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Nguyen SA, Oughli HA, Lavretsky H. Use of Complementary and Integrative Medicine for Alzheimer's Disease and Cognitive Decline. J Alzheimers Dis 2024; 97:523-540. [PMID: 38073388 DOI: 10.3233/jad-230710] [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: 01/23/2024]
Abstract
Integrative medicine takes a holistic approach because it considers multiple aspects of the individual. This includes a person's physical, emotional, interpersonal, behavioral, nutritional, environmental, and spiritual dimensions of wellbeing that contribute to the Whole Person Health. There is increasing interest and popularity of integrative approaches to treating cognitive decline and dementia because of the multifactorial nature of aging and the limited pharmacological interventions available in treating cognitive decline and dementia, particularly Alzheimer's disease, the most common type of dementia. This review summarizes the existing evidence using complementary and integrative medicine therapies in cognitive decline and Alzheimer's disease. This includes the use of mind-body therapies, lifestyle interventions (nutritional, physical exercise, stress reduction), and other integrative modalities. Unfortunately, there are still limited studies available to guide clinicians despite the increasing popularity of integrative treatments.
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Affiliation(s)
- Sarah A Nguyen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Hanadi Ajam Oughli
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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2
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Lannon-Boran C, Hannigan C, Power JM, Lambert J, Kelly M. The effect of mindfulness-based intervention on cognitively unimpaired older adults' cognitive function and sleep quality: a systematic review and meta-analysis. Aging Ment Health 2024; 28:23-35. [PMID: 37485984 DOI: 10.1080/13607863.2023.2228255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023]
Abstract
Objective: This systematic review and meta-analysis aimed to investigate the effect of mindfulness-based intervention (MBI) on cognitively unimpaired older adults' cognitive function and sleep quality.Method: Studies published in English since 2010 were considered for inclusion. Databases searched were PubMed, Embase, Web of Science, and PsycInfo. We included randomized controlled trials (RCTs) with adults over 55 with no known cognitive impairment, that recorded cognitive outcomes and/or sleep quality pre- and post-intervention, and that implemented Mindfulness-Based Stress Reduction (MBSR), or an MBI closely based on MBSR protocol.Results: Seven RCTs fit the inclusion criteria, with 276 participants in MBI groups and 287 in controls. Four studies investigated mindfulness and cognitive function, two investigated mindfulness and sleep quality, and one investigated mindfulness, cognitive function, and sleep quality. Some studies were not reported in sufficient detail to be included in meta-analyses. Results of meta-analyses showed no significant differences between MBI groups vs controls on cognitive measures of executive function, free recall, and delayed recall. Meta-analysis revealed that MBI significantly improved sleep quality compared to controls.Conclusion: Given that poor sleep quality is strongly linked to increased risk of cognitive decline, further research investigating sleep quality's role in the mindfulness-cognitive function relationship in cognitively unimpaired older adults is recommended.
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Affiliation(s)
- Colm Lannon-Boran
- Department of Psychology, National College of Ireland, Dublin, Ireland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Caoimhe Hannigan
- Department of Psychology, National College of Ireland, Dublin, Ireland
| | | | - Jonathan Lambert
- School of Computing, National College of Ireland, Dublin, Ireland
| | - Michelle Kelly
- Department of Psychology, National College of Ireland, Dublin, Ireland
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3
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Zhang M, Jia J, Yang Y, Zhang L, Wang X. Effects of exercise interventions on cognitive functions in healthy populations: A systematic review and meta-analysis. Ageing Res Rev 2023; 92:102116. [PMID: 37924980 DOI: 10.1016/j.arr.2023.102116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Chronic exercise intervention is a non-pharmacological therapy suggested to improve cognitive function in various populations. However, few meta-analyses have assessed the cognitive benefits associated with all FITT-VP variables (exercise frequency, intensity, bout duration time, type, volume or total intervention length, and progression) in healthy populations by age. Thus, this meta-analysis assessed the effects of each FITT-VP variable on cognitive function in healthy children, adults, and older adults. This study followed PRISMA guidelines. After searching PubMed and the Web of Science, we included 54 randomized controlled trials to examined the effects of FITT-VP variables on five cognitive domains: global cognition, executive function, memory, attention, and information processing. Moderation analyses assessed the effects by age and by each exercise variables. Exercise benefitted overall cognition and all subcognitive domains. Aerobic and resistance exercise showed the greatest benefits on global cognition and executive function respectively, whereas mind-body exercise benefitted memory. Among all populations, older adults showed the greatest benefits of exercise on global cognition, executive function, and memory compared with controls. Additional studies are needed to assess the effects of exercise on attention and information processing. This meta-analysis offers new insights on the relationships between cognition and FITT-VP exercise variables in healthy populations.
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Affiliation(s)
- Minggang Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Jiafeng Jia
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Yang Yang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Lepu Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiaochun Wang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China.
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4
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Verzili B, Valério de Arruda M, Herrmann F, Reyes MB, Galduróz RF. A systematic review with meta-analysis of Yoga's contributions to neuropsychiatric aspects of aging. Behav Brain Res 2023; 454:114636. [PMID: 37598905 DOI: 10.1016/j.bbr.2023.114636] [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: 09/05/2022] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
Yoga is one of the most common Complementary and Alternative Medicines (CAM) for mind-body approaches to psychological and stress-related conditions in aging. Such wide usage demands the review and systematization of the scientific literature, searching for accumulated evidence of its effectiveness. We reviewed the literature to assess whether Yoga would offer significant improvements to neuropsychiatric aspects of the elderly: anxiety, depression, stress, memory and executive functions. METHODS This systematic review with meta-analyses organized the results from all analyzed articles, comparing them between the experimental and either the control or waiting groups, calculating the effect size (Cohen-d) and the p-value of a two-tailed T-test. We presented the transformed metadata in forest graphs. RESULTS AND DISCUSSION Given the heterogeneity of methods, results, and effect sizes of each study and due to the number of articles found, this meta-analysis indicates that it is not possible to state that Yoga reduces anxiety and stress in the elderly or improves cognition. However, this meta-analysis found significant results of Yoga in reducing depression with small to medium effect sizes. CONCLUSION According to the currently available literature on Yoga and aspects of aging, we concluded that yoga was effective in most studies on reducing depression.
