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Plini ERG, Melnychuk MC, Andrews R, Boyle R, Whelan R, Spence JS, Chapman SB, Robertson IH, Dockree PM. Greater physical fitness ( VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ ) in healthy older adults associated with increased integrity of the locus coeruleus-noradrenergic system. Acta Physiol (Oxf) 2024:e14191. [PMID: 38895950 DOI: 10.1111/apha.14191] [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: 04/25/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024]
Abstract
AIM Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greaterVo 2 max $$ {\mathrm{Vo}}_{2_{\mathrm{max}}} $$ - a measure of oxygen uptake and physical fitness (PF). METHODS We hypothesized that greaterVo 2 max $$ {\mathrm{Vo}}_{2_{\mathrm{max}}} $$ would be related to greater Locus Coeruleus (LC) MRI signal intensity. In a sample of 41 healthy subjects, we performed Voxel-Based Morphometry analyses, then repeated for the other neuromodulators as a control procedure (Serotonin, Dopamine and Acetylcholine). RESULTS As hypothesized, greaterVo 2 max $$ {\mathrm{Vo}}_{2_{\mathrm{max}}} $$ related to greater LC signal intensity, and weaker associations emerged for the other neuromodulators. CONCLUSION This newly established link betweenVo 2 max $$ {\mathrm{Vo}}_{2_{\mathrm{max}}} $$ and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the NA system as a possible key factor building Reserve, it also provides ground for increasing LC-NA system resilience to neurodegeneration viaVo 2 max $$ {\mathrm{Vo}}_{2_{\mathrm{max}}} $$ enhancement.
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Affiliation(s)
- Emanuele R G Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Michael C Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ralph Andrews
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Robert Whelan
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jeffrey S Spence
- Center for BrainHealth, The University of Texas at Dallas, Dallas, Texas, USA
| | - Sandra B Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, Texas, USA
| | - Ian H Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Paul M Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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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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Rabini G, Meli C, Prodomi G, Speranza C, Anzini F, Funghi G, Pierotti E, Saviola F, Fumagalli GG, Di Giacopo R, Malaguti MC, Jovicich J, Dodich A, Papagno C, Turella L. Tango and physiotherapy interventions in Parkinson's disease: a pilot study on efficacy outcomes on motor and cognitive skills. Sci Rep 2024; 14:11855. [PMID: 38789492 PMCID: PMC11126665 DOI: 10.1038/s41598-024-62786-6] [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: 01/20/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Pharmacological treatments in Parkinson's disease (PD), albeit effective in alleviating many motor symptoms, have limited effects in non-motor signatures as cognitive impairment, as well as in other aspects included postural instability. Consequently, complementary interventions are nowadays a prerogative of clinical practice managing PD symptomatology. In this pilot longitudinal study, we recruited twenty-four PD patients participating in one of two interventions: adapted Argentine Tango or group-based physiotherapy. Participants underwent a motor and neuropsychological evaluation before and after four months of activities, carried out twice a week. We found a general stabilization of motor and cognitive abilities, with significant improvements in several motor skills, mainly pertaining to static and dynamic balance, similarly in both groups. At cognitive level, we measured a significant improvement in both groups in the Action Naming task. Interestingly, only PD patients in the Tango group improved their performance in the test measuring facial emotion recognition. These findings highlight the crucial role that physical activities have in the stabilization and slowdown of disease's progression in PD. They further highlight the beneficial effects of a group-based physical intervention, which, especially in the case of Tango, could lead to behavioral ameliorations in domains other than the motor, such as emotion recognition.
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Affiliation(s)
- Giuseppe Rabini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy.
