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Oppewal A, Hilgenkamp TIM. The association between gait and physical fitness in adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:454-466. [PMID: 29575346 DOI: 10.1111/jir.12484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 01/26/2018] [Accepted: 02/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Gait deviations are often seen in adults with intellectual disabilities (ID). Their low physical fitness levels may be associated with these deviations. Understanding the impact of fitness on gait in this population is important for developing interventions to improve gait. In a cross-sectional study, we assessed the association between multiple physical fitness components and spatiotemporal gait parameters in adults with ID. METHOD Gait characteristics of 31 adults (42.77 ± 16.70 years) with ID without Down syndrome were assessed with the GAITRite at comfortable (CS) and fast speed (FS), along with fitness assessments (body composition, muscular endurance, strength, balance, Short Physical Performance Battery). RESULTS At CS, adults with ID with higher BMI and/or waist circumference spent more time in double support. At FS, those with better muscular endurance took steps faster, those with better balance took bigger steps and strides and those with better Short Physical Performance Battery scores took bigger steps and strides at higher velocity. CONCLUSIONS Body composition was mostly associated with gait at CS, while the other physical fitness components were mostly associated with gait at FS. Better fitness may therefore be more important in more challenging conditions. These insights are useful for developing interventions to improve gait in adults with ID.
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Affiliation(s)
- A Oppewal
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - T I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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102
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Effects of a 10-week multimodal exercise program on physical and cognitive function of nursing home residents: a psychomotor intervention pilot study. Aging Clin Exp Res 2018; 30:471-479. [PMID: 28776280 DOI: 10.1007/s40520-017-0803-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 07/17/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Nursing home institutionalization tends to exacerbate loss of functioning. AIMS Examine the feasibility and the effect of a psychomotor intervention-a multimodal exercise program promoting simultaneous cognitive and motor stimulation-on the executive (planning ability and selective attention) and physical function of nursing home residents. METHODS Seventeen participants engaged in a 10-week multimodal exercise program and 17 maintained usual activities. RESULTS Exercise group improved planning ability (25-32%), selective attention (19-67%), and physical function [aerobic endurance, lower body strength, agility, balance, gait, and mobility (19-41%)], corresponding to an effect size ranging from 0.29 (small) to 1.11 (high), p < 0.05. DISCUSSION The multimodal exercise program was feasible and well tolerated. The program improved executive and physical functions of the nursing home residents, reverting the usual loss of both cognitive and motor functioning in older adult institutionalized. CONCLUSIONS Multimodal exercise programs may help to maintain or improve nursing home residents' functioning.
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103
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The Effect of a Short Period of Supplementation with Glutamine Dipeptide on the Cognitive Responses after a Resistance Training Session of Women with HIV/AIDS: A Randomized Double-Blind Placebo-Controlled Crossover Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2525670. [PMID: 29850491 PMCID: PMC5903303 DOI: 10.1155/2018/2525670] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/25/2018] [Indexed: 02/06/2023]
Abstract
The aim of the present study was to investigate the effect of a short period of supplementation with glutamine dipeptide (GDP) on the acute responses to resistance training on the executive functions of people with HIV/AIDS. The sample consisted of 10 HIV+ women (45.00 ± 12.77 years old; 65.71 ± 12.04 kg; 1.54 ± 0.05 m) who were submitted to a randomized double-blind crossover procedure according to two experimental conditions: orally supplemented with 20 g/day of GDP or with maltodextrin for seven days. On the seventh day of supplementation all participants did cognitive function tests before and immediately after a resistance training session. Seven days of washout were adopted between conditions. Stroop and N-back tests were used to evaluate the executive functions. The training reduced the response time of each card in isolation and the latency time among them. GDP supplementation increased the magnitude of this effect, thus, reducing the latency time from the first to the last card in the Stroop test by almost 50% (P < 0.01). Considering the N-back test, there were no significant differences. It is suggested that GDP supplementation may increase the magnitude of the effect of an acute resistance training session in cognitive functions, particularly in the inhibitory control of people with HIV/AIDS. This trial is registered with NCT03236532.
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104
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Ahlskog JE. Aerobic Exercise: Evidence for a Direct Brain Effect to Slow Parkinson Disease Progression. Mayo Clin Proc 2018; 93:360-372. [PMID: 29502566 DOI: 10.1016/j.mayocp.2017.12.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/01/2017] [Accepted: 12/18/2017] [Indexed: 12/21/2022]
Abstract
No medications are proven to slow the progression of Parkinson disease (PD). Of special concern with longer-standing PD is cognitive decline, as well as motor symptoms unresponsive to dopamine replacement therapy. Not fully recognized is the substantial accumulating evidence that long-term aerobic exercise may attenuate PD progression. Randomized controlled trial proof will not be forthcoming due to many complicating methodological factors. However, extensive and diverse avenues of scientific investigation converge to argue that aerobic exercise and cardiovascular fitness directly influence cerebral mechanisms mediating PD progression. To objectively assess the evidence for a PD exercise benefit, a comprehensive PubMed literature search was conducted, with an unbiased focus on exercise influences on parkinsonism, cognition, brain structure, and brain function. This aggregate literature provides a compelling argument for regular aerobic-type exercise and cardiovascular fitness attenuating PD progression.