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Affiliation(s)
- Bruna Verzili
- Graduate Program in Neuroscience and Cognition, Center for Mathematics Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil.
| | - Marcel Valério de Arruda
- Graduate Program in Neuroscience and Cognition, Center for Mathematics Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil
| | - Flavio Herrmann
- Graduate Program in Neuroscience and Cognition, Center for Mathematics Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil
| | - Marcelo B Reyes
- Graduate Program in Neuroscience and Cognition, Center for Mathematics Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil
| | - Ruth F Galduróz
- Graduate Program in Neuroscience and Cognition, Center for Mathematics Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil
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5
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Gothe NP, Erlenbach E, Garcia V, Malani R, Voss S, Camacho PB, McAuley E, Burd N, Sutton BP, Damoiseaux JS. Yoga, aerobic and stretching exercise effects on neurocognition: Randomized controlled trial protocol. Contemp Clin Trials 2023; 131:107240. [PMID: 37244365 PMCID: PMC10527553 DOI: 10.1016/j.cct.2023.107240] [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: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
As the global population ages, the prevalence of cognitive decline and dementia is expected to rise, creating a significant health and economic burden. The purpose of this trial is to rigorously test, for the first time, the efficacy of yoga training as a physical activity intervention to mitigate age-related cognitive decline and impairment. We are conducting a 6-month randomized controlled trial (RCT) of exercise among 168 middle aged and older adults to compare the efficacy of yoga vs. aerobic exercise on cognitive function, brain structure and function, cardiorespiratory fitness, and circulating inflammatory and molecular markers. Using a single-blind, three arm RCT, 168 older adults ages 55-79 will be assigned to either: a Hatha yoga group, an aerobic exercise group or a stretching-toning active control group. Participants will engage in hour long group exercise 3x/week for 6-months. A comprehensive neurocognitive test battery, brain imaging, cardiovascular fitness test, and a blood draw will take place at baseline; end of the 6-month intervention, and at 12-month follow-up. Our primary outcomes of interest are brain regions, such as hippocampal volume and prefrontal cortex, and cognitive functions, such as episodic memory, working memory and executive functions, that are typically affected by aging and Alzheimer's disease. Not only will this RCT test whether yoga is a means to mitigate age-related cognitive decline, but it may also offer an alternative to aerobic exercise, which could be particularly appealing to older adults with compromised physical functioning. ClinicalTrials.gov Identifier: NCT04323163.
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Affiliation(s)
- Neha P Gothe
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA; Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
| | - Emily Erlenbach
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Veronica Garcia
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Revati Malani
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Stephanie Voss
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Paul B Camacho
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Nicholas Burd
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Bradley P Sutton
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Jessica S Damoiseaux
- Institute of Gerontology, Department of Psychology, Wayne State University, Detroit, MI, USA
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6
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Ren T, Ye X, Li Z, Li Q, Zhang X, Dou W, Jia X, Li BM, Wang C. Associations between physical activity and proactive control and the modulating role of working memory. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102374. [PMID: 37665846 DOI: 10.1016/j.psychsport.2022.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/29/2022] [Accepted: 12/28/2022] [Indexed: 09/06/2023]
Abstract
Accumulating evidence indicates positive associations between physical activity (PA) and cognitive control. Proactive control, the ability to maintain goal-relevant information in preparation of upcoming task demands, is a critical component of cognitive control. However, little research has examined the association between PA and proactive control. To address this issue, a total of 132 university students were recruited and divided into two groups based on reported regular PA during past week. All participants completed two common cognitive control tasks: the AX Continuous Performance Task (AX-CPT) and the Cued Task-Switching Paradigm (CTS). In comparison with the low PA group, the high PA group showed greater proactive control efficiency on both tasks. Moreover, proactive control indices significantly correlated between the two tasks for the high but not for the low PA group. Further, working memory significantly modulated the association between PA and proactive control efficiency of CTS. Although the present cross-section design does not allow us to test the causal relationship between PA and proactive control, these findings may have important implications for developing effective intervention strategies which aim to promote proactive control through increasing PA or to promote PA through increasing proactive control. Moreover, individual differences in working memory are important to consider when we aim to design such interventions.
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Affiliation(s)
- Tian Ren
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China; Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Xuejian Ye
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Zheng Li
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Qingyi Li
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Xinyuan Zhang
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Wenjie Dou
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Xi Jia
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Bao-Ming Li
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Chunjie Wang
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.
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7
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Klamut O, Weissenberger S. Embodying Consciousness through Interoception and a Balanced Time Perspective. Brain Sci 2023; 13:brainsci13040592. [PMID: 37190557 DOI: 10.3390/brainsci13040592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/14/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
This review presents current research and scientific knowledge in body mind sciences through the lens of interoception, as a representative of the body; and time perspective, as the representative of the mind. This intertwining dichotomy has been a subject of discourse in many fields, all having the common denominator of consciousness. Our aim is to expand on the congruities of these seemingly deconstructed worlds-of science and philosophy, of the body and the mind, to show that the place of consciousness lies in the zone between these two. Being aware of the body in the present moment. We introduce interoception and time perspective, focusing on how interoceptive signals are depicted in autonomic nervous system (ANS) regulation, and how this relates to the concept of a balanced time perspective (BTP), a highly adaptive psychological characteristic. Time perspective and interoception are also reviewed in the case of clinical conditions. We assess findings on interoceptive pathways in the body, finding convergence with balanced time perspective through the neuroanatomical lens. We conclude with findings that both dysregulated interoceptive states and a time perspective disbalance are recognized as defining features of mental disorders, proposing prospective practical therapeutic approaches, as well as implications for further research in the field.