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Prodomi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Chiara Speranza
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Federica Anzini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Enrica Pierotti
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giorgio Giulio Fumagalli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Raffaella Di Giacopo
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Maria Chiara Malaguti
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Luca Turella
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
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Wrześniewski K, Pałka T, Blecharz J. The influence of vibratory massage after physical exertion on selected psychological processes. Front Psychol 2024; 15:1380282. [PMID: 38765830 PMCID: PMC11099259 DOI: 10.3389/fpsyg.2024.1380282] [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: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024] Open
Abstract
Good mental preparation of an athlete plays an important role in achieving optimal sports results. An athlete who enters a competition should not feel fatigue resulting from intense physical exercise. Therefore, new and effective methods are being sought that could help accelerate the process of both physical and mental regeneration. Vibrotherapy is one of them. The aim of the study was to determine the optimal frequency of vibration, its duration and the position in which the subjects were placed during the treatments, in relation to the reduction of subjectively perceived exertion muscle pain, mental discomfort, emotional states and the level of cognitive processes that were disturbed by intense physical activity. Sixteen healthy male volunteers were involved in this study. The participants were assessed for their aerobic and anaerobic capacity. Each of the subjects performed a set of intensive physical exercises and then underwent vibrotherapy treatment. In random order, each of the men tested the effectiveness of eight combinations of frequency, duration, and body position. Psychological tests were conducted for each combination: frequency, duration of treatment, and position during treatment, in four stages: (1) before the start of the experiment (baseline POMS measurements), (2) immediately after the exercise (VAS scale, scale examining psychological discomfort and STROOP test), (3) immediately after the vibration treatment (POMS measurements, VAS scale, scale examining psychological discomfort and STROOP test), (4) 24 h after the vibration treatment (VAS scale examining subjective assessment of perceived pain and psychological discomfort). Based on the results, it was concluded that all the studied variables improved significantly over time (after the vibration treatment and 24 h after training). In addition, a statistically significant interaction measurement × frequency was noted for vigor scale (52HZ favored greater improvement in this state), and a statistically significant interaction was found for measurement × time for the VAS scale (p < 0.05) - the lower pain value was indicated 24 h after the 10-min vibration treatment. The type of frequency used, position, and duration of the treatment did not play a statistically significant role in changing STROOP test results and severity of psychological discomfort (p > 0.05).
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Affiliation(s)
- Krzysztof Wrześniewski
- Department of Psychology, Institute of Social Sciences, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
| | - Tomasz Pałka
- Department of Physiology and Biochemistry, Institute of Biomedical Sciences, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
| | - Jan Blecharz
- Department of Psychology, Institute of Social Sciences, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
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Callow DD, Zipunnikov V, Spira AP, Wanigatunga SK, Pettigrew C, Albert M, Soldan A. Actigraphy Estimated Sleep Moderates the Relationship between Physical Activity and Cognition in Older Adults. Ment Health Phys Act 2024; 26:100573. [PMID: 38264712 PMCID: PMC10803079 DOI: 10.1016/j.mhpa.2023.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Background and Aims Physical inactivity and poor sleep are common in older adults and may interact to contribute to age- and disease-related cognitive decline. However, prior work regarding the associations among physical activity, and cognition in older adults is primarily limited to subjective questionnaires that are susceptible to inaccuracies and recall bias. Therefore, this study examined whether objectively measured physical activity and sleep characteristics, each estimated using actigraphy, are independently or interactively associated with cognitive performance. Methods The study included 157 older adults free of dementia (136 cognitively unimpaired; 21 MCI; M age = 71.7) from the BIOCARD cohort. Results Using multiple linear regression, cognition was regressed on estimated total volume of physical activity (TVPA), sleep efficiency (SE), wake after sleep onset (WASO), and total sleep time (TST) (adjusted for age, sex, education, diagnosis, vascular risk factors, and Apolipoprotein E (APOE)-e4 genetic status). Models were also run for domain-specific cognitive composite scores. TVPA and SE each were positively associated with a global cognitive composite score. TVPA was positively associated with executive function and language composites, and SE was positively related to executive function, visuospatial, and language composites. Importantly, a TVPA by SE interaction (p = 0.015) suggested that adults with the poorest SE experienced the greatest benefit from physical activity in relation to global cognition. The other sleep metrics were unrelated to cognitive performance. Conclusion These results suggest that TVPA and SE may synergistically benefit cognition in older adults.
