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Gambling card game crossword hypertension symptoms

Postby Shakarisar В» 30.11.2019

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NCBI Bookshelf. This chapter explores interventions that are aimed at improving cognition or slowing cognitive decline but that are not aimed at specific risk factors. Among the many approaches that fall into this category are cognitive stimulation through memory and other cognitive skills training, participation in the arts, technology-based cognitive stimulation, electrical stimulation, medications, and chemical stimulation such as the use of nootropic drugs or supplements.

The chapter reviews studies that examine the effects on cognition of combining several interventions e. There has been considerable scholarly and commercial interest over the past several years in the question of whether cognitive stimulation, either through such everyday activities as completing crossword puzzles, participating in a book club, playing card games, learning to play a musical instrument, and learning a new language see Chapter 4A or through more formal training, can assist in the maintenance or enhancement of cognitive function as people age.

A second, equally important question is whether cognitive stimulation and training will transfer to real-world activities and tasks i. For example, can a computer-based memory training program help people better remember their shopping list, medical and other appointments, and the names and faces of new acquaintances?

Or can computer-based, cognitive training improve driving performance and safety? Fortunately, an increasing number of randomized controlled trials RCTs are assessing whether cognitive training, such as adaptive computer-based programs, can create improvements in trained performance and whether the benefits of such training will transfer to untrained tasks and skills.

In general, these studies reveal that older adults can indeed benefit from training, albeit often at a slower rate than younger adults do Baltes et al.

Transfer effects benefits for untrained-for tasks are often quite limited, as a study by Ball and colleagues illustrates. In this study, the largest RCT of cognitive training to date, 2, older adults were randomized among three training groups training for memory, reasoning, and speed of processing and a no-contact control group.

Participants did improve on the trained tasks and other measures of these processes. However, no significant transfer occurred between the trained and untrained cognitive processes e. Interestingly, the benefits of training were still observed for the reasoning and speed-of-processing groups, as compared with the control group, after 10 years. Participants in each of the three training groups also reported less difficulty with instrumental activities of daily living IADLs , although no differences were observed for the performance-based everyday activities Rebok et al.

The IADL results should be interpreted with caution, since they might be partly attributable to expectancy differences between the training groups and the no-contact controls Boot et al. Another major focus of the cognitive training literature has been on improving working memory also see Chapter 2 , on which many other cognitive processes depend Bopp and Verhaeghen, ; Hale et al.

It is now relatively well established that young adults show near-transfer effects with working memory. However, the transfer results for older adults have been mixed, with some studies failing to observe any transfer, even to similar memory tasks Dahlin et al.

A number of factors that might mediate transfer have been suggested, including age, health, general cognitive ability, baseline performance, motivation, and expectancies Boot et al. Another approach to strengthening cognitive skills for older adults has been the use of video games, which employ a somewhat different set of training strategies than the computer-based training. For example, Anguera and colleagues worked with video games incorporating cognitive training tasks that have shown some promise in training and transfer in the scientific literature.

A study by Smith and colleagues used a commercially available adaptive cognitive training program focused on auditory detection, discrimination, and comprehension. The researchers compared an experimental group to an active control group that watched educational videos 1 hour daily for 40 sessions.

Older adults in the active group improved, relative to the control group, on auditory measures from the Repeatable Battery for the Assessment of Neuropsychological Status as well as on other measures of attention and memory. Effect sizes were generally small to modest, and a subset of these effects was maintained over a 3-month period Nouchi et al.

Not all video game-based cognitive training programs have been as successful, with some failing to find any transfer of training effects Ackerman et al. Research on the use of video games designed for enjoyment rather than specifically for cognitive training has produced a mixed pattern of effects in older adults, with some showing transfer effects Basak et al.

In this report the committee does not attempt to compare one approach to cognitive training with another; rather, it considers the overall literature on this topic. The committee recognizes that future studies will better inform the research community and the general public about the effectiveness of these approaches to training, especially in whether the skills they support transfer to everyday tasks and challenges.

Ongoing debate by experts in the field about the utility of commercial cognitive training games Cognitive Training Data, ; Stanford Center on Longevity, points to the need for careful evaluation of these efforts. Given the early stage of research in this field and the need to demonstrate and validate transfer effects from cognitive training products to real-life situations, consumers need information from independent evaluations of commercial cognitive training products.

