Cognitive Disorders

Why do cognitive disorders carry a greater likelihood of obesity?

"In part due to caretakers without sufficient knowledge of the disorder"

What should be central to program design for individuals with cognitive disorders?

"Individualization of programming, with instruction techniques adjusted since cognitive function varies widely"

Why might free weights and aerobic machines not be the best equipment choice for cognitive disorders?

"Because equipment choice should depend on individual anatomical and cognitive capabilities"

What aerobic exercise intensity and duration should individuals with cognitive disorders begin with (table 9.1)?

"Light to moderate intensity (30% to <60% VO2 or heart rate reserve) for 10-20 minute sessions"

What is the DHHS aerobic exercise goal for individuals with cognitive disorders as they progress?

"At least 150 minutes of moderate-intensity (40% to <60% VO2 or heart rate reserve) aerobic exercise per week"

How should resistance training progress for individuals with cognitive disorders?

Start with 1-2 sessions per week for 1 set of 8-12 reps, progressing to 2-4 sets with 1-2 minutes of rest

What two core features characterize Autism Spectrum Disorder (ASD)?

Deficits in social communication/social interaction, and restrictive repetitive behaviors, interests, and activities

Name examples of restrictive repetitive behaviors seen in ASD.

Sensitivity to sensory stimuli, stereotyped behaviors like body rocking, obsession with an object or topic, and insistence on sameness

What are the four conditions previously classified under the ASD umbrella?

Pervasive developmental disorder-not otherwise specified (PDD-NOS), childhood disintegrative disorder (CDD), Asperger's syndrome, and classical autism

At what age is ASD usually diagnosed?

"In the first 14 months to 3 years of life"

What did the DSM-5 (2013) do to the classification of autism?

"Consolidated the previous categories (like Asperger's Syndrome and Autistic Disorder) into a single diagnosis called Autism Spectrum Disorder"

What are the three DSM-5 support levels for ASD?

• Level 1: requires support

• Level 2: requires substantial support

• Level 3: requires very substantial support

Why are children and adolescents with ASD more susceptible to decreasing physical activity with age?

• A shortage of programs tailored to their needs

• The common practice of preoccupying them with movies, TV, or other media

What are the two main categories of medications used for ASD-related symptoms and what do they treat?

SSRIs and antipsychotic agents

What may be the most beneficial effect of exercise for individuals with ASD?

A decrease in repetitive behaviors resulting in increased academic engagement, with a dose-response relationship

What exercise environment and communication considerations are recommended for ASD?

• Neutral decorations

• clothing to avoid overstimulation

• Relatively flat verbal communication without sarcasm or jargon

How long should rest periods be during exercise for individuals with ASD and why?

2-3 minutes, to avoid increased physiological stress

What causes Down syndrome?

"Three copies of the 21st chromosome (a genetic disorder)"

What are the known risk factors for having a child with Down syndrome?

"Older maternal age (over 35) and a younger mother who is a heavy smoker"

What physical and fitness characteristics are commonly seen in Down syndrome?

Generalized muscle weakness, poor cardiovascular fitness, impaired coordination, and poor exercise economy

What has research shown about medications/supplements for Down syndrome?

None have proven conclusively beneficial, some being detrimental

What have structured training programs been shown to improve in individuals with Down syndrome?

"Leg strength, functional performance (such as stair climbing), and peak VO2"

What exercise activities are recommended for individuals with Down syndrome?

"Walking and jogging for efficiency and independence, and dancing, swimming, and water aerobics (especially to music)"

What is exercise economy?

"The volume of oxygen required to move at a given speed, power output, or work rate

What is atlantoaxial instability?

"Abnormal movement between the first and second vertebrae (bones) in the neck"

In which population is atlantoaxial instability much more common?

"People with Down syndrome"

What is usually recommended when symptoms of atlantoaxial instability are present?

"Surgical repair"

What precaution should be taken whenever a person with Down syndrome undergoes anesthesia?

"Caution to prevent spinal injury

What is intellectual disability (ID)?

"A general deficit in cognitive ability resulting from a variety of different sources"

Name sources/causes of intellectual disability.

"Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions (like cri-du-chat or Prader Willi syndrome), infections, birth defects, asphyxia during birth, and metabolic conditions

Are medications prescribed to improve intellectual disability itself?

No

What has research shown about the effects of exercise on cognitive abilities/behavior in people with ID?

"Exercise has a temporary but positive effect, similar to the general population, though few controlled studies exist across different ID etiologies

What is dementia?

"An umbrella term describing a collection of symptoms relating to a loss of memory and brain function that interferes with daily life"

How does Alzheimer's disease (AD) differ from dementia in general?

"AD is progressive and degenerative, whereas dementia may be more static or even reversible

At what age does Alzheimer's disease usually begin, and how does risk change with age?

Usually after age 60, with risk progressively increasing with age

What are possible risk factors for Alzheimer's disease?

"Genetic predisposition, high blood pressure, high cholesterol, and a history of diabetes"

What neural changes is Alzheimer's disease thought to be associated with?

"Amyloid plaques building up between neurons and neurofibrillary tangles forming within neurons"

What exercise accommodations may be needed for individuals with deteriorating dementia and how should an exercise professional respond to anger outbursts?

• Accommodations for wheelchairs or walkers

• Repetition of instructions with patience