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Affiliation(s)
- Daniel D Callow
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Corinne Pettigrew
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Anja Soldan
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
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6
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Plaza-Florido A, Esteban-Cornejo I, Mora-Gonzalez J, Torres-Lopez LV, Osuna-Prieto FJ, Gil-Cosano JJ, Radom-Aizik S, Labayen I, Ruiz JR, Altmäe S, Ortega FB. Gene-exercise interaction on brain health in children with overweight/obesity: the ActiveBrains randomized controlled trial. J Appl Physiol (1985) 2023; 135:775-785. [PMID: 37589055 PMCID: PMC10642513 DOI: 10.1152/japplphysiol.00435.2023] [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: 06/30/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023] Open
Abstract
We investigated the interaction between a genetic score and an exercise intervention on brain health in children with overweight/obesity. One hundred one children with overweight/obesity (10.0 ± 1.5 yr, 59% girls) were randomized into a 20-wk combined exercise intervention or a control group. Several cognitive and academic outcomes were measured with validated tests. Hippocampal volume was quantified using magnetic resonance imaging. Six brain health-related polymorphisms [rs6265 (BDNF), rs2253206 (CREB1), rs2289656 (NTRK2), rs4680 (COMT), rs429358, and rs7412 (APOE)] were genotyped. Cognitive flexibility and academic skills improved significantly more in the exercise than in the control group only in the children with a "favorable" genetic profile [mean z-score, 0.41-0.67 (95% CI 0.11 to 1.18)], yet not in those with "less favorable" genetic profile. An individual response analysis showed that children responded to exercise in cognitive flexibility only in the "genetically favorable" group [i.e., 62% of them had a meaningful (≥0.2 Cohen d) increase in the exercise group compared with only 25% in the control group]. This finding was consistent in per-protocol and intention-to-treat analyses (P = 0.01 and P = 0.03, respectively). The results were not significant or not consistent for the rest of outcomes studied. Our findings suggest that having a more favorable genetic profile makes children with overweight/obesity more responsive to exercise, particularly for cognitive flexibility.NEW & NOTEWORTHY Interindividual differences have been reported in brain health-related outcomes in response to exercise interventions in adults, which could be partially explained by genetic background differences. However, the role of genetic polymorphisms on brain health-related outcomes in response to exercise interventions remains unexplored in pediatric population. The current study in children with overweight/obesity showed that a genetic score composed of six brain health-related polymorphisms (BDNF, CREB1, NTRK2, COMT, and APOE) regulated the exercise-induced response on several brain health outcomes, yet mainly and more consistently on cognitive flexibility.
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Affiliation(s)
- Abel Plaza-Florido
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine, Irvine, California, United States
| | - Irene Esteban-Cornejo
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Jose Mora-Gonzalez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Lucia V Torres-Lopez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Francisco J Osuna-Prieto
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Sanitaria Pere Virgili, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Jose J Gil-Cosano
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Department of Communication and Education, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine, Irvine, California, United States
| | - Idoia Labayen
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain
- Research Institute for Sustainability & Food Chain Innovation (IS-FOOD), Public University of Navarre, Pamplona, Spain
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Signe Altmäe
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
- Division of Obstetrics and Gynecology, Department of Clinical Scinece, Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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7
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Plini ERG, Melnychuk MC, Andrews R, Boyle R, Whelan R, Spence JS, Chapman SB, Robertson IH, Dockree PM. Greater physical fitness (Vo2Max) in healthy older adults associated with increased integrity of the Locus Coeruleus-Noradrenergic system. RESEARCH SQUARE 2023:rs.3.rs-2556690. [PMID: 36798156 PMCID: PMC9934752 DOI: 10.21203/rs.3.rs-2556690/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greater Vo2max - a measure of oxygen uptake and physical fitness (PF). In the current study, we hypothesised that greater Vo2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. As hypothesised, greater Vo2max related to greater LC signal intensity across 41 healthy adults (age range 60-72). As a control procedure, in which these analyses were repeated for the other neuromodulators' seeds (for Serotonin, Dopamine and Acetylcholine), weaker associations emerged. This newly established link between Vo2max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the noradrenergic system as a possible key factor building Reserve, it also provide grounds for increasing LC-NA system resilience to neurodegeneration via Vo2max enhancement.
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Affiliation(s)
- Emanuele RG Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Michael C Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Ralph Andrews
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Building 149, Charlestown MA, USA
| | - Robert Whelan
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Jeffrey S. Spence
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Sandra B. Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Ian H Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Building 149, Charlestown MA, USA
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Paul M Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
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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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9
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Sonsalla MM, Lamming DW. Geroprotective interventions in the 3xTg mouse model of Alzheimer's disease. GeroScience 2023:10.1007/s11357-023-00782-w. [PMID: 37022634 PMCID: PMC10400530 DOI: 10.1007/s11357-023-00782-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/23/2023] [Indexed: 04/07/2023] Open
Abstract
Alzheimer's disease (AD) is an age-associated neurodegenerative disease. As the population ages, the increasing prevalence of AD threatens massive healthcare costs in the coming decades. Unfortunately, traditional drug development efforts for AD have proven largely unsuccessful. A geroscience approach to AD suggests that since aging is the main driver of AD, targeting aging itself may be an effective way to prevent or treat AD. Here, we discuss the effectiveness of geroprotective interventions on AD pathology and cognition in the widely utilized triple-transgenic mouse model of AD (3xTg-AD) which develops both β-amyloid and tau pathologies characteristic of human AD, as well as cognitive deficits. We discuss the beneficial impacts of calorie restriction (CR), the gold standard for geroprotective interventions, and the effects of other dietary interventions including protein restriction. We also discuss the promising preclinical results of geroprotective pharmaceuticals, including rapamycin and medications for type 2 diabetes. Though these interventions and treatments have beneficial effects in the 3xTg-AD model, there is no guarantee that they will be as effective in humans, and we discuss the need to examine these interventions in additional animal models as well as the urgent need to test if some of these approaches can be translated from the lab to the bedside for the treatment of humans with AD.
