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  Physical activity level in people with age related white matter changes correlates to better motor performance, lower comorbidity and higher cognitive level. Objective:    The aim of this study is to evaluate the activity level on people with age-related white matter changes as identified on magnetic resonance imaging (MRI) in relation to motor performance, cognition and perceived health. SIGNIFICANCE OF THE STUDY    Physical activity plays a pivotal role in the development of disability. It is important implications since inactive older people with low physiologic reserves are more vulnerable to disease events and subsequent disability. Problem:    The negative effect of vascular risk factors on progression of both cardio and cerebrovascular disorder. METHODS IN SOLVING THE PROBLEM      Gather information on comorbidity, physical activity level, physical function, cognition, level of white matter changes and perceived  health was collected. Physical activity level was classified with a yes or no question and with the Frenchay Activities Index (FAI).    Examine the net contribution of various degrees of age related brain white matter changes (ARWMC) on the development of disability in older people. Result:    Only 36% of the subjects in this study were physically active according to the yes/no question. 27.5% of the subjects were active according to the FAI score which evaluates the everyday activities. Being active discriminated subjects with better physical function. Subjects active according to the FAI score had a high er cognitive level (p ≤ 0.01), lower comorbidity (p = 0.02) and performed better on all motor function tasks as assessed by walking speed (p ≤ 0.01) and the Short Physical Performance battery (SPPB) (p ≤ 0.01).   Recommendation:    Moderate physical activity for at least 30 min, no less than 3 times/week to maintain cardiovascular fitness. This level of exercise can decrease vascular risk factors and the incidence of coronary heart disease.    In addition, low intensity physical activity renders other health benefits such as maintaining physical function, a higher quality of life, and wellbeing. Many of our daily activities include activities that are dependent on lower extremity function, which has been found to be able to predict short-term mortality and nursing home admission in older adults  Conclusion:    Being physically active seems to be a long term protective factor. In our study, the majority of subjects with Age Related White Matter Changes (ARWMC) with no or mild Instrumental Activity of Daily Living (IADL) disability did not attain recommended level of activity at first year follow up. Whether or not increasing physical activity may slow down cognitive decline and lessen development of disability in physically inactive subjects with manifest ARWC remains to be studied. Trial registration: not applicable. Does the diagnosis of Alzheimer’s Disease imply immediate revocation of a driving license? Objectives    To present and discuss the current knowledge about the driving behavior and fitness of patients with Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI). And by integrating the various sources of evidence develop a rationale that supports the implementation of a personalized approach when taking decisions about the driving fitness of patients belonging in the specific clinical groups Significance of the study:     To present the current knowledge about the driving behavior of individual with two common cognitive disorder, namely Alzheimer Disease and Mild Cognitive Impairment. Problem:    CONTINUE TO DRIVE OR NOT? Methods of resolving the problem    Implementation of a personalized approach that is based on the unique profile of each driver with AD.    AD patients should be required to undergo a detailed driving evaluation that covers various components, namely a practice road rule test, assessment of physical, visual, sensory and cognitive abilities, as well as on-road assessment.    More consistent and regular monitoring of driving ability on patients with MCI is suggested to be formally implemented. Conclusion    In conclusion, decisions related to the critical question “Continue to drive or not?” and concerns about the group drivers with cerebral diseases should be based on an interdisciplinary approach that integrates the specialties of neurology, neuropsychology and transportation engineering.
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