题名

The effect of acute exercise on executive functions in people with Alzheimer's disease or mild cognitive impairment: A review

并列篇名

急性健身運動對阿茲海默症與輕度認知障礙患者執行功能之影響：文獻回顧

DOI

10.6223/qcpe.202303_37(1).0003

作者

Yan-Ho Lo(羅恩豪)；Jing-Yi Ai(艾競一)；Shih-Chun Kao(高士駿)；Feng-Tzu Chen(陳豐慈)；Yu-Kai Chang(張育愷)

关键词

cognitive function ； Dementia ； brain health ； aging ； physical activity ； 認知功能 ； 失智症 ； 大腦健康 ； 老化 ； 身體活動

期刊名称

中華體育季刊

卷期/出版年月

37卷1期（2023 / 03 / 01）

页次

25 - 39

内容语文

英文;繁體中文
中文摘要

Alzheimer's disease (AD) and Mild cognitive impairment (MCI) are the mental disorders that worsen executive functions (EF) and negatively affect quality of life. Medical treatments for AD and MCI are effective but have unpleasant side effects. Non-medical approaches, like exercise, play an important role in the treatment of AD and MCI, as acute exercise has benefits on EF. In this context, the purpose of this review was to differentiate the acute exercise effects on different domains of EF, and to recognize the potential affecting mechanisms. After reviewing, we found 4 studies via researching on PubMed, Scopus, and Google Scholar. The results showed that acute aerobic exercise has positive impacts on multi aspects of EF across a range of AD and MCI subjects, including inhibitory control (IC), working memory (WM), and planning. Furthermore, acute exercise, combined with cognitive trainings, generated more benefits to EF than aerobic exercise alone in AD populations. As for the MCI populations, acute aerobic exercise and resistant exercise with moderate intensity enhanced IC, but high intensity acute exercise impaired IC. Additionally, brain-derived neurotrophic factor (BDNF) and insulin-like growth factor 1 (IGF-1) are potential mechanisms known to mediate the effects of acute exercise on EF in people with AD and MCI. More studies are needed in order to properly investigate the remaining aspects of EF (e.g., shifting), and to find the most suitable exercise protocol for maximizing the beneficial effects, as well as for clarifying whether the acute exercise-induced IGF-1 can benefit the EF in AD and MCI populations.
英文摘要