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Affiliation(s)
- Michelle M Sonsalla
- Department of Medicine, University of Wisconsin-Madison, 2500 Overlook Terrace, VAH C3127 Research 151, Madison, WI, 53705, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
- Comparative Biomedical Sciences Graduate Program, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Dudley W Lamming
- Department of Medicine, University of Wisconsin-Madison, 2500 Overlook Terrace, VAH C3127 Research 151, Madison, WI, 53705, USA.
- William S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA.
- Comparative Biomedical Sciences Graduate Program, University of Wisconsin-Madison, Madison, WI, 53706, USA.
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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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11
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Xie L, Gou B, Bai S, Yang D, Zhang Z, Di X, Su C, Wang X, Wang K, Zhang J. Unsupervised cluster analysis reveals distinct subgroups in healthy population with different exercise responses of cardiorespiratory fitness. J Exerc Sci Fit 2023; 21:147-156. [PMID: 36688000 PMCID: PMC9827383 DOI: 10.1016/j.jesf.2022.12.005] [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: 10/07/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
Background Considerable attention has been paid to interindividual differences in the cardiorespiratory fitness (CRF) response to exercise. However, the complex multifactorial nature of CRF response variability poses a significant challenge to our understanding of this issue. We aimed to explore whether unsupervised clustering can take advantage of large amounts of clinical data and identify latent subgroups with different CRF exercise responses within a healthy population. Methods 252 healthy participants (99 men, 153 women; 36.8 ± 13.4 yr) completed moderate endurance training on 3 days/week for 4 months, with exercise intensity prescribed based on anaerobic threshold (AT). Detailed clinical measures, including resting vital signs, ECG, cardiorespiratory parameters, echocardiography, heart rate variability, spirometry and laboratory data, were obtained before and after the exercise intervention. Baseline phenotypic variables that were significantly correlated with CRF exercise response were identified and subjected to selection steps, leaving 10 minimally redundant variables, including age, BMI, maximal oxygen uptake (VO2max), maximal heart rate, VO2 at AT as a percentage of VO2max, minute ventilation at AT, interventricular septal thickness of end-systole, E velocity, root mean square of heart rate variability, and hematocrit. Agglomerative hierarchical clustering was performed on these variables to detect latent subgroups that may be associated with different CRF exercise responses. Results Unsupervised clustering revealed two mutually exclusive groups with distinct baseline phenotypes and CRF exercise responses. The two groups differed markedly in baseline characteristics, initial fitness, echocardiographic measurements, laboratory values, and heart rate variability parameters. A significant improvement in CRF following the 16-week endurance training, expressed by the absolute change in VO2max, was observed only in one of the two groups (3.42 ± 0.4 vs 0.58 ± 0.65 ml⋅kg-1∙min-1, P = 0.002). Assuming a minimal clinically important difference of 3.5 ml⋅kg-1∙min-1 in VO2max, the proportion of population response was 56.1% and 13.9% for group 1 and group 2, respectively (P<0.001). Although group 1 exhibited no significant improvement in CRF at group level, a significant decrease in diastolic blood pressure (70.4 ± 7.8 vs 68.7 ± 7.2 mm Hg, P = 0.027) was observed. Conclusions Unsupervised learning based on dense phenotypic characteristics identified meaningful subgroups within a healthy population with different CRF responses following standardized aerobic training. Our model could serve as a useful tool for clinicians to develop personalized exercise prescriptions and optimize training effects.
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Affiliation(s)
- Lin Xie
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Bo Gou
- Department of Physical Activity and Public Health, Xi'an Physical Education University, Xi'an, 710068, China
| | - Shuwen Bai
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Dong Yang
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Zhe Zhang
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Xiaohui Di
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Chunwang Su
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Xiaoni Wang
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Kun Wang
- Department of Physical Activity and Public Health, Xi'an Physical Education University, Xi'an, 710068, China,Corresponding author.
| | - Jianbao Zhang
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China,Corresponding author. Key Laboratory of Biomedical Information Engineering of Education Ministry, Department of Life Science and Technology, Xi'an Jiaotong University, No.28, Xianning West Road, Xi'an, China.