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105
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Panza GA, Taylor BA, MacDonald HV, Johnson BT, Zaleski AL, Livingston J, Thompson PD, Pescatello LS. Can Exercise Improve Cognitive Symptoms of Alzheimer's Disease? J Am Geriatr Soc 2018; 66:487-495. [DOI: 10.1111/jgs.15241] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Gregory A. Panza
- Department of Kinesiology; University of Connecticut; Storrs Connecticut
- Department of Cardiology; Hartford Hospital; Hartford Connecticut
| | - Beth A. Taylor
- Department of Kinesiology; University of Connecticut; Storrs Connecticut
- Department of Cardiology; Hartford Hospital; Hartford Connecticut
| | | | - Blair T. Johnson
- Department ofPyschosocial Sciences; University of Connecticut; Storrs Connecticut
| | - Amanda L. Zaleski
- Department of Kinesiology; University of Connecticut; Storrs Connecticut
- Department of Cardiology; Hartford Hospital; Hartford Connecticut
| | - Jill Livingston
- Department ofResearch Services; University of Connecticut; Storrs Connecticut
| | - Paul D. Thompson
- Department of Cardiology; Hartford Hospital; Hartford Connecticut
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106
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Lam FM, Huang MZ, Liao LR, Chung RC, Kwok TC, Pang MY. Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. J Physiother 2018; 64:4-15. [PMID: 29289581 DOI: 10.1016/j.jphys.2017.12.001] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/03/2017] [Accepted: 11/20/2017] [Indexed: 12/31/2022] Open
Abstract
QUESTION Does physical exercise training improve physical function and quality of life in people with cognitive impairment and dementia? Which training protocols improve physical function and quality of life? How do cognitive impairment and other patient characteristics influence the outcomes of exercise training? DESIGN Systematic review with meta-analysis of randomised trials. PARTICIPANTS People with mild cognitive impairment or dementia as the primary diagnosis. INTERVENTION Physical exercise. OUTCOME MEASURES Strength, flexibility, gait, balance, mobility, walking endurance, dual-task ability, activities of daily living, quality of life, and falls. RESULTS Forty-three clinical trials (n=3988) were included. According to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system, the meta-analyses revealed strong evidence in support of using supervised exercise training to improve the results of 30-second sit-to-stand test (MD 2.1 repetitions, 95% CI 0.3 to 3.9), step length (MD 5cm, 95% CI 2 to 8), Berg Balance Scale (MD 3.6 points, 95% CI 0.3 to 7.0), functional reach (3.9cm, 95% CI 2.2 to 5.5), Timed Up and Go test (-1second, 95% CI -2 to 0), walking speed (0.13m/s, 95% CI 0.03 to 0.24), and 6-minute walk test (50m, 95% CI 18 to 81) in individuals with mild cognitive impairment or dementia. Weak evidence supported the use of exercise in improving flexibility and Barthel Index performance. Weak evidence suggested that non-specific exercise did not improve dual-tasking ability or activity level. Strong evidence indicated that exercise did not improve quality of life in this population. The effect of exercise on falls remained inconclusive. Poorer physical function was a determinant of better response to exercise training, but cognitive performance did not have an impact. CONCLUSION People with various levels of cognitive impairment can benefit from supervised multi-modal exercise for about 60minutes a day, 2 to 3days a week to improve physical function. [Lam FMH , Huang MZ, Liao LR, Chung RCK, Kwok TCY, Pang MYC (2018) Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. Journal of Physiotherapy 64: 4-15].
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Affiliation(s)
- Freddy Mh Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Mei-Zhen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Lin-Rong Liao
- Department of Rehabilitation, Jiangsu Provincial Yixing Jiuru Rehabilitation Hospital, Yixing, China
| | - Raymond Ck Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Timothy Cy Kwok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Marco Yc Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review. Eur Rev Aging Phys Act 2017; 14:20. [PMID: 29276545 PMCID: PMC5738846 DOI: 10.1186/s11556-017-0189-z] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/05/2017] [Indexed: 01/11/2023] Open
Abstract
The decline in cognitive and motor functions with age affects the performance of the aging healthy population in many daily life activities. Physical activity appears to mitigate this decline or even improve motor and cognitive abilities in older adults. The current systematic review will focus mainly on behavioral studies that look into the dual effects of different types of physical training (e.g., balance training, aerobic training, strength training, group sports, etc.) on cognitive and motor tasks in older adults with no known cognitive or motor disabilities or disease. Our search retrieved a total of 1095 likely relevant articles, of which 41 were considered for full-text reading and 19 were included in the review after the full-text reading. Overall, observations from the 19 included studies conclude that improvements on both motor and cognitive functions were found, mainly in interventions that adopt physical-cognitive training or combined exercise training. While this finding advocates the use of multimodal exercise training paradigms or interventions to improve cognitive-motor abilities in older adults, the sizeable inconsistency among training protocols and endpoint measures complicates the generalization of this finding.