阿茲海默症與輕度認知障礙是一種精神障礙，它不僅會使患者的執行功能下降，且對其生活品質有負面影響。雖然目前藥物對兩種族群都能有效改善其症狀，但是也附帶著一些副作用，因此非藥物治療方法（例如：急性健身運動）在阿茲海默症與輕微認知障礙的治療中發揮重要的作用，且其對執行功能有著長期和短期的正向效益。為此，本回顧的目的將以急性健身運動之視角，探討其對不同執行功能之影響，且將討論其可能機制。本文經PubMed、Scopus及Google Scholar等資料庫進行搜尋後，發現共有四篇研究進行探討。回顧顯示，急性有氧運動對阿茲海默症與輕微認知損傷參與者的抑制控制、工作記憶，及計畫均有正面影響。此外，相較於單一有氧運動急性運動介入，健身運動結合認知訓練對阿茲海默症執行功能之效應更佳。而在輕微認知損傷族群中，中等強度急性有氧與阻力運動皆可增強抑制控制，而高強度健身運動則會降低了其表現。另外，本文回顧指出，腦源性神經營養因子與第一類型胰島素樣生長因子係影響執行功能之可能機制。未來仍需更多研究針對急性健身運動對特定類別之執行功能（例如：轉換）進行探究，並建立最適改善執行功能之健身運動處方，進一步釐清急性健身運動改善阿茲海默症與輕微認知障礙執行功能之其他可能機制。
主题分类 社會科學 > 體育學
参考文献
  1. 陳泰睿, T. R.,粘瑞狄, J. T.,張育愷, Y. K.(2022)。不穩定阻力訓練對老年人認知功能之影響：文獻回顧。中華體育季刊，36(1)，69-81。
    連結：
  2. 陳豐慈, F, T.,詹貴惠, K. H.,馮勝賢, S. H.,吳聰義, T. Y.,高士竣, S. C.,張育愷, Y. K.(2019)。新觀點：健身運動與營養補充劑對認知老化之影響。體育學報，52(S)，1-15。
    連結：
  3. 陳豐慈, F. T.,張育愷, Y. K.,齊璘, L.(2018)。健身運動對倫敦塔作業之影響：文獻回顧與未來展望。中華體育季刊，32(1)，63-73。
    連結：
  4. (2021).2021 Alzheimer's disease facts and figures.Alzheimer's & Dementia,17(3),327-406.
  5. Aleman, A.,Torres-Alemán, I.(2009).Circulating insulin-like growth factor 1 and cognitive function: Neuromodulation throughout the lifespan.Progress in Neurobiology,89(3),256-265.
  6. Antypa, D.,Basta, M.,Vgontzas, A.,Zaganas, I.,Panagiotakis, S.,Vogiatzi, E.,Kokosali, E.,Simos, P.(2022).The association of basal cortisol levels with episodic memory in older adults is mediated by executive function.Neurobiology of Learning and Memory,190,107600.
  7. Arazi, H.,Babaei, P.,Moghimi, M.,Asadi, A.(2021).Acute effects of strength and endurance exercise on serum BDNF and IGF-1 levels in older men.BMC Geriatrics,21(1),50.
  8. Baddeley, A.(2012).Working memory: Theories, models, and controversies.Annual Review of Psychology,63(1),1-29.
  9. Bailey, C. E.(2007).Cognitive accuracy and intelligent executive function in the brain and in business.Annals of the New York Academy of Sciences Journal,1118,122-141.
  10. Baker, L. D.,Frank, L. L.,Foster-Schubert, K.,Green, P. S.,Wilkinson, C. W.,McTiernan, A.,Plymate, S. R.,Fishel, M. A.,Watson, G. S.,Cholerton, B. A.,Duncan, G. E.,Mehta, P. D.,Craft, S.(2010).Effects of aerobic exercise on mild cognitive impairment: A controlled trial.Archives of Neurology,67(1),71-79.
  11. Bartholomew, J. B.,Miller, B. M.(2002).Affective responses to an aerobic dance class: The impact of perceived performance.Research Quarterly for Exercise and Sport,73(3),301-309.
  12. Bellar, D.,Glickman, E. L.,Juvancic-Heltzel, J.,Gunstad, J.(2011).Serum insulin like growth factor-1 is associated with working memory, executive function and selective attention in a sample of healthy, fit older adults.Neuroscience,178,133-137.
  13. Ben Ayed, I.,Castor-Guyonvarch, N.,Amimour, S.,Naija, S.,Aouichaoui, C.,Ben Omor, S.,Tabka, Z.,El Massioui, F.(2021).Acute exercise and cognitive function in Alzheimer's disease.Journal of Alzheimer's Disease,82(2),749-760.
  14. Boecker, H.(2011).On the emerging role of neuroimaging in determining functional and structural brain integrity induced by physical exercise: Impact for predictive, preventive, and personalized medicine.EPMA Journal,2(3),277-285.
  15. Brown, T. E.,Landgraf, J. M.(2010).Improvements in executive function correlate with enhanced performance and functioning and health-related quality of life: Evidence from 2 large, double-blind, randomized, placebo-controlled trials in ADHD.Postgraduate Medicine,122(5),42-51.
  16. Byun, K.,Hyodo, K.,Suwabe, K.,Ochi, G.,Sakairi, Y.,Kato, M.,Dan, I.,Soya, H.(2014).Positive effect acute mild exercise on executive function via arousal-related prefrontal activations: An FNIRS study.Neuroimage,98,336-345.
  17. Cass, S. P.(2017).Alzheimer's disease and exercise: A literature review.Current Sports Medicine Reports,16(1),19-22.
