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Song F, Ding K, Qi W, Sun W, Xiang H, Sun M, Xia R. Effects of Baduanjin Exercise on lung function and 6 min walk in COPD patients: a systematic review and meta-analysis. Sci Rep 2024; 14:17788. [PMID: 39090183 PMCID: PMC11294359 DOI: 10.1038/s41598-024-68581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024] Open
Abstract
COPD is a public health problem of global concern, which seriously affects the quality of life of patients and is also the third leading cause of death from non-communicable diseases. To investigate the effect of Ba duan jin exercise on lung function and the results of a 6-min walking trial in patients with stable COPD. Literature databases such as Web of Science, Embase, PubMed, Cochrane Library, Chinese Biomedical Literature (CBM), CNKI, Wanfang Data and VIP were searched by computer, the search period is up to January 2024. Literature screening, quality evaluation and data extraction were carried out independently by two researchers. And use RevMan 5.3 software and StataMP 18 (64-bit) software to process the relevant outcome indicators. A total of 16 RCT studies with 1184 patients were included. The meta-analysis results showed that compared with the control group, Ba Duan Jin exercise could improve FEV1 (MD = 0.29, 95% CI (0.20, 0.37), P < 0.0001), FEV1/FVC (%) (MD = 3.86, 95% CI (2.24, 5.47), P < 0.00001), and 6-min walking distance (MD = 45.41, 95% CI (33.93, 56.89), P < 0.00001) in stable COPD patients. The results of subgroup analysis based on the duration of the intervention cycle, research quality, and intervention frequency showed that periodic Ba Duan Jin exercise can significantly improve the relevant lung function levels to varying degrees. At the same time, the intervention effect of Ba Duan Jin exercise during the implementation process is also affected by the duration of the exercise cycle, exercise frequency, and the completion of the exercise plan. Ba Duan Jin exercise has a positive improvement effect on lung function and 6-min walking distance in stable COPD patients. In the process of exercise implementation, attention should be paid to cultivating exercise habits, stabilizing and improving attendance rates, and strictly implementing training techniques to achieve the best clinical outcomes for these patients.
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Affiliation(s)
- Feiyun Song
- Department of Sports Rehabilitation, College of Physical Education, Anqing Normal University, Anqing, 246133, China
| | - Kexin Ding
- Department of Sports Rehabilitation, College of Physical Education, Anqing Normal University, Anqing, 246133, China
| | - Wei Qi
- Department of Sports Rehabilitation, College of Physical Education, Anqing Normal University, Anqing, 246133, China
| | - Wen Sun
- Department of Sports Rehabilitation, College of Physical Education, Anqing Normal University, Anqing, 246133, China
| | - Heping Xiang
- Department of Sports Rehabilitation, College of Physical Education, Anqing Normal University, Anqing, 246133, China.
| | - Mingyun Sun
- Department of Sports Rehabilitation, College of Physical Education, Anqing Normal University, Anqing, 246133, China.
| | - Rui Xia
- School of Physical Education, Chaohu University, Hefei, 238000, China
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Qin T, Fan C, Liu Q, Wang J, Zhu X. Development and validation of a nomogram for predicting cognitive frailty in patients on maintenance haemodialysis. J Adv Nurs 2024. [PMID: 38807450 DOI: 10.1111/jan.16253] [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: 02/03/2023] [Revised: 04/10/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
AIMS This study aimed to construct a nomogram for predicting the risk of cognitive frailty in patients on maintenance haemodialysis. DESIGN An explorative cross-sectional design was adopted. METHODS From April 2022 to July 2022, 496 participants were recruited from five haemodialysis centres in Qingdao, Shandong Province, China. Participants with cognitive frailty were screened by Frailty Phenotype scale and Mini-Mental State Examination. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were utilized to determine predictors. The predictive performance of the nomogram was validated by calibration and discrimination. Decision curve analysis was used to assess clinical utility. Internal validation was implemented using 1000 bootstrap samples to mitigate overfitting. RESULTS The prevalence of cognitive frailty was 17.5% (n = 87). Six risk predictors, namely health empowerment, alexithymia, age, educational level, marital status and dialysis vintage, were screened and used to develop a nomogram model. The nomogram had satisfactory discrimination and calibration, and decision curve analysis revealed considerable clinical utility. CONCLUSIONS A nomogram incorporated with the six risk predictors was developed, and it exhibited excellent prediction performance. The nomogram may strengthen the effective screening of patients at high risk of cognitive frailty. IMPACT This study established a tool for healthcare staff to predict cognitive frailty probability and identify risk factors in patients on maintenance haemodialysis. The nomogram can meet the needs of personalized care and precision medicine simultaneously. PATIENT OR PUBLIC CONTRIBUTION Data were collected from patients on maintenance haemodialysis by using questionnaire survey. REPORTING METHOD STROBE checklist was used.
