mueller; Hsen Hsouna; Asma Aloui; Omar Hammouda; Laisa Paineiras-Domingos; Annemarie Braakman-Jansen; Christian Wrede; Sophia Bastoni; Carlos Pernambuco; Leonardo Mataruna-Dos-Santos; Morteza Taheri; Khadijeh Irandoust; Aïmen Khacharem; Nicola Bragazzi; Jana Strahler; Jad Washif; Albina Andreeva; Samira Khoshnami; Evangelia Samara; Vasiliki Zisi; Parasanth Sankar; Waseem Ahmed; Mohamed Romdhani; Jan Delhey; Stephen Bailey; Nicholas Bott; Faiez Gargouri; Lotfi Chaari; Hadj Batatia; Gamal Ali; Osama Abdelkarim; Mohamed Jarraya; Kais Abed; Nizar Souissi; Lisette Gemert-Pijnen; Bryan Riemann; Laurel Riemann; Wassim Moalla; Jonathan Gómez-Raja; Monique Epstein; Robbert Sanderman; Sebastian Schulz; Achim Jerg; Ramzi Al-Horani; Taiysir Mansi; Mohamed Jmail; Fernando Barbosa; Fernando Ferreira-Santos; Boštjan Šimunič; Rado Pišot; Saša Pišot; Andrea Gaggioli; Piotr Zmijewski; Christian Apfelbacher; Jürgen Steinacker; Helmi Saad; Jordan Glenn; Karim Chamari; Tarak Driss; Anita Hoekelmann; on behalf of the ECLB-COVID19 Consortium. 2020. "COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study." International Journal of Environmental Research and Public Health 17, no. 17: 6237.

Journal article
Published: 28 May 2020 in Nutrients
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Background: Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours. Methods: Following a structured review of the literature, the “Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)” Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses “before” and “during” confinement conditions. Results: 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly. Conclusion: While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.

ACS Style

Achraf Ammar; Michael Brach; Khaled Trabelsi; Hamdi Chtourou; Omar Boukhris; Liwa Masmoudi; Bassem Bouaziz; Ellen Bentlage; Daniella How; Mona Ahmed; Patrick Müller; Notger Müller; Asma Aloui; Omar Hammouda; Laisa Paineiras-Domingos; Annemarie Braakman-Jansen; Christian Wrede; Sofia Bastoni; Carlos Pernambuco; Leonardo Mataruna; Morteza Taheri; Khadijeh Irandoust; Aïmen Khacharem; Nicola Bragazzi; Karim Chamari; Jordan Glenn; Nicholas Bott; Faiez Gargouri; Lotfi Chaari; Hadj Batatia; Gamal Ali; Osama Abdelkarim; Mohamed Jarraya; Kais El Abed; Nizar Souissi; Lisette Van Gemert-Pijnen; Bryan Riemann; Laurel Riemann; Wassim Moalla; Jonathan Gómez-Raja; Monique Epstein; Robbert Sanderman; Sebastian Schulz; Achim Jerg; Ramzi Al-Horani; Taiysir Mansi; Mohamed Jmail; Fernando Barbosa; Fernando Ferreira-Santos; Boštjan Šimunič; Rado Pišot; Andrea Gaggioli; Stephen Bailey; Jürgen Steinacker; Tarak Driss; Anita Hoekelmann; On Behalf of the ECLB-COVID19 Consortium. Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients 2020, 12, 1583 .

AMA Style

Achraf Ammar, Michael Brach, Khaled Trabelsi, Hamdi Chtourou, Omar Boukhris, Liwa Masmoudi, Bassem Bouaziz, Ellen Bentlage, Daniella How, Mona Ahmed, Patrick Müller, Notger Müller, Asma Aloui, Omar Hammouda, Laisa Paineiras-Domingos, Annemarie Braakman-Jansen, Christian Wrede, Sofia Bastoni, Carlos Pernambuco, Leonardo Mataruna, Morteza Taheri, Khadijeh Irandoust, Aïmen Khacharem, Nicola Bragazzi, Karim Chamari, Jordan Glenn, Nicholas Bott, Faiez Gargouri, Lotfi Chaari, Hadj Batatia, Gamal Ali, Osama Abdelkarim, Mohamed Jarraya, Kais El Abed, Nizar Souissi, Lisette Van Gemert-Pijnen, Bryan Riemann, Laurel Riemann, Wassim Moalla, Jonathan Gómez-Raja, Monique Epstein, Robbert Sanderman, Sebastian Schulz, Achim Jerg, Ramzi Al-Horani, Taiysir Mansi, Mohamed Jmail, Fernando Barbosa, Fernando Ferreira-Santos, Boštjan Šimunič, Rado Pišot, Andrea Gaggioli, Stephen Bailey, Jürgen Steinacker, Tarak Driss, Anita Hoekelmann, On Behalf of the ECLB-COVID19 Consortium. Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients. 2020; 12 (6):1583.

Chicago/Turabian Style

Achraf Ammar; Michael Brach; Khaled Trabelsi; Hamdi Chtourou; Omar Boukhris; Liwa Masmoudi; Bassem Bouaziz; Ellen Bentlage; Daniella How; Mona Ahmed; Patrick Müller; Notger Müller; Asma Aloui; Omar Hammouda; Laisa Paineiras-Domingos; Annemarie Braakman-Jansen; Christian Wrede; Sofia Bastoni; Carlos Pernambuco; Leonardo Mataruna; Morteza Taheri; Khadijeh Irandoust; Aïmen Khacharem; Nicola Bragazzi; Karim Chamari; Jordan Glenn; Nicholas Bott; Faiez Gargouri; Lotfi Chaari; Hadj Batatia; Gamal Ali; Osama Abdelkarim; Mohamed Jarraya; Kais El Abed; Nizar Souissi; Lisette Van Gemert-Pijnen; Bryan Riemann; Laurel Riemann; Wassim Moalla; Jonathan Gómez-Raja; Monique Epstein; Robbert Sanderman; Sebastian Schulz; Achim Jerg; Ramzi Al-Horani; Taiysir Mansi; Mohamed Jmail; Fernando Barbosa; Fernando Ferreira-Santos; Boštjan Šimunič; Rado Pišot; Andrea Gaggioli; Stephen Bailey; Jürgen Steinacker; Tarak Driss; Anita Hoekelmann; On Behalf of the ECLB-COVID19 Consortium. 2020. "Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey." Nutrients 12, no. 6: 1583.

