Araştırma Makalesi
Alzheimer Hastalarında Kas İskelet Problemleri ve Kognitif Bozukluklar Arasındaki İlişkinin Değerlendirilmesi
Öz
Amaç: Bu çalışmanın amacı, Alzheimer hastalığı (AH) olan bireylerde görülebilecek kas-iskelet sistemi sorunları ile bilişsel bozuklukları değerlendirmek ve bu sorunlar arasındaki etkileşimi belirlemektir.
Gereç ve Yöntemler: Çalışmaya nöroloji doktoru tarafından AH tanısı konulan toplam 25 birey dahil edilmiştir. Katılımcıların demografik verileri kaydedilmiş, postür analizi yapılmış ve Standardize Mini Mental Test (SMMT), Barthel İndeksi (Bİ) ve Global Yıkım Ölçeği (GYÖ) uygulanmıştır.
Bulgular: Postür analizi sonuçlarında; %80’ninde başın anterior tilti, %76’sında omuz protraksiyonu, %8’inde çökük göğüs tipi varlığı, %84’ünde torakal kifozda artış olduğu, %12’inde genu varum varlığı ve %32’sinde halluks valgus varlığı tespit edildi. Bireylerin SMMT sonuçları ile Bİ ve GYÖ sonuçları arasında anlamlı ilişki olduğu görüldü (p=0.024 ve p=0.002). Ayrıca GYÖ evreleri arttıkça Bİ’deki bağımlılık düzeylerinin anlamlı olarak arttığı tespit edilirken (p=0.008) eğitim düzeyleri ile GYÖ evreleri arasında anlamlı bir ilişki olmadığı tespit edildi.
Sonuç: Demans ve tam fonksiyonel bağımlılık yaşayan AH'li bireylerde kas-iskelet sistemi bozukluklarının gelişmesi muhtemeldir. Bu nedenle, tıbbi tedavi ile birlikte fizyoterapi uygulamalarının teşvik edilmesi, fonksiyonel bağımlılığı ve bilişsel bozukluğu iyileştirmek için önemlidir.
Anahtar Kelimeler
Etik Beyan
Araştırma, ilgi Klinik Araştırmalar Etik Kurulu tarafından 23.12.2014 tarihli 2015/11 no’lu karar ile onaylandı. Tüm katılımcıların hakları korundu ve Helsinki Deklarasyonu ilkelerine uygun olarak yazılı ve sözlü bilgilendirilmiş onam alındı.
Kaynakça
- 1. Mehta RI, Schneider JA. What is ‘Alzheimer's disease’? The neuropathological heterogeneity of clinically defined Alzheimer's dementia. Current opinion in neurology 2021; 34(2):237-45.
- 2. Patterson C. World alzheimer report 2018. 2018.
- 3. Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus S, Schneider LS, Selbæk G, Teri L, Mukadamet N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet 2020; 396(10248):413-46.
- 4. Oh ES, Rabins PV. Dementia (Japanese Version). Annals of internal medicine 2019; 171(5):JITC33-JITC48.
- 5. Sheppard O, Coleman M. Alzheimer’s disease: etiology, neuropathology and pathogenesis. Exon Publications 2020:1-21.
- 6. De la Rosa A, Olaso-Gonzalez G, Arc-Chagnaud C, Millan F, Salvador-Pascual A, García-Lucerga C, Blasco-Lafarga C, Garcia-Dominguez E, Carretero A, Correas AG, Vina J, Gomez-Cabreraet MC. Physical exercise in the prevention and treatment of Alzheimer's disease. Journal of sport and health science 2020; 9(5):394-404.
- 7. Zhang X-X, Tian Y, Wang Z-T, Ma Y-H, Tan L, Yu J-T. The epidemiology of Alzheimer’s disease modifiable risk factors and prevention. The journal of prevention of Alzheimer's disease 2021; 8:313-21.
- 8. Tarawneh R, Holtzman DM. The clinical problem of symptomatic Alzheimer disease and mild cognitive impairment. Cold Spring Harbor perspectives in medicine 2012; 2(5):a006148.
