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Li Z, Guo H, Liu X. What exercise strategies are best for people with cognitive impairment and dementia? A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 124:105450. [PMID: 38692156 DOI: 10.1016/j.archger.2024.105450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/03/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Explore the types of exercise that are appropriate for people with dementia, as well as the intensity and frequency of exercise training that is appropriate for older patients to carry out. METHODS Cochrane Library, PubMed, Embase, Web of Science, Scopus databases were searched by computer to collect RCT studies that met the inclusion criteria of this article. The search time limit was until January 2024. Two reviewers independently screened literature, extracted data, and assessed the quality and risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.4 and Stata 15.1 software. RESULTS The results of our study showed that physical exercise improved patients' cognitive ability and walking ability, with aerobic and multicomponent training showing the best improvement, and that the number of training sessions should not be too high, with the experimental group showing the best results when the total number of interventions was less than 30. CONCLUSION We recommend long-term exercise training for middle-aged and elderly patients with dementia or those who are predisposed to dementia. The type of training we recommend is multi-component training and aerobic training, and we recommend 2-3 sessions of exercise per week for about 60 min each.
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Affiliation(s)
- Zecheng Li
- College of Sports Science, Harbin Normal University, Harbin, China
| | - Hongpeng Guo
- College of Sports Science, Harbin Normal University, Harbin, China.
| | - Xuebin Liu
- College of Sports Science, Harbin Normal University, Harbin, China
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Cai Z, Cai R, Sen L. Effects of different types of physical exercise on executive function of older adults: a scoping review. Front Psychol 2024; 15:1376688. [PMID: 39006543 PMCID: PMC11239569 DOI: 10.3389/fpsyg.2024.1376688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Objective This scoping review examined the impact of physical exercise on executive function (EF) in older adults and investigated the moderating effects of exercise types. Methods We systematically searched four electronic databases for randomized controlled trials (RCTs) investigating the effects of exercise on EF, published until November 26, 2023. The proportions of positive and null/negative effects across all studies were calculated. Results In total, 91 studies were included in the analysis. Among these, 27 (29.7%) studies employed aerobic exercise interventions for older adults' EF, with 19 (70.4%) studies reporting positive effects. Additionally, 18 (19.8%) studies utilized strength exercise interventions for older adults' EF, with 15 (83.3%) studies demonstrating positive benefits. Furthermore, 32 (35.2%) studies employed coordination exercise interventions for older adults' EF, with 25 (78.1%) studies showing positive benefits. Similarly, 30 (33%) studies applied mixed exercise interventions for older adults' EF, with 25 (83.3%) studies indicating positive benefits. Conclusion Overall, all four types of physical exercise enhance EF in older adults, with mixed exercises being the most effective.
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Affiliation(s)
- Zhidong Cai
- Department of Physical Education, Suzhou University of Science and Technology, Suzhou, China
| | - Ruibao Cai
- School of Physical Education, Chizhou University, Chizhou, China
| | - Li Sen
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, Shanghai, China
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McArthur C, Alizadehsaravi N, Affoo R, Cooke K, Douglas N, Earl M, Flynn T, Ghanouni P, Hunter S, Kalu M, Middleton L, Moody E, Smith C, Verlinden L, Weeks L. Effectiveness of physical rehabilitation on physical functioning and quality of life for long-term care residents with dementia: a systematic review and meta-analysis. JBI Evid Synth 2024:02174543-990000000-00322. [PMID: 38915237 DOI: 10.11124/jbies-23-00431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVE The objective of this review was to evaluate the effectiveness of physical rehabilitation versus non-rehabilitation comparators on physical functioning and quality of life for long-term care (LTC) residents with dementia. INTRODUCTION LTC residents living with dementia often have impaired physical functioning and quality of life. Physical rehabilitation can improve physical functioning and quality of life for individuals living with dementia; however, many LTC residents with dementia do not receive physical rehabilitation and providers are unsure what interventions to employ. A synthesis of studies examining physical rehabilitation will help guide practice in the LTC sector where most residents live with dementia. Previous syntheses have focused on all residents in LTC, specific professions, interventions, or people with dementia in the community. Our review focuses on LTC residents with dementia and a broader definition of physical rehabilitation. INCLUSION CRITERIA This review includes studies that evaluate physical rehabilitation in comparison with non-rehabilitation controls among LTC residents with any severity of dementia. We included studies that measure the effect on activities of daily living, performance-based physical functioning, and self- or proxy-rated quality of life. METHODS Searches were conducted in APA PsycINFO (EBSCOhost), CINAHL (EBSCOhost), PubMed (National Library of Medicine), Embase, Scopus, and the Cochrane CENTRAL database with no date or language limitations. Two independent reviews assessed the studies against the inclusion criteria. Two independent reviewers extracted data and conducted a quality assessment using a structured extraction form. Certainty of evidence was ascertained using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Where possible, studies were pooled in meta-analyses; otherwise, a narrative synthesis was performed. RESULTS Thirty-three studies were included (n = 3072 participants); 27 were randomized control trials and the remaining 6 were non-randomized trials. The overall risk of bias of the included studies was low to unclear. Many of the included studies focused on increasing activity or walking, while few were individually tailored or at an intensity appropriate to induce therapeutic effects on physical function. Physical function was also measured via several outcome measures, limiting our ability to pool results. There was low certainty evidence that physical rehabilitation improved activities of daily living (12 RCTs, 1348 participants, SMD 0.78; 95% CI 0.27 to 1.30) and the Short Physical Performance Battery Score (3 RCTs, 258 participants, MD 3.01 points; 95% CI 1.37 to 4.66) compared with non-rehabilitation interventions. There was low to moderate certainty evidence that physical rehabilitation demonstrated no change in the 30-Second Sit to Stand Test (2 RCTs, 293 participants, MD 0.79 repetitions; 95% CI -0.45 to 2.03), 6-Minute Walk Test (4 RCTs, 363 participants, MD 17.32 meters; 95% CI -29.41 to 64.05), gait speed (4 RCTs, 400 participants, MD 0.10 meters/seconds; 95% CI -0.02 to 0.22), Timed Up and Go Test (3 studies, 275 participants, MD -2.89 seconds; 95% CI -6.62 to 0.84), or quality of life (4 RCTs, 419 participants, SMD 0.20; 95% CI -0.08 to 0.47). CONCLUSIONS This review demonstrates that physical rehabilitation may improve activities of daily living for LTC residents living with dementia, though the evidence is of low certainty. The effect of physical rehabilitation on specific functional tasks, like gait speed and quality of life, are less clear. Future research should examine the effects of individualized, progressive interventions on outcome measures that reflect the capacity and preferences of LTC residents with more advanced dementia. REVIEW REGISTRATION PROSPERO CRD42022308444.
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Affiliation(s)
- Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | | | - Rebecca Affoo
- School of Communication Sciences and Disorders, Dalhousie University, Halifax, NS, Canada
| | - Karen Cooke
- Physiotherapy Department, Halifax, NS, Canada
| | - Natalie Douglas
- Deparment of Communicative Disorders, University of Louisiana Lafeyette: Lafeyette, LA, United States
| | - Marie Earl
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | | | - Parisa Ghanouni
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
| | - Susan Hunter
- School of Physiotherapy, Western University, London, ON, Canada
| | - Michael Kalu
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Laura Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | | | | | - Lori Weeks
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
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Yuan Y, Yang Y, Hu X, Zhang L, Xiong Z, Bai Y, Zeng J, Xu F. Effective dosage and mode of exercise for enhancing cognitive function in Alzheimer's disease and dementia: a systematic review and Bayesian Model-Based Network Meta-analysis of RCTs. BMC Geriatr 2024; 24:480. [PMID: 38824515 PMCID: PMC11143595 DOI: 10.1186/s12877-024-05060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/08/2024] [Indexed: 06/03/2024] Open
Abstract
OBJECTIVE Research the dose-response relationship between overall and certain types of exercise and cognitive function in older adults with Alzheimer's disease and dementia. DESIGN Systemic and Bayesian Model-Based Network Meta-Analysis. METHODS In our study, we analyzed data from randomized controlled trials investigating the effects of different exercises on cognitive outcomes in older adults with AD. We searched the Web of Science, PubMed, Cochrane Central Register of Controlled Trials, and Embase up to November 2023. Using the Cochrane Risk of Bias tool (Rob2) for quality assessment and R software with the MBNMA package for data analysis, we determined standard mean differences (SMDs) and 95% confidence intervals (95%CrI) to evaluate exercise's impact on cognitive function in AD. RESULTS Twenty-seven studies with 2,242 AD patients revealed a nonlinear relationship between exercise and cognitive improvement in AD patients. We observed significant cognitive enhancements at an effective exercise dose of up to 1000 METs-min/week (SMDs: 0.535, SD: 0.269, 95% CrI: 0.023 to 1.092). The optimal dose was found to be 650 METs-min/week (SMDs: 0.691, SD: 0.169, 95% CrI: 0.373 to 1.039), with AE (Aerobic exercise) being particularly effective. For AE, the optimal cognitive enhancement dose was determined to be 660 METs-min/week (SMDs: 0.909, SD: 0.219, 95% CrI: 0.495 to 1.362). CONCLUSION Nonlinear dose-response relationship between exercise and cognitive improvement in Alzheimer's disease, with the optimal AE dose identified at 660 METs-min/week for enhancing cognitive function in AD.
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Affiliation(s)
- Yuan Yuan
- Department of Physical Education, Kunsan National University, Daehak-RoJeollabuk-Do, Gunsan-Si, 541150, Korea
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei, 238000, China
| | - XiaoFei Hu
- The School of Physical Education, Handan University, Handan, 056005, China
| | - Lin Zhang
- Department of Rehabilitation, West China Hospital Sichuan University Jintang Hospital, Chengdu, 610499, China.
| | - Zhiyu Xiong
- The School of Physical Education and Health, East China Jiaotong University, Nanchang, 330013, China
| | - Ying Bai
- Department of Physical Education, Kunsan National University, Daehak-RoJeollabuk-Do, Gunsan-Si, 541150, Korea
| | - JiaLe Zeng
- The School of Physical Education, Jiangxi Normal University, Nanchang, 330224, China
| | - Feng Xu
- College of Physical Education, Fujian Normal University, FuZhou, 350007, China
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Wang L, Xian X, Zhou M, Xu K, Cao S, Cheng J, Dai W, Zhang W, Ye M. Anti-Inflammatory Diet and Protein-Enriched Diet Can Reduce the Risk of Cognitive Impairment among Older Adults: A Nationwide Cross-Sectional Research. Nutrients 2024; 16:1333. [PMID: 38732579 PMCID: PMC11085298 DOI: 10.3390/nu16091333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Cognitive impairment (CI) is a common mental health disorder among older adults, and dietary patterns have an impact on cognitive function. However, no systematic researches have constructed anti-inflammatory diet (AID) and protein-enriched diet (PED) to explore their association with CI among older adults in China. METHODS The data used in this study were obtained from the 2018 waves of the China Longitudinal Health and Longevity Survey (CLHLS). We construct AID, PED, and calculate scores for CI. We use binary logistic regression to explore the relationship between them, and use restrictive cubic splines to determine whether the relationships are non-linear. Subgroup analysis and sensitivity analysis were used to demonstrate the robustness of the results. RESULTS A total of 8692 participants (mean age is 83.53 years) were included in the analysis. We found that participants with a higher AID (OR = 0.789, 95% confidence interval: 0.740-0.842, p < 0.001) and PED (OR = 0.910, 95% confidence interval: 0.866-0.956, p < 0.001) score showed lower odds of suffering from CI. Besides, the relationship between the two dietary patterns and CI is linear, and the results of subgroup analysis and sensitivity analysis are also significant. CONCLUSION Higher intakes of AID and PED are associated with a lower risk of CI among older adults, which has important implications for future prevention and control of CI from a dietary and nutritional perspective.
