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Cunha PM, Werneck AO, Santos LD, Oliveira MD, Zou L, Schuch FB, Cyrino ES. Can resistance training improve mental health outcomes in older adults? A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2024; 333:115746. [PMID: 38281452 DOI: 10.1016/j.psychres.2024.115746] [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: 07/16/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/30/2024]
Abstract
Purpose This systematic review and meta-analysis aimed to analyze the effects of resistance training (RT) and to compare the different RT prescriptions, sample characteristics, and mental health outcomes (depressive and anxiety symptoms) in older adults. Methods All studies that were available on 28th April 2023. For the analysis of intervention effects on depressive and anxiety symptoms, standardized mean differences and standard errors were calculated. Meta-analyses using random-effects models, employing robust variance meta-regression for multilevel data structures, with adjustments for small samples. Results For depressive symptoms, the mean effect was - 0.94 (95 %CI: -1.45 - -0.43, P< 0.01, I2= 93.4 %), and for anxiety symptoms, the mean effect was -1.33 (95 %CI: -2.10 - -0.56, P< 0.01, I2= 92.3 %). The mean effect was -0.51 (95 %CI: -0.67 - -0.35, P< 0.01, I2= 36.7 %) for older adults without mental disorders, and those with mental disorders the mean effect was ES= -2.15 (95 %CI: -3.01 - - 1.29, P< 0.01, I2= 91.5 %). Conclusion RT was able to improve mental health outcomes in individuals with and without mental disorders, and some RT characteristics influenced the effect of RT on mental health.
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Affiliation(s)
- Paolo M Cunha
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, Brazil.
| | - André O Werneck
- Center for Epidemiological Research in Nutrition andHealth, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Leandro Dos Santos
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Federal University of Sergipe, Sergipe, SE, Brazil
| | - Max D Oliveira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brail; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Edílson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, Brazil
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Zhang Y, Zhou JJ, Zhang XM, Liu JT, Li MR, Liang JY, Gao YL. Management of cognitive frailty: A network meta-analysis of randomized controlled trials. Int J Geriatr Psychiatry 2023; 38:e5994. [PMID: 37655500 DOI: 10.1002/gps.5994] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES We aimed to compare the effectiveness of interventions in cognitive function and frailty status and rank these interventions. METHODS Data Sources-We searched PubMed, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Library, Central Register of Controlled Trials (CENTRAL), CNKI, Wanfang, VIP and Google scholar. Data synthesis-The risk of bias was assessed using the Cochrane risk bias assessment tool. Statistical heterogeneity was assessed using the Chi-square test and quantified by I2 . The results were pooled using the standardized mean difference (SMD). The rank probability for each intervention was calculated using the surface under the cumulative ranking curve (SUCRA). Additionally, the quality of the evidence was evaluated using the GRADE approach. RESULTS A total of 10 randomized controlled trials (RCTs) involving 1110 patients were included in our analysis. The network map of cognitive function comprised 9 RCTs with 1347 participants, examining eight different interventions. Nutritional support (SUCRA = 99.9%, SMD = 3.02, 95% CI: 2.53, 3.51) may be the most effective intervention to improve cognitive function. The network map of frailty (including 9 RCTs with 1017 participants and 9 interventions) suggested that multicomponent exercises (SUCRA = 96.4%, SMD = -5.10, 95% CI: -5.96, -4.23) tended to have a greater effect. CONCLUSIONS Community-based multicomponent exercises have shown significant benefits for improving cognitive function and frailty status in older adults, with moderate certainty. For hospitalized older patients with Cognitive frailty (CF), current evidence suggests that nutritional support yields the most improvement. Additionally, aerobic exercise and dual-task training have proven effective in managing CF. Further studies are needed to validate these preliminary findings and exploring more accessible and effective physical and cognitive interventions to prevent CF in aging.