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12
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Zhang S, Zhen K, Su Q, Chen Y, Lv Y, Yu L. The Effect of Aerobic Exercise on Cognitive Function in People with Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315700. [PMID: 36497772 PMCID: PMC9736612 DOI: 10.3390/ijerph192315700] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 05/25/2023]
Abstract
A growing body of research has examined the effect of aerobic exercise on cognitive function in people with Alzheimer's Disease (AD), but the findings of the available studies were conflicting. The aim of this study was to explore the effect of aerobic exercise on cognitive function in AD patients. Searches were performed in PubMed, Web of Science, and EBSCO databases from the inception of indexing until 12 November 2021. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1942 search records initially identified, 15 randomized controlled trials (RCTs) were considered eligible for systematic review and meta-analysis. Included studies involved 503 participants in 16 exercise groups (mean age: 69.2-84 years) and 406 participants (mean age: 68.9-84 years) in 15 control groups. There was a significant effect of aerobic exercise on increasing mini-mental state examination (MMSE) score in AD patients [weighted mean difference (WMD), 1.50 (95% CI, 0.55 to 2.45), p = 0.002]. Subgroup analyses showed that interventions conducted 30 min per session [WMD, 2.52 (95% CI, 0.84 to 4.20), p = 0.003], less than 150 min per week [WMD, 2.10 (95% CI, 0.84 to 3.37), p = 0.001], and up to three times per week [WMD, 1.68 (95% CI, 0.46 to 2.89), p = 0.007] increased MMSE score significantly. In addition, a worse basal cognitive status was associated with greater improvement in MMSE score. Our analysis indicated that aerobic exercise, especially conducted 30 min per session, less than 150 min per week, and up to three times per week, contributed to improving cognitive function in AD patients. Additionally, a worse basal cognitive status contributed to more significant improvements in cognitive function.
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Affiliation(s)
- Shiyan Zhang
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China
- Department of Sports Performance, Beijing Sport University, Beijing 100084, China
| | - Kai Zhen
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China
- Department of Sports Performance, Beijing Sport University, Beijing 100084, China
| | - Qing Su
- Ersha Sports Training Center of Guangdong Province, Guangzhou 510100, China
| | - Yiyan Chen
- Department of Sports Performance, Beijing Sport University, Beijing 100084, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China
- Department of Sports Performance, Beijing Sport University, Beijing 100084, China
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13
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Jia D, Xu Y. Effects of an 8-week Baduanjin intervention combined with low-carbohydrates diet among overweight people who struggle with drug addiction. Front Public Health 2022; 10:989519. [PMID: 36339240 PMCID: PMC9633992 DOI: 10.3389/fpubh.2022.989519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/30/2022] [Indexed: 11/12/2022] Open
Abstract
Background Prior studies have consistently revealed that a combination of physical activity with caloric restriction results in a reduction in body weight in the general population. Both overweight and drug abuse are risk factors for poor physiological health, and poor mental health has been associated with drug abuse and unhealthy body mass index (BMI). However, the effects of low-carbohydrates diet (LC) combined with mind-body exercise intervention on improving anthropometric characteristics, lipid metabolism, quality of life, and craving among overweight people who struggle with drug addiction have yet to be clarified. Methods Fifty-four eligible male patients were randomly assigned to the control group (CON; n = 18), the Baduanjin intervention group (BA, 60 min × 5 times/week, 8 weeks; n = 18), and the Baduanjin combined with LC intervention group (LC; n = 18). We compared the anthropometric characteristics, blood biochemical parameters, quality of life, and drug craving responses between the three groups at baseline (week 0), week 4, and week 8. Results After repeated measurements in the general linear model, both the BA and LC groups exerted significant effects on decreasing waist circumference, BMI, body weight, hip circumference, body fat percentage, total cholesterol level, and triglyceride level (P < 0.05). There was no significant difference in the HDL-C level observed among the BA and LC groups at 8 weeks (P > 0.05); however, there was an overall upwards trend. A significant change in trends in the quality of life scale score was determined in the three groups (P < 0.001). The three groups showed reductions in visual analog scale score distribution over time (P < 0.05). Conclusions Either Baduanjin or an 8-week Baduanjin combined with LC can significantly reduce anthropometric characteristics and body composition, enhance the quality of life, and reduce craving in overweight/obese patients. Baduanjin combined with LC is particularly effective in improving lipid metabolism.