- 9. Schneider JA, Arvanitakis Z, Leurgans SE, Bennett DA. The neuropathology of probable Alzheimer disease and mild cognitive impairment. Annals of neurology 2009; 66(2):200-8. Epub 2009/09/11. doi: 10.1002/ana.21706. PubMed PMID: 19743450; PubMed Central PMCID: PMC2812870.
- 10. Gezici S, Şekeroğlu N. Alzheimer Hastalığının Gelişimsel Sürecinde ve Tedavisinde Potansiyel Öneme Sahip Tıbbi Bitkiler ve Fitokimyasallar. Hacettepe University Journal of the Faculty of Pharmacy 2022; 42(2):121-33.
- 11. Friedlander AH, Norman DC, Mahler ME, Norman KM, Yagiela JA. Alzheimer's disease: psychopathology, medical management and dental implications. The Journal of the American Dental Association 2006; 137(9):1240-51.
- 12. Ogama N, Endo H, Satake S, Niida S, Arai H, Sakurai T. Impact of regional white matter hyperintensities on specific gait function in Alzheimer's disease and mild cognitive impairment. Journal of Cachexia, Sarcopenia and Muscle 2021; 12(6):2045-55.
- 13. Pinto TC, Machado L, Bulgacov TM, Rodrigues-Júnior AL, Costa ML, Ximenes RC, Sougey EB. Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly? International psychogeriatrics 2019; 31(4):491-504.
- 14. Suryadevara V, Klüppel M, Del Monte F, Willis MS. The Unraveling: Cardiac and Musculoskeletal Defects and Their Role in Common Alzheimer Disease Morbidity and Mortality. The American Journal of Pathology 2020; 190(8):1609-21.
- 15. Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues J-F, Alpe´rovitch, A. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology 2007; 69(20):1921-30.
- 16. Han Y, You X, Xing W, Zhang Z, Zou W. Paracrine and endocrine actions of bone-the functions of secretory proteins from osteoblasts, osteocytes, and osteoclasts. Bone research 2018; 6(1):16.
- 17. Kirk B, Feehan J, Lombardi G, Duque G. Muscle, bone, and fat crosstalk: the biological role of myokines, osteokines, and adipokines. Current Osteoporosis Reports 2020; 18(4):388-400.
- 18. Pedersen BK. Physical activity and muscle–brain crosstalk. Nature Reviews Endocrinology 2019; 15(7):383-92.
- 19. Lu B, Nagappan G, Lu Y. BDNF and synaptic plasticity, cognitive function, and dysfunction. Neurotrophic factors 2014: 223-50.
- 20. Matthews VB, Åström M-B, Chan M, Bruce CR, Krabbe KS, Prelovsek O, Åkerström T, Yfanti C, Broholm C, Mortensen OH, Penkowa M, Hojman P, Zankari A, Watt MJ, Bruunsgaard H, Pedersen BK, Febbraio MA. Brain-derived neurotrophic factor is produced by skeletal muscle cells in response to contraction and enhances fat oxidation via activation of AMP-activated protein kinase. Diabetologia 2009; 52:1409-18.
- 21. Lima Giacobbo B, Doorduin J, Klein HC, Dierckx RA, Bromberg E, de Vries EF. Brain-derived neurotrophic factor in brain disorders: focus on neuroinflammation. Molecular neurobiology 2019; 56:3295-312.
- 22. Miranda M, Morici JF, Zanoni MB, Bekinschtein P. Brain-derived neurotrophic factor: a key molecule for memory in the healthy and the pathological brain. Frontiers in cellular neuroscience 2019:363.
- 23. Otman AS, Köse N. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. Ankara: Hipokrat Kitapevi; 2016.
- 24. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliablitiy and validity of the standardized mini mental state examination in the diagnosis of mild dementia in Turkish population. Turkish Journal of Psychiatry 2002; 13(4):273-81.
- 25. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research 1975; 12(3):189-98.
- 26. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Maryland state medical journal 1965; 14:61-5.
- 27. Küçükdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scandinavian journal of rehabilitation medicine 2000; 32(2):87-92.
- 28. Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. The American journal of psychiatry. 1982.
