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Pan Y, Li X, Zhang L, Li Y, Tang Z, Ma L. Declined intrinsic capacity predicts long-term mortality in Chinese older adults: Beijing Longitudinal Study of Aging. Maturitas 2024; 188:108082. [PMID: 39089049 DOI: 10.1016/j.maturitas.2024.108082] [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: 01/12/2024] [Revised: 06/03/2024] [Accepted: 07/26/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Intrinsic capacity reflects an individual's functions and capacities across their lifetime. There are few studies on whether the level of intrinsic capacity can predict long-term mortality in Chinese populations. OBJECTIVE To explore the effects of intrinsic capacity on long-term outcomes in older Chinese adults. METHODS Data were obtained from the Beijing Longitudinal Study of Aging. Overall, 1699 community-dwelling adults aged ≥60 years were included and followed up for 8 years. Intrinsic capacity was determined according to the World Health Organization definition. The predictive ability for adverse outcomes was assessed using the age- and sex-adjusted Cox proportional hazards model. RESULTS A decline in intrinsic capacity domains was observed in 729 (42.9 %) participants. Declines in the mobility, cognition, vitality, sensory and psychology domains were observed in 21.8 %, 15.1 %, 11.4 %, 9.10 %, and 14.2 % of the participants, respectively. Low intrinsic capacity was associated with worse physical performance, frailty, social frailty, chronic diseases, fracture, and falls. A greater decline in intrinsic capacity predicted an elevated 8-year mortality rate (decline in overall intrinsic capacity hazard ratio 2.91, 95 % confidence interval 2.44-3.47, P < 0.001; decline in one domain hazard ratio 2.11, 95 % confidence interval 1.71-2.61, P < 0.001; decline in two domains hazard ratio 3.54, 95 % confidence interval 2.81-4.45, P < 0.001; decline in three or more domains hazard ratio 5.30, 95 % confidence interval 4.09-6.87, P < 0.001); adjusted models did not affect prediction performance. Among the five domains of intrinsic capacity, cognition was the strongest predictor of mortality (hazard ratio 3.17, 95 % confidence interval 2.63-3.81, P < 0.001). CONCLUSIONS Intrinsic capacity is useful in identifying older adults at higher risk of adverse outcomes, presenting significant implications for healthcare policies in China.
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Affiliation(s)
- Yiming Pan
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Xiaxia Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Li Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Yun Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing Institute of Geriatrics, Beijing 100053, China.
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China.
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Demoniere F, Abdelli R, Rivard L. Could the Early Detection of Atrial Fibrillation Reduce the Risk of Developing Dementia? Biomedicines 2024; 12:1931. [PMID: 39200396 PMCID: PMC11351480 DOI: 10.3390/biomedicines12081931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/01/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024] Open
Abstract
Atrial fibrillation (AF) and dementia are major global public health issues and share common risk factors, especially after the age of 65 and regardless of the presence of stroke. Despite accounting for potential confounders, AF appears to be an independent risk factor for cognitive decline and dementia. The mechanisms are likely to be multifactorial and may include AF-related ischemic stroke, cerebral hypoperfusion, microbleeds, systemic inflammation, genetic factors, and small vessel disease, leading to brain atrophy and white matter damage. The early aggressive management of AF and comorbidities may reduce the risk of dementia. Indeed, the early detection of AF-related cognitive impairment should allow for the early implementation of measures to prevent the development of dementia, mainly through integrative approaches involving the correction of risk factors and maintenance of rhythm control. Well-designed prospective studies are needed to determine whether early detection and AF treatment can prevent dementia and identify whether optimal integrative measures are effective in preventing cognitive impairment and dementia.
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Affiliation(s)
| | | | - Léna Rivard
- Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, QC H1T 1C8, Canada
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Castellote-Caballero Y, Carcelén Fraile MDC, Aibar-Almazán A, Afanador-Restrepo DF, González-Martín AM. Effect of combined physical-cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial. BMC Med 2024; 22:281. [PMID: 38972988 PMCID: PMC11229192 DOI: 10.1186/s12916-024-03469-x] [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: 03/18/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment. METHODS A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test. RESULTS The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group. CONCLUSION A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults. TRIAL REGISTRATION NCT05503641.
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Affiliation(s)
- Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | - María Del Carmen Carcelén Fraile
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain.