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Affiliation(s)
- Yu Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jing-Jing Zhou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xu-Ming Zhang
- Operating Room, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jing-Ting Liu
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Min-Rui Li
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jia-Yi Liang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yu-Lin Gao
- School of Nursing, Southern Medical University, Guangzhou, China
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: A Joanna Briggs Institute Centre of Excellence, Guangzhou, China
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Miura KW, Tokunaga S, Sekiguchi T, Sugimoto H, Otake-Matsuura M. Effect of home-based group conversation intervention using smartphone application on cognitive health and psychological well-being of older adults with subjective cognitive concerns in Japan: a randomized controlled trial protocol. Front Psychol 2023; 14:1114790. [PMID: 37260952 PMCID: PMC10228629 DOI: 10.3389/fpsyg.2023.1114790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/17/2023] [Indexed: 06/02/2023] Open
Abstract
Background Social activity is a key component in the prevention of cognitive decline. However, face-to-face social intervention has limited accessibility. To address this issue, we developed the "Photo-Integrated Conversation Moderated by Application" (PICMOA), a home-based group conversation intervention using smartphones. This paper introduces the PICMOA intervention and the protocol of the ongoing randomized controlled trial (RCT), which aims to evaluate the effects of PICMOA on the cognitive functioning and psychological well-being of Japanese community dwelling older adults at the risk of cognitive function decline. Methods This study uses an RCT design in two parallel group trials with 1:1 allocation. The participants are community dwelling older adults aged 65 years and above, living in an urban city in Japan, with subjective cognitive concerns. In total, 81 participants were allocated to the intervention or control groups. The intervention group receives 30 min of weekly PICMOA sessions at their home for 12 weeks. The PICMOA intervention consists of (1) a photo preparation period before the session and (2) a structured group conversation session talking about the photos that participants took according to a specific theme. The control group receives 30 min of weekly health education videos on a tablet device. The primary outcome is cognitive functioning at pre- and post-phases of the 12-week intervention measured using the Telephone Interview for Cognitive Status in Japanese, semantic and phonemic fluency tests, and the Digit Span Forward and Backward tests. The secondary outcomes are psychological and social aspects including mental status, well-being, loneliness, and social support. Discussion Interest is growing in internet-based activities for preventing social isolation. However, the effect of remote conversation interventions on cognitive functioning remains unclear. This study addresses this issue and provides a new avenue of social participation for older adults. Clinical trial registration https://www.umin.ac.jp/ctr/, identifier: UMIN000047247.
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Affiliation(s)
- Kumi Watanabe Miura
- Cognitive Behavioral Assistive Technology Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Seiki Tokunaga
- Cognitive Behavioral Assistive Technology Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Takuya Sekiguchi
- Cognitive Behavioral Assistive Technology Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Hikaru Sugimoto
- Cognitive Behavioral Assistive Technology Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Mihoko Otake-Matsuura
- Cognitive Behavioral Assistive Technology Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
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Li F, Yan Y, Zheng L, Wang C, Guan X, Hong S, Guo H. Frailty and its combined effects with lifestyle factors on cognitive function: a cross-sectional study. BMC Geriatr 2023; 23:79. [PMID: 36747124 PMCID: PMC9900934 DOI: 10.1186/s12877-023-03761-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/19/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Frailty describes an age-related state of deterioration in biological function. This study aimed to investigate the association between frailty and cognitive function and its combined effects with lifestyles. METHODS A total of 3,279 participants from the Dongfeng-Tongji (DFTJ) cohort were tested the cognitive function by using the Chinese version of Mini-mental State Examination (MMSE). Frailty was evaluated based on a 35-item frailty index (FI). Frailty status was dichotomized into robust (FI < 0.15) and frail (FI ≥ 0.15). Multivariate generalized linear regression models and logistic regression models were used to estimate the associations of frailty with MMSE score and cognitive impairment. We also analysed the modification and combined effects of lifestyle factors, including smoking status, drinking status, and regular physical exercise, on the above associations. RESULTS FI was significantly associated with lower MMSE score [β (95%Cl) = -0.28 (-0.43, -0.13)] and cognitive impairment [OR (95%Cl) = 1.19 (1.04, 1.35)]. The association of frailty status with MMSE were found to be stronger among ever smokers [β(95%Cl) = -1.08 (-1.64, -0.51)] and physical inactive individuals [β(95%Cl) = -1.59 (-2.63, -0.54)] while weaker or not significant among never smokers [β(95%Cl) = -0.30 (-0.62, 0.01)] and physical active individuals [β(95%Cl) = -0.37 (-0.65, -0.08))]. There were significant combined effects of frailty status with unhealthy lifestyles including smoking, alcohol drinking, and physical inactive on cognitive impairment. CONCLUSIONS Frailty was associated with cognitive impairment among Chinese middle-aged and elderly people, while smoking cessation and regular physical exercise could attenuate the above associations, which highlight the potential preventive interventions.