- 29. Scheltens P, De Strooper B, Kivipelto M, Holstege H, Chételat G, Teunissen CE, Cummings J, van der Flier WM. Alzheimer's disease. The Lancet 2021; 397(10284):1577-90.
- 30. Chodosh J, Reuben DB, Albert MS, Seeman TE. Predicting cognitive impairment in high‐functioning community‐dwelling older persons: MacArthur Studies of Successful Aging. Journal of the American Geriatrics Society 2002; 50(6):1051-60.
- 31. Caramelli P, Poissant A, Gauthier S, Bellavance A, Gauvreau D, Lecours AR, Joanette, Y. Educational level and neuropsychological heterogeneity in dementia of the Alzheimer type. Alzheimer Disease & Associated Disorders 1997; 11(1):9-15.
- 32. Yavlal F, Güngör HA. Demansta klinik bulgular. Nükleer Tıp Seminerleri 2016; 3:134-8.
- 33. Özkay ÜD, Öztürk Y, Can Ö. Yaşlanan dünyanın hastalığı: Alzheimer hastalığı. SDÜ Tıp Fakültesi Dergisi 2011; 18(1):35-42.
- 34. Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM. Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Archives of neurology 2010; 67(4):428-33.
- 35. Liu S, Zhuang S, Li M, Zhu J, Zhang Y, Hu H. Relationship between sarcopenia and sleep status in female patients with mild to moderate Alzheimer's disease. Psychogeriatrics 2023; 23(1):94-107.
- 36. Schmidtbleicher D, editor Some neuromuscular aspects of human movements and the consequences for the muscular rehabilitation. ISBS-Conference Proceedings Archive; 1996.
- 37. Kawałek K, Garsztka T. An analysys of muscle balance in professional field hockey players. 2013.
- 38. Domenech-Cebrían P, Martinez-Martinez M, Cauli O. Relationship between mobility and cognitive impairment in patients with Alzheimer’s disease. Clinical Neurology and Neurosurgery 2019; 179:23-9.
- 39. Kamiya M, Osawa A, Kondo I, Sakurai T. Factors associated with cognitive function that cause a decline in the level of activities of daily living in Alzheimer's disease. Geriatrics & Gerontology International 2018; 18(1):50-6.
- 40. Lee G. Impaired cognitive function is associated with motor function and activities of daily living in mild to moderate Alzheimer's dementia. Current Alzheimer Research 2020; 17(7):680-6.
Evaluation of the Relationship Between Musculoskeletal Problems and Cognitive Disorders in Alzheimer's Patients
Öz
Objective: The objective of this study was to evaluate musculoskeletal problems and cognitive disorders that may be seen in individuals with Alzheimer's disease (AD) and to determine the interaction between these problems.
Material and Methods: Twenty-five individuals diagnosed with AD by a neurologist were included in the study. The participants' demographic data was recorded, a posture analysis was performed, and Mini-Mental State Examination (MMSE), Barthel Index (BI), and Global Deterioration Scale (GDS) were applied.
Results: Posture analyses revealed anterior head tilt in 80%, shoulder protraction in 76%, collapsed chest type in 8%, increased thoracic kyphosis in 84%, genu varum in 12%, and hallux valgus in 32%. There was a significant correlation between the MMSE results of the individuals and the results of BI and GDS (p=0.024 and p=0.002). In addition, it was determined that the dependency levels in BI increased significantly as the stages of the GDS increased (p=0.008). At the same time, there was no significant relationship between the education status and the stages of the GDS.
Conclusion: Musculoskeletal disorders are likely to develop in individuals with AD experiencing dementia and complete functional dependence. Therefore, promoting physiotherapy practices along with medical treatment is important to improve functional dependence and cognitive impairment.
Anahtar Kelimeler
Etik Beyan
The study was approved by the Clinical Research Ethics Committee with the decision dated 23.12.2014 and numbered 2015/11. The rights of all participants were protected and written and verbal informed consent was obtained in accordance with the principles of the Declaration of Helsinki.
Kaynakça
- 1. Mehta RI, Schneider JA. What is ‘Alzheimer's disease’? The neuropathological heterogeneity of clinically defined Alzheimer's dementia. Current opinion in neurology 2021; 34(2):237-45.