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108
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Marmeleira J, Galhardas L, Raimundo A. Exercise merging physical and cognitive stimulation improves physical fitness and cognitive functioning in older nursing home residents: a pilot study. Geriatr Nurs 2017; 39:303-309. [PMID: 29221898 DOI: 10.1016/j.gerinurse.2017.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/25/2017] [Accepted: 10/30/2017] [Indexed: 12/21/2022]
Abstract
The main purpose of this pilot study was to examine the feasibility and the effects of a multimodal exercise intervention on the physical and cognitive functioning of institutionalized older people. Twenty-one older adults (83.5 ± 4.9 years) living in two nursing home residences, were tested on two occasions 4 weeks apart to establish a baseline measure, and then engage in the exercise program twice weekly for 8 weeks. Participants were tested again after the exercise program. Almost all physical fitness and cognitive tests were unchanged at baseline measures, but after the exercise program, significant improvements (p < 0.05) were found in all physical fitness variables (strength, cardiorespiratory endurance, flexibility and balance) and in the majority of cognitive variables (visual attention, executive functioning and information processing speed). Exercise merging physical and cognitive stimulation could have broad impacts in the individual's level of functioning and should be promoted in nursing home residences for the elderly.
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Affiliation(s)
- José Marmeleira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Évora, Portugal; Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal.
| | - Luís Galhardas
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Évora, Portugal; Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal
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109
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Physical activity and physical fitness of nursing home residents with cognitive impairment: A pilot study. Exp Gerontol 2017; 100:63-69. [DOI: 10.1016/j.exger.2017.10.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 09/16/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022]
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110
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Nyman SR, Adamczewska N, Howlett N. Systematic review of behaviour change techniques to promote participation in physical activity among people with dementia. Br J Health Psychol 2017; 23:148-170. [PMID: 28980370 DOI: 10.1111/bjhp.12279] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/03/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this study was to systematically review the evidence for the potential promise of behaviour change techniques (BCTs) to increase physical activity among people with dementia (PWD). METHODS PsychINFO, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials databases were searched 01/01/2000-01/12/2016. Randomized controlled/quasi-randomized trials were included if they recruited people diagnosed/suspected to have dementia, used at least one BCT in the intervention arm, and had at least one follow-up measure of physical activity/adherence. Studies were appraised using the Cochrane Collaboration Risk of Bias Tool, and BCTs were coded using Michie et al., 2013, Annals of Behavioral Medicine, 46, 81. taxonomy. Intervention findings were narratively synthesized as either 'very promising', 'quite promising', or 'non-promising', and BCTs were judged as having potential promise if they featured in at least twice as many very/quite promising than non-promising interventions (as per Gardner et al., 2016, Health Psychology Review, 10, 89). RESULTS Nineteen articles from nine trials reported physical activity findings on behavioural outcomes (two very promising, one quite promising, and two non-promising) or intervention adherence (one quite promising and four non-promising). Thirteen BCTs were used across the interventions. While no BCT had potential promise to increase intervention adherence, three BCTs had potential promise for improving physical activity behaviour outcomes: goal setting (behaviour), social support (unspecified), and using a credible source. CONCLUSIONS Three BCTs have potential promise for use in future interventions to increase physical activity among PWD. Statement of contribution What is already known on this subject? While physical activity is a key lifestyle factor to enhance and maintain health and wellbeing amongst the general population, adults rarely participate in sufficient levels to obtain these benefits. Systematic reviews suggest that specific behaviour change techniques can increase physical activity, although one review suggested that self-regulatory techniques may be counterproductive when promoting physical activity among older people. Until now, no systematic review has been conducted to assess which behaviour change techniques may be associated with greater participation in physical activity among people with dementia. What does this study add? Interventions showed mixed promise for increasing physical activity and little effect on participant adherence. Goal setting (behaviour), social support (unspecified), and using a credible source are promising approaches. No technique showed promise for increasing adherence to physical activity interventions among people with dementia.
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Affiliation(s)
- Samuel R Nyman
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK
| | - Natalia Adamczewska
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK
| | - Neil Howlett
- Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
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111
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Brini S, Sohrabi HR, Peiffer JJ, Karrasch M, Hämäläinen H, Martins RN, Fairchild TJ. Physical Activity in Preventing Alzheimer’s Disease and Cognitive Decline: A Narrative Review. Sports Med 2017; 48:29-44. [DOI: 10.1007/s40279-017-0787-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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112
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The Effects of a Multicomponent Dyadic Intervention With Physical Exercise on the Cognitive Functioning of People With Dementia: A Randomized Controlled Trial. J Aging Phys Act 2017; 25:539-552. [PMID: 28120631 DOI: 10.1123/japa.2016-0038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective was to evaluate the effects of a multicomponent dyadic intervention on the cognitive functioning of people with dementia living at home in a randomized controlled trial. People with dementia and their family caregivers (n = 111) were randomly assigned to 8 home-based sessions including physical exercise and support or a minimal intervention consisting of monthly written information bulletins and monthly phone calls. Memory, executive functioning (EF), and attention were assessed at baseline, and after 3 (postmeasurement) and 6 months (follow-up). Data were analyzed by using generalized estimating equations (GEE). A small, significant effect was found on attention. No effects were found on memory and EF. Finding only a small significant effect might be explained by the ineffectiveness of the intervention, but also by moderate treatment adherence or a lack of room for improvement because half of the people with dementia were already receiving care in a day care facility.