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Affiliation(s)
- Fangqing Li
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Yike Yan
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Lei Zheng
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Chenming Wang
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Xin Guan
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Shiru Hong
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Huan Guo
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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Cento AS, Leigheb M, Caretti G, Penna F. Exercise and Exercise Mimetics for the Treatment of Musculoskeletal Disorders. Curr Osteoporos Rep 2022; 20:249-259. [PMID: 35881303 PMCID: PMC9522759 DOI: 10.1007/s11914-022-00739-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The incidence of musculoskeletal disorders affecting bones, joints, and muscles is dramatically increasing in parallel with the increased longevity of the worldwide population, severely impacting on the individual's quality of life and on the healthcare costs. Inactivity and sedentary lifestyle are nowadays considered the main drivers of age-associated musculoskeletal disorders and exercise may counteract such alterations also in other bone- and muscle-centered disorders. This review aims at clarifying the potential use of exercise training to improve musculoskeletal health. RECENT FINDINGS Both the skeletal muscle and the bone are involved in a complex crosstalk determining, in part through tissue-specific and inflammatory/immune released factors, the occurrence of musculoskeletal disorders. Exercise is able to modulate the levels of those molecules and several associated molecular pathways. Evidence from preclinical and clinical trials supports the adoption of exercise and the future use of exercise mimicking drugs will optimize the care of individuals with musculoskeletal disorders.
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Affiliation(s)
- Alessia S Cento
- Department of Clinical and Biological Sciences, University of Torino, Corso Raffaello, 30, 10125, Torino, Italy
| | - Massimiliano Leigheb
- Orthopaedics and Traumatology Unit, "Maggiore della Carità" Hospital, Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Giuseppina Caretti
- Department of Biosciences, University of Milan, Via Celoria 26, 20133, Milan, Italy
| | - Fabio Penna
- Department of Clinical and Biological Sciences, University of Torino, Corso Raffaello, 30, 10125, Torino, Italy.
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Zhang J, Cao X, Chen C, He L, Ren Z, Xiao J, Han L, Wu X, Liu Z. Predictive Utility of Mortality by Aging Measures at Different Hierarchical Levels and the Response to Modifiable Life Style Factors: Implications for Geroprotective Programs. Front Med (Lausanne) 2022; 9:831260. [PMID: 35530042 PMCID: PMC9072659 DOI: 10.3389/fmed.2022.831260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/14/2022] [Indexed: 01/01/2023] Open
Abstract
Background Aging, as a multi-dimensional process, can be measured at different hierarchical levels including biological, phenotypic, and functional levels. The aims of this study were to: (1) compare the predictive utility of mortality by three aging measures at three hierarchical levels; (2) develop a composite aging measure that integrated aging measures at different hierarchical levels; and (3) evaluate the response of these aging measures to modifiable life style factors. Methods Data from National Health and Nutrition Examination Survey 1999–2002 were used. Three aging measures included telomere length (TL, biological level), Phenotypic Age (PA, phenotypic level), and frailty index (FI, functional level). Mortality information was collected until December 2015. Cox proportional hazards regression and multiple linear regression models were performed. Results A total of 3,249 participants (20–84 years) were included. Both accelerations (accounting for chronological age) of PA and FI were significantly associated with mortality, with HRs of 1.67 [95% confidence interval (CI) = 1.41–1.98] and 1.59 (95% CI = 1.35–1.87), respectively, while that of TL showed non-significant associations. We thus developed a new composite aging measure (named PC1) integrating the accelerations of PA and FI, and demonstrated its better predictive utility relative to each single aging measure. PC1, as well as the accelerations of PA and FI, were responsive to several life style factors including smoking status, body mass index, alcohol consumption, and leisure-time physical activity. Conclusion This study demonstrates that both phenotypic (i.e., PA) and functional (i.e., FI) aging measures can capture mortality risk and respond to modifiable life style factors, despite their inherent differences. Furthermore, the PC1 that integrated phenotypic and functional aging measures outperforms in predicting mortality risk in comparison with each single aging measure, and strongly responds to modifiable life style factors. The findings suggest the complementary of aging measures at different hierarchical levels and highlight the potential of life style-targeted interventions as geroprotective programs.