- 2. Patterson C. World alzheimer report 2018. 2018.
- 3. Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus S, Schneider LS, Selbæk G, Teri L, Mukadamet N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet 2020; 396(10248):413-46.
- 4. Oh ES, Rabins PV. Dementia (Japanese Version). Annals of internal medicine 2019; 171(5):JITC33-JITC48.
- 5. Sheppard O, Coleman M. Alzheimer’s disease: etiology, neuropathology and pathogenesis. Exon Publications 2020:1-21.
- 6. De la Rosa A, Olaso-Gonzalez G, Arc-Chagnaud C, Millan F, Salvador-Pascual A, García-Lucerga C, Blasco-Lafarga C, Garcia-Dominguez E, Carretero A, Correas AG, Vina J, Gomez-Cabreraet MC. Physical exercise in the prevention and treatment of Alzheimer's disease. Journal of sport and health science 2020; 9(5):394-404.
- 7. Zhang X-X, Tian Y, Wang Z-T, Ma Y-H, Tan L, Yu J-T. The epidemiology of Alzheimer’s disease modifiable risk factors and prevention. The journal of prevention of Alzheimer's disease 2021; 8:313-21.
- 8. Tarawneh R, Holtzman DM. The clinical problem of symptomatic Alzheimer disease and mild cognitive impairment. Cold Spring Harbor perspectives in medicine 2012; 2(5):a006148.
- 9. Schneider JA, Arvanitakis Z, Leurgans SE, Bennett DA. The neuropathology of probable Alzheimer disease and mild cognitive impairment. Annals of neurology 2009; 66(2):200-8. Epub 2009/09/11. doi: 10.1002/ana.21706. PubMed PMID: 19743450; PubMed Central PMCID: PMC2812870.
- 10. Gezici S, Şekeroğlu N. Alzheimer Hastalığının Gelişimsel Sürecinde ve Tedavisinde Potansiyel Öneme Sahip Tıbbi Bitkiler ve Fitokimyasallar. Hacettepe University Journal of the Faculty of Pharmacy 2022; 42(2):121-33.
- 11. Friedlander AH, Norman DC, Mahler ME, Norman KM, Yagiela JA. Alzheimer's disease: psychopathology, medical management and dental implications. The Journal of the American Dental Association 2006; 137(9):1240-51.
- 12. Ogama N, Endo H, Satake S, Niida S, Arai H, Sakurai T. Impact of regional white matter hyperintensities on specific gait function in Alzheimer's disease and mild cognitive impairment. Journal of Cachexia, Sarcopenia and Muscle 2021; 12(6):2045-55.
- 13. Pinto TC, Machado L, Bulgacov TM, Rodrigues-Júnior AL, Costa ML, Ximenes RC, Sougey EB. Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly? International psychogeriatrics 2019; 31(4):491-504.
- 14. Suryadevara V, Klüppel M, Del Monte F, Willis MS. The Unraveling: Cardiac and Musculoskeletal Defects and Their Role in Common Alzheimer Disease Morbidity and Mortality. The American Journal of Pathology 2020; 190(8):1609-21.
- 15. Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues J-F, Alpe´rovitch, A. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology 2007; 69(20):1921-30.
- 16. Han Y, You X, Xing W, Zhang Z, Zou W. Paracrine and endocrine actions of bone-the functions of secretory proteins from osteoblasts, osteocytes, and osteoclasts. Bone research 2018; 6(1):16.
- 17. Kirk B, Feehan J, Lombardi G, Duque G. Muscle, bone, and fat crosstalk: the biological role of myokines, osteokines, and adipokines. Current Osteoporosis Reports 2020; 18(4):388-400.
- 18. Pedersen BK. Physical activity and muscle–brain crosstalk. Nature Reviews Endocrinology 2019; 15(7):383-92.
- 19. Lu B, Nagappan G, Lu Y. BDNF and synaptic plasticity, cognitive function, and dysfunction. Neurotrophic factors 2014: 223-50.