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Affiliation(s)
- Dongming Jia
- School of Public Health, Hangzhou Normal University, Hangzhou, China,Zhejiang Police Vocational College, Hangzhou, China
| | - Yuming Xu
- School of Physical Education, Hangzhou Normal University, Hangzhou, China,*Correspondence: Yuming Xu
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14
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Interindividual Differences in Trainability and Moderators of Cardiorespiratory Fitness, Waist Circumference, and Body Mass Responses: A Large-Scale Individual Participant Data Meta-analysis. Sports Med 2022; 52:2837-2851. [PMID: 35781787 DOI: 10.1007/s40279-022-01725-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
Although many studies have assumed variability reflects variance caused by exercise training, few studies have examined whether interindividual differences in trainability are present following exercise training. The present individual participant data (IPD) meta-analysis sought to: (1) investigate the presence of interindividual differences in trainability for cardiorespiratory fitness (CRF), waist circumference, and body mass; and (2) examine the influence of exercise training and potential moderators on the probability that an individual will experience clinically important differences. The IPD meta-analysis combined data from 1879 participants from eight previously published randomized controlled trials. We implemented a Bayesian framework to: (1) test the hypothesis of interindividual differences in trainability by comparing variability in change scores between exercise and control using Bayes factors; and (2) compare posterior predictions of control and exercise across a range of moderators (baseline body mass index (BMI) and exercise duration, intensity, amount, mode, and adherence) to estimate the proportions of participants expected to exceed minimum clinically important differences (MCIDs) for all three outcomes. Bayes factors demonstrated a lack of evidence supporting a high degree of variance attributable to interindividual differences in trainability across all three outcomes. These findings indicate that interindividual variability in observed changes are likely due to measurement error and external behavioural factors, not interindividual differences in trainability. Additionally, we found that a larger proportion of exercise participants were expected to exceed MCIDs compared with controls for all three outcomes. Moderator analyses identified that larger proportions were associated with a range of factors consistent with standard exercise theory and were driven by mean changes. Practitioners should prescribe exercise interventions known to elicit large mean changes to increase the probability that individuals will experience beneficial changes in CRF, waist circumference and body mass.
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15
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Wang S, Liu HY, Cheng YC, Su CH. Exercise Dosage in Reducing the Risk of Dementia Development: Mode, Duration, and Intensity-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413331. [PMID: 34948942 PMCID: PMC8703896 DOI: 10.3390/ijerph182413331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022]
Abstract
Senile dementia, also known as dementia, is the mental deterioration which is associated with aging. It is characterized by a decrease in cognitive abilities, inability to concentrate, and especially the loss of higher cerebral cortex function, including memory, judgment, abstract thinking, and other loss of personality, even behavior changes. As a matter of fact, dementia is the deterioration of mental and intellectual functions caused by brain diseases in adults when they are mature, which affects the comprehensive performance of life and work ability. Most dementia cases are caused by Alzheimer’s disease (AD) and multiple infarct dementia (vascular dementia, multi-infarct dementia). Alzheimer’s disease is characterized by atrophy, shedding, and degenerative alterations in brain cells, and its occurrence is linked to age. The fraction of the population with dementia is smaller before the age of 65, and it increases after the age of 65. Since women live longer than men, the proportion of women with Alzheimer’s disease is higher. Multiple infarct dementia is caused by a cerebral infarction, which disrupts blood supply in multiple locations and impairs cerebral cortex function. Researchers worldwide are investigating ways to prevent Alzheimer’s disease; however, currently, there are no definitive answers for Alzheimer’s prevention. Even so, research has shown that we can take steps to reduce the risk of developing it. Prospective studies have found that even light to moderate physical activity can lower the risk of dementia and Alzheimer’s disease. Exercise has been proposed as a potential lifestyle intervention to help reduce the occurrence of dementia and Alzheimer’s disease. Various workout modes will be introduced based on various physical conditions. In general, frequent exercise for 6–8 weeks lessens the risk of dementia development.
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Affiliation(s)
- Sukai Wang
- College of Physical Education, Huaqiao University, Quanzhou 362021, China;
| | - Hong-Yu Liu
- Department of Exercise and Health Promotion, Chinese Culture University, Taipei 111369, Taiwan; (H.-Y.L.); (Y.-C.C.)
| | - Yi-Chen Cheng
- Department of Exercise and Health Promotion, Chinese Culture University, Taipei 111369, Taiwan; (H.-Y.L.); (Y.-C.C.)