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Affiliation(s)
- Liang Wang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Xiaobing Xian
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Mengting Zhou
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Ke Xu
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Shiwei Cao
- School of the Second Clinical, Chongqing Medical University, Chongqing 400016, China;
| | - Jingyu Cheng
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Weizhi Dai
- School of the First Clinical, Chongqing Medical University, Chongqing 400016, China;
| | - Wenjia Zhang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Mengliang Ye
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
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Deng J, Wang H, Fu T, Xu C, Zhu Q, Guo L, Zhu Y. Physical activity improves the visual-spatial working memory of individuals with mild cognitive impairment or Alzheimer's disease: a systematic review and network meta-analysis. Front Public Health 2024; 12:1365589. [PMID: 38605880 PMCID: PMC11007231 DOI: 10.3389/fpubh.2024.1365589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
Objective Our network meta-analysis aimed to ascertain the effect of physical activity on the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease as well as to propose tailored exercise interventions for each group. Methods Employing a frequentist approach, we performed a network meta-analysis to compare the effectiveness of different exercise interventions in improving the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease. Subsequently, we explored the moderating variables influencing the effectiveness of the exercise interventions through a subgroup analysis. Results We included 34 articles involving 3,074 participants in the meta-analysis, comprised of 1,537 participants from studies on mild cognitive impairment and 1,537 participants from studies on Alzheimer's disease. The articles included exhibited an average quality score of 6.6 (score studies) and 6.75 (reaction time [RT] studies), all passing the inconsistency test (p > 0.05). In the mild cognitive impairment literature, mind-body exercise emerged as the most effective exercise intervention (SMD = 0.61, 95% CI: 0.07-1.14). In Alzheimer's disease research, aerobic exercise was identified as the optimal exercise intervention (SMD = 0.39, 95% CI: 0.06-0.71). Conclusion The results of the subgroup analysis suggest that the most effective approach to enhancing the visual-spatial working memory of individuals with mild cognitive impairment entails exercising at a frequency of three or more times per week for over 60 min each time and at a moderate intensity for more than 3 months. Suitable exercise options include mind-body exercise, multicomponent exercise, resistance exercise, and aerobic exercise. For individuals with Alzheimer's disease, we recommend moderately intense exercise twice per week for over 90 min per session and for a duration of 3 months or longer, with exercise options encompassing aerobic exercise and resistance exercise.
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Affiliation(s)
- Jie Deng
- College of Physical Education, Southwest University, Chongqing, China
| | - Hong Wang
- College of Physical Education and Health Sciences, Chongqing Normal University, Chongqing, China
| | - Tingting Fu
- College of Physical Education, Southwest University, Chongqing, China
| | - Chong Xu
- Ministry of Sports and National Defense Education, Chongqing College of Electronic Engineering, Chongqing, China
| | - Qiqi Zhu
- College of Physical Education, Southwest University, Chongqing, China
| | - Liya Guo
- College of Physical Education, Southwest University, Chongqing, China
| | - Yu Zhu
- College of Physical Education, Southwest University, Chongqing, China
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Evans CJ, van den Berg MEL, Lewis LK. Physiotherapy for people with dementia: a Call to Action for the development of clinical guidelines. Physiotherapy 2024; 122:27-29. [PMID: 38241940 DOI: 10.1016/j.physio.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 01/21/2024]
Affiliation(s)
- C J Evans
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, PO Box 2100, Sturt Rd, Bedford Park, SA 5042, Australia.
| | - M E L van den Berg
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, PO Box 2100, Sturt Rd, Bedford Park, SA 5042, Australia
| | - L K Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, PO Box 2100, Sturt Rd, Bedford Park, SA 5042, Australia
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Chen Y, Li Y, Li W, Tian Y, Yang H. Physical activity trajectories and their associations with health outcomes in older adults with mild cognitive impairment or dementia: a national cohort study. Aging Clin Exp Res 2024; 36:15. [PMID: 38291179 PMCID: PMC10827827 DOI: 10.1007/s40520-023-02667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/17/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Physical activity (PA) is a promising non-pharmacological intervention for this population. However, few studies have investigated their PA trajectories, influencing factors, and their relationship with health outcomes. AIMS The aim was to identify latent trajectories in PA and their determinants in older adults with mild cognitive impairment (MCI) or dementia, as well as to assess the associations between PA trajectories and health outcomes based on the capability-opportunity-motivation behavior model. METHODS This is a cohort study. Data were obtained from a national cohort study and included participants aged 60 years and older with MCI or dementia. PA trajectories were identified using group-based trajectory modelling. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Linear regression models were used to assess the associations between PA trajectories and health outcomes. This study adhered to the STROBE checklist for reporting. RESULTS Three distinct PA trajectories were identified: high-decreasing and rebound class (9.34%), moderate-decreasing class (10.31%), and low-increasing class (80.34%). The logistic regression showed that age, sex, education level, body mass index, residence, depressive symptoms, mobility activities of daily life score, frequency of social activities score were PA predictors. Adjusting for sociodemographic variables, only the high-decreasing and rebound class remained significantly associated with worse self-rated health. DISCUSSION This study revealed three PA trajectories among older adults with MCI/dementia. Besides sociodemographic variables, addressing physical function and mental health, providing social support are vital for promoting PA in this population.
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Affiliation(s)
- Yiping Chen
- Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Yao Li
- Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Wei Li
- Peking Union Medical College Hospital, Beijing, China
| | - Yuling Tian
- First Hospital of Shanxi Medical University, No.56, Xinjian South Road, Yingze District, Taiyuan, Shanxi Province, China.
| | - Hui Yang
- First Hospital of Shanxi Medical University, No.56, Xinjian South Road, Yingze District, Taiyuan, Shanxi Province, China.
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He C, Peng X, Zhang J, Cheng W, Guo S, Hu W, Fang C, Huan M, Lu Y, Sang M, Zhou T, Wu H, Li L, Quan M. Effects of 12-week aerobic exercise with different frequencies on executive function in preschool children: a cluster randomized controlled trial. Psychol Health 2024:1-16. [PMID: 38287651 DOI: 10.1080/08870446.2024.2309542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To explore the effects of a 12-week aerobic exercise program with different frequencies on executive functions (EFs) in preschool children. METHOD Four kindergartens, comprising 126 preschool children in Shanghai, were enrolled in this 12-week cluster randomized controlled trial with a 12-week follow-up period. Kindergartens were allocated to high-frequency (three times a week) or low-frequency (once a week) exercise groups using stratified block randomization. Three core sub-EFs, including inhibition, working memory, and cognitive flexibility, were assessed at baseline, post-intervention, and the 12-week follow-up. RESULTS Compared to baseline, both groups showed significant improvements in inhibition and working memory after the intervention and at the 12-week follow-up. However, only the high-frequency exercise group demonstrated a significant improvement in cognitive flexibility after the follow-up period. Nonetheless, there were no significant differences in the core sub-functions of EFs between the two groups at the end of the intervention or the follow-up periods. CONCLUSION A 12-week aerobic exercise of three times a week was insufficient to significantly improve EFs in preschool children compared to once a week. Future studies are needed to examine the dose-response relationship of aerobic exercise on EFs and to verify the effects of different exercise modalities on EFs in preschool children.
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Affiliation(s)
- Changshuang He
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xiaoying Peng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Jinming Zhang
- Journal Editorial Department, Shandong First Medical University & Shandong Academy of Medical Sciences, Shandong, China
| | - Wei Cheng
- Department of Endocrinology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shaoyu Guo
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Wenwen Hu
- Department of Physical Education, Institute of Disaster Prevention, Sanhe, China
| | - Chunyi Fang
- Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Muyang Huan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yanhua Lu
- Sports Department, Zhengzhou Business University, Zhengzhou, China
| | - Menghao Sang
- Institute of Health, Yantai Nanshan University, Shandong, China
| | - Tang Zhou
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Hua Wu
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Longkai Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Minghui Quan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
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Neudorf B, Dinh C, Barnes V, Stergiou-Dayment C, Middleton L. Enhancing Minds in Motion® as a virtual program delivery model for people living with dementia and their care partners. PLoS One 2024; 19:e0291166. [PMID: 38241269 PMCID: PMC10798436 DOI: 10.1371/journal.pone.0291166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/23/2023] [Indexed: 01/21/2024] Open
Abstract
The Alzheimer Society of Ontario's Minds in Motion (MiM) program improves physical function and well-being of people living with dementia (PLWD) and their care partners (CP) (Regan et al., 2019). With the COVID-19 pandemic, there was an urgent need to transition to a virtual MiM that was similarly safe and effective. The purpose of this mixed methods study is to describe the standardized, virtual MiM and evaluate its acceptability, and impact on quality of life, and physical and cognitive activity of participants. Survey of ad hoc virtual MiM practices and a literature review informed the design of the standardized MiM program: 8 weeks of weekly 90-minute sessions that included 45-minutes of physical activity and 45-minutes of cognitive stimulation in each session. Participants completed a standardized, virtual MiM at one of 6 participating Alzheimer Societies in Ontario, as well as assessments of quality of life, physical and cognitive activity, and program satisfaction pre- and post-program. In all, 111 PLWD and 90 CP participated in the evaluation (average age of 74.6±9.4 years, 61.2% had a college/university degree or greater, 80.6% were married, 48.6% of PLWD and 75.6% of CP were women). No adverse events occurred. MiM participants rated the program highly (average score of 4.5/5). PLWD reported improved quality of life post-MiM (p = <0.01). Altogether, participants reported increased physical activity levels (p = <0.01) and cognitive activity levels (p = <0.01). The virtual MiM program is acceptable, safe, and effective at improving quality of life, cognitive and physical activity levels for PLWD, and cognitive and physical activity levels among CP.
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Affiliation(s)
- Bobby Neudorf
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Christopher Dinh
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | | | | | - Laura Middleton
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
- Research Institute for Aging, Toronto, Ontario, Canada
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Ahn S, Cobb SJ, Crouter SE, Lee CE, Crane MK, Anderson JG. Physical activity together for couples living with mild cognitive impairment (PAT-MCI): A feasibility study. Geriatr Nurs 2024; 55:221-228. [PMID: 38035459 DOI: 10.1016/j.gerinurse.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
Abstract
Mild cognitive impairment is a prodromal phase of Alzheimer's disease and related dementias. Cognitive and/or neuropsychiatric symptoms that could worsen over time cause challenges for patients and romantic partners, who often assume the role of informal caregivers. Although physical activity is beneficial, older adults with mild cognitive impairment and their romantic care partners are generally physically inactive. Our 16-week study was performed to see whether physical activity together is feasible to increase physical activity among four dyads (individuals with mild cognitive impairment and their spouses). Our dyadic intervention was feasible given more than 70 % of participants self-reported adherence to physical activity based on the guidelines for adults in the United States. In exit interviews, togetherness was highlighted as one of the biggest strengths of this study. Future studies with more representative samples are needed, as well as adopting a more tailored approach that accounts for individuals' levels of physical fitness.