- 20. Matthews VB, Åström M-B, Chan M, Bruce CR, Krabbe KS, Prelovsek O, Åkerström T, Yfanti C, Broholm C, Mortensen OH, Penkowa M, Hojman P, Zankari A, Watt MJ, Bruunsgaard H, Pedersen BK, Febbraio MA. Brain-derived neurotrophic factor is produced by skeletal muscle cells in response to contraction and enhances fat oxidation via activation of AMP-activated protein kinase. Diabetologia 2009; 52:1409-18.
- 21. Lima Giacobbo B, Doorduin J, Klein HC, Dierckx RA, Bromberg E, de Vries EF. Brain-derived neurotrophic factor in brain disorders: focus on neuroinflammation. Molecular neurobiology 2019; 56:3295-312.
- 22. Miranda M, Morici JF, Zanoni MB, Bekinschtein P. Brain-derived neurotrophic factor: a key molecule for memory in the healthy and the pathological brain. Frontiers in cellular neuroscience 2019:363.
- 23. Otman AS, Köse N. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. Ankara: Hipokrat Kitapevi; 2016.
- 24. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliablitiy and validity of the standardized mini mental state examination in the diagnosis of mild dementia in Turkish population. Turkish Journal of Psychiatry 2002; 13(4):273-81.
- 25. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research 1975; 12(3):189-98.
- 26. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Maryland state medical journal 1965; 14:61-5.
- 27. Küçükdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scandinavian journal of rehabilitation medicine 2000; 32(2):87-92.
- 28. Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. The American journal of psychiatry. 1982.
- 29. Scheltens P, De Strooper B, Kivipelto M, Holstege H, Chételat G, Teunissen CE, Cummings J, van der Flier WM. Alzheimer's disease. The Lancet 2021; 397(10284):1577-90.
- 30. Chodosh J, Reuben DB, Albert MS, Seeman TE. Predicting cognitive impairment in high‐functioning community‐dwelling older persons: MacArthur Studies of Successful Aging. Journal of the American Geriatrics Society 2002; 50(6):1051-60.
- 31. Caramelli P, Poissant A, Gauthier S, Bellavance A, Gauvreau D, Lecours AR, Joanette, Y. Educational level and neuropsychological heterogeneity in dementia of the Alzheimer type. Alzheimer Disease & Associated Disorders 1997; 11(1):9-15.
- 32. Yavlal F, Güngör HA. Demansta klinik bulgular. Nükleer Tıp Seminerleri 2016; 3:134-8.
- 33. Özkay ÜD, Öztürk Y, Can Ö. Yaşlanan dünyanın hastalığı: Alzheimer hastalığı. SDÜ Tıp Fakültesi Dergisi 2011; 18(1):35-42.
- 34. Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM. Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Archives of neurology 2010; 67(4):428-33.
- 35. Liu S, Zhuang S, Li M, Zhu J, Zhang Y, Hu H. Relationship between sarcopenia and sleep status in female patients with mild to moderate Alzheimer's disease. Psychogeriatrics 2023; 23(1):94-107.
- 36. Schmidtbleicher D, editor Some neuromuscular aspects of human movements and the consequences for the muscular rehabilitation. ISBS-Conference Proceedings Archive; 1996.
- 37. Kawałek K, Garsztka T. An analysys of muscle balance in professional field hockey players. 2013.
- 38. Domenech-Cebrían P, Martinez-Martinez M, Cauli O. Relationship between mobility and cognitive impairment in patients with Alzheimer’s disease. Clinical Neurology and Neurosurgery 2019; 179:23-9.
- 39. Kamiya M, Osawa A, Kondo I, Sakurai T. Factors associated with cognitive function that cause a decline in the level of activities of daily living in Alzheimer's disease. Geriatrics & Gerontology International 2018; 18(1):50-6.
- 40. Lee G. Impaired cognitive function is associated with motor function and activities of daily living in mild to moderate Alzheimer's dementia. Current Alzheimer Research 2020; 17(7):680-6.
Toplam 40 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Nöroloji ve Nöromüsküler Hastalıklar, Fizyoterapi, Yaşlı Bakımı |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 22 Mayıs 2025 |
| Yayımlanma Tarihi | 28 Mayıs 2025 |
| Gönderilme Tarihi | 20 Mart 2024 |
| Kabul Tarihi | 13 Mayıs 2024 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 11 Sayı: 2 |