  18. Cassilhas, R. C.,Lee, K. S.,Fernandes, J.,Oliveira, M. G.,Tufik, S.,Meeusen, R.,de Mello, M. T.(2012).Spatial memory is improved by aerobic and resistance exercise through divergent molecular mechanisms.Neuroscience,202,309-317.
  19. Chang, Y. K.,Labban, J. D.,Gapin, J. I.,Etnier, J. L.(2012).The effects of acute exercise on cognitive performance: A meta-analysis.Brain Research,1453,87-101.
  20. Coelho, F. G. D. M.,Vital, T. M.,Stein, A. M.,Arantes, F. J.,Rueda, A. V.,Camarini, R.,Teodorov, E.,Santos-Galduróz, R. F.(2014).Acute aerobic exercise increases brain-derived neurotrophic factor levels in elderly with Alzheimer's disease.Journal of Alzheimer's Disease,39(2),401-408.
  21. Colcombe, S. J.,Kramer, A. F.,Erickson, K. I.,Scalf, P.,McAuley, E.,Cohen, N. J.,Webb, A.,Jerome, G. J.,Marquez, D. X.,Elavsky, S.(2004).Cardiovascular fitness, cortical plasticity, and aging.Proceedings of the National Academy of Sciences of the United States of America,101(9),3316-3321.
  22. Collado-Mateo, D.,Lavín-Pérez, A. M.,Peñacoba, C.,Del Coso, J.,Leyton-Román, M.,Luque-Casado, A.,Gasque, P.,Fernández-Del-Olmo, M.,Amado-Alonso, D.(2021).Key factors associated with adherence to physical exercise in patients with chronic diseases and older adults: An umbrella review.International Journal of Environmental Research and Public Health,18(4),2023.
  23. Cotman, C. W.,Berchtold, N. C.,Christie, L. A.(2007).Exercise builds brain health: Key roles of growth factor cascades and inflammation.Trends in Neurosciences,30(9),464-472.
  24. De La Torre, J. C.(2012).Cardiovascular risk factors promote brain hypoperfusion leading to cognitive decline and dementia.Cardiovascular Psychiatry and Neurology,2012,367516.
  25. De Oliveira Silva, F.,Ferreira, J. V.,Plácido, J.,Sant’Anna, P.,Araújo, J.,Marinho, V.,Laks, J.,Camaz Deslandes, A.(2019).Three months of multimodal training contributes to mobility and executive function in elderly individuals with mild cognitive impairment, but not in those with Alzheimer's disease: A randomized controlled trial.Maturitas,126,28-33.
  26. Delfino, L. L.,Komatsu, R. S.,Komatsu, C.,Neri, A. L.,Cachioni, M.(2018).Path analysis of caregiver characteristics and neuropsychiatric symptoms in Alzheimer's disease patients.Geriatrics & Gerontology International,18(8),1177-1182.
  27. Devenney, K. E.,Guinan, E. M.,Kelly Á, M.,Mota, B. C.,Walsh, C.,Olde Rikkert, M.,Schneider, S.,Lawlor, B.(2019).Acute high-intensity aerobic exercise affects brain-derived neurotrophic factor in mild cognitive impairment: A randomised controlled study.BMJ Open Sport & Exercise Medicine,5(1),000499.
  28. Diamond, A.(2013).Executive Functions.Annual Review of Psychology,64(1),135-168.
  29. Eakin, L.,Minde, K.,Hechtman, L.,Ochs, E.,Krane, E.,Bouffard, R.,Greenfield, B.,Looper, K.(2004).The marital and family functioning of adults with ADHD and their spouses.Journal of Attention Disorders,8(1),1-10.
  30. Erickson, K. I.,Kramer, A. F.(2009).Aerobic exercise effects on cognitive and neural plasticity in older adults.British Journal of Sports Medicine,43(1),22.
  31. Erickson, K. I.,Voss, M. W.,Prakash, R. S.,Basak, C.,Szabo, A.,Chaddock, L.,Kim, J. S.,Heo, S.,Alves, H.,White, S. M.,Wojcicki, T. R.,Mailey, E.,Vieira, V. J.,Martin, S. A.,Pence, B. D.,Woods, J. A.,McAuley, E.,Kramer, A. F.(2011).Exercise training increases size of hippocampus and improves memory.Proceedings of the National Academy of Sciences of the United States of America,108(7),3017-3022.
  32. Eshkoor, S. A.,Hamid, T. A.,Mun, C. Y.,Ng, C. K.(2015).Mild cognitive impairment and its management in older people.Clinical Interventions in Aging,10,687-693.