Journal article
Published: 10 April 2020 in International Journal of Environmental Research and Public Health
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Currently, it is well accepted that physical exercise-induced oxidative stress may damage biological structures and impair cellular functions. However, it is still unclear which type of exercise results in the greatest oxidative stress responses among a healthy untrained population. The aim of the present study was to compare the acute oxidative stress response (i.e., 0 to 20 min) following different types of exercise (anaerobic, aerobic, and combined). Ten healthy, untrained males (19.5 ± 1.7 years) performed three randomized exercise bouts: anaerobic (30 s Wingate test), aerobic (30 min at 60% maximal aerobic power (MAP)) or combined (anaerobic and aerobic). Venous blood samples were collected before, as well as at 0 (P0), 5 (P5), 10 (P10), and 20 (P20) min after each session. Rates of malondialdehyde (MDA) and antioxidant activities (i.e., glutathione peroxidase (GPX), superoxide dismutase (SOD), glutathione reductase (GR), α-tocopherol, and total antioxidant status (TAS)) were assessed. Independent of exercise type, plasma MDA, GPX, SOD, and GR contents increased above baseline, whereas plasma α-tocopherol decreased under baseline after the test sessions (p < 0.05). Aerobic and anaerobic exercises generated faster responses (at P0) when compared to the combined exercise (P5 to P10) for the majority of the tested parameters. Plasma TAS content only increased following the aerobic exercise at P10 (p = 0.03). Five to twenty-minutes post exercise, the highest MDA response was registered in the aerobic condition, and the highest GPX and SOD responses were recorded in the anaerobic (at P5) and aerobic (at P20) conditions (p < 0.05). In conclusion, aerobic, anaerobic, or combined exercises have the potential to acutely increase oxidative stress and antioxidant activities, but with different responses magnitude. These findings confirm that oxidative stress response seems to be dependent on the intensity and the duration of the physical exercise and may help in understanding how varying exercise bouts influence the degree of oxidative stress among healthy untrained young adults.

ACS Style

Achraf Ammar; Khaled Trabelsi; Omar Boukhris; Jordan M Glenn; Nick Bott; Liwa Masmoudi; Ahmed Hakim; Hamdi Chtourou; Tarak Driss; Anita Hoekelmann; Kais El Abed. Effects of Aerobic-, Anaerobic- and Combined-Based Exercises on Plasma Oxidative Stress Biomarkers in Healthy Untrained Young Adults. International Journal of Environmental Research and Public Health 2020, 17, 2601 .

AMA Style

Achraf Ammar, Khaled Trabelsi, Omar Boukhris, Jordan M Glenn, Nick Bott, Liwa Masmoudi, Ahmed Hakim, Hamdi Chtourou, Tarak Driss, Anita Hoekelmann, Kais El Abed. Effects of Aerobic-, Anaerobic- and Combined-Based Exercises on Plasma Oxidative Stress Biomarkers in Healthy Untrained Young Adults. International Journal of Environmental Research and Public Health. 2020; 17 (7):2601.

Chicago/Turabian Style

Achraf Ammar; Khaled Trabelsi; Omar Boukhris; Jordan M Glenn; Nick Bott; Liwa Masmoudi; Ahmed Hakim; Hamdi Chtourou; Tarak Driss; Anita Hoekelmann; Kais El Abed. 2020. "Effects of Aerobic-, Anaerobic- and Combined-Based Exercises on Plasma Oxidative Stress Biomarkers in Healthy Untrained Young Adults." International Journal of Environmental Research and Public Health 17, no. 7: 2601.

Review
Published: 19 March 2020 in Journal of Clinical Medicine
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Context: As the food industry is continually involved in the development of new attractive alternative therapeutic agents, the evaluation of the beneficial impact of (poly)phenols on cognitive and brain function during aging has gained increasing interest. Objective: This systematic review and meta-analysis aimed to evaluate the acute and chronic effects of (poly)phenol-rich diet supplementation on cognitive function and brain health in aging adults. Data Sources: PubMed and Web of Science databases were searched for relevant randomized placebo-controlled trials (RCTs) published from inception to July 2019. Study Selection: Two researchers independently screened 4303 records, using the PICOS criteria: Participants were aging adults; Intervention was based on acute and/or chronic (poly)phenols-rich supplementation; Comparator was any comparator; Outcomes included cognitive function and neuroprotective measures; and Study design was RCTs. A third researcher was consulted when discrepancies arose. Fifteen high-quality (mean PEDro score = 8.8 ± 0.56) RCTs (total participants: 918 healthy older adults) were included in the final sample. Data Extraction: Information on study design, employed treatment, characteristics of participants, outcomes, and the correspondent assessing methods were extracted. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data Analysis and Results: A random-effects meta-analysis was used to pool estimates across studies. Effect size (ES) and its 95% confidence interval (CI) was calculated. Pooled results yielded a trivial ES (−0.2 to 0.03) for brain-derived neurotrophic factor and neuroinflammatory parameters and small (0.36) to moderate (0.82) ES for executive functions. Conclusion: This meta-analysis failed to provide evidence regarding the neuroprotective and anti-inflammatory effect of (poly)phenols supplementation in aging adults. However, findings from individual studies, included in this systematic review, suggest polyphenol-rich supplementation may improve some cognitive and brain functions in older adults. The beneficial effect of polyphenols seems to depend on ingested dose and bioavailability. Results suggest at least an intermediate dose (≥500 mg), and intermediate (≈9%) to high (43%) bioavailability rates are needed to cross the brain blood barrier and to exert a significant effect on cognitive health.

ACS Style

Achraf Ammar; Khaled Trabelsi; Patrick Müller; Bassem Bouaziz; Omar Boukhris; Jordan M Glenn; Nick Bott; Tarak Driss; Hamdi Chtourou; Notger Müller; Anita Hökelmann. The Effect of (Poly)phenol-Rich Interventions on Cognitive Functions and Neuroprotective Measures in Healthy Aging Adults: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine 2020, 9, 835 .

AMA Style

Achraf Ammar, Khaled Trabelsi, Patrick Müller, Bassem Bouaziz, Omar Boukhris, Jordan M Glenn, Nick Bott, Tarak Driss, Hamdi Chtourou, Notger Müller, Anita Hökelmann. The Effect of (Poly)phenol-Rich Interventions on Cognitive Functions and Neuroprotective Measures in Healthy Aging Adults: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020; 9 (3):835.

Chicago/Turabian Style

Achraf Ammar; Khaled Trabelsi; Patrick Müller; Bassem Bouaziz; Omar Boukhris; Jordan M Glenn; Nick Bott; Tarak Driss; Hamdi Chtourou; Notger Müller; Anita Hökelmann. 2020. "The Effect of (Poly)phenol-Rich Interventions on Cognitive Functions and Neuroprotective Measures in Healthy Aging Adults: A Systematic Review and Meta-Analysis." Journal of Clinical Medicine 9, no. 3: 835.