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8
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McCormick CR. Lifestyle factors and their impact on the networks of attention. APPLIED COGNITIVE PSYCHOLOGY 2021. [DOI: 10.1002/acp.3904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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9
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Sakhare A, Stradford J, Ravichandran R, Deng R, Ruiz J, Subramanian K, Suh J, Pa J. Simultaneous Exercise and Cognitive Training in Virtual Reality Phase 2 Pilot Study: Impact on Brain Health and Cognition in Older Adults. Brain Plast 2021; 7:111-130. [PMID: 34868877 PMCID: PMC8609488 DOI: 10.3233/bpl-210126] [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] [Accepted: 07/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Aerobic exercise and environmental enrichment have been shown to enhance brain function. Virtual reality (VR) is a promising method for combining these activities in a meaningful and ecologically valid way. Objective: The purpose of this Phase 2 pilot study was to calculate relative change and effect sizes to assess the impact of simultaneous exercise and cognitive training in VR on brain health and cognition in older adults. Methods: Twelve cognitively normal older adults (64.7±8.8 years old, 8 female) participated in a 12-week intervention, 3 sessions/week for 25–50 minutes/session at 50–80% HRmax. Participants cycled on a custom-built stationary exercise bike while wearing a VR head-mounted display and navigating novel virtual environments to train spatial memory. Brain and cognitive changes were assessed using MRI imaging and a cognitive battery. Results: Medium effect size (ES) improvements in cerebral flow and brain structure were observed. Pulsatility, a measure of peripheral vascular resistance, decreased 10.5% (ES(d) = 0.47). Total grey matter volume increased 0.73% (ES(r) = 0.38), while thickness of the superior parietal lobule, a region associated with spatial orientation, increased 0.44% (ES(r) = 0.30). Visual memory discrimination related to pattern separation showed a large improvement of 68% (ES(ηp2) = 0.43). Cognitive flexibility (Trail Making Test B) (ES(r) = 0.42) and response inhibition (ES(W) = 0.54) showed medium improvements of 14% and 34%, respectively. Conclusions: Twelve weeks of simultaneous exercise and cognitive training in VR elicits positive changes in brain volume, vascular resistance, memory, and executive function with moderate-to-large effect sizes in our pilot study.
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Affiliation(s)
- Ashwin Sakhare
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Joy Stradford
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Roshan Ravichandran
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Rong Deng
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Julissa Ruiz
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Keshav Subramanian
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Jaymee Suh
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Judy Pa
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
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Gothe NP. Examining the effects of light versus moderate to vigorous physical activity on cognitive function in African American adults. Aging Ment Health 2021; 25:1659-1665. [PMID: 32426993 DOI: 10.1080/13607863.2020.1768216] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Physical activity (PA) recommendations for older adults often endorse participation in moderate to vigorous intensity (MVPA). However, health disparities are evident such that African Americans engage in lower levels of MVPA, have a higher prevalence of chronic health and cognitive impairments. The purpose of this cross-sectional study was to examine the role of light PA in addition to MVPA and their associations with measures of executive function among African American older adults. METHODS One hundred and ten participants (mean age = 64.78 ± 5.7, males = 14) completed measures of cognitive functioning, including the Trail making, Flanker and the N-back tasks. Additionally, participants completed a 6-minute walk test to estimate their cardiovascular fitness and were given an Actigraph accelerometer for 7-days to objectively assess their light and MVPA. RESULTS Regression analyses controlling for age, fitness and education showed that higher levels of light PA but not MVPA predicted better cognitive performance on the incongruent flanker reaction time (β=-.24), trails B (β=-.24) and 1-back accuracy (β=.28). Both light PA and MVPA predicted faster reaction times on the 1-back and 2-back conditions of the n-back (light PA: β's=-.22-.23; MVPA: β's=-.28). CONCLUSIONS Light PA demonstrated similar or better associations than MVPA with cognitive functions which are known to decline with age. Designing and promoting light PA interventions in African American older adults maybe more feasible given the prevalence of disability and functional health disparities. Intervention studies testing the efficacy and effectiveness of light PA are needed and could have a significant public health impact among aging African Americans.