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113
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Bénéfices de l’activité physique en endurance chez les seniors âgés de 70 ans ou plus : une revue systématique. Presse Med 2017; 46:794-807. [DOI: 10.1016/j.lpm.2017.05.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 05/07/2017] [Accepted: 05/23/2017] [Indexed: 01/13/2023] Open
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114
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Körperliche Aktivität zur Stärkung kognitiver Ressourcen. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2017. [DOI: 10.1007/s11553-017-0612-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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115
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Bossers WJR, van der Woude LHV, Boersma F, Hortobágyi T, Scherder EJA, van Heuvelen MJG. Comparison of Effect of Two Exercise Programs on Activities of Daily Living in Individuals with Dementia: A 9-Week Randomized, Controlled Trial. J Am Geriatr Soc 2017; 64:1258-66. [PMID: 27321604 DOI: 10.1111/jgs.14160] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare the effects of two exercise programs on proxy- and performance-based measures of activities of daily living (ADLs) and to explore potential motor and cognitive mediators underlying ADL improvements in individuals with dementia. DESIGN A parallel, three-group, single-blind, randomized, controlled trial. SETTING Psychogeriatric wards. PARTICIPANTS Individuals with dementia (mean age 85.6 ± 5.1). INTERVENTIONS Each 9-week intervention consisted of thirty-six 30-minute sessions. A combined group (n = 35) participated in two strength and two walking sessions, an aerobic group (n = 35) participated in four walking sessions, and a social control group (n = 35) participated in four nonexercise social visits per week. The social group was used as a reference for the mediation analysis, which was performed in the combined and aerobic groups. MEASUREMENTS ADLs were assessed using the Katz index (proxy-reported ADL performance), Erlangen-ADL test (E-ADL) (instrumental ADL performance), and 7-item Physical Performance Test (PPT-7) (physical ADL performance). RESULTS There was a group effect for Katz index (P = .02), E-ADL (P < .001), and PPT-7 (P = .003). Differences from baseline to after the intervention were similar in the combined and aerobic groups. Exercise-induced changes in global cognition mediated changes in Katz index (95% confidence interval (CI) = 0.05-0.41), leg muscle strength mediated changes in E-ADL (95% CI = 0.03-0.43), and leg muscle strength (95% CI = 0.01-0.36) and walking endurance (95% CI = 0.01-0.43) mediated changes in PPT-7 only in the combined group. CONCLUSION Physical exercise can improve ADL levels in individuals with dementia, but improvements are small and seem independent of exercise type. Additional analyses suggest that combined aerobic and strength exercise may be more effective than aerobic-only exercise to effectively target ADL dysfunction in individuals with dementia. Future research is warranted to justify these exercise-specific findings.
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Affiliation(s)
- Willem J R Bossers
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Froukje Boersma
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik J A Scherder
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Marieke J G van Heuvelen
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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116
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Dinoff A, Herrmann N, Swardfager W, Lanctôt KL. The effect of acute exercise on blood concentrations of brain-derived neurotrophic factor in healthy adults: a meta-analysis. Eur J Neurosci 2017; 46:1635-1646. [PMID: 28493624 DOI: 10.1111/ejn.13603] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/20/2017] [Accepted: 05/01/2017] [Indexed: 12/12/2022]
Abstract
It has been hypothesized that one mechanism through which physical activity provides benefits to cognition and mood is via increasing brain-derived neurotrophic factor (BDNF) concentrations. Some studies have reported immediate benefits to mood and various cognitive domains after a single session of exercise. This meta-analysis sought to determine the effect of a single exercise session on concentrations of BDNF in peripheral blood, in order to evaluate the potential role of BDNF in mediating the beneficial effects of exercise on brain health. MEDLINE, Embase, PsycINFO, SPORTDiscus, Rehabilitation & Sports Medicine Source, and CINAHL databases were searched for original, peer-reviewed reports of peripheral blood BDNF concentrations before and after acute exercise interventions. Risk of bias within studies was assessed using standardized criteria. Standardized mean differences (SMDs) were generated from random effects models. Risk of publication bias was assessed using a funnel plot and Egger's test. Potential sources of heterogeneity were explored in subgroup analyses. In 55 studies that met inclusion criteria, concentrations of peripheral blood BDNF were higher after exercise (SMD = 0.59, 95% CI: 0.46-0.72, P < 0.001). In meta-regression analysis, greater duration of exercise was associated with greater increases in BDNF. Subgroup analyses revealed an effect in males but not in females, and a greater BDNF increase in plasma than serum. Acute exercise increased BDNF concentrations in the peripheral blood of healthy adults. This effect was influenced by exercise duration and may be different across genders.
