Anastasios Siountas

A review of physical and cognitive interventions in aging.

Maintaining a healthy brain is a critical factor for the quality of life of elderly individuals and the preservation of their independence. Challenging aging brains through cognitive training and physical exercises has shown to be effective against age-related cognitive decline and disease. But how effective are such training interventions? What is the optimal combination/strategy? Is there enough evidence from neuropsychological observations, animal studies, as well as, structural and functional neuroimaging investigations to interpret the underlying neurobiological mechanisms responsible for the observed neuroplasticity of the aging brain? This piece of work summarizes recent findings toward these questions, but also highlights the role of functional brain connectivity work, an emerging discipline for future research in healthy aging and the study of the underlying mechanisms across the life span. The ultimate aim is to conclude on recommended multimodal training, in light of contemporary trends in the design of exergaming interventions. The latter issue is discussed in conjunction with building up neuroscientific knowledge and envisaged future research challenges in mapping, understanding and training the aging brain.

Gains in cognition through combined cognitive and physical training: the role of training dosage and severity of neurocognitive disorder.

Physical as well as cognitive training interventions improve specific cognitive functions but effects barely generalize on global cognition. Combined physical and cognitive training may overcome this shortcoming as physical training may facilitate the neuroplastic potential which, in turn, may be guided by cognitive training. This study aimed at investigating the benefits of combined training on global cognition while assessing the effect of training dosage and exploring the role of several potential effect modifiers. In this multi-center study, 322 older adults with or without neurocognitive disorders (NCDs) were allocated to a computerized, game-based, combined physical and cognitive training group (n = 237) or a passive control group (n = 85). Training group participants were allocated to different training dosages ranging from 24 to 110 potential sessions. In a pre-post-test design, global cognition was assessed by averaging standardized performance in working memory, episodic memory and executive function tests. The intervention group increased in global cognition compared to the control group, p = 0.002, Cohen’s d = 0.31. Exploratory analysis revealed a trend for less benefits in participants with more severe NCD, p = 0.08 (cognitively healthy: d = 0.54; mild cognitive impairment: d = 0.19; dementia: d = 0.04). In participants without dementia, we found a dose-response effect of the potential number and of the completed number of training sessions on global cognition, p = 0.008 and p = 0.04, respectively. The results indicate that combined physical and cognitive training improves global cognition in a dose-responsive manner but these benefits may be less pronounced in older adults with more severe NCD. The long-lasting impact of combined training on the incidence and trajectory of NCDs in relation to its severity should be assessed in future long-term trials.

Diffusion Tensor Imaging in brain tumors: A study on gliomas and metastases

PURPOSE To explore the role of Diffusion Tensor Imaging in preoperative glioma grading, as well as in differentiation between gliomas and metastatic brain tumors. We measured diffusion tensor variables in enhancement and edema regions, which were compared between the different subject groups. MATERIALS AND METHODS We performed DTI in 48 patients (11 Low Grade Gliomas, 27 High Grade Gliomas, 10 Single Metastatic brain tumors). We measured FA, λ1, λ2, λ3, ADC, Cl, Cp, Cs, RA, and VR in enhancing portions of tumors and edema regions. Additionally, ratios of enhancement to edema values were created for each variable. RESULTS In peritumoral edema, Cl and RA were proven to be significantly different in pair-wise comparisons, in addition to ADC, Cp, Cs and VR in enhancement regions. Enhancement to edema values were significantly different as well. CONCLUSION Diffusion tensor indices could be used for the differentiation between low and high grade gliomas, as well as for distinction between gliomas and metastases.

Thessaloniki Active and Healthy Ageing Living Lab: the roadmap from a specific project to a living lab towards openness

This paper exhibits the roadmap of the Thessaloniki Active and Healthy Ageing Living Lab (Thess-AHALL) from the demand of a specific project to openness, fostering collaborations with other researchers. It presents how carefully and intensive efforts of a multidisciplinary team turned a need for trials pertaining to a specific project to the establishment of Thess-AHALL fostering openness and collaborations with any type of stakeholder (research, education, commercial, etc.). Thess-AHALL is, located in the Lab of Medical Physics in the Aristotle University of Thessaloniki in Greece. A detailed presentation of the roadmap, the studies and research conducted in Thess-AHALL are presented.

Moving from lab testing of Active & Healthy Ageing technologies to real-life implementation

This paper exhibits two different cases of pilot contexts, that embrace the main principles of the Living Lab approach, which is the user-driven testing and development of technology in real-life environments. In the first case, a pilot phase was conducted in an ehome-like space within the premises of the Lab of Medical Physics Laboratory, based on a free-form protocol, allowing for increased ecologically validity of the studys results. In the second case, some elderly participants of the initial cohort agreed to install the technology to their own homes, providing the chance for monitoring in their daily life context. Transition from lab to homes revealed many factors that would not have been recognized in the first place. Comparing those two different Living Lab settings reveal pros and cons for each approach, depending on the case scenario.

Virtual Scenarios for Stealth Assessment of the Elderly: Perceptions and Acceptance of Technology-Based Health and Wellness Interventions

As adults get older, the risks are increasing on their health, such as chronic diseases, functional decline and geriatric syndromes which threaten their well-being. Technology has many features to support aging wellness enabling older people maintaining healthy and sociable as they grow. However, the needs of the elderly of the population are not always the same. Stealth assessment, coming from the educational domain, can assess such needs. Virtual scenarios, interactive simulation technologies that recreate realistic scenarios combined with novel and effective interaction modalities such as dialogue integrations are contemporary means for such endeavors. Thus, coalescing all these axes and disciplines this work aims to explore the applicability of a dialogue based virtual scenario stealth assessment approach for evaluating the perceptions of elderly towards technology based health interventions. Utilizing a simple dialogue based authoring and deployment platform a simple scenario was devised. 21 elderly, aged 60-80 (6 males, 15 females) run the scenario and filled out a validator questionnaire for their perceptions towards technology. Correlation was discovered between the devised instrument and the elderlys desire to use technology in everyday life. These results provide the necessary foundations for refining future iteration of such stealth assessment instruments with Evidence Centered Design Principles.