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | | | - Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
- Department of Psychology, Centro de Educación Superior de Enseñanza e Investigación Educativa, Plaza de San Martín, 4, Madrid, 28013, Spain
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Hu Z, Tang L, Zhan Y. Cognition as mediator of pulmonary function and risk of sarcopenia among older adults. BMC Public Health 2024; 24:1347. [PMID: 38762539 PMCID: PMC11102626 DOI: 10.1186/s12889-024-18848-5] [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: 03/21/2024] [Accepted: 05/14/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND The relationship between lung function and sarcopenia remains ambiguous. The primary aim of this study was to investigate the potential association between lung function and sarcopenia in the older adults, as well as to examine the mediating role of cognitive function in this relationship. METHODS The participants were selected from a nationally representative population-based cohort in China. The peak expiratory flow (PEF) measurement was used to evaluate the lung function in older persons. The sarcopenia was diagnosed using the guidelines of the Asian Working Group for Sarcopenia (AWGS) in 2019. The Cox proportional hazard model was utilized to perform primary analyses of the relationship between PEF and sarcopenia. The mediating effect of cognitive function was evaluated using the counterfactual mediation method. RESULTS This cohort study included 4,011 older adults (average age, 66.6 years; 53.3% males). During a follow-up period of 3.86 years, 349 individuals were diagnosed with sarcopenia. After adjusting for potential confounders, each one-standard-deviation increase in PEF was associated with a 28% reduction in the risk of sarcopenia (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.63, 0.80). There was a significant mediation of cognition for the association between PEF and incident sarcopenia, and the proportion mediated was 12.2% (95% CI: 4.5%, 23.1%). CONCLUSIONS Older adults with impaired lung function are more likely to develop sarcopenia. Nevertheless, cognition can explain only a small portion of this association. Thus, other potential pathways between lung function and sarcopenia must be elucidated.
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Affiliation(s)
- Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
| | - Lu Tang
- The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Baek JE, Hyeon SJ, Kim M, Cho HY, Hahm SC. Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial. BMC Geriatr 2024; 24:369. [PMID: 38658827 PMCID: PMC11044356 DOI: 10.1186/s12877-024-04942-1] [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: 08/17/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment. METHODS A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively. RESULTS There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise. CONCLUSIONS Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment. TRIAL REGISTRATION This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).
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Affiliation(s)
- Ji-Eun Baek
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon
| | - Sang-Jun Hyeon
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea
| | - May Kim
- Department of Physical Education, College of Education, Korea University, Seoul, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon.
| | - Suk-Chan Hahm
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea.
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Jiang Y, Ramasawmy P, Antal A. Uncorking the limitation-improving dual tasking using transcranial electrical stimulation and task training in the elderly: a systematic review. Front Aging Neurosci 2024; 16:1267307. [PMID: 38650865 PMCID: PMC11033383 DOI: 10.3389/fnagi.2024.1267307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction With aging, dual task (DT) ability declines and is more cognitively demanding than single tasks. Rapidly declining DT performance is regarded as a predictor of neurodegenerative disease. Task training and non-invasive transcranial electrical stimulation (tES) are methods applied to optimize the DT ability of the elderly. Methods A systematic search was carried out in the PUBMED, TDCS (transcranial direct current stimulation) databases, as well as Web of Science, and a qualitative analysis was conducted in 56 included studies. Aiming to summarize the results of studies that implemented tES, task training, or the combination for improving DT ability and related performance changes in healthy elderly and geriatric patients. For different approaches, the training procedures, parameters, as well as outcomes were discussed. Results Task training, particularly cognitive-motor DT training, has more notable effects on improving DT performance in the elderly when compared to the neuromodulation method. Discussion Anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (L-DLPFC), or its combination with task training could be promising tools. However, additional evidence is required from aged healthy people and patients, as well as further exploration of electrode montage.
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Affiliation(s)
- Yong Jiang
- Department of Neurology, University Medical Center, Georg August University of Göttingen, Göttingen, Germany
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Béraud-Peigné N, Maillot P, Perrot A. The effects of a new immersive multidomain training on cognitive, dual-task and physical functions in older adults. GeroScience 2024; 46:1825-1841. [PMID: 37743415 PMCID: PMC10828343 DOI: 10.1007/s11357-023-00952-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023] Open
Abstract
The aim of this study was to assess the potential of multidomain training using Immersive and Interactive Wall Exergames (I2WE) to improve the cognitive and physical functions of older adults. This new generation of exergames offers specific advantageous characteristics (e.g., immersion, virtual cognitive solicitation, high physical stimulation, complex motor skills, multiple social interactions) that could make I2WE an enjoyable multidomain training medium for older adults. A pilot study was set up with 34 participants (M = 69.91 years old). It used the pre-tests - training (3 months, 2 one-hour sessions per week for the 2 groups) - post-tests method to compare: a) the cognitive and the Dual-Task (DT) effects (primary outcomes), b) the physical effects and perceived pleasure (secondary outcomes) between an experimental group following an I2WE program (n = 19) to an active control group performing a Walking and Muscle-Strengthening (WMS) program (n = 15). While visuospatial short-term memory was improved for both groups, only I2WE training enhanced visuospatial working memory, inhibition, and DT. All physical functions, except upper body strength, were enhanced for the 2 groups. The perceived pleasure was higher for the I2WE group than the WMS group. The results of this first study have important clinical implications, showing that I2WE can optimize strategies to improve older adults' physical and cognitive health. Virtual and immersive cognitive stimulation combined with varied physical activity (i.e., aerobic, muscle-strengthening, complex motor skills) appear to be major assets of these new exergames. Moreover, the high level of perceived pleasure to I2WE makes it a promising tool for engaging older adults in sustained multidomain practice.