  33. Fernandez, A. M.,Torres-Alemán, I.(2012).The many faces of insulin-like peptide signalling in the brain.Nature Reviews Neuroscience,13(4),225-239.
  34. Friedman, N. P.,Miyake, A.,Corley, R. P.,Young, S. E.,DeFries, J. C.,Hewitt, J. K.(2006).Not all executive functions are related to intelligence.Psychological Science,17(2),172-179.
  35. Gajewski, P. D.,Hanisch, E.,Falkenstein, M.,Thönes, S.,Wascher, E.(2018).What does the n-back task measure as we get older? Relations between working-memory measures and other cognitive functions across the lifespan.Frontiers in Psychology,9,2208.
  36. Griesbach, G. S.,Hovda, D. A.,Gomez-Pinilla, F.(2009).Exercise-induced improvement in cognitive performance after traumatic brain injury in rats is dependent on BDNF activation.Brain Research,1288,105-115.
  37. Griesbach, G. S.,Hovda, D.,Molteni, R.,Wu, A.,Gomez-Pinilla, F.(2004).Voluntary exercise following traumatic brain injury: Brain-derived neurotrophic factor upregulation and recovery of function.Neuroscience,125(1),129-139.
  38. Hyodo, K.,Dan, I.,Suwabe, K.,Kyutoku, Y.,Yamada, Y.,Akahori, M.,Byun, K.,Kato, M.,Soya, H.(2012).Acute moderate exercise enhances compensatory brain activation in older adults.Neurobiol Aging,33(11),2621-2632.
  39. Ide, K.,Secher, N. H.(2000).Cerebral blood flow and metabolism during exercise.Progress in Neurobiology,61(4),397-414.
  40. Jekel, K.,Damian, M.,Wattmo, C.,Hausner, L.,Bullock, R.,Connelly, P. J.,Dubois, B.,Eriksdotter, M.,Ewers, M.,Graessel, E.(2015).Mild cognitive impairment and deficits in instrumental activities of daily living: A systematic review.Alzheimer's Research & Therapy,7(1),1-20.
  41. Ji, Z.,Feng, T.,Mei, L.,Li, A.,Zhang, C.(2019).Influence of acute combined physical and cognitive exercise on cognitive function: An NIRS study.The Journal of Life & Environmental Sciences,7,7418.
  42. Jiang, T.,Yu, J. T.,Tan, L.(2012).Novel disease-modifying therapies for Alzheimer's disease.Journal of Alzheimer's Disease,31(3),475-492.
  43. Karssemeijer, E. G. A.,Aaronson, J. A.,Bossers, W. J.,Smits, T.,Olde Rikkert, M. G. M.,Kessels, R. P. C.(2017).Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: A meta-analysis.Ageing Research Reviews,40,75-83.
  44. Kelley, A. S.,McGarry, K.,Gorges, R.,Skinner, J. S.(2015).The burden of health care costs for patients with dementia in the last 5 years of life.Annals of Internal Medicine,163(10),729-736.
  45. Kim, H. J.,Lee, S. Y.,Lee, H. G.,Cho, Y. H.,Ko, E. M.(2018).Effects of a single-session cognitive enhancement fitness program on serum brain-derived neurotrophic factor levels and cognitive function in middle-aged women.Journal of Sports Science and Medicine,17(1),110-116.
  46. Landers, D. M.,Arent, S. M.(2007).Physical activity and mental health.Handbook of sport psychology
  47. Law, L. L. F.,Barnett, F.,Yau, M. K.,Gray, M. A.(2014).Effects of functional tasks exercise on older adults with cognitive impairment at risk of Alzheimer's disease: A randomised controlled trial.Age and Ageing,43(6),813-820.
  48. Li, L.,Men, W.-W.,Chang, Y.-K.,Fan, M.-X.,Ji, L.,Wei, G.-X.(2014).Acute aerobic exercise increases cortical activity during working memory: A functional MRI study in female college students.PLoS ONE,9(6),99222.
  49. Livingston, G.,Huntley, J.,Sommerlad, A.,Ames, D.,Ballard, C.,Banerjee, S.,Brayne, C.,Burns, A.,Cohen-Mansfield, J.,Cooper, C.(2020).Dementia prevention, intervention, and care: 2020 report of the lancet commission.The Lancet,396(10248),413-446.
  50. Marston, K. J.,Brown, B. M.,Rainey-Smith, S. R.,Peiffer, J. J.(2019).Resistance exercise-induced responses in physiological factors linked with cognitive health.Journal of Alzheimer's Disease,68(1),39-64.