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Affiliation(s)
- Sangwoo Ahn
- College of Nursing, University of Tennessee, Knoxville, Tennessee, United States.
| | - Sandra J Cobb
- College of Nursing, University of Tennessee, Knoxville, Tennessee, United States
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, Tennessee, United States
| | - Chung Eun Lee
- Paul H. Chook Department of Information Systems and Statistics, Baruch College, New York, New York, United States
| | - Monica K Crane
- Genesis Neuroscience Clinic, Knoxville, Tennessee, United States
| | - Joel G Anderson
- College of Nursing, University of Tennessee, Knoxville, Tennessee, United States
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12
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Ahn S, Chung JW, Crouter SE, Lee JA, Lee CE, Anderson JG. Gait and/or balance disturbances associated with Alzheimer's dementia among older adults with amnestic mild cognitive impairment: A longitudinal observational study. J Adv Nurs 2023; 79:4815-4827. [PMID: 37386779 PMCID: PMC10646827 DOI: 10.1111/jan.15768] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 05/23/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
AIMS To explore whether gait and/or balance disturbances are associated with the onset of Alzheimer's dementia (AD) among older adults with amnestic mild cognitive impairment (MCI). DESIGN This study employed a longitudinal retrospective cohort design. METHODS We obtained data from the National Alzheimer's Coordinating Center's Uniform Data Set collected from 35 National Institute on Aging Alzheimer's Disease Research Centers between September 2005 and December 2021. The mean age of participants (n = 2692) was 74.5 years with women making up 47.2% of the sample. Risk of incident AD according to baseline gait and/or balance disturbances as measured using the Postural Instability and Gait Disturbance Score, a subscale of the Unified Parkinson's Disease Rating Scale Motor Score, was examined by the Cox proportional hazards regression models adjusting for baseline demographics, medical conditions and study sites. The mean follow-up duration was 4.0 years. RESULTS Among all the participants, the presence or the severity of gait and/or balance disturbances was associated with an increased risk of AD. The presence or the severity of gait and/or balance disturbances was associated with a higher risk of Alzheimer's dementia among the subgroups of female and male participants. CONCLUSION Gait and/or balance disturbances may increase the risk of developing AD, regardless of sex. IMPACT Gait and/or balance disturbances among community-dwelling older adults with amnestic MCI may need to be frequently assessed by nurses to identify potential risk factors for cognitive decline. NO PATIENT OR PUBLIC CONTRIBUTION Given the secondary analysis, patients, service users, caregivers or members of the public were not directly involved in this study.
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Affiliation(s)
- Sangwoo Ahn
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Jae Woo Chung
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott E. Crouter
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, Tennessee, USA
| | - Jung-Ah Lee
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, California, USA
| | - Chung Eun Lee
- Paul H. Chook Department of Information Systems and Statistics, Baruch College, New York, New York, USA
| | - Joel G. Anderson
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
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13
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Zhang M, Jia J, Yang Y, Zhang L, Wang X. Effects of exercise interventions on cognitive functions in healthy populations: A systematic review and meta-analysis. Ageing Res Rev 2023; 92:102116. [PMID: 37924980 DOI: 10.1016/j.arr.2023.102116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Chronic exercise intervention is a non-pharmacological therapy suggested to improve cognitive function in various populations. However, few meta-analyses have assessed the cognitive benefits associated with all FITT-VP variables (exercise frequency, intensity, bout duration time, type, volume or total intervention length, and progression) in healthy populations by age. Thus, this meta-analysis assessed the effects of each FITT-VP variable on cognitive function in healthy children, adults, and older adults. This study followed PRISMA guidelines. After searching PubMed and the Web of Science, we included 54 randomized controlled trials to examined the effects of FITT-VP variables on five cognitive domains: global cognition, executive function, memory, attention, and information processing. Moderation analyses assessed the effects by age and by each exercise variables. Exercise benefitted overall cognition and all subcognitive domains. Aerobic and resistance exercise showed the greatest benefits on global cognition and executive function respectively, whereas mind-body exercise benefitted memory. Among all populations, older adults showed the greatest benefits of exercise on global cognition, executive function, and memory compared with controls. Additional studies are needed to assess the effects of exercise on attention and information processing. This meta-analysis offers new insights on the relationships between cognition and FITT-VP exercise variables in healthy populations.
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Affiliation(s)
- Minggang Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Jiafeng Jia
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Yang Yang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Lepu Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiaochun Wang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China.
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14
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Morella I, Negro M, Dossena M, Brambilla R, D'Antona G. Gut-muscle-brain axis: Molecular mechanisms in neurodegenerative disorders and potential therapeutic efficacy of probiotic supplementation coupled with exercise. Neuropharmacology 2023; 240:109718. [PMID: 37774944 DOI: 10.1016/j.neuropharm.2023.109718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/13/2023] [Accepted: 09/16/2023] [Indexed: 10/01/2023]
Abstract
Increased longevity is often associated with age-related conditions. The most common neurodegenerative disorders in the older population are Alzheimer's disease (AD) and Parkinson's disease (PD), associated with progressive neuronal loss leading to functional and cognitive impairments. Although symptomatic treatments are available, there is currently no cure for these conditions. Gut dysbiosis has been involved in the pathogenesis of AD and PD, thus interventions targeting the "gut-brain axis" could potentially prevent or delay these pathologies. Recent evidence suggests that the skeletal muscle and the gut microbiota can affect each other via the "gut-muscle axis". Importantly, cognitive functions in AD and PD patients significantly benefit from physical activity. In this review, we aim to provide a comprehensive picture of the crosstalk between the brain, the skeletal muscle and the gut microbiota, introducing the concept of "gut-muscle-brain axis". Moreover, we discuss human and animal studies exploring the modulatory role of exercise and probiotics on cognition in AD and PD. Collectively, the findings presented here support the potential benefits of physical activity and probiotic supplementation in AD and PD. Further studies will be needed to develop targeted and multimodal strategies, including lifestyle changes, to prevent or delay the course of these pathologies.
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Affiliation(s)
- Ilaria Morella
- Neuroscience and Mental Health Innovation Institute, School of Biosciences, Cardiff University, Cardiff, UK
| | - Massimo Negro
- Centro di Ricerca Interdipartimentale Nelle Attività Motorie e Sportive (CRIAMS)-Sport Medicine Centre, University of Pavia, Voghera, Italy
| | - Maurizia Dossena
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, 27100 Pavia, Italy
| | - Riccardo Brambilla
- Neuroscience and Mental Health Innovation Institute, School of Biosciences, Cardiff University, Cardiff, UK; Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, 27100 Pavia, Italy
| | - Giuseppe D'Antona
- Centro di Ricerca Interdipartimentale Nelle Attività Motorie e Sportive (CRIAMS)-Sport Medicine Centre, University of Pavia, Voghera, Italy; Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
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15
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Yan J, Li X, Guo X, Lin Y, Wang S, Cao Y, Lin H, Dai Y, Ding Y, Liu W. Effect of Multicomponent Exercise on Cognition, Physical Function and Activities of Daily Life in Older Adults With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023; 104:2092-2108. [PMID: 37142178 DOI: 10.1016/j.apmr.2023.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To review the evidence for the effectiveness of multicomponent exercise (an exercise program combining aerobic, endurance, balance, and flexibility exercises) on cognition, physical function, and activities of daily living in people with dementia and mild cognitive impairment (MCI). DATA SOURCES AND STUDY SELECTION We conducted this study under the guidance of a designated protocol (PROSPERO CRD42022324641). Pertinent randomized controlled trials were selected from PubMed, Embase, Web of Science, and the Cochrane Library by 2 independent authors through May 2022. DATA EXTRACTION Two authors independently extracted the data and assessed the quality of the included studies following the Cochrane Risk of Bias tool. Outcome data were extracted in a random effects model and estimated as Hedges' g and 95% confidence interval (CI). To validate specific results, the Egger test combined the Duval and Tweedie "trim and fill" method and sensitivity analysis with study removed were performed. DATA SYNTHESIS A total of 21 publications were eligible for the quantitative analysis. In dementia, estimates of Hedges' g showed effects on global cognition (g=0.403; 95% CI, 0.168-0.638; P<.05), especially executive function (g=0.344; 95% CI, 0.111-0.577; P<.05), flexibility (g=0.671; 95% CI, 0.353-0.989; P<.001), agility and mobility (g=0.402; 95% CI, 0.089-0.714; P<.05), muscle strength (g=1.132; 95% CI, 0.420-1.845; P<.05), and activities of daily living (g=0.402; 95% CI, 0.188-0.615; P<.05). Also, a positive trend was observed in gait speed. Additionally, multicomponent exercise had positive effects on global cognition (g=0.978; 95% CI, 0.298-1.659; P<.05) and executive function (g=0.448; 95% CI, 0.171-0.726; P<.05) in patients with MCI. CONCLUSIONS Our findings confirm the viability of multicomponent exercise as a management strategy for patients with dementia and MCI.
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Affiliation(s)
- Jiamin Yan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaohan Li
- College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaoqin Guo
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yanting Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Sinuo Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yajun Cao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huawei Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yaling Dai
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yanyi Ding
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weilin Liu
- The Institute of Rehabilitation Industry, Fujian University of Traditional Chinese Medicine, China.
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16
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Lee DY, Im SC, Kang NY, Kim K. Analysis of Effect of Intensity of Aerobic Exercise on Cognitive and Motor Functions and Neurotrophic Factor Expression Patterns in an Alzheimer's Disease Rat Model. J Pers Med 2023; 13:1622. [PMID: 38003937 PMCID: PMC10672300 DOI: 10.3390/jpm13111622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
The effect of aerobic exercise at different intensities on Alzheimer's disease (AD) still remains unclear. We investigated the effect of aerobic exercise at different intensities on cognitive and motor functions and neurotrophic factor expression. Thirty-two AD-induced rats were randomly assigned to control (CG), low-intensity (Group I), medium-intensity (Group II), and high-intensity (Group III) exercise groups. Each group, except for the CG, performed aerobic exercise for 20 min a day five times a week. After performing aerobic exercise for 4 weeks, their cognitive and motor functions and neurotrophic factor expression patterns were analyzed and compared between the groups. All variables of cognitive and motor functions and neurotrophic factor expression were significantly improved in Groups I, II, and III compared to those in the CG (p < 0.05). Among the neurotrophic factors, brain-derived neurotrophic factor (BDNF) expression was significantly improved in Group III compared to that in Groups I and II (p < 0.05). In the intra-group comparison of cognitive and motor functions, no significant difference was observed in CG, but the aerobic exercise groups showed improvements. Only Group III showed a significant improvement in the time it took to find eight food items accurately (p < 0.05). Aerobic exercise improved the cognitive and motor functions and neurotrophic factor expression patterns in the AD-induced rat model, with high-intensity aerobic exercise having greater effects on cognitive function and BDNF expression.
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Affiliation(s)
| | | | | | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan 38453, Republic of Korea; (D.-Y.L.); (S.-C.I.); (N.-Y.K.)
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17
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Papatsimpas V, Vrouva S, Papathanasiou G, Papadopoulou M, Bouzineki C, Kanellopoulou S, Moutafi D, Bakalidou D. Does Therapeutic Exercise Support Improvement in Cognitive Function and Instrumental Activities of Daily Living in Patients with Mild Alzheimer's Disease? A Randomized Controlled Trial. Brain Sci 2023; 13:1112. [PMID: 37509042 PMCID: PMC10377697 DOI: 10.3390/brainsci13071112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
This randomized controlled trial aims to investigate the effect of 12 weeks of therapeutic exercise on cognitive function and daily activities in patients with mild Alzheimer's disease (AD). A total of 171 patients with mild AD from the Amarousion Day Care Center of the Alzheimer Society of Athens and the Athens General Hospital "G. Gennimatas" were randomly divided into three groups. Group A (aerobic and resistance exercise, n = 57), group B (resistance exercise, n = 57), and group C (control group, n = 57). Group A followed a weekly program consisting of 5 days with 30 min walking and 3 days with resistance exercises for about 45 min. Group B followed only a resistance exercise program, the same as group A. Group C did not participate in any exercise program. After the intervention, cognitive function was assessed with the Cognitive Examination-Revised (ACE-R), Trail Making Test A-B (TMT A-B), and Digit Span Test Forward and Backward (DST F-B) and daily activities with the instrumental activities of daily living scale (IADLs). A significant intervention effect was observed for all outcome measures (global cognitive function and instrumental activities of daily living). ANCOVA Bonferroni corrected post hoc tests revealed that the aerobic and resistance group improved compared to the control group on all measurement scales. The resistance group also showed an improvement compared to the control group. No significant effects were found between the aerobic and resistance group and the resistance group in any of the outcome measures.