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Affiliation(s)
- Adam Dinoff
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Walter Swardfager
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
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117
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Roemers P, Mazzola PN, De Deyn PP, Bossers WJ, van Heuvelen MJG, van der Zee EA. Burrowing as a novel voluntary strength training method for mice: A comparison of various voluntary strength or resistance exercise methods. J Neurosci Methods 2017; 300:112-126. [PMID: 28587894 DOI: 10.1016/j.jneumeth.2017.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/01/2017] [Accepted: 05/30/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. NEW METHOD The current study tested functional and muscular effects of two novel voluntary strength training methods, burrowing (digging a substrate out of a tube) and unloaded tower climbing, in male C57Bl6 mice. To compare these two novel methods with existing exercise methods, resistance running and (non-resistance) running were included. Motor coordination, grip strength and muscle fatigue were measured at baseline, halfway through and near the end of a fourteen week exercise intervention. Endurance was measured by an incremental treadmill test after twelve weeks. RESULTS Both burrowing and resistance running improved forelimb grip strength as compared to controls. Running and resistance running increased endurance in the treadmill test and improved motor skills as measured by the balance beam test. Post-mortem tissue analyses revealed that running and resistance running induced Soleus muscle hypertrophy and reduced epididymal fat mass. Tower climbing elicited no functional or muscular changes. COMPARISON WITH EXISTING METHODS As a voluntary strength exercise method, burrowing avoids the confounding effects of stress and positive reinforcers elicited in forced strength exercise methods. Compared to voluntary resistance running, burrowing likely reduces the contribution of aerobic exercise components. CONCLUSIONS Burrowing qualifies as a suitable voluntary strength training method in mice. Furthermore, resistance running shares features of strength training and endurance (aerobic) exercise and should be considered a multi-modal aerobic-strength exercise method in mice.
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Affiliation(s)
- P Roemers
- Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, The Netherlands.
| | - P N Mazzola
- Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, The Netherlands
| | - P P De Deyn
- Department of Neurology and Alzheimer Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W J Bossers
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M J G van Heuvelen
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - E A van der Zee
- Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, The Netherlands.
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Karssemeijer EGA, Bossers WJR, Aaronson JA, Kessels RPC, Olde Rikkert MGM. The effect of an interactive cycling training on cognitive functioning in older adults with mild dementia: study protocol for a randomized controlled trial. BMC Geriatr 2017; 17:73. [PMID: 28327083 PMCID: PMC5361710 DOI: 10.1186/s12877-017-0464-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 03/14/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To date there is no cure or an effective disease-modifying drug to treat dementia. Available acetylcholine-esterase inhibiting drugs or memantine only produce small benefits on cognitive and behavioural functioning and their clinical relevance remains controversial. Combined cognitive-aerobic interventions are an appealing alternative or add-on to current pharmacological treatments. The primary aim of this study is to investigate the efficacy of a combined cognitive-aerobic training and a single aerobic training compared to an active control group in older adults with mild dementia. We expect to find a beneficial effect on executive functioning in both training regimes, compared to the control intervention, with the largest effect in the combined cognitive-aerobic group. Secondary, intervention effects on cognitive functioning in other domains, physical functioning, physical activity levels, activities of daily living, frailty and quality of life are studied. METHODS The design is a single-blind, randomized controlled trial (RCT) with three groups: a combined cognitive-aerobic bicycle training (interactive cycling), a single aerobic bicycle training and a control intervention, which consists of stretching and toning exercises. Older adults with mild dementia follow a 12-week training program consisting of three training sessions of 30-40 min per week. The primary study outcome is objective executive functioning measured with a neuropsychological assessment. Secondary measures are objective cognitive functioning in other domains, physical functioning, physical activity levels, activities of daily living, frailty, mood and quality of life. The three groups are compared at baseline, after 6 and 12 weeks of training, and at 24-week follow-up. DISCUSSION This study will provide novel information on the effects of an interactive cycling training on executive function in older adults with mild dementia. Furthermore, since this study has both a combined cognitive-aerobic training and a single aerobic training group the effectiveness of the different components of the intervention can be identified. The results of this study may be used for physical and mental activity recommendations in older adults with dementia. TRIAL REGISTRATION The Netherlands National Trial Register NTR5581 . Registered 14 February 2016.
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Affiliation(s)
- E G A Karssemeijer
- Department of Geriatric Medicine, Donders Institute for Brain Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands. .,Radboud university medical center, Radboudumc Alzheimer Center, PO 9101 (hp 925), Nijmegen, 6500 HB, The Netherlands.