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Affiliation(s)
- Neha P Gothe
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, Illinois, USA
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11
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Chen FT, Etnier JL, Chan KH, Chiu PK, Hung TM, Chang YK. Effects of Exercise Training Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis. Sports Med 2021; 50:1451-1467. [PMID: 32447717 PMCID: PMC7376513 DOI: 10.1007/s40279-020-01292-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Chronic exercise training has been shown be to positively associated with executive function (EF) in older adults. However, whether the exercise training effect on EF is affected by moderators including the specific sub-domain of EF, exercise prescription variables, and sample characteristics remains unknown. Objectives This systematic and meta-analytic review of randomized controlled trials (RCTs) investigated the effects of exercise training on EF in older adults and explored potential moderators underlying the effects of exercise training on EF. Methods In accordance with the PRISMA guidelines, the electronic databases MEDLINE (PubMed) and EMBASE (Scopus) were searched from January 2003 to November 2019. All studies identified for inclusion were peer-reviewed and published in English. To be included, studies had to report findings from older (> 55 years old), cognitively normal adults or adults with mild cognitive impairment (MCI) randomized to an exercise training or a control group. The risk of bias in each study was appraised using the Cochrane risk-of-bias tool. Fixed-effects models were used to compare the effects of exercise training and control conditions on EF assessed at baseline and post-intervention. In addition, subgroup analyses were performed for three moderators (i.e., the specific sub-domain of EF, exercise prescription variables, and sample characteristics). Results Thirty-three RCTs were included. Overall, exercise training was associated with a significant small improvement in EF [Q(106) = 260.09, Hedges’ g = 0.21; p < 0.01]. The EF sub-domain moderator was not significant [Q(2) = 4.33, p > 0.05], showing that the EF improvement in response to exercise is evident for measures of inhibition, updating, and shifting. Regarding exercise prescription variables, results were significantly moderated by frequency of exercise training [Q(1) = 10.86, p < 0.05], revealing that effect sizes (ESs) were larger for moderate frequency (g = 0.31) as compared to low frequency exercise (g = 0.15). The results also showed type of exercise training moderated the ESs [Q(4) = 26.18, p < 0.05], revealing that ESs were largest for other forms of exercise (g = 0.44), followed by Tai Chi and yoga (g = 0.38), resistance exercise (g = 0.22), aerobic exercise (g = 0.14), and combined exercise (g = 0.10). In addition, The results showed moderated length of training the ESs [Q(2) = 16.64, p < 0.05], revealing that ESs were largest for short length (g = 0.32), followed by mid length (g = 0.26) and long length (g = 0.09). No significant difference in effects was observed as a function of exercise intensity [Q(1) = 2.87 p > 0.05] and session time [Q(2) = 0.21, p > 0.05]. Regarding sample characteristics, the results were significantly moderated by age [Q(2) = 20.64, p < 0.05], with significant benefits for young-old (55–65 years old) (g = 0.30) and mid-old (66–75 years old) (g = 0.25), but no effect on EF for old-old (more than 75 years old). The results were also significantly moderated by physical fitness levels [Q(1) = 10.80, p < 0.05], revealing that ESs were larger for sedentary participants (g = 0.33) as compared to physically fit participants (g = 0.16). In addition, results were also significantly moderated by cognitive status [Q(1) = 11.44, p < 0.05], revealing that ESs were larger for participants with cognitively normal (g = 0.26) as compared to those with mild cognitive impairment (g = 0.08). No significant differences in effects were observed as a function of sex [Q(2) = 5.38, p > 0.05]. Conclusions Exercise training showed a small beneficial effect on EF in older adults and the magnitude of the effect was different across some moderators.
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Affiliation(s)
- Feng-Tzu Chen
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Jennifer L Etnier
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Kuei-Hui Chan
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan, ROC
| | - Ping-Kun Chiu
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan, ROC
| | - Tsung-Ming Hung
- Department of Physical Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei, Taiwan, ROC.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei, Taiwan, ROC. .,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan, ROC.
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12
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Lang AJ, Malaktaris A, Maluf KS, Kangas J, Sindel S, Herbert M, Bomyea J, Simmons AN, Weaver J, Velez D, Liu L. A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery. Contemp Clin Trials Commun 2021; 21:100719. [PMID: 33604485 PMCID: PMC7875811 DOI: 10.1016/j.conctc.2021.100719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/07/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Posttraumatic stress disorder (PTSD) is a chronic, disabling, and prevalent mental health disorder among Veterans. Despite the availability of empirically supported psychotherapies, many Veterans remain symptomatic after treatment and/or prefer to seek complementary and integrative health approaches, including yoga, to manage PTSD. The randomized controlled trial (RCT) described herein will evaluate the efficacy of a manualized yoga program as compared to nonaerobic exercise in reducing PTSD severity among Veterans. A secondary aim of this study is to better understand the mechanisms of change. METHODS Veterans (N = 192) with PTSD will be randomized to hatha yoga or nonaerobic physical activity control; both groups consist of 12 weekly, 60-min group or online training sessions with 15-20 min of daily at-home practice. Outcome measures will be administered at baseline, mid-treatment, posttreatment, and 12-week follow-up. PROJECTED OUTCOMES This study will evaluate changes in PTSD severity (primary outcome) as well as depression, anxiety, anger, sleep problems, and psychosocial disability (secondary outcomes). We will also use multiple mediation to examine two potential models of the mechanisms of clinical effect: the Attention Model (i.e., yoga increases attentional control, which reduces PTSD symptoms), the Coping Model (i.e., yoga increases distress tolerance, which improves coping, which reduces PTSD symptoms), and the combination of these models. This aspect of the study is innovative and important given the absence of an existing, comprehensive model for understanding yoga's impact on PTSD. Ultimately, we hope to develop guidelines for application of yoga to PTSD recovery.