  51. Mattson, M. P.(2004).Pathways towards and away from Alzheimer's disease.Nature,430(7000),631-639.
  52. McGeorge, P.,Phillips, L. H.,Crawford, J. R.,Garden, S. E.,Sala, S. D.,Milne, A. B.,Hamilton, S.,Callender, J. S.(2001).Using virtual environments in the assessment of executive dysfunction.Presence: Teleoperators and Virtual Environments,10(4),375-383.
  53. McNab, F.,Leroux, G.,Strand, F.,Thorell, L.,Bergman, S.,Klingberg, T.(2008).Common and unique components of inhibition and working memory: An FMRI within-subjects investigation.Neuropsychologia,46(11),2668-2682.
  54. Miyake, A.,Friedman, N. P.,Emerson, M. J.,Witzki, A. H.,Howerter, A.,Wager, T. D.(2000).The unity and diversity of executive functions and their contributions to complex "frontal lobe" tasks: A latent variable analysis.Cognitive Psychology,41(1),49-100.
  55. O’Leary, K.,O’Neill, S.,Dockray, S.(2015).A systematic review of the effects of mindfulness interventions on cortisol.Journal of Health Psychology,21(9),2108-2121.
  56. O'Connor, C.,Robertson, I. H.,Levine, B.(2011).The prosthetics of vigilant attention: Random cuing cuts processing demands.Neuropsychology,25,535-543.
  57. Panza, G. A.,Taylor, B. A.,MacDonald, H. V.,Johnson, B. T.,Zaleski, A. L.,Livingston, J.,Thompson, P. D.,Pescatello, L. S.(2018).Can Exercise Improve Cognitive Symptoms of Alzheimer's Disease?.Journal of the American Geriatrics Society,66(3),487-495.
  58. Peruyero, F.,Zapata, J.,Pastor, D.,Cervelló, E.(2017).The acute effects of exercise intensity on inhibitory cognitive control in adolescents.Frontiers in Psychology,8,921.
  59. Piepmeier, A. T.,Etnier, J. L.(2015).Brain-derived neurotrophic factor (BDNF) as a potential mechanism of the effects of acute exercise on cognitive performance.Journal of Sport and Health Science,4(1),14-23.
  60. Piercy, K. L.,Troiano, R. P.,Ballard, R. M.,Carlson, S. A.,Fulton, J. E.,Galuska, D. A.,George, S. M.,Olson, R. D.(2018).The physical activity guidelines for americans.JAMA,320(19),2020-2028.
  61. Reitz, C.,Mayeux, R.(2014).Alzheimer disease: epidemiology, diagnostic criteria, risk factors and biomarkers.Biochemical Pharmacology,88(4),640-651.
  62. Roberts, R.,Knopman, D. S.(2013).Classification and Epidemiology of MCI.Clinics in Geriatric Medicine,29(4),753-772.
  63. Rossi, C.,Angelucci, A.,Costantin, L.,Braschi, C.,Mazzantini, M.,Babbini, F.,Fabbri, M. E.,Tessarollo, L.,Maffei, L.,Berardi, N.,Caleo, M.(2006).Brain-derived neurotrophic factor (BDNF) is required for the enhancement of hippocampal neurogenesis following environmental enrichment.European Journal of Neuroscience,24(7),1850-1856.
  64. Scarmeas, N.,Luchsinger, J. A.,Schupf, N.,Brickman, A. M.,Cosentino, S.,Tang, M. X.,Stern, Y.(2009).Physical activity, diet, and risk of Alzheimer disease.JAMA,302(6),627-637.
  65. Shatil, E.(2013).Does combined cognitive training and physical activity training enhance cognitive abilities more than either alone? A four-condition randomized controlled trial among healthy older adults.Frontiers in Aging Neuroscience,5,8.
  66. Stein, A. M.,da Silva, T. M. V.,Coelho, F. G. D. M.,Rueda, A. V.,Camarini, R.,Galduróz, R. F. S.(2021).Acute exercise increases circulating igf-1 in alzheimer's disease patients, but not in older adults without dementia.Behavioural Brain Research,396,112903.
  67. Stopford, C. L.,Thompson, J. C.,Neary, D.,Richardson, A. M. T.,Snowden, J. S.(2012).Working memory, attention, and executive function in Alzheimer’s disease and frontotemporal dementia.Cortex,48(4),429-446.