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Affiliation(s)
- Jingyun Zhang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Chen Chen
- National Institute of Environmental and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liu He
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Ziyang Ren
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Junhua Xiao
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Liyuan Han
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Xifeng Wu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Xifeng Wu
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Zuyun Liu ;
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Pérez-Zepeda MU, Martínez-Velilla N, Kehler DS, Izquierdo M, Rockwood K, Theou O. The impact of an exercise intervention on frailty levels in hospitalised older adults: secondary analysis of a randomised controlled trial. Age Ageing 2022; 51:6530461. [PMID: 35180287 DOI: 10.1093/ageing/afac028] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/12/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND physical activity reduces frailty in community-dwelling older adults. How exercise influences frailty in hospitalised older adults requires additional investigation. OBJECTIVES (i) to examine the impact of an exercise intervention on frailty in older adults admitted to an acute care ward, and (ii) to determine the impact of baseline frailty on the effectiveness of this intervention. SETTING/PARTICIPANTS this is a secondary analysis of a randomised controlled clinical trial that tested an intensive exercise intervention in ≥75-year-old adults admitted to an acute care ward. METHODS the intervention included two daily sessions of moderate-intensity exercises (control received usual care). A 63-item Frailty Index (FI) was constructed, and three groups were formed: <0.2, 0.2-0.29 and ≥0.3. Other outcomes included Short Physical Performance Battery (SPPB) and Barthel Index (BI). RESULTS a total of 323 individuals were included. The mean age was 87.1 years (± 4.8 standard deviation [SD]) and 56.3% were females. The intervention group improved FI from 0.26 (± 0.10 SD) to 0.20 (± 0.10 SD), whereas the control group FI worsened from 0.25 (± 0.1 SD) to 0.27 (± 0.10 SD). After stratifying by baseline FI, SPPB and depression improved in the intervention group across all levels of frailty; FI, BI and quality of life only improved in individuals with a baseline FI ≥ 0.2. CONCLUSIONS frailty improves with an intensive individualised exercise intervention, especially in those with high baseline levels of frailty. In addition, frailty is a useful outcome when examining the impact of an intervention of hospitalised older adults.