Journal article
Published: 25 October 2019 in JMIR mHealth and uHealth
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Background As the global prevalence of dementia continues to rise, multidomain lifestyle interventions that address modifiable risk factors associated with pathological cognitive decline are increasing. Although some digital options have been developed to increase the reach and scalability of these programs, because of cultural differences, the efficacy of the programs in one population cannot easily be generalized to populations in other countries. Objective This investigation aimed to examine the usability and engagement of a digitally delivered multidomain cognitive lifestyle intervention developed in the United States for a Japanese population. Methods This feasibility investigation utilized a quasi-experimental, single-arm, nonrandomized, longitudinal design where participants engaged in the behavioral intervention on a smartphone. Of the 559 participants that initially enrolled (age: mean 51 years, SD 7.5 years; 51.7% female [289/559]), 242 completed the final testing trial. Participants enrolled in a multidomain lifestyle program that consisted of (1) psychoeducational material, (2) physical activity tracker, (3) nutrition tracker, (4) audio-based meditations, and (5) health coaching. Engagement with the program was assessed through the total number of app sessions and the use of the exercise, diet, and meditation tracking features within the app. The total number of minutes exercised was collected through subjective user inputs, and nutrition was quantified by the Mediterranean-DASH Intervention for Neurodegenerative Delay diet adherence score. Results Significant relationships existed between overall nutrition score and frequency of nutrition tracking (r=0.18), frequency of physical activity tracking (r=0.19), and the total number of minutes exercised (r=0.22). Total minutes exercised was significantly correlated with total app sessions (r=0.57), frequency of physical activity tracking (r=0.85), frequency of nutrition tracking (r=0.64), number of times participants meditated (r=0.46), and total lessons read (r=0.36). The number of completed lessons was significantly related to frequency of physical activity tracking (r=0.40), frequency of nutrition tracking (r=0.43), the total number of times participants meditated (r=0.35), and total minutes exercised (r=0.33). Dividing the cohort into two groups based on lesson completion ( Conclusions Overall, this cross-cultural feasibility study in Japanese users demonstrated that the various engagement metrics were significantly correlated, and greater engagement was related to improved nutrition scores and increased time exercising. In addition, the relationships between lesson completion and other engagement metrics suggest that there may be value in exploring mechanisms that enhance lesson completion. Future research should examine the program in randomized control trials to more rigorously evaluate program efficacy.

ACS Style

Jordan Glenn; Erica Nicole Madero; Michelle Gray; Nami Fuseya; Mari Ikeda; Tomoo Kawamura; Yoshiko Arita; Nick Thomas Bott. Engagement With a Digital Platform for Multimodal Cognitive Assessment and Multidomain Intervention in a Japanese Population: Pilot, Quasi-Experimental, Longitudinal Study. JMIR mHealth and uHealth 2019, 7, e15733 .

AMA Style

Jordan Glenn, Erica Nicole Madero, Michelle Gray, Nami Fuseya, Mari Ikeda, Tomoo Kawamura, Yoshiko Arita, Nick Thomas Bott. Engagement With a Digital Platform for Multimodal Cognitive Assessment and Multidomain Intervention in a Japanese Population: Pilot, Quasi-Experimental, Longitudinal Study. JMIR mHealth and uHealth. 2019; 7 (10):e15733.

Chicago/Turabian Style

Jordan Glenn; Erica Nicole Madero; Michelle Gray; Nami Fuseya; Mari Ikeda; Tomoo Kawamura; Yoshiko Arita; Nick Thomas Bott. 2019. "Engagement With a Digital Platform for Multimodal Cognitive Assessment and Multidomain Intervention in a Japanese Population: Pilot, Quasi-Experimental, Longitudinal Study." JMIR mHealth and uHealth 7, no. 10: e15733.

Journal article
Published: 17 October 2019 in Journal of Medical Internet Research
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Background Hospitalized older adults often experience isolation and disorientation while receiving care, placing them at risk for many inpatient complications, including loneliness, depression, delirium, and falls. Embodied conversational agents (ECAs) are technological entities that can interact with people through spoken conversation. Some ECAs are also relational agents, which build and maintain socioemotional relationships with people across multiple interactions. This study utilized a novel form of relational ECA, provided by Care Coach (care.coach, inc): an animated animal avatar on a tablet device, monitored and controlled by live health advocates. The ECA implemented algorithm-based clinical protocols for hospitalized older adults, such as reorienting patients to mitigate delirium risk, eliciting toileting needs to prevent falls, and engaging patients in social interaction to facilitate social engagement. Previous pilot studies of the Care Coach avatar have demonstrated the ECA’s usability and efficacy in home-dwelling older adults. Further study among hospitalized older adults in a larger experimental trial is needed to demonstrate its effectiveness. Objective The aim of the study was to examine the effect of a human-in-the-loop, protocol-driven relational ECA on loneliness, depression, delirium, and falls among diverse hospitalized older adults. Methods This was a clinical trial of 95 adults over the age of 65 years, hospitalized at an inner-city community hospital. Intervention participants received an avatar for the duration of their hospital stay; participants on a control unit received a daily 15-min visit from a nursing student. Measures of loneliness (3-item University of California, Los Angeles Loneliness Scale), depression (15-item Geriatric Depression Scale), and delirium (confusion assessment method) were administered upon study enrollment and before discharge. Results Participants who received the avatar during hospitalization had lower frequency of delirium at discharge (P<.001), reported fewer symptoms of loneliness (P=.01), and experienced fewer falls than control participants. There were no significant differences in self-reported depressive symptoms. Conclusions The study findings validate the use of human-in-the-loop, relational ECAs among diverse hospitalized older adults.

ACS Style

Nicholas Bott; Sharon Wexler; Lin Drury; Chava Pollak; Victor Wang; Kathleen Scher; Sharon Narducci. A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study. Journal of Medical Internet Research 2019, 21, e13440 .

AMA Style

Nicholas Bott, Sharon Wexler, Lin Drury, Chava Pollak, Victor Wang, Kathleen Scher, Sharon Narducci. A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study. Journal of Medical Internet Research. 2019; 21 (10):e13440.

Chicago/Turabian Style

Nicholas Bott; Sharon Wexler; Lin Drury; Chava Pollak; Victor Wang; Kathleen Scher; Sharon Narducci. 2019. "A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study." Journal of Medical Internet Research 21, no. 10: e13440.

Review
Published: 19 September 2019 in Nutrients
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: Background: Currently, there is no pharmaceutical intervention to treat or delay pathological cognitive decline or Alzheimer’s disease and related dementias (ADRD). Multidomain lifestyle interventions are increasingly being studied as a non-pharmacological solution to enhance cognitive reserve, maintain cognition, and reduce the risk of or delay ADRD. Review of completed and prospective face-to-face (FTF) and digital multidomain interventions provides an opportunity to compare studies and informs future interventions and study design. Methods: Electronic databases (PubMed, PsycINFO, clinicaltrials.gov and NIH RePORTER) were searched for multidomain lifestyle programs. Studies were included if the program (1) included a control group, (2) included at least 3 interventions, (3) were at least 6 months in duration, and (4) included measurement of cognitive performance as an outcome. Results: In total, 17 multidomain lifestyle programs aimed at enhancing cognitive reserve and reducing risk of ADRD were found. Thirteen programs are FTF in intervention delivery, with 3 FTF programs replicating the FINGER protocol as part of the World Wide Fingers Consortium. Four programs are delivered digitally (website, Web application, or mobile app). Program characteristics (e.g., target population, duration, frequency, outcomes, and availability) and results of completed and prospective studies are reviewed and discussed. Conclusion: This review updates and discusses completed and current multidomain lifestyle interventions aimed at enhancing cognitive reserve and reducing risk of ADRD. A growing number of international studies are investigating the efficacy and utility of these programs in both FTF and digital contexts. While a diversity of study designs and interventions exist, FTF and digital programs that build upon the foundational work of the FINGER protocol have significant potential to enhance cognitive reserve and reduce risk of ADRD.