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Affiliation(s)
- Tong Qin
- Nursing department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chun Fan
- Department of Pharmacy, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Qingwei Liu
- Nursing department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jizhe Wang
- Nursing department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiuli Zhu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
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Wang X, Wu J, Zhang H, Zheng G. Effect of Baduanjin exercise on executive function in older adults with cognitive frailty: A randomized controlled trial. Clin Rehabil 2024; 38:510-519. [PMID: 38092741 DOI: 10.1177/02692155231215891] [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] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To investigate the effectiveness of Baduanjin exercise on executive function in community-dwelling older adults with cognitive frailty. DESIGN Randomized controlled trial. SETTING Community residential centers. SUBJECTS 120 eligible older adults. INTERVENTIONS Baduanjin training group received supervised Baduanjin training, 60 min sessions three times per week for 24 weeks. The control group did not receive any exercise intervention. MAIN MEASURES Primary outcome was executive function, assessed using Clock Drawing Test. Secondary outcomes included the subcomponents of executive function (working memory, inhibitory control and cognitive flexibility), attention and cognitive frailty (global cognitive function, physical frailty) assessed using Verbal Fluency Test, Trail Making Test-A/B, Stroop Test, Montreal Cognitive Assessment and Edmonton Frailty Scale, respectively, at baseline and 24 weeks after intervention. RESULTS After the 24-week intervention, the scores of Clock Drawing Test and Verbal Fluency Test, the Trail Making Test-B time and the Card correct numbers of Stroop Test in Baduanjin training group showed significant improvement compared with control group (all P < 0.05) with small to moderate effect sizes and the significant interaction effect of group by time in the Clock Drawing Test and Trail Making Test-B test (P = 0.003 and P = 0.043); cognitive frailty variables, including Montreal Cognitive Assessment and Edmonton Frail Scale scores, also showed significant improvement (P = 0.002 and P = 0.004) with a moderate effect sizes and a significant interaction effect (P < 0.001, P = 0.013). No adverse events were reported. CONCLUSION Regular Baduanjin training may be an effective and safe intervention to improve cognitive frailty and executive function in community-dwelling older adults with cognitive frailty. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2100050857. Data of registration: 8/5/2020, https://www.chictr.org.cn/showproj.html?proj = 133037.
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Affiliation(s)
- Xiaoqian Wang
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Dongtai Hospital of Traditional Chinese Medicine, Dongtai, Jiangsu, China
| | - Jiawei Wu
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Haoran Zhang
- Department of Physical Education, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Fukatsu-Chikumoto A, Hirano T, Takahashi S, Ishida T, Yasuda K, Donishi T, Suga K, Doi K, Oishi K, Ohata S, Murata Y, Yamaji Y, Asami-Noyama M, Edakuni N, Kakugawa T, Matsunaga K. Correlation between frailty and reduction in cortical thickness in patients with chronic obstructive pulmonary disease. Sci Rep 2024; 14:6106. [PMID: 38480723 PMCID: PMC10937661 DOI: 10.1038/s41598-024-53933-0] [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: 06/20/2023] [Accepted: 02/06/2024] [Indexed: 03/17/2024] Open
Abstract
Physical inactivity and cognitive impairment in patients with chronic obstructive pulmonary disease (COPD) can lead to frailty and poor prognoses. However, little is known regarding the association between frailty and the human brain. We hypothesized that the brain structure could change according to frailty in patients with COPD and focused on cortical thickness. Cortical thickness measured by magnetic resonance imaging and frailty scores using the Kihon Checklist (KCL) were assessed in 40 patients with stable COPD and 20 healthy controls. Among the 34 regions assessed, multiple regions were thinner in patients with COPD than in healthy individuals (p < 0.05). We found significant negative correlations between the eight regions and the KCL scores only in patients with COPD. After adjusting for age and cognitive impairment, the association between the left and six right regions remained statistically significant. The correlation coefficient was the strongest in the bilateral superior frontal gyrus (left: ρ = - 0.5319, p = 0.0006) (right: ρ = - 0.5361, p = 0.0005). Interestingly, among the KCL scores, the daily activity domain showed the strongest correlation (sensitivity, 90%; specificity, 73%) with the bottom quartile of the reduction in the superior frontal gyrus. Frailty in patients with COPD is associated with a thickness reduction in the cortical regions, reflecting social vulnerability.