  68. Taylor Tavares, J. V.,Clark, L.,Cannon, D. M.,Erickson, K.,Drevets, W. C.,Sahakian, B. J.(2007).Distinct profiles of neurocognitive function in unmedicated unipolar depression and bipolar II depression.Biological Psychiatry,62(8),917-924.
  69. Tomporowski, P. D.,Pesce, C.(2019).Exercise, sports, and performance arts benefit cognition via a common process.Psychological Bulletin,145(9),929-951.
  70. Tsai, C.-L.,Ukropec, J.,Ukropcová, B.,Pai, M.-C.(2018).An acute bout of aerobic or strength exercise specifically modifies circulating exerkine levels and neurocognitive functions in elderly individuals with mild cognitive impairment.NeuroImage: Clinical,17,272-284.
  71. Tsai, C.-L.,Wang, C.-H.,Pan, C.-Y.,Chen, F.-C.,Huang, T.-H.,Chou, F.-Y.(2014).Executive function and endocrinological responses to acute resistance exercise.Frontiers in Behavioral Neuroscience,8,262.
  72. Tsukamoto, H.,Suga, T.,Takenaka, S.,Tanaka, D.,Takeuchi, T.,Hamaoka, T.,Isaka, T.,Ogoh, S.,Hashimoto, T.(2016).Repeated high-intensity interval exercise shortens the positive effect on executive function during post-exercise recovery in healthy young males.Physiology & Behavior,160,26-34.
  73. Unterrainer, J. M.,Owen, A. M.(2006).Planning and problem solving: From neuropsychology to functional neuroimaging.Journal of Physiology-Paris,99(4-6),308-317.
  74. Valenzuela, P. L.,Castillo-García, A.,Morales, J. S.,de la Villa, P.,Hampel, H.,Emanuele, E.,Lista, S.,Lucia, A.(2020).Exercise benefits on Alzheimer’s disease: State-of-the-science.Ageing Research Reviews,62,101108.
  75. Voss, M. W.,Vivar, C.,Kramer, A. F.,van Praag, H.(2013).Bridging animal and human models of exercise-induced brain plasticity.Trends in Cognitive Sciences,17(10),525-544.
  76. Wang, H.,Abbas, K. M.,Abbasifard, M.,Abbasi-Kangevari, M.,Abbastabar, H.,Abd-Allah, F.,Abdelalim, A.,Abolhassani, H.,Abreu, L. G.,Abrigo, M. R. M.,Abushouk, A. I.,Adabi, M.,Adair, T.,Adebayo, O. M.,Adedeji, I. A.,Adekanmbi, V.,Adeoye, A. M.,Adetokunboh, O. O.,Advani, S. M.,Murray, C. J. L.(2020).Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: A comprehensive demographic analysis for the Global Burden of Disease Study 2019.The Lancet,396(10258),1160-1203.
  77. Welsh, M. C.,Satterlee-Cartmell, T.,Stine, M.(1999).Towers of hanoi and london: Contribution of working memory and inhibition to performance.Brain and Cognition,41(2),231-242.
  78. Westerberg, H.,Klingberg, T.(2007).Changes in cortical activity after training of working memory-A single-subject analysis.Physiology & Behavior,92(1-2),186-192.
  79. Will Crescioni, A.,Ehrlinger, J.,Alquist, J. L.,Conlon, K. E.,Baumeister, R. F.,Schatschneider, C.,Dutton, G. R.(2011).High trait self-control predicts positive health behaviors and success in weight loss.Journal of Health Psychology,16(5),750-759.
  80. Xue, H.,Sun, Q.,Liu, L.,Zhou, L.,Liang, R.,He, R.,Yu, H.(2017).Risk factors of transition from mild cognitive impairment to alzheimer's disease and death: A cohort study.Comprehensive Psychiatry,78,91-97.
  81. Yanagisawa, H.,Dan, I.,Tsuzuki, D.,Kato, M.,Okamoto, M.,Kyutoku, Y.,Soya, H.(2010).Acute moderate exercise elicits increased dorsolateral prefrontal activation and improves cognitive performance with stroop test.Neuroimage,50(4),1702-1710.
  82. Yazar, T.,Yazar, H. O.,Demir, E. Y.,Özdemir, F.,Çankaya, S.,Enginyurt, Ö.(2018).Assessment of the mental health of carers according to the stage of patients with diagnosis of Alzheimer-type dementia.Neurological Sciences,39(5),903-908.
  83. Zucchella, C.,Sinforiani, E.,Tamburin, S.,Federico, A.,Mantovani, E.,Bernini, S.,Casale, R.,Bartolo, M.(2018).The multidisciplinary approach to Alzheimer's disease and dementia: A narrative review of non-pharmacological treatment.Frontiers in Neurology,9,1058.
print cancel