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Affiliation(s)
- Vasileios Papatsimpas
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Department of Physical Therapy, General Hospital of Athens G. GENNIMATAS, 11527 Athens, Greece
| | - Sotiria Vrouva
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Department of Physical Therapy, 401 Army General Hospital of Athens, 11525 Athens, Greece
| | - George Papathanasiou
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | - Marianna Papadopoulou
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | | | | | - Dimitra Moutafi
- Pathological Department, General Hospital Konstantopouleio, 14233 Nea Ionia, Greece
| | - Daphne Bakalidou
- Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), School of Health and Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
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18
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Illesca-Matus R, Ardiles NM, Munoz F, Moya PR. Implications of Physical Exercise on Episodic Memory and Anxiety: The Role of the Serotonergic System. Int J Mol Sci 2023; 24:11372. [PMID: 37511128 PMCID: PMC10379296 DOI: 10.3390/ijms241411372] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
There is a growing interest in investigating the effects of physical exercise on cognitive performance, particularly episodic memory. Similarly, an increasing number of studies in recent decades have studied the effects of physical activity on mood and anxiety disorders. Moreover, the COVID-19 pandemic has raised awareness of the importance of regular physical activity for both mental and physical health. Nevertheless, the exact mechanisms underlying these effects are not fully understood. Interestingly, recent findings suggest that the serotonergic system may play a key role in mediating the effects of physical exercise on episodic memory and anxiety. In this review, we discuss the impact of physical exercise on both episodic memory and anxiety in human and animal models. In addition, we explore the accumulating evidence that supports a role for the serotonergic system in the effects of physical exercise on episodic memory and anxiety.
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Affiliation(s)
- Ricardo Illesca-Matus
- Laboratorio de Neurodinámica Básica y Aplicada, Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
- Centro de Investigación Avanzada en Educación (CIAE), Universidad de Chile, Santiago 8320000, Chile
| | - Nicolás M Ardiles
- Centro Interdisciplinario de Neurociencia de Valparaíso, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2340000, Chile
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2340000, Chile
| | - Felipe Munoz
- Programa de Doctorado en Ciencias e Ingeniería para la Salud, Universidad de Valparaíso, Valparaíso 2340000, Chile
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua 2820000, Chile
| | - Pablo R Moya
- Centro Interdisciplinario de Neurociencia de Valparaíso, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2340000, Chile
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2340000, Chile
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19
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Scott SN, Hayes C, Zeuger T, Davies AP, Andrews RC, Cocks M. Clinical Considerations and Practical Advice for People Living With Type 2 Diabetes Who Undertake Regular Exercise or Aim to Exercise Competitively. Diabetes Spectr 2023; 36:114-126. [PMID: 37193206 PMCID: PMC10182970 DOI: 10.2337/dsi22-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This article provides practical tips for advising people with type 2 diabetes on how to engage in regular exercise safely and effectively. Its focus is on individuals who wish to exceed the minimum physical activity recommendation of 150 minutes/week of moderate-intensity exercise or even compete in their chosen sport. Health care professionals who work with such individuals must have a basic understanding of glucose metabolism during exercise, nutritional requirements, blood glucose management, medications, and sport-related considerations. This article reviews three key aspects of individualized care for physically active people with type 2 diabetes: 1) initial medical assessment and pre-exercise screenings, 2) glucose monitoring and nutritional considerations, and 3) the combined glycemic effects of exercise and medications.
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Affiliation(s)
- Sam N. Scott
- Team Novo Nordisk Professional Cycling Team, Atlanta, GA
| | | | - Thomas Zeuger
- Department of Endocrinology and Metabolic Diseases, Kantonsspital Olten, Olten, Switzerland
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern, University Hospital, University of Bern, Bern, Switzerland
| | - Andrew P. Davies
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, U.K
| | - Rob C. Andrews
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K
| | - Matthew Cocks
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, U.K
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20
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Zeng Y, Wang J, Cai X, Zhang X, Zhang J, Peng M, Xiao D, Ouyang H, Yan F. Effects of physical activity interventions on executive function in older adults with dementia: A meta-analysis of randomized controlled trials. Geriatr Nurs 2023; 51:369-377. [PMID: 37127013 DOI: 10.1016/j.gerinurse.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND To date quantitative meta-analysis with large samples to investigate the effects and potential moderators of physical activity (PA) on executive function (EF) in older adults with dementia is insufficient. Therefore, we conducted this meta-analysis. DESIGN Meta-analysis of randomized controlled trials (RCTs). PARTICIPANTS Old people with Alzheimer's disease (AD) or related dementia of varying types and severity as the primary diagnosis. METHODS PubMed, Web of Science, the Cochrane Library and Embase databases were searched for relevant studies published from 01 January, 2010 to 01 March, 2022. The results of executive function were reported in all RCTs. Random-effects meta-analysis was used to calculate the size of effects. Subgroup analyses of three moderators (including the specific sub-domains of EF, exercise prescription variables, and sample characteristics) were performed. RESULTS Eighteen RCTs were included with a combined sample size of 1366. Overall, PA interventions improved overall EF (standardized mean difference [SMD]=0.23, 95% confidence interval [CI] 0.05 to 0.41, p<0.05). The EF sub-domain "planning" was significant moderator (SMD=0.31, 95%CI 0.11 to 1.51, p<0.01), but inhibitory control, working memory and cognitive flexibility were not significant. Regarding exercise prescription variables, type of resistance training; moderate intensity; total duration ≤24 weeks and short (once or twice a week) frequency improved overall EF performance. Session length may be a moderator. Regarding sample characteristics, old-old, AD and both dementia and AD had significant benefits. CONCLUSIONS AND IMPLICATIONS EF in older adults with AD or related dementia benefited from physical activity, and the benefit was affected by the type, intensity, total duration, frequency of exercise. Physical activity can be an alternative intervention in aging patients with dementia, to improve EF performance or prevent or EF decline.
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Affiliation(s)
- Yuena Zeng
- School of Nursing, Jinan University, Guangzhou, Guangdong 510632, China
| | - Jinying Wang
- Department of Rehabilitation, Shenzhen Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong 518172, China
| | - Xiaoyan Cai
- School of Nursing, Jinan University, Guangzhou, Guangdong 510632, China
| | - Xiaoying Zhang
- School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Jiahui Zhang
- School of Nursing, Jinan University, Guangzhou, Guangdong 510632, China
| | - Mingmei Peng
- School of Nursing, Jinan University, Guangzhou, Guangdong 510632, China; Hemodialysis Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China
| | - Duan Xiao
- Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China
| | - Hui Ouyang
- Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China.
| | - Fengxia Yan
- School of Nursing, Jinan University, Guangzhou, Guangdong 510632, China.
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21
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Ding Z, Leung PY, Lee TL, Chan AS. Effectiveness of lifestyle medicine on cognitive functions in mild cognitive impairments and dementia: A systematic review on randomized controlled trials. Ageing Res Rev 2023; 86:101886. [PMID: 36806378 DOI: 10.1016/j.arr.2023.101886] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
Mild cognitive impairment (MCI) and dementia are associated with lifestyle risk factors, making lifestyle medicine a potentially viable intervention for people with MCI and dementia. The present study aims to examine the effectiveness of lifestyle medicine on cognitive functions among people with MCI and dementia, by performing a systematic review and meta-analysis on randomized controlled trials (RCT). A systematic literature search was conducted to extract RCTs adopting lifestyle interventions of diet, exercise, and stress management or emotional well-being. Results showed that 65 studies were eligible. Exercise was the most promising lifestyle intervention that improved various cognitive functions among people with MCI and dementia, and was more effective in MCI than in dementia. Interventions on stress management or emotional well-being did not show a significant effect on people with MCI, and the evidence for people with dementia was insufficient to conclude. Similarly, due to the lack of RCTs on a healthy dietary pattern, the effectiveness of diet interventions was not examined. In conclusion, the exercise component of lifestyle medicine can be an effective and clinically significant intervention for protecting people with MCI and dementia against cognitive declines, especially when served as an early intervention at the stage of MCI.
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Affiliation(s)
- Zihan Ding
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Pui-Ying Leung
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsz-Lok Lee
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China.
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Jiménez-Roldán MJ, Sañudo B, Carrasco Páez L. Influence of High-Intensity Interval Training on IGF-1 Response, Brain Executive Function, Physical Fitness and Quality of Life in Sedentary Young University Women-Protocol for a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5327. [PMID: 37047943 PMCID: PMC10094041 DOI: 10.3390/ijerph20075327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Sedentary lifestyles have become a social problem, mainly among women. A sedentary lifestyle has been associated with poorer health in this population, negatively affecting physical and mental health. Physical exercise, in particular high-intensity interval training (HIIT), has been shown to be a neuroprotective tool. The present study provides a protocol design for a parallel-group Randomized Controlled Trial (RCT), whose aim will be to compare the effect of two physical interventions, HIIT and physical activity (increasing daily steps), on Insulin Growth Factor-1 (saliva IGF-1 concentrations), executive functions, quality of life, body composition, physical fitness, and physical activity in young sedentary women. At least 77 women will be recruited and randomly assigned to either a HIIT group (12-week exercise HIIT intervention, 3 sessions/week), the HIIT + PA group (12-week exercise HIIT intervention, 3 sessions/week, plus 10,000 steps/day), or a control group (usual care). The primary outcome measure will the chronic change in IGF-1 concentration levels measured in saliva. Secondary outcome measures will be: (i) executive functions; (ii) body composition; (iii) physical fitness; (iv) physical activity; and (v) quality of life. All outcomes will be assessed at the beginning of the study, after the intervention, and after three months of follow-up. After this intervention, we will be able to determine whether HIIT together with increased physical activity could be more effective than HIIT alone in IGF-1 stimulation. Furthermore, by comparing both intervention groups, we will be able to determine the differential effects on numerous health-related variables. Consequently, the conclusions of this study could help better understand the effects of a training program on IGF-1 concentration levels and executive functions. In addition, various strategies could be proposed through physical exercise to improve cognition in this age group, as well as to improve the health status of this sedentary population.