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Affiliation(s)
- Néva Béraud-Peigné
- CIAMS, Université Paris Saclay, Orsay, France.
- CIAMS, Université Paris Saclay, Orléans, France.
- I3SP, Université Paris-Cité, Paris, France.
| | | | - Alexandra Perrot
- CIAMS, Université Paris Saclay, Orsay, France
- CIAMS, Université Paris Saclay, Orléans, France
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Utne I, Stokke K, Ritchie C, Løyland B, Grov EK, Rasmussen HL, Lindemann K, Paul SM, Torstveit AH, Miaskowski C. Changes in Subjective Measures of Cognitive Function in Older Adults From the Initiation Through 12 Months After the Receipt of Chemotherapy. Cancer Nurs 2023; 46:E365-E374. [PMID: 35781267 DOI: 10.1097/ncc.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment has a negative impact on older patients with cancer. OBJECTIVES The aim of this study was to evaluate for interindividual differences in 2 subjective measures of cognitive function in older patients (n = 112), as well as determine which demographic, clinical, and symptom characteristics, and levels of physical function, were associated with initial levels and with the trajectory of each of these 2 measures. METHODS Cognitive function was assessed using the cognitive function scale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Attentional Function Index at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess for interindividual differences in and characteristics associated with initial levels and changes in cognitive function. RESULTS Characteristics associated with decreases in Quality of Life Questionnaire Core 30 scores at the initiation of chemotherapy were longer time since the cancer diagnosis and higher depression scores. Characteristics associated with poorer Attentional Function Index scores at enrollment were lower levels of education and higher depression scores. No characteristics were associated with worse trajectories of either cognitive function measure. CONCLUSION Some older patients undergoing chemotherapy experience decrements in cognitive function. IMPLICATIONS FOR PRACTICE Our findings suggest that clinicians need to assess for depressive symptoms in older patients before the initiation of chemotherapy. Evidence-based interventions (eg, cognitive stimulation, increased physical activity) can be recommended to maintain and increase cognitive function in older oncology patients.
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Affiliation(s)
- Inger Utne
- Author Affiliations: Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University (Drs Utne, Løyland, and Grov, and Mss Rasmussen and Torstveit), Norway; Division of Cancer Medicine, Oslo University Hospital (Ms Stokke), Norway; Division of Palliative Care and Geriatric Medicine, Mongan Institute, Center for Aging and Serious Illness, Massachusetts General Hospital (Dr Ritchie), Boston; Department of Gynecological Oncology, Oslo University Hospital (Dr Lindemann), Norway; and School of Nursing, University of California, San Francisco (Drs Paul and Miaskowski)
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Downey R, Gagné N, Mohanathas N, Campos JL, Pichora-Fuller KM, Bherer L, Lussier M, Phillips NA, Wittich W, St-Onge N, Gagné JP, Li K. At-home computerized executive-function training to improve cognition and mobility in normal-hearing adults and older hearing aid users: a multi-centre, single-blinded randomized controlled trial. BMC Neurol 2023; 23:378. [PMID: 37864139 PMCID: PMC10588173 DOI: 10.1186/s12883-023-03405-1] [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: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults. METHODS A multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45-60 years old) and older adults (65-80 years old), as well as older hearing aid users (65-80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE's StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia's PERFORM Centre. DISCUSSION This research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss. TRIAL REGISTRATION Identifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
- PERFORM Centre, Concordia University, Montréal, Québec, Canada.
| | - Nathan Gagné
- Department of Psychology, Concordia University, Montréal, Québec, Canada
| | - Niroshica Mohanathas
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jennifer L Campos
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | | - Louis Bherer
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Nancy St-Onge
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jean-Pierre Gagné
- École d'orthophonie Et d'audiologie, Université de Montréal, Montréal, Québec, Canada
| | - Karen Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
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Montero-Odasso M, Zou G, Speechley M, Almeida QJ, Liu-Ambrose T, Middleton LE, Camicioli R, Bray NW, Li KZH, Fraser S, Pieruccini-Faria F, Berryman N, Lussier M, Shoemaker JK, Son S, Bherer L. Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2324465. [PMID: 37471089 DOI: 10.1001/jamanetworkopen.2023.24465] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Importance Exercise, cognitive training, and vitamin D may enhance cognition in older adults with mild cognitive impairment (MCI). Objective To determine whether aerobic-resistance exercises would improve cognition relative to an active control and if a multidomain intervention including exercises, computerized cognitive training, and vitamin D supplementation would show greater improvements than exercise alone. Design, Setting, and Participants This randomized clinical trial (the SYNERGIC Study) was a multisite, double-masked, fractional factorial trial that evaluated the effects of aerobic-resistance exercise, computerized cognitive training, and vitamin D on cognition. Eligible participants were between ages 65 and 84 years with MCI enrolled from September 19, 2016, to April 7, 2020. Data were analyzed from February 2021 to December 2022. Interventions Participants were randomized to 5 study arms and treated for 20 weeks: arm 1 (multidomain intervention with exercise, cognitive training, and vitamin D), arm 2 (exercise, cognitive training, and placebo vitamin D), arm 3 (exercise, sham cognitive training, and vitamin D), arm 4 (exercise, sham cognitive training, and placebo vitamin D), and arm 5 (control group with balance-toning exercise, sham cognitive training, and placebo vitamin D). The vitamin D regimen was a 10 000 IU dose 3 times weekly. Main Outcomes and Measures Primary outcomes were changes in ADAS-Cog-13 and Plus variant at 6 months. Results Among 175 randomized participants (mean [SD] age, 73.1 [6.6] years; 86 [49.1%] women), 144 (82%) completed the intervention and 133 (76%) completed the follow-up (month 12). At 6 months, all active arms (ie, arms 1 through 4) with aerobic-resistance exercise regardless of the addition of cognitive training or vitamin D, improved ADAS-Cog-13 when compared with control (mean difference, -1.79 points; 95% CI, -3.27 to -0.31 points; P = .02; d = 0.64). Compared with exercise alone (arms 3 and 4), exercise and cognitive training (arms 1 and 2) improved the ADAS-Cog-13 (mean difference, -1.45 points; 95% CI, -2.70 to -0.21 points; P = .02; d = 0.39). No significant improvement was found with vitamin D. Finally, the multidomain intervention (arm 1) improved the ADAS-Cog-13 score significantly compared with control (mean difference, -2.64 points; 95% CI, -4.42 to -0.80 points; P = .005; d = 0.71). Changes in ADAS-Cog-Plus were not significant. Conclusions and Relevance In this clinical trial, older adults with MCI receiving aerobic-resistance exercises with sequential computerized cognitive training significantly improved cognition, although some results were inconsistent. Vitamin D supplementation had no effect. Our findings suggest that this multidomain intervention may improve cognition and potentially delay dementia onset in MCI. Trial Registration ClinicalTrials.gov Identifier: NCT02808676.
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Affiliation(s)
- Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medicine, Division of Geriatric, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Guangyong Zou
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Mark Speechley
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Quincy J Almeida
- Carespace Health & Wellness, Waterloo, Ontario, Canada
- Movement Disorders Research & Rehabilitation Centre, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Nick W Bray
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Karen Z H Li
- PERFORM Centre and Department of Psychology, Concordia University, Montréal, Quebec, Canada
| | - Sarah Fraser
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | | | - Nicolas Berryman
- Département des sciences de l'activité physique Université du Québec à Montréal, Montréal, Quebec, Canada
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
| | - Maxime Lussier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Integrated Health and Social Services University Network for South-Central Montreal, Montreal, Quebec, Canada
| | - J Kevin Shoemaker
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Surim Son
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Louis Bherer
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Research Centre, Montreal Heart Institute, and Department of Medicine, University of Montréal, Montréal, Quebec, Canada
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11
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Phillips CB, McVey A, Tian J, Stephan AT, Davis WB, Aflagah EL, Ross LA. Feasibility of a pilot dyadic randomized controlled trial testing the effects of three behavioral interventions on older adults' cognitive, physical and everyday function. FRONTIERS IN AGING 2023; 4:1166338. [PMID: 37305226 PMCID: PMC10248235 DOI: 10.3389/fragi.2023.1166338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023]
Abstract
Introduction: Maintaining functional abilities is critical for optimizing older adults' well-being and independence. This randomized controlled trial (RCT) pilot examined the feasibility of testing the effects of three commercially available interventions on function-related outcomes in older adults. Methods: Pairs of community-dwelling older adults (N=55, Mage=71.4) were randomized to a 10-week intervention (cognitive-COG, physical-EX, combined exergame-EXCOG, or control-CON). Cognitive, physical, and everyday function were assessed at baseline, immediately post-intervention, and 6-months post-intervention. Feasibility was evaluated using recruitment, enrollment, training adherence, and retention metrics. Variability and patterns of change in functional outcomes were examined descriptively. Results: A total of 208 individuals were screened, with 26% subsequently randomized. Across training arms, 95% of training sessions were completed and 89% of participants were retained at immediate post-test. Variability in functional outcomes and patterns of change differed across study arms. Discussion: Results support a fully powered RCT, with several modifications to the pilot study design, to investigate short- and long-term training impacts.