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Affiliation(s)
- Ariel J. Lang
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Departments of Psychiatry and Family Medicine and Public Health, 3350 La Jolla Village Dr. (MC 111N1), San Diego, CA, 92161, USA
| | - Anne Malaktaris
- VA San Diego Healthcare System/Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA
| | - Katrina S. Maluf
- San Diego State University, School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Julie Kangas
- VA San Diego Healthcare System, UCSD Department of Psychiatry, 8810 Rio San Diego Dr., San Diego, CA, 92108, USA
| | - Selin Sindel
- University of California San Diego, Department of Cognitive Science, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Matthew Herbert
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Jessica Bomyea
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Alan N. Simmons
- VA San Diego Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 9500 Gilman Dr. MC 0855, La Jolla, CA, 92037, USA
| | - Judy Weaver
- Connected Warriors, 4950 Communication Ave, Ste 115, Boca Raton, FL, 33431, USA
| | - Deborah Velez
- Veteran's Medical Research Foundation, 3350 La Jolla Village Dr, San Diego, CA, 92037, USA
| | - Lin Liu
- VA San Diego Healthcare System, UCSD Department of Preventive Medicine and Public Health, 9500 Gilman Dr., MC0725, La Jolla, CA, 92093-0725, USA
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13
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Hoy S, Östh J, Pascoe M, Kandola A, Hallgren M. Effects of yoga-based interventions on cognitive function in healthy older adults: A systematic review of randomized controlled trials. Complement Ther Med 2021; 58:102690. [PMID: 33618011 DOI: 10.1016/j.ctim.2021.102690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The world's elderly population is growing. Physical activity has positive effects on health and cognition, but is decreasing among the elderly. Interest in yoga-based exercises has increased in this population, especially as an intervention targeting balance, flexibility, strength, and well-being. Recent interest has arisen regarding yoga's potential benefits for cognition. OBJECTIVE To systematically review evidence from randomized controlled trials (RCTs) examining the effects of yoga-based interventions on cognitive functioning in healthy adults aged ≥60. A secondary aim was to describe intervention characteristics and, where possible, the extent to which these influenced study outcomes. METHOD The review was conducted in accordance with PRISMA guidelines. Searches were performed from inception to June 2020 using the following electronic databases: (1) PubMed (NLM); (2) Embase (Elsevier); (3) Cochrane Central (Wiley); (4) PsycINFO (EBSCOhost); and (5) Cinahl (EbscoHost). INCLUSION CRITERIA RCTs of yoga-based interventions assessing cognition in healthy adults ≥60 years. Risk of bias was assessed using the revised Cochrane risk of bias tool. RESULTS A total of 1466 records were initially identified; six studies (5 unique trials) were included in the review. Four of the six articles reported significant positive effects of yoga-based interventions on cognition, including gross memory functioning and executive functions. Intervention characteristics and assessment methods varied between studies, with a high overall risk of bias in all studies. CONCLUSION Yoga-based interventions are associated with improvements in cognition in healthy older adults. Adequately powered RCTs with robust study designs and long-term follow-ups are required. Future studies should explicitly report the intervention characteristics associated with changes in cognitive function.
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Affiliation(s)
- Sara Hoy
- The Swedish School of Sport and Health Sciences (GIH), Stockholm 114 33, Sweden.
| | - Josefine Östh
- Department of Global Public Health, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Michaela Pascoe
- Institute for Health and Sport, Victoria University, Melbourne VIC 3011, Australia
| | - Aaron Kandola
- Division of Psychiatry, University, College London, London W1T 7BN, United Kingdom
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Stockholm 171 77, Sweden
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Zimmer P, Javelle F, Lampit A. Comment on: "Effects of Exercise Training Interventions on Executive Function in Older Adults: A Systematic Review and Meta‑analysis". Sports Med 2020; 51:593-595. [PMID: 33128735 PMCID: PMC7900026 DOI: 10.1007/s40279-020-01369-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Philipp Zimmer
- Institute for Sport and Sport Science, Division of Performance and Health (Sports Medicine), TU Dortmund University, Otto-Hahn-Straße 3, 44227, Dortmund, Germany.
| | - Florian Javelle
- Institute for Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Neurology, CHARITÉ-Universitätsmedizin Berlin, Berlin, Germany
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Farina M, Breno Costa D, Webber de Oliveira JA, Polidoro Lima M, Machado WDL, Moret-Tatay C, Fernandes Lopes RM, Argimon IIDL, Irigaray TQ. Cognitive function of Brazilian elderly persons: longitudinal study with non-clinical community sample. Aging Ment Health 2020; 24:1807-1814. [PMID: 31282174 DOI: 10.1080/13607863.2019.1636203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Several biopsychosocial changes in individuals' life might happen, resulting in a decline of long-term cognitive abilities. In this way, the aim of this study was to compare cognition in non-clinical older adults in Brazil during a four-year period, as well as to examine which variables may explain cognitive function variations identified during this time. For this purpose, a longitudinal study was developed including 108 older Brazilians in phase I and 64 in phase II, from 2013 to 2017. Socio-demographic variables were assessed and the following instruments were administered: the Mini-Mental State Examination (MMSE), the Wechsler Adult Intelligence Scale (WAIS) - 3rd Edition - Digital Symbol-Coding subtests, the Verbal Fluency Test (animal category), the Rey Auditory-Verbal Learning Test, the Beck Anxiety Inventory (BAI), and the Geriatric Depression Scale 15-item version (GDS-15). In order to compare cognitive variables, the Wilcoxon signed-rank test for repeated measures was used. Temporal comparisons of nominal variables were carried out using McNemar's chi-square tests for matched pairs. Finally, multiple linear regression and correlation analyses were applied, using the participants' cognitive performance variation scores (Δ) as dependent variables. Global cognitive function delayed verbal episodic memory, and processing speed experienced a significant decline in four years. Symptoms of anxiety were the main predictor of cognitive performance variations in this sample.
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Affiliation(s)
- Marianne Farina
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Dalton Breno Costa
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - João André Webber de Oliveira
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Centro Universitário Ritter dos Reis (UniRitter), Porto Alegre, Brazil
| | | | | | - Carmen Moret-Tatay
- Universidad Católica Valencia - San Vicente Mártir (UCV), Valencia, Spain
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16
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A 10-week yoga practice has no effect on cognition, but improves balance and motor learning by attenuating brain-derived neurotrophic factor levels in older adults. Exp Gerontol 2020; 138:110998. [PMID: 32544572 DOI: 10.1016/j.exger.2020.110998] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 12/23/2022]
Abstract
Despite studies investigating the effect of yoga on cognitive and motor functioning in older adults, the effect on dual-task performance and motor learning and the specific mechanisms underlying the positive effect of yoga remain unclear. Thus, the aim of this study was to investigate the effects of yoga on cognition, balance under single- and dual-task conditions, and motor learning. The potential role of brain-derived neurotrophic factor (BDNF) in induced improvement was also explored. Participants aged 60-79 years were randomized to either a control group (n = 15) or a yoga group (n = 18) for a 10-week period. The yoga group received 90-min duration yoga classes two times per week. Changes in cognition, balance under single- and dual-task conditions, and learning fast and accurate reaching movements were assessed. Yoga practice decreased (P < 0.05) the velocity vector of the center of pressure under single- and dual-task conditions, whereas no changes in cognitive performance were observed. Although reaction and movement times during learning were decreased in both groups (P < 0.05), a faster reaction time (P < 0.05) and shorter movement time (P < 0.05) were observed in the yoga group than in the control group. Significant moderate relationships (P < 0.05) between changes in BDNF levels and functional improvements were observed. Thus, 10 weeks of yoga practice resulted in improved balance and learning in the speed-accuracy motor task that were mediated by increased BDNF levels, but had no impact on cognition in older adults.