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Affiliation(s)
| | - Borja Sañudo
- Department of Physical Education and Sport, University of Sevilla, 41004 Sevilla, Spain
| | - Luis Carrasco Páez
- Department of Physical Education and Sport, University of Sevilla, 41004 Sevilla, Spain
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Li R, Ding M, Wang J, Pan H, Sun X, Huang L, Fu C, He C, Wei Q. Effectiveness of robotic-assisted gait training on cardiopulmonary fitness and exercise capacity for incomplete spinal cord injury: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37:312-329. [PMID: 36373899 DOI: 10.1177/02692155221133474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the effects of robotic-assisted gait training on cardiopulmonary fitness and exercise capacity for people with incomplete spinal cord injury. METHODS PubMed, Embase, Web of Science, PEDro, CENTRAL and CINAHL were searched from inception until September 4, 2022. Randomized controlled trials that evaluated the effects of robotic-assisted gait training on cardiopulmonary fitness and exercise capacity for individuals with incomplete spinal cord injury were selected. Mean differences (MD) with 95% confidence interval (CI) were calculated. The methodological quality was evaluated by the Cochrane Risk of Bias 2.0 tool. Subgroup analyses were conducted according to the time since injury. RESULTS In total 19 studies involving 770 patients were eligible for analysis. Individuals with acute incomplete spinal cord injury in robotic-assisted gait training groups showed significantly greater improvements in 6-minute walking test (MD 53.32; 95% CI 33.49 to 73.15; P < 0.001), lower extremity motor scale (MD 5.22; 95% CI 3.63 to 6.80; P < 0.001) and walking index for spinal cord injury II (MD 3.18; 95% CI 1.34 to 5.02; P < 0.001). Robotic-assisted gait training improved peak oxygen consumption to a greater degree for chronic incomplete spinal cord injury patients (MD 4.90; 95% CI 0.96 to 8.84; P = 0.01). CONCLUSION Robot-assisted gait training may be a feasible and effective intervention in terms of cardiopulmonary fitness and exercise capacity for individuals with incomplete spinal cord injury.
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Affiliation(s)
- Ran Li
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Mingfu Ding
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Jiao Wang
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Hongxia Pan
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Xin Sun
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Liyi Huang
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Chenying Fu
- National Clinical Research Center for Geriatrics, 34753West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Aging and Geriatric Mechanism Laboratory, West China Hospital, 12530Sichuan University, Chengdu, People's Republic of China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Quan Wei
- Department of Rehabilitation Medicine, West China Hospital, 12530Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
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Ghodrati N, Haghighi AH, Hosseini Kakhak SA, Abbasian S, Goldfield GS. Effect of Combined Exercise Training on Physical and Cognitive Function in Women With Type 2 Diabetes. Can J Diabetes 2023; 47:162-170. [PMID: 36572617 DOI: 10.1016/j.jcjd.2022.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES One of the consequences of old age is cognitive and physical decline, which can cause a wide range of problems. These complications are more pronounced in those with type 2 diabetes (T2D). The aim of this pilot study was to investigate the effect of combined exercise training on blood biomarkers, physical fitness, and cognitive function in elderly women with T2D. METHODS Twenty-one elderly women with T2D were randomly allocated to training (n=12) and control (n=9) groups. The exercise training program was a combination of aerobic, resistance, and balance exercises performed 3 times per week over 12 weeks. In the same period, the control group received no training intervention. Blood markers, including brain-derived neurotrophic factor (BDNF), irisin, glycated hemoglobin (A1C), fasting blood sugar (FBS), cardiorespiratory fitness (CRF), lower and upper body strength, and cognitive function, were measured in all participants at baseline and after 12 weeks. RESULTS Serum BDNF levels were not significantly different between the exercise and control groups at 12 weeks (p>0.05). FBS and A1C levels in the exercise group decreased significantly compared with the control group (p<0.05). CRF, dynamic balance, and both upper and lower body strength in the exercise group improved significantly compared with the control group (p<0.05). Irisin levels decreased significantly in the control group, but levels did not change significantly in the exercise group. Greater improvements from exercise were observed on the Montreal Cognitive Assessment index compared with the control group (p=0.05), but no other group differences in cognitive function were noted. CONCLUSIONS Combined exercise improved some physical fitness and diabetes-related surrogate factors, as well as select cognitive functions, but had no significant effect on cognition-related biochemical factors (i.e. BDNF) in women with T2D.
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Affiliation(s)
- Nafiseh Ghodrati
- Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Amir Hossein Haghighi
- Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran.
| | - Seyed Alireza Hosseini Kakhak
- Department of Exercise Physiology, Faculty of Sport Sciences, Ferdowsi University of Mashhad and Hakim Sabzevari University, Sabzevar, Iran
| | - Sadegh Abbasian
- Department of Sport Sciences, Khavaran Institute of Higher Education, Mashhad, Iran
| | - Gary S Goldfield
- Healthy Active Living & Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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25
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The Effects of Aerobic and Resistance Exercises on the Cognitive and Physical Function of Persons with Mild Dementia: A Randomized Controlled Trial Protocol. Healthcare (Basel) 2023; 11:healthcare11050677. [PMID: 36900682 PMCID: PMC10000686 DOI: 10.3390/healthcare11050677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Dementia causes deterioration in cognitive and physical functions. The scope of this study is to investigate the effect of different exercise programs on cognitive functions and functionality of persons suffering from mild Alzheimer's disease (AD) by generating information on the exercise types and their parameters. A randomized controlled trial (RCT) will be performed involving aerobic and resistance exercise interventions, taking place both at the sample collection center and at home. Participants will be randomly divided into two different intervention groups and a control group. All groups will be assessed twice; once at baseline and once after 12 weeks. The primary outcome shall comprise the effect of exercise programs on cognitive functions using cognitive testing, such as Addenbrooke's Cognitive Examination-Revisited (ACE-R), Mini Mental State Examination (MMSE), Trail Making Test A-Β (TMT A-B), and Digit Span Test (DST): Digit Span Forward (DSF) and Digit Span Backward (DSB). The effect on functionality will be assessed using the Senior Fitness Test (SFT), Berg Balance Scale (BBS), and Instrumental Activities of Daily Living Scale (IADL) questionnaire. Secondary outcomes include the effect of exercise on depression using the Geriatric Depression Scale-15 (GDS-15), on physical activity using the International Physical Activity Questionnaire (IPAQ), as well as the participants' compliance with the intervention. This study will investigate the possible effect of intervention of different exercise types and the comparison between them. Exercise forms a low-cost and reduced-risk intervention.
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26
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The benefits of regular aerobic exercise training on cerebrovascular function and cognition in older adults. Eur J Appl Physiol 2023; 123:1323-1342. [PMID: 36801969 PMCID: PMC9938957 DOI: 10.1007/s00421-023-05154-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
We compared the differences in cerebrovascular and cognitive function between 13 aerobic exercise trained, older adults and 13 age-, height- and sex-matched sedentary, untrained controls. We determined whether other measures accounted for differences in cerebrovascular and cognitive function between these groups and examined the associations between these functions. Participants undertook anthropometric, mood, cardiovascular, exercise performance, strength, cerebrovascular, and cognitive measurements, and a blood collection. Transcranial Doppler ultrasonography determined cerebrovascular responsiveness (CVR) to hypercapnia and cognitive stimuli. The trained group had a higher CVR to hypercapnia (80.3 ± 7.2 vs 35.1 ± 6.7%, P < 0.001), CVR to cognitive stimuli (30.1 ± 2.9 vs 17.8 ± 1.4%, P = 0.001) and total composite cognitive score (117 ± 2 vs 98 ± 4, P < 0.001) than the controls. These parameters no longer remained statistically different between the groups following adjustments for covariates. There were positive correlations between the total composite cognitive score and CVR to hypercapnia (r = 0.474, P = 0.014) and CVR to cognitive stimuli (r = 0.685, P < 0.001). We observed a relationship between cerebrovascular and cognitive function in older adults and an interaction between regular lifelong aerobic exercise training and cardiometabolic factors that may directly influence these functions.
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27
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Lin LL, Liu CC. Effectiveness of Comprehensive Physical Activity Health Promotion Program on the Essential Physical Functions of Older Patients With Multiple Diseases and Dementia in Rural Area. Gerontol Geriatr Med 2023; 9:23337214231184127. [PMID: 37435006 PMCID: PMC10331075 DOI: 10.1177/23337214231184127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
Against the backdrop of aging populations worldwide, physical activity programs aimed at promoting the health of older adults have begun to flourish. However, few studies have focused on elderly residents in rural areas who may have multiple comorbidities. Therefore, the current study aimed to investigate the effects of a 12-week physical activity program on health promotion among rural elderly with multiple diseases. The study included 18 elderly participants, with a mean age of 82.39 years, who had dementia and one or more additional diseases. Among the participants, 89% were female. The results showed that the 12-week physical activity program intervention significantly improved participants' walking speed and range of motion of the arm joints. Based on these findings, it is hoped that this study will provide a reference for future researchers and practitioners targeting rural or elderly populations who may have multiple diseases to develop more comprehensive physical activity programs.
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Affiliation(s)
- Lain-Li Lin
- Ching Kuo Institute of Management and Health, Keelung, Taiwan
| | - Chih-Chi Liu
- National Taiwan Normal University, Taipei, Taiwan
- Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan
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Rassam P, Pazzianotto-Forti EM, Matsumura U, Orchanian-Cheff A, Aliabadi S, Kulkarni M, Fat Fur RL, Rodrigues A, Langer D, Rozenberg D, Reid WD. Impact of cognitive capacity on physical performance in chronic obstructive pulmonary disease patients: A scoping review. Chron Respir Dis 2023; 20:14799731231163874. [PMID: 37029090 PMCID: PMC10087654 DOI: 10.1177/14799731231163874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is often accompanied by impaired cognitive and physical function. However, the role of cognitive function on motor control and purposeful movement is not well studied. The aim of the review was to determine the impact of cognition on physical performance in COPD. Methods: Scoping review methods were performed including searches of the databases: MEDLINE, EMBASE, Cochrane Systematic Reviews, Cochrane (CENTRAL), APA PsycINFO, and CINAHL. Two reviewers independently assessed articles for inclusion, data abstraction, and quality assessment. Results: Of 11,252 identified articles, 44 met the inclusion criteria. The review included 5743 individuals with COPD (68% male) with the forced expiratory volume in one second range of 24-69% predicted. Cognitive scores correlated with strength, balance, and hand dexterity, while 6-min walk distance (n = 9) was usually similar among COPD patients with and without cognitive impairment. In 2 reports, regression analyses showed that delayed recall and the trail making test were associated with balance and handgrip strength, respectively. Dual task studies (n = 5) reported impaired balance or gait in COPD patients compared to healthy adults. Cognitive or physical Interventions (n = 20) showed variable improvements in cognition and exercise capacity. Conclusions: Cognition in COPD appears to be more related to balance, hand, and dual task function, than exercise capacity.