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Affiliation(s)
- Ayumi Fukatsu-Chikumoto
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan.
| | - Shun Takahashi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, 641-0012, Japan
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, 583-8555, Japan
- Clinical Research and Education Center, Asakayama General Hospital, Sakai, 590-0018, Japan
| | - Takuya Ishida
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, 641-0012, Japan
| | - Kasumi Yasuda
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, 641-0012, Japan
| | - Tomohiro Donishi
- Department of System Neurophysiology, Wakayama Medical University, Wakayama, 641-0012, Japan
| | - Kazuyoshi Suga
- Department of Radiology, St. Hill Hospital, Ube, 755-0155, Japan
| | - Keiko Doi
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Ube, 755-8505, Japan
| | - Keiji Oishi
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Shuichiro Ohata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Yoriyuki Murata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Maki Asami-Noyama
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Nobutaka Edakuni
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Tomoyuki Kakugawa
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Ube, 755-8505, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
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Wu X, Huang K, Jiang T, Yu H. Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: a cohort study. Psychogeriatrics 2024; 24:295-302. [PMID: 38158615 DOI: 10.1111/psyg.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUNDS Cognitive frailty, a clinical syndrome with physical frailty and cognitive impairment, leads to mortality and other adverse health outcomes in older adults. This study aimed to investigate the prevalence of cognitive frailty, and its influencing factors, and follow its impact on short-term mortality in elderly chronic obstructive pulmonary disease patients, to provide a theoretical scientific reference basis for clinical intervention and management of cognitive frailty. METHODS A sample of 243 elderly chronic obstructive pulmonary disease patients in the respiratory department of a tertiary care hospital was conveniently sampled from November 2021 to February 2023, and the prevalence of cognitive frailty was investigated using the General Information Survey Scale, the Fried Phenotype Scale, the Mini-Mental State Examination, the Anxiety Self-Rating Scale, the Brief Geriatric Depression Scale, and the Mortality Record. The mortality was recorded by telephone follow-up after 6 months. A database was created and statistical analysis such as one-way analysis of variance, logistic regression analysis, Kaplan-Meier, and Cox survival analysis were used to analyze the data. RESULTS A total of 47 patients (19.3%) had cognitive frailty; there were statistical differences in the prevalence of cognitive frailty by medical payment type, physical exercise, and sleeping time (P < 0.05). During a 6-month follow-up, 38 patients (15.6%) died. Cox survival analysis showed that the risk of death in elderly chronic obstructive pulmonary disease patients in the cognitive frailty group was 3.212 times higher than that in the normal cognitive function and non-frailty group (95% CI 1.646-6.270, P = 0.001), and 5.266 times higher than that in the normal cognitive function and frailty group (95% CI 3.159-8.778, P < 0.001). CONCLUSIONS The prevalence of cognitive frailty in elderly chronic obstructive pulmonary disease patients is high, and clinical staff should pay attention to patients' medical burden and financial ability, and reduce the incidence of cognitive frailty by instructing patients to perform physical exercise and arrange sleep time. Cognitive frailty is an important risk factor for mortality within 6 months in elderly chronic obstructive pulmonary disease patients, and early intervention should be emphasised to reduce or delay cognitive frailty and mortality.