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Affiliation(s)
- Mario Ulises Pérez-Zepeda
- Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
- Instituto Nacional de Geriatría, Mexico City, Mexico
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Dustin Scott Kehler
- Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Olga Theou
- Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
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Daryanti Saragih I, Yang YP, Saragih IS, Batubara SO, Lin CJ. Effects of resistance bands exercise for frail older adults: A systematic review and meta-analysis of randomised controlled studies. J Clin Nurs 2021; 31:43-61. [PMID: 34289511 DOI: 10.1111/jocn.15950] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/20/2021] [Accepted: 06/22/2021] [Indexed: 01/16/2023]
Abstract
AIMS AND OBJECTIVES Research examining the effectiveness of resistance band exercises for improving physical and psychological dimensions among frail older adults has been inconsistent. We aimed to examine the effects of resistance band exercises for improving outcomes in frail older adults. BACKGROUND To provide robust evidence regarding the effectiveness of resistance band exercises and explore other potential outcomes in frail older adults, a systematic review of RCTs remains necessary. DESIGN Systematic literature review and meta-analysis were conducted in accordance with the PRISMA guidelines. METHODS Four databases were searched. English language papers were retrieved from 2006 to 2020. Three reviewers reviewed the methodology of the selected studies using the Joanna Briggs Institute tool for randomised controlled trials. The pooled standardised mean difference was calculated using a random-effects model. Heterogeneity among pooled studies was assessed using the τ2 , Q and I2 statistics, and publication bias was evaluated using Egger's test and the visual inspection of funnel plots. RESULTS A total of 15 studies met the eligibility criteria for this study. Overall, resistance band exercise reduced frailty after 24 weeks (SMD: -0.29; 95% CI: -0.55 to -0.03) and reduced depression after both 12 weeks (SMD: -0.19; 95% CI: -0.38 to -0.01) and 24 weeks (SMD: -0.30; 95% CI: -0.52 to -0.09). However, no significant effects were observed for frailty after 12 weeks, and no significant effects were observed for grip strength, leg strength, activities of daily living or quality of life at any time. CONCLUSION Resistance band exercise might be considered a viable strategy for frail older adults in the community or in long-term care facilities. More research implementing a standardised protocol remains necessary to identify the effects of different training volumes and the dose-response relationship for the very old and frail population. RELEVANCE TO CLINICAL PRACTICE As a safe complementary intervention for frail older adults, health providers should consider resistance band exercises when caring for frail older adults because this intervention has clinical benefits.
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Affiliation(s)
| | - Ya-Ping Yang
- National Tainan Junior College of Nursing (NTIN), Tainan, Taiwan
| | | | | | - Chia-Ju Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
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Zhang J, Liu Z, Liu Y, Ye L. Exercise interventions for older people at risk for frailty: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25940. [PMID: 34011071 PMCID: PMC8137036 DOI: 10.1097/md.0000000000025940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Frailty is a state of age-related reduced physiological reserve characterized by an increased risk of adverse clinical outcomes. Studies have shown that exercise can improve frailty in older people. However, it remains to be seen which exercises will most improve the fitness of older people with frailty or those at the risk for frailty.Objective: This protocol aims to determine whether physical exercise can improve frailty in older people, and if which methods are most effective. METHODS We searched the following databases for relevant articles published between January 1, 2012 and January 1, 2021: PubMed, EMBASE, the Cochrane Library, Wanfang, the China National Knowledge Infrastructure, Clinical Trials Database, and the Science Network. Two independent reviewers will carry out data extraction, discuss and resolve differences, and obtain consensus from the third author. We will select randomized control trials (RCTs) according to the preformulated inclusion criteria. The main outcomes in this study are scores from Fried Frailty Phenotype Criteria; the Frailty Trait Scale-short form; the SHARE Frailty Instrument; the FRAIL scale; the Gérontopôle Frailty Screening Tool; the Clinical Frailty Scale, the Rockwood and Mitnitsky Frailty Index; the Study of Osteoporotic Fractures Index; the Edmonton Frailty Scale; the Fatigue, Resistance, Ambulation, Illness and Loss of Weight Index; the Multidimensional Prognostic Index; the Tilburg Frailty Indicator; PRISMA-7; the Groningen Frailty Indicator; the Sherbrooke Postal Questionnaire; and the Kihon Checklist. Secondary outcomes are muscle strength, gait velocity, stair-climbing power, and level of spontaneous physical activity. If the heterogeneity test shows slight or no statistical heterogeneity, a fixed effects model will be used for data synthesis; otherwise, a random effects model will be used. We will develop a unified data extraction table that includes a number of parameters. The Cochrane Cooperative Bias Risk Tool will be used to evaluate the methodological quality of the selected RCTs. RevMan Manager 5.3 and STATA 14.0 will be used for data analysis if enough RCTs (more than 10) are identified and selected. RESULT The final results will provide information on the effectiveness of intervention programs for frail older adul and further demonstrate which exercise programs are more effective and which methods can significantly improve frailty. CONCLUSION This protocol will contribute to the development of more effective interventions for elderly individuals with frailty. ETHICS AND DISSEMINATION This study applies existing literature references; therefore, ethical approval is not required. INPLASY REGISTRATION NUMBER INPLASY202130107.