| | - Chun-Hsien Su
- College of Kinesiology and Health, Chinese Culture University, Taipei 111369, Taiwan
- Correspondence: ; Tel.: +886-975159678
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16
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Bonafiglia JT, Preobrazenski N, Gurd BJ. A Systematic Review Examining the Approaches Used to Estimate Interindividual Differences in Trainability and Classify Individual Responses to Exercise Training. Front Physiol 2021; 12:665044. [PMID: 34819869 PMCID: PMC8606564 DOI: 10.3389/fphys.2021.665044] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Many reports describe statistical approaches for estimating interindividual differences in trainability and classifying individuals as "responders" or "non-responders." The extent to which studies in the exercise training literature have adopted these statistical approaches remains unclear. Objectives: This systematic review primarily sought to determine the extent to which studies in the exercise training literature have adopted sound statistical approaches for examining individual responses to exercise training. We also (1) investigated the existence of interindividual differences in trainability, and (2) tested the hypothesis that less conservative thresholds inflate response rates compared with thresholds that consider error and a smallest worthwhile change (SWC)/minimum clinically important difference (MCID). Methods: We searched six databases: AMED, CINAHL, EMBASE, Medline, PubMed, and SportDiscus. Our search spanned the aerobic, resistance, and clinical or rehabilitation training literature. Studies were included if they used human participants, employed standardized and supervised exercise training, and either: (1) stated that their exercise training intervention resulted in heterogenous responses, (2) statistically estimated interindividual differences in trainability, and/or (3) classified individual responses. We calculated effect sizes (ESIR) to examine the presence of interindividual differences in trainability. We also compared response rates (n = 614) across classification approaches that considered neither, one of, or both errors and an SWC or MCID. We then sorted response rates from studies that also reported mean changes and response thresholds (n = 435 response rates) into four quartiles to confirm our ancillary hypothesis that larger mean changes produce larger response rates. Results: Our search revealed 3,404 studies, and 149 were included in our systematic review. Few studies (n = 9) statistically estimated interindividual differences in trainability. The results from these few studies present a mixture of evidence for the presence of interindividual differences in trainability because several ESIR values lay above, below, or crossed zero. Zero-based thresholds and larger mean changes significantly (both p < 0.01) inflated response rates. Conclusion: Our findings provide evidence demonstrating why future studies should statistically estimate interindividual differences in trainability and consider error and an SWC or MCID when classifying individual responses to exercise training. Systematic Review Registration: [website], identifier [registration number].
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Affiliation(s)
- Jacob T Bonafiglia
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | | | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Bezold J, Trautwein S, Barisch-Fritz B, Scharpf A, Krell-Roesch J, Nigg CR, Woll A. Effects of a 16-week multimodal exercise program on activities of daily living in institutionalized individuals with dementia. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00760-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractWe aimed to examine the effects of a 16-week multimodal exercise program (MEP) on activities of daily living (ADL) in individuals with dementia (IWD). Furthermore, we investigated the participants’ individual response to the MEP and whether baseline cognitive and motor performance explain ADL performance. We conducted a multicenter randomized controlled trial (RCT) involving 319 participants aged ≥ 65 years with mild to moderate dementia. ADL were assessed at baseline and after the 16-week intervention using the Barthel Index (BI), the Erlangen Test of Activities of Daily Living (E-ADL) and the 7‑item Physical Performance Test (PPT-7). We additionally assessed cognitive and motor performance using standardized and validated assessments. Intervention effects were examined through two-factor analysis of variance with repeated measurements applying a per protocol and an intention-to-treat analysis. We compared baseline cognitive and motor performance between positive-responders (positive-R), non-responders (non-R), and negative-responders (negative-R) and examined cognitive and motor performance as potential cofounders of ADL by conducting multiple regression analyses. There were no significant time×group effects on ADL. Between 20 and 32% of participants responded positively to the intervention, i.e., improved ADL performance from baseline to follow-up. Positive-R had worse baseline motor performance compared to non-R. Cognitive and motor performance explained up to 51.4% of variance in ADL. The MEP had no significant overall effect on ADL in IWD. This may be related to insufficient exercise intensity. However, our results indicate that the response to the MEP depends on individual prerequisites which should thus be considered in further research on individual exercise approaches.