| | - W J R Bossers
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - J A Aaronson
- Department of Medical Psychology, Donders Institute for Brain Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - R P C Kessels
- Department of Medical Psychology, Donders Institute for Brain Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - M G M Olde Rikkert
- Department of Geriatric Medicine, Donders Institute for Brain Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.,Radboud university medical center, Radboudumc Alzheimer Center, PO 9101 (hp 925), Nijmegen, 6500 HB, The Netherlands
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Castellano CA, Paquet N, Dionne IJ, Imbeault H, Langlois F, Croteau E, Tremblay S, Fortier M, Matte JJ, Lacombe G, Fülöp T, Bocti C, Cunnane SC. A 3-Month Aerobic Training Program Improves Brain Energy Metabolism in Mild Alzheimer’s Disease: Preliminary Results from a Neuroimaging Study. J Alzheimers Dis 2017; 56:1459-1468. [DOI: 10.3233/jad-161163] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Christian-Alexandre Castellano
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Department of Physiology and Pharmacology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nancy Paquet
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle J. Dionne
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Imbeault
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
| | - Francis Langlois
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
| | - Etienne Croteau
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Department of Physiology and Pharmacology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sébastien Tremblay
- Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Fortier
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
| | | | - Guy Lacombe
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Tamás Fülöp
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Christian Bocti
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Stephen C. Cunnane
- Research Center on Aging, Health and Social Services Center - Sherbrooke University Geriatrics Institute, CIUSSS de l’Estrie - CHUS, Sherbrooke, QC, Canada
- Department of Physiology and Pharmacology, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
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Szalewska D, Radkowski M, Demkow U, Winklewski PJ. Exercise Strategies to Counteract Brain Aging Effects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1020:69-79. [PMID: 28382606 DOI: 10.1007/5584_2017_3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Stimulating structural and functional adaptation that improves cognitive performance in specific tasks is the major objective of therapeutic exercise training. In this review we briefly summarize central physiological mechanisms activated by exercise. We further discuss the influence of different kinds of exercise on cognitive improvement. In particular, the effects on cognitive function of aerobic endurance, resistance and respiratory exercise, and combinations thereof are presented. The accumulating evidence reinforces the position that regular aerobic, and possibly also resistance training, offers a powerful tool to cope with biologic aging of central nervous system functions. Nevertheless, the potential magnitude of cognition improvement or restrain of age-related cognition deterioration and the quantity of physical activity required to induce meaningful responses remain to be clarified.
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Affiliation(s)
| | - Marek Radkowski
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Demkow
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
| | - Pawel J Winklewski
- Department of Human Physiology, Medical University of Gdansk, 15 Tuwima Street, 80-210, Gdansk, Poland. .,Department of Clinical Sciences, Institute of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland.
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Zeng Z, Deng YH, Shuai T, Zhang H, Wang Y, Song GM. Effect of physical activity training on dementia patients: A systematic review with a meta-analysis. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.cnre.2016.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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The Effect of Exercise Training on Resting Concentrations of Peripheral Brain-Derived Neurotrophic Factor (BDNF): A Meta-Analysis. PLoS One 2016; 11:e0163037. [PMID: 27658238 PMCID: PMC5033477 DOI: 10.1371/journal.pone.0163037] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/01/2016] [Indexed: 12/23/2022] Open
Abstract
Background The mechanisms through which physical activity supports healthy brain function remain to be elucidated. One hypothesis suggests that increased brain-derived neurotrophic factor (BDNF) mediates some cognitive and mood benefits. This meta-analysis sought to determine the effect of exercise training on resting concentrations of BDNF in peripheral blood. Methods MEDLINE, Embase, PsycINFO, SPORTDiscus, Rehabilitation & Sports Medicine Source, and CINAHL databases were searched for original, peer-reviewed reports of peripheral blood BDNF concentrations before and after exercise interventions ≥ 2 weeks. Risk of bias was assessed using standardized criteria. Standardized mean differences (SMDs) were generated from random effects models. Risk of publication bias was assessed using funnel plots and Egger’s test. Potential sources of heterogeneity were explored in subgroup analyses. Results In 29 studies that met inclusion criteria, resting concentrations of peripheral blood BDNF were higher after intervention (SMD = 0.39, 95% CI: 0.17–0.60, p < 0.001). Subgroup analyses suggested a significant effect in aerobic (SMD = 0.66, 95% CI: 0.33–0.99, p < 0.001) but not resistance training (SMD = 0.07, 95% CI: -0.15–0.30, p = 0.52) interventions. No significant difference in effect was observed between males and females, nor in serum vs plasma. Conclusion Aerobic but not resistance training interventions increased resting BDNF concentrations in peripheral blood.
