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Cognitive Reserve Exercise

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Pt is a 69 y/o female referred to skilled PT due to decline in ADL’s of transfer and gait, BLE muscle weakness with decreased coordination, increasing confusion and required increasing assistance with functional ADL’s. Pt was noted with 2 fall incidents on 3/3/2018 and 3/19/2018. PMH: Alzheimer’s disease, cellulitis, hypertension, hyperlipidemia, depressive disorder. PLOF: a resident in assistive living facility (ALF), mod I with ADL’s and self care, bed mobility and transfer, SBA with ambulation w/o AD. CLOF: gait with no AD and SBA for 150’, standing dynamic balance at fair-, BLE coordination at fair-. Pt’s goal is return to prior level of function of I. The following article exploring cognitive reserve might help the patient as well as people …show more content…

There is a reverse dose-response relationship between dementia risk and increased duration of exposure to reserve-enhancing factors over the life course.1 This may be explained by the environment, such as mental stimulation and physical exercise, influencing brain plasticity. Mental stimulation may increase synaptogenesis, and physical exercise may promote non-neuronal components of the brain. The ability of the brain to response to environmental stimuli by adding new neuron or by activating compensatory processes could be influenced by environment and sustained in late life. Also, this study found no evidence of an interaction between genetic predisposition (APOE e4 status) and cognitive reserve factors over the life course on dementia risk. This suggests that protective effects of cognitive reserve on dementia operate independently of genetic predisposition to the disease. Enhancing neuroplasticity by reserve-enhancing factors may compensate for the deterioration of the brain function to the same extent in both APOE e4 carriers and non-carriers. Conclusion of this study is the importance of adopting a life course enhancing cognitive reserve, which prevents or postpones dementia occurrence. Even late-life activity influence reduced risk of dementia, so it is never too late to initiate intervention enhancing cognitive factors. Still intervention at earlier life period might more beneficial because of greater exposure to cognitive reserve-enhancing factors lower risk of dementia. Finally, cumulative exposure to reserve-enhancing factors over the lifespan equally effective both individuals with and without genetic

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