ACS Style

Nicholas T. Bott; Aidan Hall; Erica N. Madero; Jordan M. Glenn; Nami Fuseya; Joshua L. Gills; Michelle Gray. Face-to-Face and Digital Multidomain Lifestyle Interventions to Enhance Cognitive Reserve and Reduce Risk of Alzheimer’s Disease and Related Dementias: A Review of Completed and Prospective Studies. Nutrients 2019, 11, 2258 .

AMA Style

Nicholas T. Bott, Aidan Hall, Erica N. Madero, Jordan M. Glenn, Nami Fuseya, Joshua L. Gills, Michelle Gray. Face-to-Face and Digital Multidomain Lifestyle Interventions to Enhance Cognitive Reserve and Reduce Risk of Alzheimer’s Disease and Related Dementias: A Review of Completed and Prospective Studies. Nutrients. 2019; 11 (9):2258.

Chicago/Turabian Style

Nicholas T. Bott; Aidan Hall; Erica N. Madero; Jordan M. Glenn; Nami Fuseya; Joshua L. Gills; Michelle Gray. 2019. "Face-to-Face and Digital Multidomain Lifestyle Interventions to Enhance Cognitive Reserve and Reduce Risk of Alzheimer’s Disease and Related Dementias: A Review of Completed and Prospective Studies." Nutrients 11, no. 9: 2258.

Preprint content
Published: 01 August 2019
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BACKGROUND As the global prevalence of dementia continues to rise, multidomain lifestyle interventions that address modifiable risk factors associated with pathological cognitive decline are increasing. Although some digital options have been developed to increase the reach and scalability of these programs, because of cultural differences, the efficacy of the programs in one population cannot easily be generalized to populations in other countries. OBJECTIVE This investigation aimed to examine the usability and engagement of a digitally delivered multidomain cognitive lifestyle intervention developed in the United States for a Japanese population. METHODS This feasibility investigation utilized a quasi-experimental, single-arm, nonrandomized, longitudinal design where participants engaged in the behavioral intervention on a smartphone. Of the 559 participants that initially enrolled (age: mean 51 years, SD 7.5 years; 51.7% female [289/559]), 242 completed the final testing trial. Participants enrolled in a multidomain lifestyle program that consisted of (1) psychoeducational material, (2) physical activity tracker, (3) nutrition tracker, (4) audio-based meditations, and (5) health coaching. Engagement with the program was assessed through the total number of app sessions and the use of the exercise, diet, and meditation tracking features within the app. The total number of minutes exercised was collected through subjective user inputs, and nutrition was quantified by the Mediterranean-DASH Intervention for Neurodegenerative Delay diet adherence score. RESULTS Significant relationships existed between overall nutrition score and frequency of nutrition tracking (r=0.18), frequency of physical activity tracking (r=0.19), and the total number of minutes exercised (r=0.22). Total minutes exercised was significantly correlated with total app sessions (r=0.57), frequency of physical activity tracking (r=0.85), frequency of nutrition tracking (r=0.64), number of times participants meditated (r=0.46), and total lessons read (r=0.36). The number of completed lessons was significantly related to frequency of physical activity tracking (r=0.40), frequency of nutrition tracking (r=0.43), the total number of times participants meditated (r=0.35), and total minutes exercised (r=0.33). Dividing the cohort into two groups based on lesson completion (<10 lessons completed vs ≥10 lessons completed), significant differences were observed between the total minutes exercised, frequency of physical activity tracking, frequency of nutrition tracking, and total number of times participants meditated (all P values <.01). CONCLUSIONS Overall, this cross-cultural feasibility study in Japanese users demonstrated that the various engagement metrics were significantly correlated, and greater engagement was related to improved nutrition scores and increased time exercising. In addition, the relationships between lesson completion and other engagement metrics suggest that there may be value in exploring mechanisms that enhance lesson completion. Future research should examine the program in randomized control trials to more rigorously evaluate program efficacy.

ACS Style

Jordan Glenn; Erica Nicole Madero; Michelle Gray; Nami Fuseya; Mari Ikeda; Tomoo Kawamura; Yoshiko Arita; Nick Thomas Bott. Engagement With a Digital Platform for Multimodal Cognitive Assessment and Multidomain Intervention in a Japanese Population: Pilot, Quasi-Experimental, Longitudinal Study (Preprint). 2019, 1 .

AMA Style

Jordan Glenn, Erica Nicole Madero, Michelle Gray, Nami Fuseya, Mari Ikeda, Tomoo Kawamura, Yoshiko Arita, Nick Thomas Bott. Engagement With a Digital Platform for Multimodal Cognitive Assessment and Multidomain Intervention in a Japanese Population: Pilot, Quasi-Experimental, Longitudinal Study (Preprint). . 2019; ():1.

Chicago/Turabian Style

Jordan Glenn; Erica Nicole Madero; Michelle Gray; Nami Fuseya; Mari Ikeda; Tomoo Kawamura; Yoshiko Arita; Nick Thomas Bott. 2019. "Engagement With a Digital Platform for Multimodal Cognitive Assessment and Multidomain Intervention in a Japanese Population: Pilot, Quasi-Experimental, Longitudinal Study (Preprint)." , no. : 1.

Review
Published: 21 May 2019 in Journal of Alzheimer's Disease
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Alzheimer's disease (AD) is the most common form of dementia. With an aging population and no disease modifying treatments available, AD is quickly becoming a global pandemic. A substantial body of research indicates that lifestyle behaviors contribute to the development of AD, and that it may be worthwhile to approach AD like other chronic diseases such as cardiovascular disease, in which prevention is paramount. Exercise is an important lifestyle behavior that may influence the course and pathology of AD, but the biological mechanisms underpinning these effects remain unclear. This review focuses on how exercise can modify four possible mechanisms which are involved with the pathology of AD: oxidative stress, inflammation, peripheral organ and metabolic health, and direct interaction with AD pathology. Exercise is just one of many lifestyle behaviors that may assist in preventing AD, but understanding the systemic and neurobiological mechanisms by which exercise affects AD could help guide the development of novel pharmaceutical agents and non-pharmacological personalized lifestyle interventions for at-risk populations.

ACS Style

Hugo McGurran; Jordan M. Glenn; Erica N. Madero; Nicholas T. Bott. Prevention and Treatment of Alzheimer’s Disease: Biological Mechanisms of Exercise. Journal of Alzheimer's Disease 2019, 69, 311 -338.

AMA Style

Hugo McGurran, Jordan M. Glenn, Erica N. Madero, Nicholas T. Bott. Prevention and Treatment of Alzheimer’s Disease: Biological Mechanisms of Exercise. Journal of Alzheimer's Disease. 2019; 69 (2):311-338.

Chicago/Turabian Style

Hugo McGurran; Jordan M. Glenn; Erica N. Madero; Nicholas T. Bott. 2019. "Prevention and Treatment of Alzheimer’s Disease: Biological Mechanisms of Exercise." Journal of Alzheimer's Disease 69, no. 2: 311-338.