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van Alphen HJ, Hortobágyi T, van Heuvelen MJ. Barriers, motivators, and facilitators of physical activity in dementia patients: A systematic review. Arch Gerontol Geriatr 2016; 66:109-18. [DOI: 10.1016/j.archger.2016.05.008] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 05/09/2016] [Accepted: 05/29/2016] [Indexed: 11/30/2022]
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van Alphen HJM, Volkers KM, Blankevoort CG, Scherder EJA, Hortobágyi T, van Heuvelen MJG. Older Adults with Dementia Are Sedentary for Most of the Day. PLoS One 2016; 11:e0152457. [PMID: 27031509 PMCID: PMC4816298 DOI: 10.1371/journal.pone.0152457] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 03/15/2016] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Self-reported data suggest that older adults with dementia are inactive. The purpose of the present study was to objectively assess the physical activity (PA) levels of community-dwelling and institutionalized ambulatory patients with dementia, and to compare with the PA levels of cognitive healthy older adults. METHODS We used actigraphy to assess the PA levels in institutionalized (n = 83, age: 83.0 ± 7.6, Mini-Mental-State Examination (MMSE): 15.5 ± 6.5) and community-dwelling dementia patients (n = 37, age: 77.3 ± 5.6, MMSE-score: 20.8 ± 4.8), and healthy older adults (n = 26, age: 79.5 ± 5.6, MMSE-score: 28.2 ± 1.6). We characterized PA levels based on the raw data and classified <100 counts/min as sedentary behavior. RESULTS Institutionalized dementia patients had the lowest daily PA levels (1.69 ± 1.33 counts/day), spent 72.1% of the day sedentary, and were most active between 8:00 and 9:00 am. Institutionalized vs. community-dwelling dementia patients had 23.5% lower daily PA levels (difference M = 0.52, p = .004) and spent 9.3% longer in sedentariness (difference M = 1.47, p = .032). Community-dwelling dementia patients spent 66.0% of the day sedentary and were most active between 9:00 to 10:00 am with a second peak between 14:00 to 15:00. Community-dwelling dementia patients vs healthy older adults' daily PA levels and sedentary time were 21.6% lower and 8.9% longer, respectively (difference M = 0.61, p = .007; difference M = 1.29, p = .078). CONCLUSIONS Institutionalized and community-dwelling dementia patients are sedentary for most of the day and the little PA they perform is of lower intensity compared to their healthy peers. Their highest PA peak is when they get out of bed in the morning. In addition, it seems that institutionalized living is associated with lower PA levels in dementia patients. These are the first results that objectively characterize institutionalized as well as community-dwelling dementia patients' PA levels and confirm that dementia patients are inactive.
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Affiliation(s)
- Helena J. M. van Alphen
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Karin M. Volkers
- Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | | | - Erik J. A. Scherder
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke J. G. van Heuvelen
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
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Groot C, Hooghiemstra A, Raijmakers P, van Berckel B, Scheltens P, Scherder E, van der Flier W, Ossenkoppele R. The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials. Ageing Res Rev 2016; 25:13-23. [PMID: 26607411 DOI: 10.1016/j.arr.2015.11.005] [Citation(s) in RCA: 367] [Impact Index Per Article: 45.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/10/2015] [Accepted: 11/16/2015] [Indexed: 12/21/2022]
Abstract
Non-pharmacological therapies, such as physical activity interventions, are an appealing alternative or add-on to current pharmacological treatment of cognitive symptoms in patients with dementia. In this meta-analysis, we investigated the effect of physical activity interventions on cognitive function in dementia patients, by synthesizing data from 802 patients included in 18 randomized control trials that applied a physical activity intervention with cognitive function as an outcome measure. Post-intervention standardized mean difference (SMD) scores were computed for each study, and combined into pooled effect sizes using random effects meta-analysis. The primary analysis yielded a positive overall effect of physical activity interventions on cognitive function (SMD[95% confidence interval]=0.42[0.23;0.62], p<.01). Secondary analyses revealed that physical activity interventions were equally beneficial in patients with Alzheimer's disease (AD, SMD=0.38[0.09;0.66], p<.01) and in patients with AD or a non-AD dementia diagnosis (SMD=0.47[0.14;0.80], p<.01). Combined (i.e. aerobic and non-aerobic) exercise interventions (SMD=0.59[0.32;0.86], p<.01) and aerobic-only exercise interventions (SMD=0.41[0.05;0.76], p<.05) had a positive effect on cognition, while this association was absent for non-aerobic exercise interventions (SMD=-0.10[-0.38;0.19], p=.51). Finally, we found that interventions offered at both high frequency (SMD=0.33[0.03;0.63], p<.05) and at low frequency (SMD=0.64[0.39;0.89], p<.01) had a positive effect on cognitive function. This meta-analysis suggests that physical activity interventions positively influence cognitive function in patients with dementia. This beneficial effect was independent of the clinical diagnosis and the frequency of the intervention, and was driven by interventions that included aerobic exercise.
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de Souto Barreto P, Demougeot L, Pillard F, Lapeyre-Mestre M, Rolland Y. Exercise training for managing behavioral and psychological symptoms in people with dementia: A systematic review and meta-analysis. Ageing Res Rev 2015; 24:274-85. [PMID: 26369357 DOI: 10.1016/j.arr.2015.09.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/20/2015] [Accepted: 09/09/2015] [Indexed: 12/11/2022]
Abstract
This systematic review and meta-analysis of randomized controlled trials assessed the effects of exercise on behavioral and psychological symptoms of dementia (BPSD, including depression) in people with dementia (PWD). Secondary outcomes for the effects of exercise were mortality and antipsychotic use. Twenty studies were included in this review (n=18 in the meta-analysis). Most studies used a multicomponent exercise training (n=13) as intervention; the control group was often a usual care (n=10) or a socially-active (n=8) group. Exercise did not reduce global levels of BPSD (n=4. Weighted mean difference -3.884; 95% CI -8.969-1.201; I(2)=69.4%). Exercise significantly reduced depression levels in PWD (n=7). Standardized mean difference -0.306; 95% CI -0.571 to -0.041; I(2)=46.8%); similar patterns were obtained in sensitivity analysis performed among studies with: institutionalized people (p=0.038), multicomponent training (p=0.056), social control group (p=0.08), and low risk of attrition bias (p=0.11). Exploratory analysis showed that the principal BPSD (other than depression) positively affected by exercise was aberrant motor behavior. Exercise had no effect on mortality. Data on antipsychotics were scarce. In conclusion, exercise reduces depression levels in PWD. Future studies should examine whether exercise reduces the use (and doses) of antipsychotics and other drugs often used to manage BPSD.