Questions to be examined by consumer organizations and evaluation researchers include. Furthermore, the committee recommends a review of regulatory policies and guidelines see Recommendations section and the development of consumer product evaluation criteria for cognition-related products see Chapter 6. In summary, the literature on cognitive stimulation and cognitive training is promising, in that studies have shown that older adults can improve on trained abilities, albeit often at a slower pace than that of younger adults for an exception, see Kramer et al.

Studies of the transfer of training effects to other tasks have had mixed results, with few showing transfer effects extending to tasks that are dissimilar to the training tasks including transfer to real-world tasks and skills. As the developers of cognitive training products strive to demonstrate the benefits of these products in real-life situations, claims regarding the effectiveness of their products will require careful evaluation by consumers and in regulatory review. Engagement in the arts has been gaining increasing interest as a potential intervention to maintain or improve a variety of aspects of health, including cognition.

The state of the science regarding the impact of participation in writing, theater, music, dance, and visual arts has been reviewed Noice et al. Much of the published literature reports the results of studies employing quasi-experimental and intervention designs. Moreover, many of the studies have substantial limitations in design and implementation e. Methodological rigor might be improved by creating teams of researchers who have content and research expertise. To date, some RCT evidence supports the use of theatrical acting, dance, and piano playing to improve specific aspects of cognition e.

However, many of the studies have inconsistent results or do not show persistent benefits. A 6-month, once-weekly dance intervention was found to improve many aspects of cognitive and physical function along with subjective well-being, without causing any improvement in physical fitness Kattenstroth et al. Furthermore, virtually no studies directly compare different arts interventions.

In summary, despite the limitations of existing research, the results are promising. Additional studies on the influence of the arts on cognitive health are needed that have the methodological rigor that teams of researchers with expertise in the arts, cognition, and methodology can bring. Continued controversy exists on the usefulness of medications and pharmacologics for preventing cognitive decline and for enhancing or improving cognitive function in older adults.

Several medications evaluated over the past decade are thought to have cognitive-enhancing properties either directly or through disease modification. Although a few have been found to slow cognitive decline in older people with dementia, the few controlled studies in people without dementia have had mostly mixed or no results. The majority of these studies are observational, have some methodological shortcomings in design, and vary widely in how they measured cognitive function.

This section highlights a few specific pharmacologics and introduces the category of nootropic medications. As noted in Chapter 4B , there also are a number of medications that can cause cognitive decline.

Cognitive outcomes have been examined as secondary outcomes in some studies, but few studies have focused specifically on cognitive outcomes. A prospective cohort study looked at the effects of low doses of acetylsalicylic acid on women who had high cardiovascular disease risk and were free of dementia; the women given the acetylsalicylic acid showed smaller declines in Mini-Mental State Examination MMSE scores than a comparison group, but the differences in scores were small.

There were no differences between the groups for risk of dementia Kern et al. Study participants taking acetylsalicylic acid declined on several measures Waldstein et al.

Studies of the effects of hormone therapy on cognitive function have found very small or adverse effects. A 4-year RCT of hormone treatment in postmenopausal women with cardiovascular disease did not find improvements in cognitive function compared to the use of a placebo Grady et al. A Cochrane review of 16 double-blind RCTs showed no effects of hormone replacement therapy either estrogen alone or in combination with progestagen in preventing cognitive impairment Lethaby et al.

Participants in the meta-analysis were followed for an average of 4 to 5 years, and some negative effects were found after 1 year of estrogen replacement therapy and 3 and 4 years of the combined form.

Continued controversy exists regarding the hypothesis that hormone replacement therapy may confer cognitive and other benefits depending on the timing, formulation, dosage, and duration of treatment, and additional research is needed Maki, Some have argued that cognition and verbal memory, in particular, may benefit from early hormone therapy, although this may apply only to specific combinations of hormones Maki, ; Sherwin et al.

Several trials are under way to attempt to address some of the questions regarding hormone therapy safety and to ascertain its impact on cognitive outcomes. The KEEPS Cognitive and Affective Study is a multicenter clinical trial investigating the benefits of hormone replacement therapies administered to perimenopausal women.

This study includes women 42 to 58 years of age. Final results have not yet been published NIH, Nootropics are a broad range of medications, supplements, and nutriceuticals that aim to stimulate cognitive performance or facilitate learning.