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Sharma S, Nivethitha L, Mooventhan A. Effect of Moola Bandha (Perineum Contraction), A Yogic Lock on Cognitive Functions of College Students: An Exploratory Study. JOURNAL OF RELIGION AND HEALTH 2020; 59:1388-1397. [PMID: 31172394 DOI: 10.1007/s10943-019-00856-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Academic performance and excellence of college students are mainly depending on their cognitive functions. The purpose of this study was to examine the effectiveness of a yogic lock or hold, Moola bandha (perineum contraction) on cognitive functions of teacher training college students. Twenty-three healthy volunteers with the mean ± standard deviation age of 21.96 ± 1.64 years were recruited from a district institute of education and training (DIET) college, North India. All the subjects were asked to perform Moola bandha for the duration of 30 min a day (15 min in the morning and 15 min in the evening) for a period of 30 days. Assessments were taken before and after the intervention period. Results of this study showed a significant increase in the scores of d2 attention total number, digits span forward and backward test, Stroop tasks (neutral total and correct, congruent total and correct, and incongruent correct), and self-control scale along with a significant reduction in d2 attention (omission, commission, and timings), trail making text A and B duration, and positive and negative affective schedule's negative affect scores compared with its respective baseline. These results suggest that 30 min of daily practice of Moola bandha for 30 days is effective in improving the cognitive functions of teacher training college students.
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Affiliation(s)
- Sakshi Sharma
- Department of Yoga Therapy, S-VYASA Deemed to be University, Bengaluru, Karnataka, India
| | - L Nivethitha
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, 600106, Tamilnadu, India
| | - A Mooventhan
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, 600106, Tamilnadu, India.
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18
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Chobe S, Chobe M, Metri K, Patra SK, Nagaratna R. Impact of Yoga on cognition and mental health among elderly: A systematic review. Complement Ther Med 2020; 52:102421. [PMID: 32951703 DOI: 10.1016/j.ctim.2020.102421] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cognitive decline and psychological health problems are the most frequently observed and under-treated issues among the elderly. Many studies have assessed the efficacy of Yoga on cognitive and mental health parameters among the elderly. However, up to date, there is no systematic review done to evaluate the role of Yoga-based interventions on cognition and mental health in the elderly. OBJECTIVE This review evaluates the beneficial effect of Yoga in improving cognitive and mental health in the elderly. METHODOLOGY A comprehensive search has performed on Medline, Google Scholar, PubMed, and PsycINFO electronic database from their inception to January 2019. The literature search was constructed around search term for "mental health", "cognition", "yoga" and "elderly". Out of 3388 records, we were considered only Randomized control trials (RCTs) with Yoga-based interventions on the older people for this review. Risk of bias was assessed using Delphi list and PEDro criteria. RESULTS After filtering out irrelevant studies, in our search, we come across 13 RCTs, and they included in this systematic review. Of 13 RCTs, four studies assessed only cognitive parameters and five studies assessed only psychological parameters, and four studies evaluated both. Study quality was fair to moderate of included RCTs on the Delphi list and PEDro criteria. Maximum studied variables in cognition were executive functions, memory, attention, and language while in mental health depression, anxiety, stress, and mood. Yoga-based interventions have some beneficial effects on attention, executive functions among cognitive variables, and depression among mental health parameters among the elderly. CONCLUSION The present review indicates that Yoga-based interventions have some positive evidence in improving attention, executive functions and memory of cognition, while depression in mental health compared to active control among the elderly. However, methodological limitations and small number of studies preclude confirming the potential benefits of Yoga-based interventions on cognition and mental health among the elderly. Further, this review strongly recommends more randomized control trials with standard study methodology, use of validated modules of Yoga intervention, and long term follow up to have definite conclusions.
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Affiliation(s)
- Shivaji Chobe
- Department of Yoga, Central University of Rajasthan, Ajmer, India; Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhan Samsthana (SVYASA University), Bengaluru, India.
| | - Meenakshi Chobe
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhan Samsthana (SVYASA University), Bengaluru, India.
| | - Kashinath Metri
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhan Samsthana (SVYASA University), Bengaluru, India.
| | - Sanjib Kumar Patra
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhan Samsthana (SVYASA University), Bengaluru, India.
| | - R Nagaratna
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhan Samsthana (SVYASA University), Bengaluru, India.
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19
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Wang B, Guo W. Exercise mode and attentional networks in older adults: a cross-sectional study. PeerJ 2020; 8:e8364. [PMID: 31938580 PMCID: PMC6953334 DOI: 10.7717/peerj.8364] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 12/06/2019] [Indexed: 12/17/2022] Open
Abstract
Background Previous studies have indicated that physical exercise enhances attentional function; however, the relationship between exercise mode and attentional networks has not been clarified for older adults (>60 years old). This study aimed to investigate the relationship between attentional networks and different exercise modes in older adults. Methods Two hundred and fifty-nine participants aged between 60 to 81 years were enrolled and classified into three groups (closed-skill group, open-skill group, or sedentary control group) using an exercise-related questionnaire. All participants completed an attention network test (ANT), which measured executive control, orienting, and alerting networks. Results The open-skill group had significantly higher executive network efficiency compared to the closed-skill (p < 0.01) and sedentary (p < 0.01) groups. The closed-skill group had significantly higher values compared to the sedentary control group (p < 0.05). Differences were not detected among groups for alerting and orienting networks (p > 0.05). The open-skill group had significantly higher values compared to the sedentary control group regarding proportion score of executive network (p < 0.01). In comparison, no significant differences were detected among groups for proportion scores of alerting and orienting networks. Conclusion This study extends current knowledge by demonstrating that open-skill exercises selectively enhance the executive control of attentional networks in older adults. Open-skill exercises combines physical exercise and cognitive training, potentially representing a more effective exercise mode to maintain or enhance attentional function in older adults.
