Browsing by Author "Soto, Isabel"
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Item Assessing Cognitive Function: The Role of the Memory Alteration Test in Predicting Stroop Color-Word Performance within the Self-Management Program for Brain Health(2024-03-21) Aboutaj, Amin; Ross, Sarah; Soto, Isabel; Severance, JenniferPurpose: The Self-Management Program for Brain Health is designed to empower participants to make lifestyle changes that enhance cognitive function and potentially delay dementia onset. This study investigates the predictive relationship between the Memory Alteration test and Stroop Color-Word (Stroop CW) performance in these participants, aiming to contribute valuable insights to the complex interplay between memory and executive processing abilities. Methods: Cognitively healthy adults (n = 21, age range 56–90) participated in the study, meeting inclusion criteria and undergoing vital sign assessment, Memory Alteration, and Stroop CW tests. The Memory Alteration test, a reliable screening tool, employed a cut-off of < 40 for cognitive impairment. Stroop CW raw scores were age-corrected, and T-scores were obtained. Statistical analyses included correlation coefficient (r) and p-value calculations. Results: A statistically significant positive correlation (r = 0.55, p = 0.009) between Memory Alteration and Stroop CW scores was observed. Subgroup analysis confirmed the hypothesis, revealing a consistent correlation pattern for those scoring below (mean Memory Alteration 37.86±0.55, Stroop CW 48.43±2.32, r = 0.88, p = 0.009) and above (mean Memory Alteration 44.93±0.85, Stroop CW 50.79±1.89, r = 0.67, p = 0.009) the normal Memory Alteration cut-off of 40. Conclusions: The study supports the predictive ability of the Memory Alteration test on Stroop CW performance in cognitively healthy adults. It underscores the clinical relevance of the Memory Alteration test as a reliable screening tool for early cognitive impairment and processing speed changes. Clinicians are encouraged to become familiar with the Memory Alteration test, considering its inclusion as an additional cognitive screening tool. By adding this brief and non-invasive assessment into routine practice, healthcare professionals can enhance their ability to identify subtle cognitive changes early on, facilitating proactive interventions and contributing to improved patient outcomes. Limitations include sample size and variability, suggesting the need for larger, more diverse samples in future research. The ongoing Self-Management Program for Brain Health presents an opportunity to address these limitations and advance our understanding of cognitive assessment and brain health.Item Establishing Equivalent Aerobic Exercise Parameters Between Early-Stage Parkinson's Disease and Pink1 Knockout Rats(IOS Press, 2022-06-28) Salvatore, Michael F.; Soto, Isabel; Kasanga, Ella A.; James, Rachael; Shifflet, Marla K.; Doshier, Kirby; Little, Joel T.; John, Joshia; Alphonso, Helene M.; Cunningham, J. Thomas; Nejtek, Vicki A.BACKGROUND: Rodent Parkinson's disease (PD) models are valuable to interrogate neurobiological mechanisms of exercise that mitigate motor impairment. Translating these mechanisms to human PD must account for physical capabilities of the patient. OBJECTIVE: To establish cardiovascular parameters as a common metric for cross-species translation of aerobic exercise impact. METHOD: We evaluated aerobic exercise impact on heart rate (HR) in 21 early-stage PD subjects (Hoehn Yahr /=3 months, >/=3x/week. In 4-month-old Pink1 knockout (KO) rats exercising in a progressively-increased treadmill speed regimen, we determined a specific treadmill speed that increased HR to an extent similar in human subjects. RESULTS: After completing aerobic exercise for approximately 30 min, PD subjects had increased HR approximately 35% above baseline ( approximately 63% maximum HR). Motor and cognitive test results indicated the exercising subjects completed the timed up and go (TUG) and trail-making test (TMT-A) in significantly less time versus exercise-naive PD subjects. In KO and age-matched wild-type (WT) rats, treadmill speeds of 8-10 m/min increased HR up to 25% above baseline ( approximately 67% maximum HR), with no further increases up to 16 m/min. Exercised KO, but not WT, rats showed increased locomotor activity compared to an age-matched exercise-naive cohort at 5 months old. CONCLUSION: These proof-of-concept results indicate HR is a cross-species translation parameter to evaluate aerobic exercise impact on specific motor or cognitive functions in human subjects and rat PD models. Moreover, a moderate intensity exercise regimen is within the physical abilities of early-stage PD patients and is therefore applicable for interrogating neurobiological mechanisms in rat PD models.Item Is there a Neurobiological Rationale for the Utility of the Iowa Gambling Task in Parkinson's Disease?(IOS Press, 2021-04-13) Salvatore, Michael F.; Soto, Isabel; Alphonso, Helene M.; Cunningham, Rebecca L.; James, Rachael; Nejtek, Vicki A.Up to 23% of newly diagnosed, non-demented, Parkinson's disease (PD) patients experience deficits in executive functioning (EF). In fact, EF deficits may occur up to 39-months prior to the onset of motor decline. Optimal EF requires working memory, attention, cognitive flexibility, and response inhibition underlying appropriate decision-making. The capacity for making strategic decisions requires inhibiting imprudent decisions and are associated with noradrenergic and dopaminergic signaling in prefrontal and orbitofrontal cortex. Catecholaminergic dysfunction and the loss of noradrenergic and dopaminergic cell bodies early in PD progression in the aforementioned cortical areas likely contribute to EF deficits resulting in non-strategic decision-making. Thus, detecting these deficits early in the disease process could help identify a significant portion of individuals with PD pathology (14-60%) before frank motor impairment. A task to evaluate EF in the domain of non-strategic decision-making might be useful to indicate the moderate loss of catecholamines that occurs early in PD pathology prior to motor decline and cognitive impairment. In this review, we focus on the potential utility of the Iowa Gambling Task (IGT) for this purpose, given significant overlap between in loss of dopaminergic and noradrenergic cells bodies in early PD and the deficits in catecholamine function associated with decreased EF. As such, given the loss of catecholamines already well-underway after PD diagnosis, we evaluate the potential utility of the IGT to identify the risk of therapeutic non-compliance and a potential companion approach to detect PD in premotor stages.Item Lessons Learned from Age-Friendly, Team-Based Training(MDPI, 2023-08-25) Murphy, Sara C.; Severance, Jennifer J.; Camp, Kathlene; Knebl, Janice; Fairchild, Thomas J.; Soto, IsabelAccording to the Institute of Medicine, immediate steps must be taken across the United States to educate and train the healthcare workforce to work collaboratively to address the needs of the growing older adult population. The Geriatric Practice Leadership Institute (GPLI) was designed to support professional teams working in acute and post-acute care in transforming their organization into a designated Age-Friendly Health System. The program was built around the Institute for Healthcare Improvement's Age-Friendly Health Systems 4Ms framework. This framework focuses on What Matters, Medication, Mentation, and Mobility (the 4Ms) in supporting care for older adults. The GPLI program is an online, seven-month team-based program with four to seven participants from one organization per team. Additionally, each team selected, developed, and completed a quality improvement project based on Age-Friendly Health Systems 4Ms. The curriculum also includes organizational culture, leadership, and interprofessional team-building modules. Using a post-completion survey, the experiences of 41 participants in the GPLI program were assessed. All respondents found the information in the program 'very' or 'extremely' valuable, and their executive sponsor 'very' or 'extremely' valuable in supporting their team's involvement and project. The GPLI program has trained over 200 healthcare professionals and teams that have successfully implemented projects across their organizations.