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Affiliation(s)
- Christine B. Phillips
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - Ava McVey
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - Junyan Tian
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, United States
| | - Abigail T. Stephan
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - W. Bennett Davis
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Erica L. Aflagah
- Department of Neurology, Neuropsychology Division, University of Nebraska Medical Center, Omaha, NE, United States
| | - Lesley A. Ross
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
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12
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Liao X, Shen J, Li M. Effects of multi-domain intervention on intrinsic capacity in older adults: A systematic review of randomized controlled trials (RCTs). Exp Gerontol 2023; 174:112112. [PMID: 36736466 DOI: 10.1016/j.exger.2023.112112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Intrinsic capacity is central to the maintenance of function in older adults, and maintaining optimal intrinsic capacity is of great importance to promote healthy aging. The purpose of this systematic review and meta-analysis was to analyze the impact of multi-domain interventions on intrinsic capacity in older adults, intervention components, and potential interactions between components. A total of 6740 published articles were screened until August 2022, and the review included 25 randomized controlled trials that analyzed populations, interventions, control groups, and outcomes. The meta-analysis showed improvements in the primary outcome indicators in the intervention group compared to the control group. These included increased scores on the Mini-Mental State Examination as an indicator of cognitive function, decreased scores on the Geriatric Depression Scale (GDS-15) as an indicator of psychological ability and increased scores on the Short Physical Performance Battery (SPPB) as an indicator of physical performance, with only the SPPB indicator analyzed showing greater heterogeneity. Significant improvements were also seen in the secondary indicators Time-to-Walk Test (TUG), gait speed, Chair Stand Test (CST), grip strength values and BMI. There was insufficient data for the Mini Nutritional Assessment (MNA) as an indicator of vitality to conduct a meta-analysis. Studies were of moderate to high quality. The results of this review indicate that multi-domain interventions can maintain the level of intrinsic capacity in older adults and are equally effective in older adults with declining self-care abilities.
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Affiliation(s)
- Xiaoyan Liao
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
| | - Jun Shen
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China.
| | - Miao Li
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
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13
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Perrot A, Maillot P. Factors for optimizing intervention programs for cognition in older adults: the value of exergames. NPJ AGING 2023; 9:4. [PMID: 36991073 DOI: 10.1038/s41514-023-00103-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
AbstractThis review presents factors that could optimize the effectiveness of an intervention program on cognitive health in older adults. Combined, multi-dimensional and interactive programs appear to be relevant. On one hand, for the characteristics to be implemented in the physical dimension of a program, multimodal interventions stimulating the aerobic pathway and muscle strengthening during the solicitation of gross motor activities, seem to be interesting. On the other hand, regarding the cognitive dimension of a program, complex and variable cognitive stimuli appear to hold the greatest promise for generating cognitive benefits and the broadest transfers to untrained tasks. The field of video games also brings interesting enrichment through the gamification of situations and the feeling of immersion. However, some gray areas remain to be clarified, notably the ideal response dose, the balance between physical and cognitive solicitation and the programs’ customization.
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14
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Xiao Y, Yang T, Shang H. The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease. Brain Sci 2023; 13:brainsci13030437. [PMID: 36979247 PMCID: PMC10046387 DOI: 10.3390/brainsci13030437] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
Rehabilitation is a high-potential approach to improving physical and cognitive functions in Parkinson’s disease (PD). Dual-task training innovatively combines motor and cognitive rehabilitation in a comprehensive module. Patients perform motor and cognitive tasks at the same time in dual-task training. The previous studies of dual-task training in PD had high heterogeneity and achieved controversial results. In the current review, we aim to summarize the current evidence of the effect of dual-task training on motor and cognitive functions in PD patients to support the clinical practice of dual-task training. In addition, we also discuss the current opinions regarding the mechanism underlying the interaction between motor and cognitive training. In conclusion, dual-task training is suitable for PD patients with varied disease duration to improve their motor function. Dual-task training can improve motor symptoms, single-task gait speed, single-task steep length, balance, and objective experience of freezing of gait in PD. The improvement in cognitive function after dual-task training is mild.
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15
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Gallou-Guyot M, Mandigout S, Marie R, Robin L, Daviet JC, Perrochon A. Feasibility and potential cognitive impact of a cognitive-motor dual-task training program using a custom exergame in older adults: A pilot study. Front Aging Neurosci 2023; 15:1046676. [PMID: 36819724 PMCID: PMC9932982 DOI: 10.3389/fnagi.2023.1046676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Dual-task training may be relevant and efficient in the context of active aging. An issue in training programs lies in enhancing the adherence of participants. This can potentially be improved using games as support. We designed and developed a custom interactive exergame in this way. The objective of this pilot study was to explore the potential use of this exergame and the feasibility of our intervention, including the level of safety and adherence. The result's trends on cognitive and motor capacities, as well as on the level of motivation for physical activity, fear of falling, and quality of life of participants, were also explored. Methods Older adults aged 65 years or older were recruited and realized 30 min of supervised training in groups of 4, 2-3 times a week for 12 weeks. Exercises consisted of incorporated cognitive and motor dual tasks, with an increased difficulty over the weeks. Our program's safety, engagement, attendance, and completion levels were evaluated. Participants' postural control in single-task and dual-task conditions, as well as their performances in mental inhibition, flexibility, working memory, mobility, and postural control, and their levels of motivation for physical activity, fear of falling, and quality of life were also assessed. We realized a per protocol statistical analysis with a p-value set at 0.05. Results Thirty-nine participants (aged 84.6 ± 8.5 years) were recruited. No adverse events, and 89% adherence, 88% attendance, and 87% completion rates were observed. A potentially significant effect of our exergame on working memory in single-task conditions and on the cognitive aspect of dual-task conditions was also observed. We observed no differences in other parameters. Discussion Our exergame seemed feasible and safe and was enjoyed by participants, mainly due to the gamification of our training program. Moreover, our exergame may be efficient for cognitive training in older adults, as well as for the maintenance of motor functions, motivation for physical activity, fear of falling, and quality of life levels. This constitutes the first step for our solution with interesting results that need to be further studied.