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Affiliation(s)
- Peter Rassam
- Rehabilitation Sciences Institute, School of Graduate Studies, Temerty Faculty of Medicine, 7938University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, 7938University of Toronto, Toronto, ON, Canada
| | | | - Umi Matsumura
- Department of Health Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Ani Orchanian-Cheff
- Library and Information Services, 7989University Health Network, Toronto, ON, Canada
| | - Saina Aliabadi
- Rehabilitation Sciences Institute, School of Graduate Studies, Temerty Faculty of Medicine, 7938University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, 7989University Health Network, Toronto, ON, Canada
| | - Manjiri Kulkarni
- Rehabilitation Sciences Institute, School of Graduate Studies, Temerty Faculty of Medicine, 7938University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, 7938University of Toronto, Toronto, ON, Canada
| | | | - Antenor Rodrigues
- Department of Critical Care, St Michael's Hospital, Toronto, ON, Canada
| | - Daniel Langer
- Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, 26657Katholieke Universiteit Leuven, Leuven, Belgium
- Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Leuven, Belgium
| | - Dmitry Rozenberg
- Division of Respirology, Temerty Faculty of Medicine, 7938University of Toronto, University Health Network, Toronto, ON, Canada
- Toronto General Hospital Research Institute, Toronto, ON, Canada
| | - W Darlene Reid
- Department of Physical Therapy, 7938University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, 7989University Health Network, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, 7938University of Toronto, Toronto, ON, Canada
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Menengi̇ç KN, Yeldan İ, Çınar N, Şahiner T. Effectiveness of motor-cognitive dual-task exercise via telerehabilitation in Alzheimer’s disease: An online pilot randomized controlled study. Clin Neurol Neurosurg 2022; 223:107501. [DOI: 10.1016/j.clineuro.2022.107501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/12/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
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Chen Y, Zhan Y, Wang H, Zhang H, Cai Y, Wang L, Zhu W, Shen H, Pei J. Mediating effect of lower extremity muscle strength on the relationship between mobility and cognitive function in Chinese older adults: A cross-sectional study. Front Aging Neurosci 2022; 14:984075. [DOI: 10.3389/fnagi.2022.984075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Aging is a multifactorial process associated with irreversible decline in mobility and cognitive function. However, the mechanisms underlying the relationship between mobility and cognitive function remain elusive. In specific, the mediating effect of muscle strength, which is essential to maintain mobility, on this relationship has yet to be clarified. Accordingly, we performed a cross-sectional study involving Chinese older adults to understand the role of muscle strength in the relationship between mobility and cognitive function. The cognitive function and physical performance of 657 community-dwelling participants aged over 65 years old were observed. Cognitive function was assessed using the Mini-Mental State Examination, whereas physical performance, including mobility and muscle strength, was measured via Timed Up-and-Go Test and knee extension strength measurement. Data were statistically analyzed using PROCESS Model 4 developed by Hayes, and 595 complete data were finally included. Physical performance (mobility and muscle strength) was significantly correlated with cognitive function (p < 0.01). Muscle strength was negatively correlated with mobility (r = −0.273, p < 0.001) and positively correlated with cognitive function (r = 0.145, p < 0.001). Muscle strength accounted for 20.1% of the total mediating effects on the relationship between mobility and cognitive function, which revealed the partial mediating role of lower extremity muscle strength in this relationship.
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The effects of aerobic exercise and transcranial direct current stimulation on cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101738. [PMID: 36162707 DOI: 10.1016/j.arr.2022.101738] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Aerobic exercise (AE) may slow age-related cognitive decline. However, such cognition-sparing effects are not uniform across cognitive domains and studies. Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation and is also emerging as a potential alternative to pharmaceutical therapies. Like AE, the effectiveness of tDCS is also inconsistent for reducing cognitive impairment in ageing. The unexplored possibility exists that pairing AE and tDCS could produce synergistic effects and reciprocally augment cognition-improving effects in older individuals with and without cognitive impairments. Previous research found such synergistic effects on cognition when cognitive training is paired with tDCS in older individuals with and without mild cognitive impairment (MCI) or dementia. AIM The purpose of this systematic review with meta-analysis was to explore if pairing AE with tDCS could augment singular effects of AE and tDCS on global cognition (GC), working memory (WM) and executive function (EF) in older individuals with or without MCI and dementia. METHODS Using a PRISMA-based systematic review, we compiled studies that examined the effects of AE alone, tDCS alone, and AE and tDCS combined on cognitive function in older individuals with and without mild cognitive impairment (MCI) or dementia. Using a PICOS approach, we systematically searched PubMed, Scopus and Web of Science searches up to December 2021, we focused on 'MoCA', 'MMSE', 'Mini-Cog' (measures) and 'cognition', 'cognitive function', 'cognitive', 'cognitive performance', 'executive function', 'executive process', 'attention', 'memory', 'memory performance' (outcome terms). We included only randomized controlled trials (RTC) in humans if available in English full text over the past 20 years, with participants' age over 60. We assessed the methodological quality of the included studies (RTC) by the Physiotherapy Evidence Database (PEDro) scale. RESULTS Overall, 68 studies were included in the meta-analyses. AE (ES = 0.56 [95% CI: 0.28-0.83], p = 0.01) and tDCS (ES = 0.69 [95% CI: 0.12-1.26], p = 0.02) improved GC in all three groups of older adults combined (healthy, MCI, demented). In healthy population, AE improved GC (ES = 0.46 [95% CI: 0.22-0.69], p = 0.01) and EF (ES = 0.27 [95% CI: 0.05-0.49], p = 0.02). AE improved GC in older adults with MCI (ES = 0.76 [95% CI: 0.21-1.32], p = 0.01). tDCS improved GC (ES = 0.69 [90% CI: 0.12-1.26], p = 0.02), all three cognitive function (GC, WM and EF) combined in older adults with dementia (ES = 1.12 [95% CI: 0.04-2.19], p = 0.04) and improved cognitive function in older adults overall (ES = 0.69 [95% CI: 0.20-1,18], p = 0.01). CONCLUSION Our systematic review with meta-analysis provided evidence that beyond the cardiovascular and fitness benefits of AE, pairing AE with tDCS may have the potential to slow symptom progression of cognitive decline in MCI and dementia. Future studies will examine the hypothesis of this present review that a potentiating effect would incrementally improve cognition with increasing severity of cognitive impairment.
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Agbangla NF, Séba MP, Bunlon F. Snacktivity TM, Giant Games and Immersive Virtual Reality Exercises: A Rapid Narrative Review of These New Physical Activity Practices among Older People Living in Nursing Homes and Long-Term Care Facilities. Healthcare (Basel) 2022; 10:1897. [PMID: 36292344 PMCID: PMC9601483 DOI: 10.3390/healthcare10101897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/24/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2023] Open
Abstract
In developed countries, the increasing number of older adults raises many public health challenges. Physical activity can enable healthy aging, as it is beneficial for both mental and physical health. Despite this, not all older adults engage in physical activity or have access to it. To counteract this, new physical practices such as SnacktivityTM, giant games and immersive virtual reality exercises are being developed. The main objective of this rapid narrative review is to summarize the effects of SnacktivityTM, giant games and immersive Virtual Reality (VR) exercise among older adults living in nursing homes and long-term care facilities. A scientific review was performed using the search engines PubMed, PsycInfo and Web of Science on 7 July 2022. Fifty-nine items are identified in total, and five items are included in the literature review. Synthesis of the studies shows that immersive virtual reality and giant games improve the motivation and enjoyment of older adults and are beneficial for their functional abilities. Furthermore, no interventional studies have tested the effect of SnacktivityTM in older adults. This review suggests that future studies should be conducted to further explore the effects of these new physical activity practices in older adults living in nursing homes or long-term care facilities.
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Affiliation(s)
- Nounagnon Frutueux Agbangla
- Unité de Recherche Pluridisciplinaire Sport Santé Société (URePSSS), ULR 7369, Univ. Artois, Univ. Lille, Univ. Littoral Côte d’Opale, F-62800 Lille, France
| | - Marie-Philippine Séba
- Institut des Sciences du Sport-Santé de Paris (URP 3625), Université Paris Cité, F-75015 Paris, France
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López-García A, Sánchez-Ruíz ME. Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11854. [PMID: 36231155 PMCID: PMC9565761 DOI: 10.3390/ijerph191911854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/14/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Physical exercise can help older people maintain capacities such as muscle strength, balance, postural control, bone mass, and functionality in ADL that usually decline with age. Dementia patients can attend day care centers where they participate in activities such as cognitive training, music and art therapy, and physical exercise sessions. This research aimed to determine the effectiveness of simple lower limb strength and single leg stance training, feasible in the facilities of day care centers, to reduce the risk of falls in the elderly with dementia. Twenty patients with dementia were divided into intervention and control groups. They participated in mobility, strength, coordination, and balance exercise sessions for 45-50 min on weekdays for 5 weeks. In addition, the intervention group patients performed simple lower limb strength (sit-to-stands) and single leg stance exercises in every session. Risk of falls was assessed with the Tinetti test and the SPPB. Comparisons of post- and pre-intervention scores for the Tinetti test and SPPB were statistically increased (0.8 ± 0.7, p = 0.03; 1.5 ± 1.3 points, p = 0.02) in intervention patients. Simple lower limb strength and single leg stance exercises feasible to be done in day care facilities are effective tools for reducing the risk of falls in the elderly with dementia.
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Daďová K, Petr M, Tufano JJ, Sontáková L, Krauzová E, Štěpán M, Šiklová M, Šteffl M. Calanus Oil Supplementation Does Not Further Improve Short-Term Memory or Brain-Derived Neurotrophic Factor in Older Women Who Underwent Exercise Training. Clin Interv Aging 2022; 17:1227-1236. [PMID: 35990804 PMCID: PMC9384871 DOI: 10.2147/cia.s368079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose In our study, we examined changes in short-term episodic memory and brain-derived neurotrophic factor (BDNF) in women after an exercise program alone or in combination with omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation. Patients and Methods Fifty-five healthy elderly women (65–80 years) were randomly split into two groups: in the first group were women attending an exercise program while taking wax esters-rich oil (Calanus) supplementation (n = 28) and in the other group were women undergoing the same exercise program while taking placebo (n = 27). The 16-week exercise program consisted of functional circuit training (twice a week) and Nordic walking lessons (once a week). Short-term episodic memory was evaluated by the Czech screening Test “Pojmenování OBrázků A jejich Vybavení” (POBAV) baseline and after the program lasting 16 weeks. Results Our results show that short-term memory significantly improved following the exercise program, but there was no added value in using n-3 PUFA supplements. BDNF values did not differ between baseline and follow-up in either group. However, there was a statistically significant positive relationship between relative change (%) in the POBAV test and VO2peak in the placebo group (r = 0.49). Conclusion Despite the added value of n-3 PUFA supplementation not being proven, our results may strengthen the importance of physical activity in averting age-related memory decline and dementia.
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Affiliation(s)
- Klára Daďová
- Department of Adapted Physical Education and Sports Medicine, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Miroslav Petr
- Department of Physiology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - James J Tufano
- Department of Physiology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Lenka Sontáková
- Department of Physiology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Eva Krauzová
- Department of Pathophysiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Internal Medicine, Královské Vinohrady University Hospital and Third Faculty of Medicine, Prague, Czech Republic
| | - Marek Štěpán
- Department of Pathophysiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michaela Šiklová
- Department of Pathophysiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Šteffl
- Department of Physiology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
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Sharew NT. The Effect of Multimodal Non-pharmacological Interventions on Cognitive Function Improvement for People With Dementia: A Systematic Review. Front Public Health 2022; 10:894930. [PMID: 35903373 PMCID: PMC9314571 DOI: 10.3389/fpubh.2022.894930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionDementia is a progressive brain degeneration characterized by a progressive deterioration in cognition and independent living capacity. Since dementia is a complex syndrome, multimodal non-pharmacological interventions (MNPIs) are highly recommended. Currently, there is less available evidence to describe the content, length, and frequency of multimodal interventions for cognitive function improvement for people with dementia (PWD).MethodA comprehensive search was performed in PubMed, EMBASE, CINAHL, Web of Science, and Medline international databases. The quality appraisal of the studies was done by the Cochrane risk of bias assessment tools.ResultsA total of 19 controlled trial studies were included. Most of the included studies reported that MNPIs resulted in improvement, stability, or attenuation of decline in cognitive function of PWD. The reported effectiveness of MNPIs on cognitive function ranged from medium (0.29 Cohen's d) to large (2.02 Cohen's d) effect sizes. The median duration of intervention was 12 weeks for a 1-h session.ConclusionThis systematic review showed that MNPIs might improve people's cognitive functions for PWD. Physical exercise, music, and cognitive interventions were used in the content of multimodal interventions in a majority of the studies. Therefore, high-quality randomized controlled trial (RCT) studies with repeated-measured design on the combined effect of physical exercise, music, and cognitive intervention on cognitive function for PWD are recommended.Systematic Review Registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020222065.