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Affiliation(s)
- Biye Wang
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China.,Institute of Sports, Exercise and Brain, Yangzhou University, Yangzhou, Jiangsu, China
| | - Wei Guo
- College of Physical Education, Yangzhou University, Yangzhou, Jiangsu, China.,Institute of Sports, Exercise and Brain, Yangzhou University, Yangzhou, Jiangsu, China
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20
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Effect of Yoga versus Light Exercise to Improve Well-Being and Promote Healthy Aging among Older Adults in Central India: A Study Protocol for a Randomized Controlled Trial. Geriatrics (Basel) 2019; 4:geriatrics4040064. [PMID: 31744171 PMCID: PMC6960920 DOI: 10.3390/geriatrics4040064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga’s effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60–80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied. Discussion: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences.Trial Registration: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.
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21
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Hishikawa N, Takahashi Y, Fukui Y, Tokuchi R, Furusawa J, Takemoto M, Sato K, Yamashita T, Ohta Y, Abe K. Yoga-plus exercise mix promotes cognitive, affective, and physical functions in elderly people. Neurol Res 2019; 41:1001-1007. [PMID: 31588880 DOI: 10.1080/01616412.2019.1672380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives: Increased attention is being paid to Asian medicine in balanced total health care. We investigated the effects of mixed exercise including yoga ('Yoga-plus') among elderly individuals. Methods: A total of 385 subjects (72 males and 313 females, 75.5 ± 8.7 years old) participated in a 12-month (M) exercise program at a health and welfare center, a day service center, and a nursing home. Cognitive, affective, and physical functions, and activities of daily living (ADL), were compared at baseline (0M), 6M and 12M of exercise intervention. Results: Mean scores on the frontal assessment battery, clock drawing test, cube copying test, letter fluency, and category fluency significantly improved after the Yoga-plus intervention, while mini-mental state examination, Hasegawa dementia score-revised, and trail-making test performance were relatively stable. Affective scores on the geriatric depression scale (GDS), apathy scale (AS) and Abe's behavioral and psychological symptoms of dementia were not significantly affected by exercise therapy, but subgroups with higher baseline GDS (GDS ≥ 5) and AS (AS ≥ 16) scores showed a significant improvement after intervention. One-leg standing time and 3-m timed up and go test performance significantly improved after 12M intervention. Discussion: Yoga-plus improved cognitive, affective, ADL, and physical functions in a local elderly population, particularly among below-baseline individuals, indicating the benefits of dementia prevention among elderly individuals.
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Affiliation(s)
- Nozomi Hishikawa
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
| | | | - Yusuke Fukui
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
| | - Ryo Tokuchi
- Department of Occupational Therapy, Okayama Institute for Medical and Technical Sciences , Okayama , Japan
| | - Junichi Furusawa
- Department of Occupational Therapy, Mizunaga Rehabilitation Hospital , Okayama , Japan
| | - Mami Takemoto
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
| | - Kota Sato
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
| | - Toru Yamashita
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
| | - Yasuyuki Ohta
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
| | - Koji Abe
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan
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22
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Hillman CH, McAuley E, Erickson KI, Liu-Ambrose T, Kramer AF. On mindful and mindless physical activity and executive function: A response to Diamond and Ling (2016). Dev Cogn Neurosci 2019; 37:100529. [PMID: 30318345 PMCID: PMC6969305 DOI: 10.1016/j.dcn.2018.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 01/16/2018] [Accepted: 01/19/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
| | | | | | | | - Arthur F Kramer
- Northeastern University, United States; University of Illinois, United States
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23
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Östh J, Diwan V, Jirwe M, Diwan V, Choudhary A, Mahadik VK, Pascoe M, Hallgren M. Effects of yoga on well-being and healthy ageing: study protocol for a randomised controlled trial (FitForAge). BMJ Open 2019; 9:e027386. [PMID: 31147363 PMCID: PMC6549603 DOI: 10.1136/bmjopen-2018-027386] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Due to ageing populations worldwide, the burden of disability is increasing. It is therefore important to develop interventions that improve healthy ageing, reduce disability onset and enhance life quality. Physical activity can promote healthy ageing and help maintain independence, yet many older adults are inactive. Yoga is a form of physical activity that aims to improve health and may be particularly suitable for older adults. Research indicates positive effects of yoga on several health-related outcomes; however, empirical studies examining the benefits of yoga on well-being among the elderly remain scarce. This study protocol reports the methodology for a 12-week yoga programme aimed to improve health and well-being among physically inactive older adults. METHODS AND ANALYSIS Three group parallel, single-blind randomised controlled trial. Two comparison groups are included: aerobic exercise and a non-active wait-list control. In total, 180 participants aged 65-85 years will be recruited. Assessments will be performed at baseline and postintervention (12-week follow-up). The primary outcome is subjective well-being. Secondary outcomes include physical activity/sedentary behaviour, mobility/fall risk, cognition, depression, anxiety, mood, stress, pain, sleep quality, social support and cardiometabolic risk factors. Data will be analysed using intention-to-treat analyses, with mixed linear modelling. ETHICS AND DISSEMINATION This study is approved by the Ethical Review Board in Stockholm (2017/1862-31/2). All participants must voluntarily agree to participate and are free to withdraw from the study at any point. Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. A summary of key results will be publicly available through newspaper articles. TRIAL REGISTRATION NUMBER DRKS00015093, U1111-1217-4248.