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Affiliation(s)
- Matthieu Gallou-Guyot
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,*Correspondence: Matthieu Gallou-Guyot,
| | | | - Romain Marie
- Institut d’Ingénierie Informatique de Limoges, Limoges, France,3iL Ingénieurs, Limoges, France
| | - Louise Robin
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec City, QC, Canada
| | - Jean-Christophe Daviet
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Pôle Neurosciences Tête et Cou, Service de Médecine Physique et de Réadaptation, Hôpital Jean Rebeyrol, CHU Limoges, Limoges, France
| | - Anaick Perrochon
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France
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16
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Downey R, Bherer L, Pothier K, Vrinceanu T, Intzandt B, Berryman N, Lussier M, Vincent T, Karelis AD, Nigam A, Vu TTM, Bosquet L, Li KZH. Multiple routes to help you roam: A comparison of training interventions to improve cognitive-motor dual-tasking in healthy older adults. Front Aging Neurosci 2022; 14:710958. [PMID: 36408116 PMCID: PMC9670126 DOI: 10.3389/fnagi.2022.710958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Cognitive-motor dual-tasking is a complex activity that predicts falls risk and cognitive impairment in older adults. Cognitive and physical training can both lead to improvements in dual-tasking; however, less is known about what mechanisms underlie these changes. To investigate this, 33 healthy older adults were randomized to one of three training arms: Executive function (EF; n = 10), Aerobic Exercise (AE; n = 10), Gross Motor Abilities (GMA; n = 13) over 12 weeks (1 h, 3×/week). Single and dual-task performance (gait speed, m/s; cognitive accuracy, %) was evaluated before and after training, using the 2-back as concurrent cognitive load. Training arms were designed to improve cognitive and motor functioning, through different mechanisms (i.e., executive functioning – EF, cardiorespiratory fitness – CRF, and energy cost of walking – ECW). Compared to baseline, we observed few changes in dual-task gait speed following training (small effect). However, dual-task cognitive accuracy improved significantly, becoming facilitated by walking (large effect). There were no differences in the magnitude of improvements across training arms. We also found that older adults with lower cognitive ability (i.e., MoCA score < 26; n = 14) improved more on the dual-task cognitive accuracy following training, compared to older adults with higher cognitive ability (i.e., MoCA ≥26; n = 18). Taken together, the results suggest that regardless of the type of intervention, training appears to strengthen cognitive efficiency during dual-tasking, particularly for older adults with lower baseline cognitive status. These gains appear to occur via different mechanisms depending on the form of intervention. Implications of this research are paramount, as we demonstrate multiple routes for improving cognitive-motor dual-tasking in older adults, which may help reduce risk of cognitive impairment.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- *Correspondence: Rachel Downey, ; Karen Z. H. Li
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Kristell Pothier
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
- Psychologie des Ages de la Vie et Adaptation, University of Tours, Tours, France
| | - Tudor Vrinceanu
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Brittany Intzandt
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Nicolas Berryman
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Thomas Vincent
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Antony D. Karelis
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
| | | | - Laurent Bosquet
- Faculté des sciences du sport, Université de Poitiers, Poitiers, France
| | - Karen Z. H. Li
- Department of Psychology, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- *Correspondence: Rachel Downey, ; Karen Z. H. Li
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17
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Keawtep P, Wichayanrat W, Boripuntakul S, Chattipakorn SC, Sungkarat S. Cognitive Benefits of Physical Exercise, Physical-Cognitive Training, and Technology-Based Intervention in Obese Individuals with and without Postmenopausal Condition: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013364. [PMID: 36293943 PMCID: PMC9603710 DOI: 10.3390/ijerph192013364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 06/14/2023]
Abstract
Obesity and estrogen deprivation have been identified as significant risk factors for cognitive impairment. Thus, postmenopausal conditions when paired with obesity may amplify the risks of developing dementia. Physical exercise has been recommended as a primary treatment for preventing obesity-related comorbidities and alleviating menopausal symptoms. This narrative review aimed to summarize the effects of exercise on cognition in obese individuals with and without menopausal condition, along with potential physiological mechanisms linking these interventions to cognitive improvement. Research evidence has demonstrated that exercise benefits not only physical but also cognitive and brain health. Among various types of exercise, recent studies have suggested that combined physical-cognitive exercise may exert larger gains in cognitive benefits than physical or cognitive exercise alone. Despite the scarcity of studies investigating the effects of physical and combined physical-cognitive exercise in obese individuals, especially those with menopausal condition, existing evidence has shown promising findings. Applying these exercises through technology-based interventions may be a viable approach to increase accessibility and adherence to the intervention. More evidence from randomized clinical trials with large samples and rigorous methodology is required. Further, investigations of biochemical and physiological outcomes along with behavioral changes will provide insight into underlying mechanisms linking these interventions to cognitive improvement.