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18
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Yu F, Mathiason MA, Han S, Gunter JL, Jones D, Botha H, Jack C. Mechanistic Effects of Aerobic Exercise in Alzheimer's Disease: Imaging Findings From the Pilot FIT-AD Trial. Front Aging Neurosci 2021; 13:703691. [PMID: 34690736 PMCID: PMC8530186 DOI: 10.3389/fnagi.2021.703691] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Despite strong evidence from animal models of Alzheimer's disease (AD) supporting aerobic exercise as a disease-modifying treatment for AD, human mechanistic studies are limited with mixed findings. The objective of this pilot randomized controlled trial was to examine the effects of 6-month aerobic exercise on hippocampal volume, temporal meta-regions of interest (ROI) cortical thickness, white matter hyperintensity (WMH) volume, and network failure quotient (NFQ), measured with MRI, in community-dwelling older adults with AD dementia. Additionally, the relationships between 6- and 12-month changes in MRI biomarkers and the AD Assessment Scale-Cognition (ADAS-Cog) were examined. Sixty participants were randomized, but one was excluded because baseline MRI failed quality control: 38 randomized to cycling and 21 to stretching. The intervention was moderate-intensity cycling for 20-50 mins, three times a week for 6 months. Control was low-intensity stretching. The study outcomes include hippocampal volume, temporal meta-ROI cortical thickness, WMH volume, and NFQ. Outcomes were measured at baseline, 6 months, and 12 months. The sample averaged 77.3 ± 6.3 years old with 15.6 ± 2.9 years of education and 53% men. Both groups experienced significant declines over 6 months in hippocampal volume (2.64% in cycling vs. 2.89% in stretching) and temporal meta-ROI cortical thickness (0.94 vs. 1.54%), and over 12 months in hippocampal volume (4.47 vs. 3.84%) and temporal meta-ROI cortical thickness (2.27 vs. 1.79%). These declines did not differ between groups. WMH volume increased significantly with the cycling group increasing less (10.9%) than stretching (24.5%) over 6 months (f = 4.47, p = 0.04) and over 12 months (12.1 vs. 27.6%, f = 5.88, p = 0.02). NFQ did not change significantly over time. Pairwise correlational analyses showed a significant negative correlation between 6-month changes in hippocampal volume and ADAS-Cog (r = -0.34, p < 0.05). To conclude, aerobic exercise may reduce the decline in hippocampal volume and temporal meta-ROI cortical thickness during the intervention period, but the effect sizes are likely to be very small and dose-dependent and reverse once the intervention stops. Aerobic exercise is effective on slowing down WMH progression but has no effect on NFQ. Hippocampal atrophy was associated with cognitive decline during the intervention period. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01954550.
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Affiliation(s)
- Fang Yu
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ, United States
- University of Minnesota School of Nursing, Minneapolis, MN, United States
| | | | - SeungYong Han
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ, United States
| | | | - David Jones
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| | - Hugo Botha
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| | - Clifford Jack
- Mayo Clinic Department of Radiology, Rochester, MN, United States
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Salisbury D, Mathiason MA, Yu F. Exercise Dose and Aerobic Fitness Response in Alzheimer's Dementia in the FIT-AD Trial. Int J Sports Med 2021; 43:850-858. [PMID: 34492709 DOI: 10.1055/a-1639-2307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to examine the effects of a 6-month cycling aerobic exercise intervention on cardiorespiratory fitness and the dose-response relationship in community-dwelling older adults with mild-to-moderate Alzheimer's dementia. The FIT-AD trial was a single blind, 2-parallel group, pilot randomized controlled trial. The aerobic exercise group participated in a 6-month, thrice weekly, moderate-vigorous intensity cycling intervention while control group performed stretching. Cardiorespiratory fitness was evaluated by peak oxygen consumption from cardiopulmonary exercise test and peak walking distance from the shuttle walk test and 6-minute walk test. Aerobic exercise dose was calculated using the novel heart rate physical activity score. The aerobic exercise group significantly increased peak oxygen consumption (1.28 ml/kg/min; p=.03) in subgroup who achieved maximal criteria on cardiopulmonary exercise test. Changes in peak oxygen consumption and peak walking distance on the shuttle walk and 6-minute walk tests did not significantly differ between aerobic exercise and stretching groups. Notably, the aerobic exercise dose was strongly and significantly correlated to change in peak oxygen consumption (r=.60; n=16; p=.01), in subset who met maximal test criteria. Emphasis on exercise dose is needed in aerobic exercise programs to maximize cardiorespiratory fitness gains in persons with mild-moderate Alzheimer's dementia.
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Affiliation(s)
- Dereck Salisbury
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, United States
| | - Michelle A Mathiason
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, United States
| | - Fang Yu
- Edison College of Nursing and Health Innovation, Arizona State University, Phoenix, United States
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Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, Aubertin-Leheudre M, Bernabei R, Cadore EL, Cesari M, Chen LK, de Souto Barreto P, Duque G, Ferrucci L, Fielding RA, García-Hermoso A, Gutiérrez-Robledo LM, Harridge SDR, Kirk B, Kritchevsky S, Landi F, Lazarus N, Martin FC, Marzetti E, Pahor M, Ramírez-Vélez R, Rodriguez-Mañas L, Rolland Y, Ruiz JG, Theou O, Villareal DT, Waters DL, Won Won C, Woo J, Vellas B, Fiatarone Singh M. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging 2021; 25:824-853. [PMID: 34409961 DOI: 10.1007/s12603-021-1665-8] [Citation(s) in RCA: 346] [Impact Index Per Article: 115.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.
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Affiliation(s)
- M Izquierdo
- Mikel Izquierdo, PhD, Department of Health Sciences, Public University of Navarra, Av. De Barañain s/n 31008 Pamplona (Navarra) Spain, Tel + 34 948 417876
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