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Affiliation(s)
- Nigussie Tadesse Sharew
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
- Interdisciplinary Centre Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- *Correspondence: Nigussie Tadesse Sharew ; orcid.org/0000-0002-6443-6992
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Impact of concurrent training versus aerobic or resistance training on cardiorespiratory fitness and muscular strength in middle-aged to older adults: A systematic review and meta-analysis. Physiol Behav 2022; 254:113888. [PMID: 35728627 DOI: 10.1016/j.physbeh.2022.113888] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/29/2022]
Abstract
The effects of aerobic training (AT) on cardiorespiratory fitness (CRF), and resistance training (RT) on muscular strength, are well known in older adults. However, less is known about the potential additive benefits of concurrent training (CT) versus AT or RT alone in this population. We conducted a systematic review and meta-analysis to investigate the effects of CT, versus AT or RT, on CRF and muscular strength in middle-aged to older adults. PubMed and Web of Science were searched through October 2021 to identify randomized trials evaluating CT versus AT and/or RT in middle-aged and older adults (>50 yrs). Studies were included that measured CRF, using maximal or peak oxygen uptake (VO2max/peak); and/or lower- and upper-body muscular strength measured using 1-repetition maximum (1RM) to 10RM tests during isoinertial contractions, or peak torque during isometric dynamometry or isokinetic dynamometry at 30 to 60°/s. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were determined using random or fixed effects models. Forty-nine studies involving 2,587 middle-aged to older participants with mean ages ranging from 55 to 88 years, were included in the meta-analysis. Results indicated that CT effectively increased VO2max/peak (SMD: 0.77, p = 0.005, 12 intervention arms) when compared to RT. In addition, CT effectively increased lower- (SMD: 0.60, p = 0.001, 43 intervention arms) and upper-body (SMD: 0.57, p = 0.001, 28 intervention arms) muscular strength when compared to AT. However, there were no differences in VO2max/peak (SMD: 0.09, p = 0.09, 33 intervention arms) between CT and AT, or in lower-body (SMD: 0.07, p = 0.48, 21 intervention arms) and upper-body (SMD: -0.07, p = 0.38, 17 intervention arms) muscular strength between CT and RT. Overall, CT was shown to be effective for increasing CRF and muscular strength in middle-aged to older adults and there was no negative effect on the magnitude of changes in these outcomes compared to either AT or RT alone. These results suggested that CT should be considered a viable strategy to improvement of CRF and muscular strength with aging.
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Kar F, Kavlak Y, Yıldız S, Yıldız P, Musmul A, Uslu S. Eight-week exercise program improved the quality of life of Alzheimer's patients through functional, cognitive, and biochemical parameters. Ir J Med Sci 2022; 192:655-663. [PMID: 35604540 DOI: 10.1007/s11845-022-03029-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In this study, it was aimed to examine the effect of 8-week exercise in Alzheimer's disease (AD) aged 65 and over through functional, cognitive, and biochemical parameters and irisin metabolism. METHODS Two groups consisting of healthy individuals and diagnosed with Alzheimer's over the age of 65 were followed up with a combined exercise program of 45-60 min, 3 days a week, for 8 weeks. At the end of the exercise period, various cognitive and functional tests were performed on the participants, and blood samples were taken for biochemical parameters and irisin level measurements. RESULTS In functional evaluations, while there was no difference in pre-exercise measurements of timed performance and quadriceps femoris muscle strength, there was a difference between groups in all other measurements (p < 0.05). Nutritional status increased significantly after exercise in AD individuals. Although there was an increase in mental score values after exercise, it was not statistically significant. Similar to the elderly with Alzheimer's, the improvements in functional tests in the healthy also led to improvements in activities of daily living and auxiliary activities of daily living. The exercise training did not have an effect on the lipid profile in AD patients, but showed an effect on glycemia and irisin levels (p < 0.05). CONCLUSION Changes in functional, cognitive, and biochemical parameters after the exercise program improved quality of life in Alzheimer's patients.
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Affiliation(s)
- Fatih Kar
- Department of Basic Sciences, Faculty of Engineering and Natural Sciences, Kütahya Health Sciences University, Kütahya, Turkey.
| | - Yasemin Kavlak
- Elderly Care Programme, Vocational School of Health Services, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Selda Yıldız
- Elderly Care Programme, Vocational School of Health Services, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Pınar Yıldız
- Department of Internal Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ahmet Musmul
- Department of Internal Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Sema Uslu
- Department of Medical Biochemistry, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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Mazo CE, Miranda ER, Shadiow J, Vesia M, Haus JM. High Intensity Acute Aerobic Exercise Elicits Alterations in Circulating and Skeletal Muscle Tissue Expression of Neuroprotective Exerkines. Brain Plast 2022; 8:5-18. [DOI: 10.3233/bpl-220137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Cathepsin B (CTSB) and brain derived neurotrophic factor (BDNF) are increased with aerobic exercise (AE) and skeletal muscle has been identified as a potential source of secretion. However, the intensity of AE and the potential for skeletal muscle contributions to circulating CTSB and BDNF have not been fully studied in humans. Objective: Determine the effects of AE intensity on circulating and skeletal muscle CTSB and BDNF expression profiles. Methods: Young healthy subjects (n = 16) completed treadmill-based AE consisting of VO2max and calorie-matched acute AE sessions at 40%, 65% and 80% VO2max. Fasting serum was obtained before and 30-minutes after each bout of exercise. Skeletal muscle biopsies (vastus lateralis) were taken before, 30-minutes and 3-hours after the 80% bout. Circulating CTSB and BDNF were assayed in serum. CTSB protein, BDNF protein and mRNA expression were measured in skeletal muscle tissue. Results: Serum CTSB increased by 20±7% (p = 0.02) and 30±18% (p = 0.04) after 80% and VO2max AE bouts, respectively. Serum BDNF showed a small non-significant increase (6±3%; p = 0.09) after VO2max. In skeletal muscle tissue, proCTSB increased 3 h-post AE (87±26%; p < 0.01) with no change in CTSB gene expression. Mature BDNF protein decreased (31±35%; p = 0.03) while mRNA expression increased (131±41%; p < 0.01) 3 h-post AE. Skeletal muscle fiber typing revealed that type IIa and IIx fibers display greater BDNF expression compared to type I (p = 0.02 and p < 0.01, respectively). Conclusions: High intensity AE elicits greater increases in circulating CTSB compared with lower intensities. Skeletal muscle protein and gene expression corroborate the potential role of skeletal muscle in generating and releasing neuroprotective exerkines into the circulation. NEW AND NOTEWORTHY: 1) CTSB is enriched in the circulation in an aerobic exercise intensity dependent manner. 2) Skeletal muscle tissue expresses both message and protein of CTSB and BDNF. 3) BDNF is highly expressed in glycolytic skeletal muscle fibers.
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Affiliation(s)
- Corey E. Mazo
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Edwin R. Miranda
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - James Shadiow
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael Vesia
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Jacob M. Haus
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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Ayenigbara IO. Preventive Measures against the Development of Dementia in Old Age. Korean J Fam Med 2022; 43:157-167. [PMID: 35610962 PMCID: PMC9136504 DOI: 10.4082/kjfm.21.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/07/2022] [Indexed: 11/03/2022] Open
Abstract
Dementia is a neurological condition characterized by numerous types of central nervous system diseases, which gradually deteriorates an individual’s reasoning, rational thinking, and judgment abilities. As a serious public health concern that currently affects more than 50 million older adults, dementia is one of the most significant causes of incapacity, disability, and dependency among older adults. As new cases are expected to increase exponentially in the next three decades, dementia, which is not a normal feature of healthy aging despite the fact that it generally affects older adults disproportionately, requires enormous management and care efforts due to its associated socioeconomic, psychological, and physical burdens that involve the patient, their caregivers, guardians, family members, and society at large. Presently, there is no cure for dementia; however, this condition could be prevented. This narrative review aimed to provide a broad overview of studies detailing the alternative lifestyle modification-centered preventive measures against dementia. A comprehensive search of key databases to find articles related to this topic revealed that participating in regular physical activities, healthy eating and dieting, avoiding all forms of smoking, avoiding air pollutants, halting or reducing alcohol consumption, exercising the mind and being socially dynamic, getting enough rest and establishing good sleeping habits, infection prevention, stress prevention, avoidance of injuries, preventing the effects of social isolation and lockdowns, continuing education, and depression prevention are protective measures against the development of dementia.
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Affiliation(s)
- Israel Oluwasegun Ayenigbara
- School and Community Health Education Unit, Department of Health Education, University of Ibadan, Ibadan, Nigeria
- *Corresponding Author: Israel Oluwasegun Ayenigbara Tel: +234-8139177538, Fax: +234-809-810-3043, E-mail:
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Balbim GM, Falck RS, Barha CK, Starkey SY, Bullock A, Davis JC, Liu-Ambrose T. Effects of exercise training on the cognitive function of older adults with different types of dementia: a systematic review and meta-analysis. Br J Sports Med 2022; 56:bjsports-2021-104955. [PMID: 35577539 DOI: 10.1136/bjsports-2021-104955] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the effect of exercise training on the cognitive function of older adults living with different types of dementia, as well as potential moderators of exercise efficacy. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Central, PsycINFO, Embase, Medline and CINAHL. ELIGIBILITY CRITERIA Peer-reviewed, randomised controlled trials, in English (1990-present), which examined the effects of exercise training on the cognitive function of older adults living with dementia. STUDY APPRAISAL AND SYNTHESIS Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0 and Physiotherapy Evidence Database Scale). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test. RESULTS Twenty-eight studies (n=2158) were included in the qualitative review and 25 in the meta-analysis. For all-cause dementia, a small effect of exercise training on cognitive function was observed (g=0.19; 95% CI 0.05 to 0.33; p=0.009). Type of dementia and exercise training characteristics did not moderate the effects of exercise training on cognitive function (p>0.05). Adherence to the intervention moderated the cognitive outcome effect size such that greater mean adherence was associated with greater cognitive outcome effect sizes (b=0.02; SE=0.01; p=0.005). CONCLUSION Exercise training showed small benefits for the cognitive function of older adults living with all-cause dementia. More research and standardised reporting of exercise training characteristics can strengthen the evidence for what works best for which types of dementia. PROSPERO REGISTRATION NUMBER CRD42020198716.
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Affiliation(s)
- Guilherme Moraes Balbim
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Ryan S Falck
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Cindy K Barha
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samantha Y Starkey
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexis Bullock
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- Faculty of Management, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
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Pickersgill JW, Turco CV, Ramdeo K, Rehsi RS, Foglia SD, Nelson AJ. The Combined Influences of Exercise, Diet and Sleep on Neuroplasticity. Front Psychol 2022; 13:831819. [PMID: 35558719 PMCID: PMC9090458 DOI: 10.3389/fpsyg.2022.831819] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/25/2022] [Indexed: 12/11/2022] Open
Abstract
Neuroplasticity refers to the brain’s ability to undergo structural and functional adaptations in response to experience, and this process is associated with learning, memory and improvements in cognitive function. The brain’s propensity for neuroplasticity is influenced by lifestyle factors including exercise, diet and sleep. This review gathers evidence from molecular, systems and behavioral neuroscience to explain how these three key lifestyle factors influence neuroplasticity alone and in combination with one another. This review collected results from human studies as well as animal models. This information will have implications for research, educational, fitness and neurorehabilitation settings.