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Affiliation(s)
- Puntarik Keawtep
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wanachaporn Wichayanrat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sirinun Boripuntakul
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siriporn C. Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai 50200, Thailand
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18
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Vrinceanu T, Blanchette CA, Intzandt B, Lussier M, Pothier K, Vu TTM, Nigam A, Bosquet L, Karelis AD, Li KZH, Berryman N, Bherer L. A Comparison of the Effect of Physical Activity and Cognitive Training on Dual-Task Performance in Older Adults. J Gerontol B Psychol Sci Soc Sci 2022; 77:1069-1079. [PMID: 34865009 PMCID: PMC9159062 DOI: 10.1093/geronb/gbab216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Studies suggest that cognitive training and physical activity can improve age-related deficits in dual-task performances. However, both of these interventions have never been compared in the same study. This article investigates the improvement in dual-task performance in 2 types of exercise training groups and a cognitive training group and explores if there are specific dual-task components that are more sensitive or more likely to improve following each type of training. METHODS Seventy-eight healthy inactive participants older than the age of 60 (M = 69.98, SD = 5.56) were randomized to one of three 12-week training programs: aerobic training (AET) = 26, gross motor abilities (GMA) = 27, and cognition (COG) = 25. Before and after the training program, the participants underwent physical fitness tests, and cognitive evaluations involving a computerized cognitive dual task. The AET consisted of high- and low-intensity aerobic training, the GMA of full-body exercises focusing on agility, balance, coordination, and stretching, and the COG of tablet-based exercises focusing on executive functions. RESULTS Repeated-measures analysis of variance on reaction time data revealed a group × time interaction (F(2,75) = 11.91, p < .01) with COG having the greatest improvement, followed by a significant improvement in the GMA group. Secondary analysis revealed the COG to also improve the intraindividual variability in reaction time (F(1,24) = 8.62, p < .01), while the GMA improved the dual-task cost (F(1,26) = 12.74, p < .01). DISCUSSION The results show that physical and cognitive training can help enhance dual-task performance by improving different aspects of the task, suggesting that different mechanisms are in play.
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Affiliation(s)
- Tudor Vrinceanu
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada
- Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Caroll-Ann Blanchette
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada
- Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Brittany Intzandt
- Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
- School of Graduate Studies, Concordia University, Montreal, Quebec, Canada
| | - Maxime Lussier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Rehabilitation Science, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada
| | - Kristell Pothier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- EA 2114, Psychologie des Âges de la Vie et Adaptation, University of Tours, Tours, France
| | - Thien Tuong Minh Vu
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada
- Research Centre, Centre hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Anil Nigam
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada
- Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Laurent Bosquet
- Laboratoire MOVE (EA6314), Université de Poitiers, Faculté des sciences du sport, Poitiers, France
- Ecole de kinésiologie et des sciences de l’activité physique, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Antony D Karelis
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Département des Sciences de l’Activité Physique, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Karen Z H Li
- PERFORM Centre, Concordia University, Montréal, Quebec, Canada
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Département des Sciences de l’Activité Physique, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Louis Bherer
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada
- Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
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19
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van Balkom TD, Berendse HW, van der Werf YD, Twisk JWR, Peeters CFW, Hoogendoorn AW, Hagen RH, Berk T, van den Heuvel OA, Vriend C. Effect of eight-week online cognitive training in Parkinson's disease: A double-blind, randomized, controlled trial. Parkinsonism Relat Disord 2022; 96:80-87. [PMID: 35248830 DOI: 10.1016/j.parkreldis.2022.02.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Cognitive training (CT) has been proposed as a treatment option for cognitive impairment in Parkinson's disease (PD). We aimed to assess the efficacy of adaptive, computerized CT on cognitive function in PD. METHODS In this double-blind, randomized controlled trial we enrolled PD patients that experienced substantial subjective cognitive complaints. Over a period of eight weeks, participants underwent 24 sessions of computerized multi-domain CT or an active control intervention for 45 min each (randomized 1:1). The primary outcome was the accuracy on the Tower of London task; secondary outcomes included effects on other neuropsychological outcomes and subjective cognitive complaints. Outcomes were assessed before and after training and at six-months follow-up, and analyzed with multivariate mixed-model analyses. RESULTS The intention-to-treat population consisted of 136 participants (n = 68 vs. n = 68, age M: 62.9y, female: 39.7%). Multivariate mixed-model analyses showed no group difference on the Tower of London accuracy corrected for baseline performance (n = 130): B: -0.06, 95% CI: -0.27 to 0.15, p = 0.562. Participants in the CT group were on average 0.30 SD (i.e., 1.5 s) faster on difficulty load 4 of this task (secondary outcome): 95% CI: -0.55 to -0.06, p = 0.015. CT did not reduce subjective cognitive complaints. At follow-up, no group differences were found. CONCLUSIONS This study shows no beneficial effect of eight-week computerized CT on the primary outcome (i.e., planning accuracy) and only minor improvements on secondary outcomes (i.e., processing speed) with limited clinical impact. Personalized or ecologically valid multi-modal intervention methods could be considered to achieve clinically meaningful and lasting effects.