Most have not been evaluated in clinical trials of older people without dementia and are not focused on preventing or remediating decline. Nootropics have been classified by their mechanism of action into 19 separate categories Froestl et al. Some are intended to enhance cognition directly, whereas others are reputed to enhance neuronal health. Accordingly, many studies of presumed nootropics have focused on specific situations e.

Classes of nootropics for which some evidence exists about their efficacy in people who do not have dementia include. The potential harms of medications and pharmacologics also need to be considered, including bleeding and effects on the central nervous and gastrointestinal systems. The committee did not identify evidence that nootropic compounds lead to long-term improvement or the preservation of cognition.

Studies that have looked for any cognition-enhancing properties of these substances have been limited by various methodological shortcomings and the risk of bias, including the lack of a consistent and standard definition for improved cognition, a paucity of RCTs, variability in the measurement of cognitive change or improvement, the short-term scale of the follow-up, and variations in drug formulations, dosages, and duration of treatment.

Some of the studies cited above were designed to evaluate other questions or conditions such as cardiovascular disease or dementia. The studies that showed minor improvements in cognitive measures did not demonstrate clinically important changes, and their impact on cognitive functioning and daily life was less clear.

In conclusion, although the situation may become clearer over time with further RCTs and larger studies, no consistent associations have yet been found. No currently available medication, either prescribed or over-the-counter, has been shown to effectively delay cognitive decline or enhance or promote cognition in healthy older adults.

Gingko biloba, an herbal extract used as a part of traditional Chinese medicine, is sold as a nutritional supplement Birks and Grimley Evans, Numerous mechanisms have been proposed for its possible benefits, including antioxidant effects, mitochondrial protection, the promotion of hippocampal neurogenesis, decreasing blood viscosity, and the enhancing of microperfusion in the brain Amieva et al. In a prospective study of 3, cognitively healthy French men and women who were age 65 years and older at baseline and who were followed for 20 years, the scores of gingko users declined less than did those of non-supplement users on the MMSE Amieva et al.

By contrast, in a large RCT conducted in 3, Americans age 72 to 96 years, twice-daily supplementation with mg of gingko did not affect the rate of change in scores on the MMSE compared with study participants receiving a placebo, over 6 years of follow-up Snitz et al.

A recent meta-analysis that examined the effects of gingko on cognition did not separately examine the subgroup without dementia or mild cognitive impairment Tan et al. Given the current results of RCTs, gingko is not considered effective in preventing cognitive decline. Coffee and tea, purportedly because of their caffeine content, are central nervous system stimulants, which increase alertness and arousal.

The literature on caffeine's effects on cognition is inconsistent but has some support in both animal and human studies. In laboratory studies of older rats, 8 weeks of coffee-supplemented diets resulted in enhanced performance on psychomotor testing and on a working memory task; the most beneficial dose was equivalent to 10 cups of coffee per day Shukitt-Hale et al. Based on further tests in which caffeine alone did not appear to explain all of the enhanced cognitive effects, the authors concluded that other bioactive compounds in coffee may play a role Shukitt-Hale et al.

In humans, short-term studies of caffeine have demonstrated improved perceptual speed and vigilance Childs and de Wit, In a recent laboratory study of 24 healthy older adults who were asked to perform a demanding working memory task and undergo functional magnetic resonance imaging fMRI , the activity in the part of the brain where working memory takes places was enhanced with acute caffeine administration compared to a placebo Haller et al.

Reviews of prospective studies have found considerable variation in their results Arab et al. In a comprehensive review, 3 of 11 prospective studies and 4 of 7 cross-sectional studies found associations between caffeine intake and cognitive outcomes, with these associations being more consistent among women and for coffee consumption Beydoun et al.

Some studies found modestly reduced levels of cognitive decline associated with caffeine intake, especially coffee, while other studies showed non-significant or no associations or evidence only for coffee intake, or benefit only for women or specific exposures. For example, in the Cardiovascular Health Study 2, women, 2, men , tea and coffee intake were associated with less cognitive decline in women but not in men Arab et al. Among 2, women age 65 years and older who were at high vascular risk and participated in the Women's Antioxidant Cardiovascular Study, consumption of caffeinated coffee, but not tea, cola, or chocolate intake, was associated with a slower cognitive decline, including slower declines in global cognition, verbal memory, and category fluency Vercambre et al.

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Re: gambling card game crossword hypertension symptoms

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