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Affiliation(s)
| | - Claudia V Turco
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Karishma Ramdeo
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Ravjot S Rehsi
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stevie D Foglia
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Aimee J Nelson
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Kanegusuku H, Correia MA, Longano P, Ritti-Dias RM, Wolosker N, Cucato GG. Effects of arm-crank exercise on cardiovascular function, functional capacity, cognition and quality of life in patients with peripheral artery disease: Study protocol for a randomized controlled trial. PLoS One 2022; 17:e0267849. [PMID: 35511887 PMCID: PMC9070866 DOI: 10.1371/journal.pone.0267849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Arm-crank exercise training (ACT) is an alternative exercise strategy for patients with symptomatic peripheral artery disease (PAD) due to the attenuation of pain symptoms during the exercise, as well as the benefits to functional capacity. Purpose The aim of this study is to describe the study protocol to analyze the effects of ACT exercise on cardiovascular function, functional capacity, cognition and quality of life in patients with symptomatic PAD. Methods This is a three-armed randomized, prospective, single-blind data collection, single-center, controlled study enrolling 45 patients with symptomatic PAD who will be randomized into 3 intervention groups: walking training (WT), ACT and control group. The WT and ACT will perform 2 sessions/week, 15 to 10 sets of 2 to 5 minutes at values of 13 to 15 on the Borg scale. Before and after 12 weeks of intervention, cardiovascular function (ambulatory blood pressure, office blood pressure, central blood pressure, heart rate variability, arterial stiffness and vascular function), functional capacity (six-minute walk test, 2 minute step test, handgrip test, Walking impairment questionnaire, Walking estimated limitation calculated by history, Baltimore activity scale for intermittent claudication, and short physical performance battery), cognition (executive function and memory), and quality of life (vascular quality of life questionnaire and World Health Organization Quality of Life) will be assessed. Results This is the first trial to evaluate the effects of ACT on regulatory mechanisms of the cardiovascular system in PAD patients. If the results are as expected, they will provide evidence the ability of ACT to promote cardiovascular benefits in the symptomatic PAD population.
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Affiliation(s)
| | | | - Paulo Longano
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil
| | | | | | - Gabriel Grizzo Cucato
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- * E-mail:
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Galhardas L, Raimundo A, Del Pozo-Cruz J, Marmeleira J. Physical and Motor Fitness Tests for Older Adults Living in Nursing Homes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5058. [PMID: 35564453 PMCID: PMC9105463 DOI: 10.3390/ijerph19095058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.
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Affiliation(s)
- Luis Galhardas
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Jesús Del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville, 41013 Sevilla, Spain;
- Epidemiology of Physical Activity and Fitness across Lifespan Research Group (EPAFit), University of Seville, 41013 Sevilla, Spain
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
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Guan Y, Yan Z. Molecular Mechanisms of Exercise and Healthspan. Cells 2022; 11:872. [PMID: 35269492 PMCID: PMC8909156 DOI: 10.3390/cells11050872] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 12/16/2022] Open
Abstract
Healthspan is the period of our life without major debilitating diseases. In the modern world where unhealthy lifestyle choices and chronic diseases taper the healthspan, which lead to an enormous economic burden, finding ways to promote healthspan becomes a pressing goal of the scientific community. Exercise, one of humanity's most ancient and effective lifestyle interventions, appears to be at the center of the solution since it can both treat and prevent the occurrence of many chronic diseases. Here, we will review the current evidence and opinions about regular exercise promoting healthspan through enhancing the functionality of our organ systems and preventing diseases.
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Affiliation(s)
- Yuntian Guan
- Department of Pharmacology, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA;
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
| | - Zhen Yan
- Department of Pharmacology, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA;
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
- Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
- Department of Molecular Physiology and Biological Biophysics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
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Hammond NG, Stinchcombe A. Prospective Associations between Physical Activity and Memory in the Canadian Longitudinal Study on Aging: Examining Social Determinants. Res Aging 2022; 44:709-723. [PMID: 35230196 PMCID: PMC9403388 DOI: 10.1177/01640275211070001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To examine associations between physical activity (PA) and prospectively assessed
memory in a cohort of cognitively healthy adults, after accounting for understudied
social determinants. Methods We used data from the Canadian Longitudinal Study on Aging (CLSA). PA (exposure) and
memory (outcome) were assessed using validated measures in 2013–2015 and 2015–2018,
respectively. Respondents reported their daily number of hours spent engaging in five
different PAs. We conducted multiple imputation and used linear regression
(n = 41,394), adjusting for five categories of covariates:
demographics, sensory health characteristics, health behaviors, health status, and
social determinants (sex/gender, education, income, social support, perceived social
standing, race, and sexual orientation). Results In crude models, nearly every intensity and duration of PA was associated with better
memory. In fully adjusted models, protective associations were attenuated; however, some
associations held: all durations of walking, most durations of light activities,
moderate activities for ≥1 hour, and strenuous activities for 1 to <2 hours. Discussion Some forms of PA may be associated with better memory. The benefits of higher intensity
PA may only be realized after social determinants are addressed.
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Affiliation(s)
- Nicole G Hammond
- School of Epidemiology and Public Health, 6363University of Ottawa, Ottawa, ON, Canada
| | - Arne Stinchcombe
- School of Psychology, 6363University of Ottawa, Ottawa, ON, Canada
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Huang X, Zhao X, Li B, Cai Y, Zhang S, Wan Q, Yu F. Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:212-223. [PMID: 34004389 PMCID: PMC9068743 DOI: 10.1016/j.jshs.2021.05.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Exercise is a promising nonpharmacological therapy for cognitive dysfunction, but it is unclear which type of exercise is most effective. The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment (MCI) or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment. METHODS We searched PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia. Primary outcomes included global cognition, executive cognition, and memory cognition. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, and quality of life. Pairwise analyses and network meta-analyses were performed using a random effects model. RESULTS A total of 73 articles from 71 trials with 5606 participants were included. All types of exercise were effective in increasing or maintaining global cognition, and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition (standard mean difference (SMD) = 1.05, 95% confidence interval (95%CI): 0.56-1.54), executive function (SMD = 0.85, 95%CI: 0.21-1.49), and memory function (SMD = 0.32, 95%CI: 0.01-0.63) in patients with cognitive dysfunction. Subgroup analyses for patients with MCI revealed different effects, and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition (SMD = 0.99, 95%CI: 0.44-1.54) and executive function (SMD = 0.72, 95%CI: 0.06-1.38). However, only resistance exercise showed significant effects on memory function for patients with MCI (SMD = 0.35, 95%CI: 0.01-0.69). Exercise interventions also showed various effects on the secondary outcomes. CONCLUSION Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive decline in patients with cognitive dysfunction, especially in patients with dementia. Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.
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Affiliation(s)
- Xiuxiu Huang
- School of Nursing, Peking University, Beijing 100191, China
| | - Xiaoyan Zhao
- School of Nursing, Peking University, Beijing 100191, China
| | - Bei Li
- School of Nursing, Peking University, Beijing 100191, China
| | - Ying Cai
- School of Nursing, Peking University, Beijing 100191, China
| | - Shifang Zhang
- School of Nursing, Peking University, Beijing 100191, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing 100191, China.
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
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Ries JD, Carroll M. Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia. Geriatrics (Basel) 2022; 7:geriatrics7020023. [PMID: 35314595 PMCID: PMC8938849 DOI: 10.3390/geriatrics7020023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/20/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023] Open
Abstract
Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC90) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable.
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Lewis LK, Henwood T, Boylan J, Hunter S, Lange B, Lawless M, Milte R, Petersen J. Re-thinking reablement strategies for older adults in residential aged care: a scoping review. BMC Geriatr 2021; 21:667. [PMID: 34847860 PMCID: PMC8638477 DOI: 10.1186/s12877-021-02627-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The number of older adults in residential aged care is increasing. Aged care residents have been shown to spend most of the day sedentary and have many co-morbidities. This review aimed to systematically explore the effectiveness of reablement strategies in residential aged care for older adults' physical function, quality of life and mental health, the features of effective interventions and feasibility (compliance, acceptability, adverse events and cost effectiveness). METHOD This scoping review was undertaken according to PRISMA guidelines (extension for scoping reviews). Five e-databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL) were searched from 2010 onwards. Randomised controlled trials investigating reablement strategies addressing physical deconditioning for older adults (mean age ≥ 65 yrs) in residential aged care on physical function, quality of life or mental health were included. Feasibility of the interventions (compliance, acceptability, satisfaction, adverse events and cost effectiveness) was explored. RESULTS Five thousand six hundred thirty-one citations were retrieved, and 63 studies included. Sample sizes ranged from 15 to 322 and intervention duration from one to 12 months. Exercise sessions were most often conducted two to three times per week (44 studies) and physiotherapist-led (27 studies). Interventions were predominately multi-component (28 studies, combinations of strength, balance, aerobic, functional exercises). Five interventions used technology. 60% of studies measuring physical function reported significant improvement in the intervention versus control, 40% of studies measuring quality of life reported significant improvements in favour of the intervention, and 26% of studies measuring mental health reported significant intervention benefits. Over half of the studies measured compliance and adverse events, four measured acceptability and none reported cost effectiveness. CONCLUSIONS There has been a research surge investigating reablement strategies in residential aged care with wide variability in the types and features of strategies and outcome measures. Few studies have measured acceptability, or cost effectiveness. Exploration of core outcomes, mapping stakeholders and co-designing a scalable intervention is warranted. TRIAL REGISTRATION Prospectively registered review protocol (Open Science Framework: DOI https://doi.org/10.17605/OSF.IO/7NX9M ).
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Affiliation(s)
- Lucy K Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Tim Henwood
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Jo Boylan
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Michael Lawless
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jasmine Petersen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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Effects of Combined Cognitive and Exercise Interventions on Poststroke Cognitive Function: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4558279. [PMID: 34840972 PMCID: PMC8612794 DOI: 10.1155/2021/4558279] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/24/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022]
Abstract
Objective We investigated combined cognitive and exercise interventions in the literature and summarized their effectiveness in improving poststroke cognitive impairment (PSCI). Data Sources. Electronic databases and trial registries were searched from their inception until July 2020. Study Selection. Trials were collected with the following study inclusion criteria: (1) patients over 18 years of age who were diagnosed with PSCI; (2) combined cognitive-exercise interventions, regardless of the order of the two types of interventions or whether they were administered simultaneously; (3) any control group studied at the same time that was deemed acceptable, including no intervention/routine care, delayed intervention, sham intervention, and passive training; (4) the use of any validated cognitive neuropsychological test to evaluate cognitive function; and (5) clinically administered random trials with controls. Data Extraction. Five randomized controlled trials met the inclusion criteria. Two reviewers independently assessed the eligibility of the full texts and methodological quality of the included studies using the Cochrane risk of bias tool. Inconsistent results were resolved by additional discussion or decided by a third examiner, if necessary. Data Analysis. Meta-analysis demonstrated that the combined interventions had a significant effect on executive function and working memory [Stroop test (time), standardized mean difference (SMD) = 0.42, 95% confidence interval (CI): 0.80–0.04, p = 0.02; Trail Making Test, SMD = 0.49, 95% CI: 0.82–0.16, p = 0.004; Forward Digit Span Test, SMD = 0.91, 95% CI: 0.54–1.29, p ≤ 0.001]. While it was impossible to conduct a meta-analysis of global cognitive function and other cognitive domains, individual experiments demonstrated that the combined interventions played a significant role in global cognition, reasoning ability, logical thinking, and visual-spatial memory function. Conclusions Our analyses demonstrated that the combined interventions had a significant effect on the improvement of PSCI, particularly in terms of executive function. However, the moderate risk of bias in the included trials and the small number of relevant studies indicated a need for more uniform diagnostic and evaluation criteria, and larger trials would provide stronger evidence to better understand the effectiveness of the combined interventions. This trial is registered with trial registration number INPLASY202160090.
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Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses. J Aging Phys Act 2021; 30:535-551. [PMID: 34489364 DOI: 10.1123/japa.2021-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/11/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.
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