Preprint
Published: 18 January 2019
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BACKGROUND Hospitalized older adults often experience isolation and disorientation while receiving care, placing them at risk for many inpatient complications, including loneliness, depression, delirium, and falls. Embodied conversational agents (ECAs) are technological entities that can interact with people through spoken conversation. Some ECAs are also relational agents, which build and maintain socioemotional relationships with people across multiple interactions. This study utilized a novel form of relational ECA, provided by Care Coach (care.coach, inc): an animated animal avatar on a tablet device, monitored and controlled by live health advocates. The ECA implemented algorithm-based clinical protocols for hospitalized older adults, such as reorienting patients to mitigate delirium risk, eliciting toileting needs to prevent falls, and engaging patients in social interaction to facilitate social engagement. Previous pilot studies of the Care Coach avatar have demonstrated the ECA’s usability and efficacy in home-dwelling older adults. Further study among hospitalized older adults in a larger experimental trial is needed to demonstrate its effectiveness. OBJECTIVE The aim of the study was to examine the effect of a human-in-the-loop, protocol-driven relational ECA on loneliness, depression, delirium, and falls among diverse hospitalized older adults. METHODS This was a clinical trial of 95 adults over the age of 65 years, hospitalized at an inner-city community hospital. Intervention participants received an avatar for the duration of their hospital stay; participants on a control unit received a daily 15-min visit from a nursing student. Measures of loneliness (3-item University of California, Los Angeles Loneliness Scale), depression (15-item Geriatric Depression Scale), and delirium (confusion assessment method) were administered upon study enrollment and before discharge. RESULTS Participants who received the avatar during hospitalization had lower frequency of delirium at discharge (P<.001), reported fewer symptoms of loneliness (P=.01), and experienced fewer falls than control participants. There were no significant differences in self-reported depressive symptoms. CONCLUSIONS The study findings validate the use of human-in-the-loop, relational ECAs among diverse hospitalized older adults.

ACS Style

Nicholas Bott; Sharon Wexler; Lin Drury; Chava Pollak; Victor Wang; Kathleen Scher; Sharon Narducci. A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study (Preprint). 2019, 1 .

AMA Style

Nicholas Bott, Sharon Wexler, Lin Drury, Chava Pollak, Victor Wang, Kathleen Scher, Sharon Narducci. A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study (Preprint). . 2019; ():1.

Chicago/Turabian Style

Nicholas Bott; Sharon Wexler; Lin Drury; Chava Pollak; Victor Wang; Kathleen Scher; Sharon Narducci. 2019. "A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study (Preprint)." , no. : 1.

Journal article
Published: 09 November 2018 in JMIR Aging
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Background: Face-to-face multidomain lifestyle interventions have shown to be effective for improving or maintaining cognitive function in older adults at risk for dementia. Remotely delivered interventions could increase access to such solutions but first require evidence to support that these programs can successfully impact health outcomes. Objective: The objective of this study was to evaluate the impact of a remotely delivered multidomain lifestyle intervention, the virtual cognitive health (VC Health) program, on the cognitive function and mental health of older adults with subjective cognitive decline (SCD). Methods: A 52-week, prospective, single-arm, pre-post, remote nationwide clinical trial was conducted to measure the change in cognitive function, depression, and anxiety levels for older adults at risk of developing dementia who participated in the VC Health program. A Web-based study platform was used to screen, consent, and enroll participants across the United States. Participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test and Web-based assessments (which included the Patient Health Questionnaire [PHQ-9] and Generalized Anxiety Disorder [GAD-7] surveys) at baseline and weeks 12, 24, and 52; all data were collected remotely. Changes in RBANS, PHQ-9, and GAD-7 were assessed using 2-tailed paired t tests and nonparametric signed-rank tests. Results: Participants (N=82) were, on average, aged 64 years (range 60.0-74.9 years), 74% (61/82) female, 88% (72/82) white, and 67% (55/82) had a college degree or higher. At baseline, participants had a mean and median RBANS Total Index score of 95.9 (SD 11.1) and 95.5 (interquartile range, IQR=13). Participants experienced a mean and median increase of 5.8 (SD 7.4) and 6 (IQR=11) in RBANS Total Index score from baseline to week 52 (P<.001). Participants had a mean and median PHQ-9 score of 8.5 (SD 4.9) and 8 (IQR=6) at baseline and experienced a mean and median decrease of 3.8 (SD 4.1) and 4 (IQR=6) units in PHQ-9 score from baseline to week 52 (P<.001). At baseline, participants had a mean and median GAD-7 score of 6.2 (SD 4.5) and 5.5 (IQR=6) and experienced a mean and median decrease of 2.9 (SD 4.1) and 2 (IQR=5) units in GAD-7 score from baseline to week 52 (P<.001). Participants were engaged and very satisfied with various program components. Conclusions: In this study, older adults with SCD who were at risk for dementia experienced statistically significant improvements in their cognitive function, depression, and anxiety levels. These findings serve as initial evidence for the overall feasibility and effectiveness of the VC Health program to improve or maintain cognitive function in older adults who are experiencing SCD. Further research should be conducted to understand the degree to which the improvements are attributable to specific components of the intervention. Trial Registration: ClinicalTrials.gov NCT02969460; https://clinicaltrials.gov/ct2/show/NCT02969460 (Archived by WebCite at http://www.webcitation.org/73XOph9Qm) [JMIR Aging 2018;1(2):e12031]

ACS Style

Shefali Kumar; Jennifer La Tran; Heidi Moseson; Caroline Tai; Jordan M Glenn; Erica N Madero; Caitlyn Krebs; Nicholas Bott; Jessie L Juusola. The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study. JMIR Aging 2018, 1, e12031 .

AMA Style

Shefali Kumar, Jennifer La Tran, Heidi Moseson, Caroline Tai, Jordan M Glenn, Erica N Madero, Caitlyn Krebs, Nicholas Bott, Jessie L Juusola. The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study. JMIR Aging. 2018; 1 (2):e12031.

Chicago/Turabian Style

Shefali Kumar; Jennifer La Tran; Heidi Moseson; Caroline Tai; Jordan M Glenn; Erica N Madero; Caitlyn Krebs; Nicholas Bott; Jessie L Juusola. 2018. "The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study." JMIR Aging 1, no. 2: e12031.

Journal article
Published: 28 September 2018 in The American Journal of Geriatric Psychiatry
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We describe a comprehensive care model for Alzheimer's disease (AD) that improves value within 1-3 years after implementation by leveraging targeted outpatient chronic care management, cognitively protective acute care, and timely caregiver support. Using current best evidence, expert opinion, and macro-economic modeling, we designed a comprehensive care model for AD that improves the quality of care while reducing total per-capita healthcare spending by more than 15%. Cost savings were measured as reduced spending by payers. Cost estimates were derived from medical literature and national databases including both public and private US payers. All estimates reflect the value in 2015 dollars using a consumer price index (CPI) inflation calculator. Outcome estimates were determined at year 2, accounting for implementation and steady-state intervention costs. After accounting for implementation and recurring operating costs of approximately $9.5 billion, estimated net cost savings of between $13-41 billion can be accomplished concurrently with improvements in quality and experience of coordinated chronic care ($.01-6.8 billion), cognitively protective acute care ($8.7-26.6 billion), timely caregiver support ($4.3-7.5 billion), and enhanced caregiver efficiency ($4.1-7.2 billion). A high-value care model for AD may improve the experience of patients with AD while significantly lowering costs.