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Affiliation(s)
- Josefine Östh
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Vinod Diwan
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Maria Jirwe
- Department of Health Promoting Sciences, Sophiahemmet Hogskola, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Vishal Diwan
- Department of Public Health and Environment, International Centre for Health Research, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Anita Choudhary
- Department of Physiology, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Vijay Khanderao Mahadik
- Department of Physiology, Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Michaela Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Quigley A, O'Brien KK, Brouillette MJ, MacKay-Lyons M. Evaluating the Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes in People Living With HIV: Protocol for a Randomized Pilot Trial. JMIR Res Protoc 2019; 8:e13818. [PMID: 31115343 PMCID: PMC6547772 DOI: 10.2196/13818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 12/19/2022] Open
Abstract
Background Despite lower mortality rates due to combination antiretroviral therapy, people living with HIV (PLWH) are grappling with increasingly complex health issues, including cognitive impairments in areas such as memory, attention, processing speed, and motor function. Yoga has been shown to be an effective form of exercise and mindfulness-based stress reduction for many clinical populations. However, no randomized trials have evaluated the impact of yoga on cognitive and physical function among PLWH. Objective The aim of this pilot randomized trial was to determine the feasibility of a yoga intervention to lay the groundwork for a full-scale, multisite, community-based trial for PLWH. Specific objectives are to (1) assess the feasibility of study protocol and procedures, (2) compare cognition in the yoga group with the usual care control group after 12 weeks of the intervention in PLWH, and (3) compare the effects of the 12-week yoga intervention versus control on balance, walking speed, physical activity, mental health, medication adherence, and quality of life among PLWH. Methods We propose a pilot randomized trial with 2 parallel groups (yoga versus control). We will recruit 25 PLWH (>35 years) from community and health organizations in Halifax, Canada. After baseline assessment with blinded assessors, participants will be randomly assigned to the yoga or control group, using a random computer generator. Participants in the yoga group will engage in supervised 60-min group-based yoga sessions 3 times a week for 12 weeks at a yoga studio. Participants in the control group will maintain their current physical activity levels throughout the study. Results As per the Consolidated Standards of Reporting Trials extension for pilot studies, means of all outcomes, mean change, and 95% CIs will be calculated for each group separately. Two-tailed independent t tests and Fisher exact tests will be used to compare groups at baseline. We will analyze quantitative postintervention questionnaire responses using Chi-square tests, and open-ended responses will be analyzed thematically. Intention-to-treat and per-protocol analyses will be used to analyze secondary variables. Changes in outcome variables will be examined between groups and within groups. Effect sizes will be reported for each outcome. A priori adherence and satisfaction criteria will be met if participants attend >70% of the yoga sessions and if >70% of the participants are satisfied with the intervention as determined by a postparticipation questionnaire. Study enrollment began in January 2018, with results expected for October 2019. Conclusions This pilot randomized trial will be the first to investigate the feasibility and effect of a yoga intervention on cognitive and physical outcomes among PLWH. This work will inform the feasibility of further investigations in terms of capacity building, participant recruitment and retention, and assessment and intervention protocols. Trial Registration ClinicalTrials.gov NCT03071562; https://clinicaltrials.gov/ct2/show/NCT03071562 (Archived by WebCite at http://www.webcitation.org/785sfhWkw) International Registered Report Identifier (IRRID) DERR1-10.2196/13818
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Affiliation(s)
- Adria Quigley
- Department of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | - Marilyn MacKay-Lyons
- Department of Physiotherapy, Dalhousie University, Halifax, NS, Canada.,Department of Medicine, Dalhousie University, Halifax, NS, Canada.,Nova Scotia Health Authority, Halifax, NS, Canada
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Zhang Y, Li C, Zou L, Liu X, Song W. The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2791. [PMID: 30544873 PMCID: PMC6313783 DOI: 10.3390/ijerph15122791] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Abstract
Background: As the situation of cognitive aging is getting worse, preventing or treating cognitive decline through effective strategies is highly important. This systematic review aims to investigate whether mind-body exercise is an effective approach for treating cognition decline. Methods: Searches for the potential studies were performed on the eight electronic databases (MEDLINE, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycArtilces, CNKI, and Wanfang). Randomized controlled trials (RCTs) examining the effect of mind-body exercise on cognitive performance in older adults were included. Data were extracted and effect sizes were pooled with 95% confidence intervals (95% CI) using random-effects models. The Physiotherapy Evidence Database Scale was employed to examine the study quality. Results: Nineteen RCTs including 2539 elders (67.3% female) with fair to good study quality were identified. Mind-body exercise, relative to control intervention, showed significant benefits on cognitive performance, global cognition (Hedges'g = 0.23), executive functions (Hedges'g = 0.25 to 0.65), learning and memory (Hedges'g = 0.37 to 0.49), and language (Hedges'g = 0.35). In addition, no significant adverse events were reported. Conclusion: Mind-body exercise may be a safe and effective intervention for enhancing cognitive function among people aged 60 years or older. Further research evidence is still needed to make a more conclusive statement.
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Affiliation(s)
- Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea.
- Physical Education Unit, School of Humanities and Social Science, the Chinese University of Hong Kong, Shenzhen 518172, China.
| | - Chunxiao Li
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637551, Singapore.
| | - Liye Zou
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong 999077, China.
| | - Xiaolei Liu
- Academy of Martial Arts and Traditional Sports, Beijing Sports University, Beijing 100084, China.
| | - Wook Song
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea.
- Institute on Aging, Seoul National University, Seoul 08826, Korea.
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