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Small GW, Greenfield S. Current and Future Treatments for Alzheimer Disease. Am J Geriatr Psychiatry 2015; 23:1101-5. [PMID: 26614911 DOI: 10.1016/j.jagp.2015.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 08/29/2015] [Accepted: 08/31/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Gary W Small
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior (GWS), UCLA Longevity Center, David Geffen School of Medicine, University of California, Los Angeles, CA.
| | - Susan Greenfield
- Department of Pharmacology (SG), University of Oxford, Oxford, UK
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Oesen S, Halper B, Hofmann M, Jandrasits W, Franzke B, Strasser EM, Graf A, Tschan H, Bachl N, Quittan M, Wagner KH, Wessner B. Effects of elastic band resistance training and nutritional supplementation on physical performance of institutionalised elderly--A randomized controlled trial. Exp Gerontol 2015; 72:99-108. [PMID: 26341720 DOI: 10.1016/j.exger.2015.08.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 08/06/2015] [Accepted: 08/25/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the effects of elastic band resistance training in combination with nutrient supplementation on muscular strength and the ability to perform mobility-related activities of daily living in older adults living in retirement care facilities. DESIGN Randomized controlled trial, with a 6-month intervention period. SETTING A retirement care facility, Vienna, Austria. PARTICIPANTS One hundred and seventeen older adults (14 males (12%) and 103 females (88%)), aged 65 to 97 years (mean age: 82.8 ± 6.0), having a mini-mental state examination score ≥ 23 and no chronic diseases posing a medical contraindication to training therapy. INTERVENTION Participants were randomly assigned, but stratified by sex, to one of three intervention groups: supervised resistance exercise training (RT), RT in combination with nutrient supplementation (RTS), or cognitive training group (CT). All interventions were performed two times a week for 6 months. RT was designed to train all major muscle groups using elastic bands. The nutrient supplement (rich in proteins, vitamin D, B2, B12) was distributed every morning as well as after each RT session. MEASUREMENTS A battery of motor ability tests and functional test were performed prior to as well as following 3 months and finally after 6 months of intervention. These tests included isokinetic torque measurements of the knee extensors and flexors in concentric mode at 60 and 120°/s, isometric handgrip strength, senior arm-lifting test, chair stand test, maximum walking speed and a 6-minute walking test (6 MWT). RESULTS A repeated-measures ANOVA analysis revealed significant improvements in physical function of lower (p=0.002) and upper extremities (p=0.006) for RT and/or RTS in comparison to CT. For isokinetic measurements, 6 MWT, and gait speed time effects (p<0.05) were detected without any group × time interaction effects. Dropouts showed lower performance in chair stand test (p=0.012), 6 MWT (p=0.003), and gait speed (p=0.013) at baseline than that of the finishers of the study. CONCLUSION Six months of a low intensity resistance exercise using elastic bands and own body weight is safe and beneficial in improving functional performance of institutionalised older people. Multinutrient supplementation did not offer additional benefits to the effects of RT in improving muscular performance.
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Affiliation(s)
- Stefan Oesen
- Research Platform Active Ageing, University of Vienna, Vienna, Austria.
| | - Barbara Halper
- Research Platform Active Ageing, University of Vienna, Vienna, Austria.
| | - Marlene Hofmann
- Research Platform Active Ageing, University of Vienna, Vienna, Austria.
| | | | - Bernhard Franzke
- Research Platform Active Ageing, University of Vienna, Vienna, Austria.
| | - Eva-Maria Strasser
- Karl Landsteiner Institute for Remobilization and Functional Health and Institute for Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Social Medical Center South, Kundratstrasse 3, 1100 Vienna, Austria.
| | - Alexandra Graf
- Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
| | - Harald Tschan
- Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria.
| | - Norbert Bachl
- Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria.
| | - Michael Quittan
- Karl Landsteiner Institute for Remobilization and Functional Health and Institute for Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Social Medical Center South, Kundratstrasse 3, 1100 Vienna, Austria.
| | - Karl Heinz Wagner
- Research Platform Active Ageing, University of Vienna, Vienna, Austria; Faculty of Life Sciences, Department of Nutritional Science, University of Vienna, Althanstraße 14, 1090 Vienna, Austria.
| | - Barbara Wessner
- Research Platform Active Ageing, University of Vienna, Vienna, Austria; Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria.
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