ACS Style

Nicholas T. Bott; Clifford C. Sheckter; Daniel Yang; Stephanie Peters; Brian Brady; Scooter Plowman; Soo Borson; Bruce Leff; Robert M. Kaplan; Terry Platchek; Arnold Milstein. Systems Delivery Innovation for Alzheimer Disease. The American Journal of Geriatric Psychiatry 2018, 27, 149 -161.

AMA Style

Nicholas T. Bott, Clifford C. Sheckter, Daniel Yang, Stephanie Peters, Brian Brady, Scooter Plowman, Soo Borson, Bruce Leff, Robert M. Kaplan, Terry Platchek, Arnold Milstein. Systems Delivery Innovation for Alzheimer Disease. The American Journal of Geriatric Psychiatry. 2018; 27 (2):149-161.

Chicago/Turabian Style

Nicholas T. Bott; Clifford C. Sheckter; Daniel Yang; Stephanie Peters; Brian Brady; Scooter Plowman; Soo Borson; Bruce Leff; Robert M. Kaplan; Terry Platchek; Arnold Milstein. 2018. "Systems Delivery Innovation for Alzheimer Disease." The American Journal of Geriatric Psychiatry 27, no. 2: 149-161.

Preprint
Published: 24 August 2018
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BACKGROUND Face-to-face multidomain lifestyle interventions have shown to be effective for improving or maintaining cognitive function in older adults at risk for dementia. Remotely delivered interventions could increase access to such solutions but first require evidence to support that these programs can successfully impact health outcomes. OBJECTIVE The objective of this study was to evaluate the impact of a remotely delivered multidomain lifestyle intervention, the virtual cognitive health (VC Health) program, on the cognitive function and mental health of older adults with subjective cognitive decline (SCD). METHODS A 52-week, prospective, single-arm, pre-post, remote nationwide clinical trial was conducted to measure the change in cognitive function, depression, and anxiety levels for older adults at risk of developing dementia who participated in the VC Health program. A Web-based study platform was used to screen, consent, and enroll participants across the United States. Participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test and Web-based assessments (which included the Patient Health Questionnaire [PHQ-9] and Generalized Anxiety Disorder [GAD-7] surveys) at baseline and weeks 12, 24, and 52; all data were collected remotely. Changes in RBANS, PHQ-9, and GAD-7 were assessed using 2-tailed paired t tests and nonparametric signed-rank tests. RESULTS Participants (N=82) were, on average, aged 64 years (range 60.0-74.9 years), 74% (61/82) female, 88% (72/82) white, and 67% (55/82) had a college degree or higher. At baseline, participants had a mean and median RBANS Total Index score of 95.9 (SD 11.1) and 95.5 (interquartile range, IQR=13). Participants experienced a mean and median increase of 5.8 (SD 7.4) and 6 (IQR=11) in RBANS Total Index score from baseline to week 52 (P<.001). Participants had a mean and median PHQ-9 score of 8.5 (SD 4.9) and 8 (IQR=6) at baseline and experienced a mean and median decrease of 3.8 (SD 4.1) and 4 (IQR=6) units in PHQ-9 score from baseline to week 52 (P<.001). At baseline, participants had a mean and median GAD-7 score of 6.2 (SD 4.5) and 5.5 (IQR=6) and experienced a mean and median decrease of 2.9 (SD 4.1) and 2 (IQR=5) units in GAD-7 score from baseline to week 52 (P<.001). Participants were engaged and very satisfied with various program components. CONCLUSIONS In this study, older adults with SCD who were at risk for dementia experienced statistically significant improvements in their cognitive function, depression, and anxiety levels. These findings serve as initial evidence for the overall feasibility and effectiveness of the VC Health program to improve or maintain cognitive function in older adults who are experiencing SCD. Further research should be conducted to understand the degree to which the improvements are attributable to specific components of the intervention. CLINICALTRIAL ClinicalTrials.gov NCT02969460;...

ACS Style

Shefali Kumar; Jennifer La Tran; Heidi Moseson; Caroline Tai; Jordan M Glenn; Erica N Madero; Caitlyn Krebs; Nicholas Bott; Jessie L Juusola. The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study (Preprint). 2018, 1 .

AMA Style

Shefali Kumar, Jennifer La Tran, Heidi Moseson, Caroline Tai, Jordan M Glenn, Erica N Madero, Caitlyn Krebs, Nicholas Bott, Jessie L Juusola. The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study (Preprint). . 2018; ():1.

Chicago/Turabian Style

Shefali Kumar; Jennifer La Tran; Heidi Moseson; Caroline Tai; Jordan M Glenn; Erica N Madero; Caitlyn Krebs; Nicholas Bott; Jessie L Juusola. 2018. "The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study (Preprint)." , no. : 1.

Journal article
Published: 13 August 2018 in JMIR Research Protocols
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A growing body of evidence supports the use of lifestyle interventions for preventing or delaying the onset of Alzheimer disease and other forms of dementia in at-risk individuals. The development of internet-delivered programs would increase the scalability and reach of these interventions, but requires validation to ensure similar effectiveness to brick-and-mortar options. We describe the study design, recruitment process, and baseline participant characteristics of the sample in the Virtual Cognitive Health (VC Health) study. Future analyses will assess the impact of the remotely delivered lifestyle intervention on (1) cognitive function, (2) depression and anxiety, and (3) various lifestyle behaviors, including diet, exercise, and sleep, in a cohort of older adults with subjective memory decline. Additional analyses will explore feasibility outcomes, as well as the participants' engagement patterns with the program. Older adults (aged 60-75 years) with subjective memory decline as measured by the Subjective Cognitive Decline 9-item (SCD-9) questionnaire, and who reported feeling worried about their memory decline, were eligible to participate in this single-arm pre-post study. All participants enrolled in the yearlong digital intervention, which consists of health coach-guided lifestyle change for improving diet, exercise, sleep, stress, and cognition. All components of this study were conducted remotely, including the collection of data and the administration of the intervention. We assessed participants at baseline, 12 weeks, 24 weeks, and 52 weeks with online surveys and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test. We will conduct intention-to-treat analysis on all outcomes. A total of 85 participants enrolled in the intervention and 82 are included in the study sample (3 participants withdrew). The study cohort of 82 participants comprises 61 (74%) female, 72 (88%) white, and 64 (78%) overweight or obese participants, and 55 (67%) have at least a college degree. The average baseline RBANS score was 95.9 (SD 11.1), which is within age-adjusted norms. The average SCD-9 score was 6.0 (SD 2.0), indicating minor subjective cognitive impairment at the beginning of the study. The average baseline Generalized Anxiety Disorder 7-item scale score was 6.2 (SD 4.5), and the average Patient Health Questionnaire 9-item score was 8.5 (SD 4.9), indicating mild levels of anxiety and depression at baseline. Internet-delivered lifestyle interventions are a scalable solution for the prevention or delay of Alzheimer disease. The results of this study will provide the first evidence for the effectiveness of a fully remote intervention and lay the groundwork for future investigations. ClinicalTrials.gov NCT02969460; http://clinicaltrials.gov/ct2/show/NCT02969460 (Archived by WebCite at http://www.webcitation.org/71LkYAkSh). RR1-10.2196/11368.

