The following text relates to the next 3 questions. Please read it all the way through before responding.
James and John are identical twins born in 1950. They were adopted into separate families at birth. James grew up in a wealthy family in an affluent suburb of Melbourne with parents with advanced degrees. James himself has a PhD and has been a lifelong participant in track and field. Growing up, James had easy access to pavements and bike ways allowing him to actively commute and his parents had easy access to fresh food. As a result of his track and field competitions he has maintained a healthy BMI and he maintains a healthy lifestyle living on a Mediterranean diet and drinking very little alcohol and avoiding smoking. He also engages in regular cognitive training with some apps on his phone. John grew up in a loving family in a rundown suburb of Melbourne. There wasn’t much opportunity for active commuting growing up and as his family was situated in a “food desert” it was difficult to access fresh food and take-away meals were a regular feature of his family’s diet. He left school at 16 and went onto becoming a semi-pro boxer in his youth. During his boxing career he suffered several traumatic brain injuries. Following his boxing career, he admits that the excessive restrictions associated with making weight have led him to consume an unhealthy diet and he has been obese (BMI 31kg/m2) since his late 30’s. He also admits that he drinks too much and has suffered from hypertension since his 40’s. John also smokes and has done so since his teens and he finds it hard to make time to be physically active and he also has some problems sleeping at night.
18A. Using the information from the case studies above and what you know about the evidence on the risk factors for cognitive decline and dementia, comment on James’ and John’s risk profile for cognitive decline/dementia (6 marks). Hint: Use Fig. 1 – Strength of Evidence for Risk Factors for Cognitive Decline and Dementia
18B. John recently had an unexpected fall which resulted in a badly sprained wrist. His GP has recommended that he start exercising again. As an exercise science professional John has engaged you to help him reduce his risk of falls through a structured exercise program. Discuss with reference to key literature, the types of training you would have John do to reduce his risk of falling in the future (6 marks). Hint: Use Sherrington et al (2011) article
18C. List 3 barriers to physical activity in older adults? (3 marks).