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Affiliation(s)
- Xia Wu
- Department of Nursing, Xiamen Medical College, Xiamen, China
| | - Kehan Huang
- Department of Nursing, Xiamen Medical College, Xiamen, China
| | - Tingting Jiang
- Department of Respiratory Medicine, Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Huiqin Yu
- Department of Nursing, Xiamen Medical College, Xiamen, China
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Yang D, Huang H, Xu DD, Zhao Y. Effects of Baduanjin exercise on patients with chronic nonspecific low back pain and surface electromyography signs of erector spinal muscle: A randomized controlled trial. Medicine (Baltimore) 2023; 102:e35590. [PMID: 37904426 PMCID: PMC10615504 DOI: 10.1097/md.0000000000035590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Chronic nonspecific low back pain (CNLBP) is a common disease usually with lower back muscle fatigue and injuries that may contribute to lumbar muscle imbalance and pain recurrence. This study aimed to examine the effectiveness of Baduanjin exercise on patients of CNLBP and to assess its impact on the surface electromyographic signals of the lumbar erector spinae muscle. METHODS A total of 60 patients diagnosed with CNLBP were admitted from the Hubei Provincial Hospital of Traditional Chinese Medicine from March 2022 to December 2022. Those patients were randomly allocated into the Baduanjin group (n = 30) or the walking group (n = 30). Both groups received a 4-week intervention, with 5 training sessions per week. The numeric pain rating scale (the minimal clinically important difference = 2.4) and Oswestry Disability Index (the minimal clinically important difference = 13.4), electromyogram signals during lumbar flexion (FLEXAEMG), lumbar extension (EXTAEMG), and maximum lumbar flexion (MAEMG), the ratios of FLEXAEMG to MAEMG and EXTAEMG to MAEMG were collected at Baseline and posttreatment and compared using the Wilcoxon signed-rank test or Mann-Whitney U test. RESULTS After treatment, the numeric pain rating scale score in the Baduanjin group exhibited a significant decrease compared to baseline (P < .05) and was found to be lower than that of the Walking group (mean difference 2.36; CI 95% -2.323 to -1.742; P = .001). Similarly, the Oswestry disability index in the Baduanjin group demonstrated a reduction compared to baseline (P < .05) and was lower than that of the Walking group (the mean difference 7.59; CI 95% -8.861 to -6.312; P = .001). The FLEXAEMG and EXTAEMG of both groups had a significant increase (P < .05), with the Baduanjin group demonstrating higher levels compared to the Walking group (P < .05). Conversely, the MAEMG of both groups displayed a significant decrease (P < .05), with the Baduanjin group exhibiting lower levels than the Walking group (P < .05). The FLEXAEMG to MAEMG and EXTAEMG to MAEMG in the Baduanjin group increased (P < .05) and were significantly higher than the Walking group (P < .05). CONCLUSION Baduanjin exercise has shown to be highly effective in reducing low back pain and in promoting lumber dysfunction, due to its ability to improve the strength and flexibility of the lumbar erector spinae muscle.
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Affiliation(s)
- Dan Yang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Hai Huang
- Department of Tuina and Rehabilitation Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Department of Tuina and Rehabilitation Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Department of Tuina and Rehabilitation Medicine, Hubei Provincial Institute of Traditional Chinese Medicine, Wuhan, China
| | - Dan Dan Xu
- Department of Tuina and Rehabilitation Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Department of Tuina and Rehabilitation Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Department of Tuina and Rehabilitation Medicine, Hubei Provincial Institute of Traditional Chinese Medicine, Wuhan, China
| | - Yan Zhao
- Department of Tuina and Rehabilitation Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Department of Tuina and Rehabilitation Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Department of Tuina and Rehabilitation Medicine, Hubei Provincial Institute of Traditional Chinese Medicine, Wuhan, China
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Paiva Prudente T, Oliva HNP, Oliva IO, Mezaiko E, Monteiro-Junior RS. Effects of Physical Exercise on Cerebral Blood Velocity in Older Adults: A Systematic Review and Meta-Analysis. Behav Sci (Basel) 2023; 13:847. [PMID: 37887497 PMCID: PMC10604216 DOI: 10.3390/bs13100847] [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: 09/16/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
As the older population grows, there is an increasing interest in understanding how physical exercise can counteract the changes seen with aging. The benefits of exercise to general health, and especially to the cardiovascular system, have been a topic of discussion for decades. However, there is still a need to elucidate the effects of training programs on the cerebrovascular blood velocity in older people. This systematic review and meta-analysis aimed to investigate the effect of physical exercise on the cerebral blood velocity in older people (PROSPERO CRD42019136305). A search was performed on PubMed, Web of Science, EBSCO, ScienceDirect, and Scopus from the inception of this study to October 2023, retrieving 493 results, of which 26 were included, analyzing more than 1000 participants. An overall moderate risk of bias was found for the studies using the Cochrane risk-of-bias tools for randomized and non-randomized clinical trials. The pooled results of randomized trials showed that older people who underwent physical exercise presented a statistically significant increase in cerebral blood velocity (3.58; 95%CI = 0.51, 6.65; p = 0.02). This result indicates that physical exercise is important to help maintain cerebral health in older adults.