ACS Style

Nicholas Bott; Shefali Kumar; Caitlyn Krebs; Jordan M Glenn; Erica N Madero; Jessie L Juusola. A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study. JMIR Research Protocols 2018, 7, e11368 .

AMA Style

Nicholas Bott, Shefali Kumar, Caitlyn Krebs, Jordan M Glenn, Erica N Madero, Jessie L Juusola. A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study. JMIR Research Protocols. 2018; 7 (8):e11368.

Chicago/Turabian Style

Nicholas Bott; Shefali Kumar; Caitlyn Krebs; Jordan M Glenn; Erica N Madero; Jessie L Juusola. 2018. "A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study." JMIR Research Protocols 7, no. 8: e11368.

Journal article
Published: 24 July 2018 in Journal of Medical Internet Research
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Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: As eye tracking-based assessment of cognition becomes more widely used in older adults, particularly those at risk for dementia, reliable and scalable methods to collect high quality data are required. Eye tracking-based cognitive tests that utilize device-embedded cameras have the potential to reach large numbers of people as a screening tool for preclinical cognitive decline. However, in order to fully validate this approach, more empirical evidence about the comparability of eye tracking-based paradigms to existing cognitive batteries is needed. Objective: Using a population of clinically normal older adults, we examined the relationship between a 30-minute Visual Paired Comparison (VPC) recognition memory task and cognitive composite indices sensitive to subtle decline in domains associated with Alzheimer’s disease. Additionally, the scoring accuracy between software used with a commercial grade eye tracking camera (60 frames per second (FPS)) and a manually scored procedure used with a laptop-embedded web camera (3 FPS) on the VPC task were compared, as well as the relationship between VPC task performance and domain-specific cognitive function. Methods: A group of 49 clinically normal older adults completed a 30-min VPC recognition memory task with simultaneous recording of eye movements by a commercial-grade eye tracking camera and a laptop-embedded camera. Relationships between webcam VPC performance and the Preclinical Alzheimer Cognitive Composite (PACC) and NIH Toolbox Cognitive Battery (NIHTB-CB) were examined. Inter-rater reliability for manually scored tests was analyzed using Krippendorff’s kappa formula and we used Spearman’s Rho correlations to investigate the relationship between VPC performance scores with both cameras. We also examined the relationship between VPC performance with the device-embedded camera and domain-specific cognitive performance. Results: Modest relationships were seen between mean VPC NP and the PACC (r = .39, P = .007) and NIHTB-CB (r = .35, P = .03) composite scores, and additional individual neurocognitive task scores including letter fluency (r = .33, P = .024), category fluency (r = .36, P = .014), and Trail Making Test A (-.40, P = .006). Robust relationships were observed between the 60 FPS eye tracker and 3 FPS webcam on both trial-level VPC novelty preference (NP) (r = .82, P < .001) and overall mean VPC NP (r = .92 P < .001). Inter-rater agreement of manually scored web camera data was high (κ = .84). Conclusions: In a sample of clinically normal older adults, performance on a 30-min VPC task correlated modestly with computerized and paper-pencil based cognitive composites that serve as preclinical AD cognitive indices. The strength of these relationships did not differ between camera devices. We suggest that using a device-embedded camera is a reliable and valid way to accurately assess performance on VPC tasks and that these tasks correlate with existing cognitive composites.

ACS Style

Nicholas Bott; Erica N Madero; Jordan Glenn; Alexander Lange; John Anderson; Doug Newton; Adam Brennan; Elizabeth A Buffalo; Dorene Rentz; Stuart Zola. Device-Embedded Cameras for Eye Tracking–Based Cognitive Assessment: Validation With Paper-Pencil and Computerized Cognitive Composites. Journal of Medical Internet Research 2018, 20, e11143 .

AMA Style

Nicholas Bott, Erica N Madero, Jordan Glenn, Alexander Lange, John Anderson, Doug Newton, Adam Brennan, Elizabeth A Buffalo, Dorene Rentz, Stuart Zola. Device-Embedded Cameras for Eye Tracking–Based Cognitive Assessment: Validation With Paper-Pencil and Computerized Cognitive Composites. Journal of Medical Internet Research. 2018; 20 (7):e11143.

Chicago/Turabian Style

Nicholas Bott; Erica N Madero; Jordan Glenn; Alexander Lange; John Anderson; Doug Newton; Adam Brennan; Elizabeth A Buffalo; Dorene Rentz; Stuart Zola. 2018. "Device-Embedded Cameras for Eye Tracking–Based Cognitive Assessment: Validation With Paper-Pencil and Computerized Cognitive Composites." Journal of Medical Internet Research 20, no. 7: e11143.

Preprint
Published: 27 May 2018
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BACKGROUND As eye tracking-based assessment of cognition becomes more widely used in older adults, particularly those at risk for dementia, reliable and scalable methods to collect high-quality data are required. Eye tracking-based cognitive tests that utilize device-embedded cameras have the potential to reach large numbers of people as a screening tool for preclinical cognitive decline. However, to fully validate this approach, more empirical evidence about the comparability of eyetracking-based paradigms to existing cognitive batteries is needed. OBJECTIVE Using a population of clinically normal older adults, we examined the relationship between a 30-minute Visual Paired Comparison (VPC) recognition memory task and cognitive composite indices sensitive to a subtle decline in domains associated with Alzheimer disease. Additionally, the scoring accuracy between software used with a commercial grade eye tracking camera at 60 frames per second (FPS) and a manually scored procedure used with a laptop-embedded web camera (3 FPS) on the VPC task was compared, as well as the relationship between VPC task performance and domain-specific cognitive function. METHODS A group of 49 clinically normal older adults completed a 30-min VPC recognition memory task with simultaneous recording of eye movements by a commercial-grade eye-tracking camera and a laptop-embedded camera. Relationships between webcam VPC performance and the Preclinical Alzheimer Cognitive Composite (PACC) and National Institutes of Health Toolbox Cognitive Battery (NIHTB-CB) were examined. Inter-rater reliability for manually scored tests was analyzed using Krippendorff’s kappa formula, and we used Spearman’s Rho correlations to investigate the relationship between VPC performance scores with both cameras. We also examined the relationship between VPC performance with the device-embedded camera and domain-specific cognitive performance. RESULTS Modest relationships were seen between mean VPC novelty preference and the PACC (r=.39, P=.007) and NIHTB-CB (r=.35, P=.03) composite scores, and additional individual neurocognitive task scores including letter fluency (r=.33, P=.02), category fluency (r=.36, P=.01), and Trail Making Test A (–.40, P=.006). Robust relationships were observed between the 60 FPS eye tracker and 3 FPS webcam on both trial-level VPC novelty preference (r=.82, P<.001) and overall mean VPC novelty preference (r=.92 P<.001). Inter-rater agreement of manually scored web camera data was high (kappa=.84). CONCLUSIONS In a sample of clinically normal older adults, performance on a 30-minute VPC task correlated modestly with computerized and paper-pencil based cognitive composites that serve as preclinical Alzheimer disease cognitive indices. The strength of these relationships did not differ between camera devices. We suggest that using a device-embedded camera is a reliable and valid way to assess performance on VPC tasks accurately and that these tasks correlate...