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Affiliation(s)
- Jianna Zhang
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhixi Liu
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Liu
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Ye
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
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Huang CH, Umegaki H, Makino T, Uemura K, Hayashi T, Kitada T, Inoue A, Shimada H, Kuzuya M. Effect of Various Exercises on Intrinsic Capacity in Older Adults With Subjective Cognitive Concerns. J Am Med Dir Assoc 2020; 22:780-786.e2. [PMID: 32768376 DOI: 10.1016/j.jamda.2020.06.048] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Physical activity is associated with improvement in overall health and well-being, but robust evidence with comprehensive assessment of general health is lacking. This study aimed to clarify the effects of physical activity on intrinsic capacity among community-dwelling older adults with subjective memory concerns. DESIGN A single-blind randomized controlled trial compared aerobic training (AT), resistance training (RT), and combined training (AT+RT) programs for improving general health evaluated by intrinsic capacity. SETTING Toyota, Japan. PARTICIPANTS Residents (65-85 years old) who screened positive for subjective memory concerns using the Kihon checklist were invited for eligibility assessment. In total, 415 community-dwelling older adults were enrolled and randomized into the AT, RT, AT+RT, and control groups. METHODS Participants in the intervention groups underwent a group training program and self-paced home training for 26 weeks. The control group received lectures about health promotion. Intrinsic capacity (IC), constructed based on locomotion, cognition, psychological function, and vitality domains, was used to assess general health at baseline, week 26, and week 52. Between-group differences were exhibited with Z-score change in individual domain and combination of all domains. RESULTS At baseline, mean age of all participants (47% women) was 72.3 ± 4.6 years, with a mean composited IC Z-score of -0.2 ± 0.5. Overall, AT and RT improved composite IC Z-scores by 0.17 (95% confidence interval [CI] 0.03-0.30) and 0.17 (95% CI 0.05-0.28) at week 26, respectively, but the beneficial effects waned at week 52. No significant differences in composite IC Z-scores were found in the AT+RT group at weeks 26 and 52. CONCLUSIONS AND IMPLICATIONS Twenty-six-week AT with self-paced home training and RT with self-paced home training improve IC among community-dwelling older adults with subjective memory concerns, but the benefits waned subsequently. It will be required to develop optimal interventions that have a continuous beneficial effect on IC among community-dwelling older adults.
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Affiliation(s)
- Chi Hsien Huang
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan; Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C.; School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan, R.O.C.; Institutes of Innovation for Future Society, Nagoya University, Nagoya, Aichi Prefecture, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan
| | - Taeko Makino
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan
| | - Kazuki Uemura
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan
| | - Takahiro Hayashi
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan
| | - Tomoharu Kitada
- Institutes of Innovation for Future Society, Nagoya University, Nagoya, Aichi Prefecture, Japan
| | - Aiko Inoue
- Institutes of Innovation for Future Society, Nagoya University, Nagoya, Aichi Prefecture, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi Prefecture, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi Prefecture, Japan; Institutes of Innovation for Future Society, Nagoya University, Nagoya, Aichi Prefecture, Japan.
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Affiliation(s)
- J E Morley
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University, SLUCare Academic Pavilion, Section 2500, 1008 S. Spring Ave., 2nd Floor, St. Louis, MO 63110, , Twitter: @drjohnmorley
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