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Affiliation(s)
- Tiago Paiva Prudente
- School of Medicine, Universidade Federal de Goiás, Goiânia 74690-900, GO, Brazil;
| | - Henrique Nunes Pereira Oliva
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA;
- Postgraduation Programme of Health Sciences, Universidade Estadual de Montes Claros, Montes Claros 39401-089, MG, Brazil
| | - Isabela Oliveira Oliva
- School of Medicine, Centro Universitario FIPMoc (UNIFIPMoc), Montes Claros 39408-007, MG, Brazil;
| | - Eleazar Mezaiko
- School of Dentistry, Universidade Federal de Goiás, Goiânia 74690-900, GO, Brazil;
| | - Renato Sobral Monteiro-Junior
- Postgraduation Programme of Health Sciences, Universidade Estadual de Montes Claros, Montes Claros 39401-089, MG, Brazil
- Postgraduation Programme of Neurology/Neuroscience, Universidade Federal, Niterói 24020-141, RJ, Brazil
- Research and Study Group in Neuroscience, Exercise, Health and Sport—GENESEs, Physical Education Department, Universidade Estadual de Montes Claros, Montes Claros 39401-089, MG, Brazil
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Karamacoska D, Butt A, Leung IHK, Childs RL, Metri NJ, Uruthiran V, Tan T, Sabag A, Steiner-Lim GZ. Brain function effects of exercise interventions for cognitive decline: a systematic review and meta-analysis. Front Neurosci 2023; 17:1127065. [PMID: 37260849 PMCID: PMC10228832 DOI: 10.3389/fnins.2023.1127065] [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: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Exercise is recognized as a modifiable lifestyle factor that can mitigate cognitive decline and dementia risk. While the benefits of exercise on cognitive aging have been reported on extensively, neuronal effects in adults experiencing cognitive decline have not been systematically synthesized. The aim of this systematic review was to assess the effects of exercise on cognition and brain function in people with cognitive decline associated with dementia risk. Method A systematic search was conducted for randomized controlled trials of ≥ 4 weeks exercise (aerobic, resistance, or mind-body) that assessed cognition and brain function using neuroimaging and neurophysiological measures in people with subjective or objective cognitive decline. Study characteristics and brain function effects were narratively synthesized, while domain-specific cognitive performance was subjected to meta-analysis. Study quality was also assessed. Results 5,204 records were identified and 12 unique trials met the eligibility criteria, representing 646 adults classified with cognitive frailty, mild or vascular cognitive impairment. Most interventions involved 40-minute sessions conducted 3 times/week. Exercise improved global cognition (g = -0.417, 95% CI, -0.694 to -0.140, p = 0.003, I2 = 43.56%), executive function (g = -0.391, 95% CI, -0.651 to -0.131, p = 0.003, I2 = 13.28%), but not processing speed or general short-term memory (both p >0.05). Across fMRI and ERP studies, significant neuronal adaptations were found with exercise cf. control throughout the brain and were linked with improved global cognition, memory, and executive function. Cerebral blood flow was also found to improve with 24 weeks of exercise, but was not linked with cognitive changes. Discussion The cognitive improvements associated with exercise are likely driven by increased metabolic activity, cerebrovascular mechanisms, and neuroplasticity throughout the brain. Our paper shows the promise in, and need for, high-quality trials integrating cognitive and brain function measures to elucidate the functional relationship between exercise and brain health in populations with a high risk of dementia. Systematic review registration PROSPERO, identifier: CRD42022291843.
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Affiliation(s)
- Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Ali Butt
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Isabella H. K. Leung
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Ryan L. Childs
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Vithya Uruthiran
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Tiffany Tan
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Genevieve Z. Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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