ACS Style

Nicholas Bott; Erica N Madero; Jordan Glenn; Alexander Lange; John Anderson; Doug Newton; Adam Brennan; Elizabeth A. Buffalo; Dorene Rentz; Stuart Zola; Alex Lange. Device-Embedded Cameras for Eye-Tracking-Based Cognitive Assessment: Validation With Paper-Pencil and Computerized Cognitive Composites (Preprint). 2018, 1 .

AMA Style

Nicholas Bott, Erica N Madero, Jordan Glenn, Alexander Lange, John Anderson, Doug Newton, Adam Brennan, Elizabeth A. Buffalo, Dorene Rentz, Stuart Zola, Alex Lange. Device-Embedded Cameras for Eye-Tracking-Based Cognitive Assessment: Validation With Paper-Pencil and Computerized Cognitive Composites (Preprint). . 2018; ():1.

Chicago/Turabian Style

Nicholas Bott; Erica N Madero; Jordan Glenn; Alexander Lange; John Anderson; Doug Newton; Adam Brennan; Elizabeth A. Buffalo; Dorene Rentz; Stuart Zola; Alex Lange. 2018. "Device-Embedded Cameras for Eye-Tracking-Based Cognitive Assessment: Validation With Paper-Pencil and Computerized Cognitive Composites (Preprint)." , no. : 1.

Book chapter
Published: 31 January 2017 in Encyclopedia of Geropsychology
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Subjective cognitive decline (SCD); Subjective cognitive impairment (SCI); Subjective memory complaints (SMC); Subjective memory decline (SMD); Subjective memory impairment (SMI) Subjective memory is one’s perceived memory ability, independent of objective standards or performance. Subjective memory reflects one’s perception about his or her personal memory functioning. It is a construct to be quantified, studied, and understood in clinical practice and can be referred to as subjective memory complaints (SMC), subjective memory decline (SMD), subjective cognitive decline (SCD), subjective memory impairment (SMI), and subjective cognitive impairment (SCI) (Edmonds et al. 2014; Stewart 2012). The precision and utility of the construct of subjective memory performance has been scrutinized since its introduction as a potential variable of interest for older adults at risk of dementia (Stewart 2012). Studies remain mixed regarding its reliab ...

ACS Style

Nicholas T. Bott; Nathan Hantke; Viktoriya Samarina. Subjective Memory. Encyclopedia of Geropsychology 2017, 2312 -2319.

AMA Style

Nicholas T. Bott, Nathan Hantke, Viktoriya Samarina. Subjective Memory. Encyclopedia of Geropsychology. 2017; ():2312-2319.

Chicago/Turabian Style

Nicholas T. Bott; Nathan Hantke; Viktoriya Samarina. 2017. "Subjective Memory." Encyclopedia of Geropsychology , no. : 2312-2319.

Book chapter
Published: 31 January 2017 in Encyclopedia of Geropsychology
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Adaptation; Cognitive strategies; Cognitive training; Compensation Cognitive rehabilitation refers to therapy designed to restore, substitute, or compensate for cognitive abilities lost due to injury or illness. Cognitive rehabilitation typically refers to training targeting improvement of skill by regaining (reestablishing or strengthening) abilities that were intact prior to the loss. The other focus of cognitive rehabilitation is developing compensatory strategies for lost abilities when they cannot be regained. In contrast, the term cognitive intervention refers to targeted training of a particular cognitive skill or domain for the purpose of enhancement regardless of the baseline state of cognitive abilities. As such, many cognitive interventions target healthy functioning individuals. Distinct from rehabilitation and intervention, cognitive stimulation therapy refers to a brief psychological intervention used to provide general stimulation of cognitive abilities ...

ACS Style

Nicholas T. Bott; Abigail Kramer. Cognitive Rehabilitation. Encyclopedia of Geropsychology 2017, 544 -551.

AMA Style

Nicholas T. Bott, Abigail Kramer. Cognitive Rehabilitation. Encyclopedia of Geropsychology. 2017; ():544-551.

Chicago/Turabian Style

Nicholas T. Bott; Abigail Kramer. 2017. "Cognitive Rehabilitation." Encyclopedia of Geropsychology , no. : 544-551.

Review
Published: 07 September 2016 in Frontiers in Psychology
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Background: The Cotard delusion (CD) is one of a variety of narrowly defined monothematic delusions characterized by nihilistic beliefs about the body’s existence or life itself. The presence of CD within the context of schizophrenia is rare (<1%), and remains understudied. Case: ‘Mr. C’ is a 58-year-old veteran with a prior diagnosis of schizophrenia, who presented with CD in the context of significant depression, suicidal ideation (SI), violence, and self-harm behavior. He perseverated in his belief that he was physically dead and possessed by demons for several weeks. This delusion was reinforced by his religious belief that life was an attribute of God, and by inference, he as a human, was dead. His condition gradually improved over the course of treatment with Divalproex and quetiapine with discussions about the rationale for his belief. Upon discharge, Mr. C. demonstrated awareness of his fixation on death and an ability to redirect himself. Discussion: This case highlights the need to better understand the co-occurrence of CD in schizophrenia, their differentiation, the increased risk of violence and self-harm behavior in this presentation, and how specific events and religious factors can influence delusional themes of CD. Pharmacotherapy and aspects of cognitive-behavioral therapy (CBT) may be effective in ameliorating these symptoms in CD.

ACS Style

Nicholas Bott; Corey Keller; Malathy Kuppuswamy; David Spelber; Joshua Zeier. Cotard Delusion in the Context of Schizophrenia: A Case Report and Review of the Literature. Frontiers in Psychology 2016, 7, 1351 .

AMA Style

Nicholas Bott, Corey Keller, Malathy Kuppuswamy, David Spelber, Joshua Zeier. Cotard Delusion in the Context of Schizophrenia: A Case Report and Review of the Literature. Frontiers in Psychology. 2016; 7 ():1351.

Chicago/Turabian Style

Nicholas Bott; Corey Keller; Malathy Kuppuswamy; David Spelber; Joshua Zeier. 2016. "Cotard Delusion in the Context of Schizophrenia: A Case Report and Review of the Literature." Frontiers in Psychology 7, no. : 1351.