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Affiliation(s)
- Tim D van Balkom
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands.
| | - Henk W Berendse
- Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands.
| | - Ysbrand D van der Werf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands.
| | - Jos W R Twisk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Biostatistics, Amsterdam Public Health, PO Box 7057, Amsterdam, Netherlands.
| | - Carel F W Peeters
- Wageningen University & Research, Mathematical & Statistical Methods Group (Biometris), PO Box 16, 6700AA, Wageningen, Netherlands.
| | | | - Rob H Hagen
- Dutch Parkinson's Disease Association, PO Box 46, 3980, CA, Bunnik, Netherlands.
| | - Tanja Berk
- Dutch Parkinson's Disease Association, PO Box 46, 3980, CA, Bunnik, Netherlands.
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands.
| | - Chris Vriend
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, PO Box 7057, Amsterdam, Netherlands.
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20
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Besnier F, Dupuy EG, Gagnon C, Vincent T, Grégoire CA, Blanchette CA, Saillant K, Bouabdallaoui N, Grau JI, Bérubé B, Olmand M, Marin MF, Belleville S, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. Investigation of the Effects of Home-Based Exercise and Cognitive Training on Cognitive and Physical Functions in Cardiac Patients: The COVEPICARDIO Study Protocol of a Randomized Clinical Trial. Front Cardiovasc Med 2021; 8:740834. [PMID: 34938780 PMCID: PMC8685268 DOI: 10.3389/fcvm.2021.740834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction: During the COVID-19 pandemic, confinement measures are likely to produce collateral damage to health (stress, confusion, anxiety), especially in frail individuals and those living with cardiovascular disease (CVD). In cardiac patients in particular, these measures dramatically increase the level of physical inactivity and sedentary lifestyle, which can decrease cardiorespiratory capacity and increase the risk of acute events, rehospitalization, and depressive syndromes. Maintaining a minimum level of physical activity and cognitive stimulation during the COVID-19 crisis is essential for cardiac patients. This study is designed to document the effects of 6 months of home-based physical exercise alone or combined with cognitive training on cognitive and physical functions in patients with CVD over 50 years old. Methods and Analysis: 122 patients (>50 years old) with stable CVD and no contraindication to perform physical exercise training will be recruited and randomly assigned to one of the 2 following arms: (1) Home-based physical exercise alone, (2) Home-based physical exercise combined with cognitive training. The intervention lasts 6 months, with remote assessments performed prior to, mid and post-training. A follow-up 6 months after the end of the intervention (12 month) is also proposed. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as performances on measures of executive functions, processing speed, and episodic memory. The secondary outcome is physical performance, including balance, gait and mobility, leg muscle strength and estimated cardiorespiratory fitness. Tertiary outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported online questionnaires. Discussion: With the COVID-19 crisis, there is a critical need for remote exercise and cognitive training, and to further investigate this topic, in particular for cardiac patients. The present context can be viewed as an opportunity to perform a major shift from center-based programs to home-based physical exercise. This is especially important to reach out to older adults living in remote areas, where access to such interventions is limited. ClinicalTrials.gov: [https://clinicaltrials.gov/ct2/show/NCT04661189], NCT04661189.
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Affiliation(s)
- Florent Besnier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Emma Gabrielle Dupuy
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Christine Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada
| | - Thomas Vincent
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada
| | | | - Caroll-Ann Blanchette
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Kathia Saillant
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Nadia Bouabdallaoui
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Josep Iglésies Grau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Béatrice Bérubé
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Miloudza Olmand
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Marie-France Marin
- Department of Psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Research Center of the Montreal Mental Health University Institute, Montréal, QC, Canada
| | - Sylvie Belleville
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Martin Juneau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Paolo Vitali
- McGill University Research Centre for Studies on Aging, Montréal, QC, Canada.,McGill University Department of Neurology and Neurosurgery, Faculty of Medicine, Montréal, QC, Canada
| | - Mathieu Gayda
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Louis Bherer
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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21
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Dupuy EG, Besnier F, Gagnon C, Vincent T, Grégoire CA, Blanchette CA, Saillant K, Bouabdallaoui N, Iglesies-Grau J, Payer M, Marin MF, Belleville S, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial. Trials 2021; 22:505. [PMID: 34325710 PMCID: PMC8319877 DOI: 10.1186/s13063-021-05476-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults' cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older. METHODS One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews' questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey). DISCUSSION This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited. TRIAL REGISTRATION Clinical trial Identifier NCT04635462 . COVEPIC was retrospectively registered on November 19, 2020.
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Affiliation(s)
- Emma Gabrielle Dupuy
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada.
| | - Florent Besnier
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Christine Gagnon
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Thomas Vincent
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Catherine-Alexandra Grégoire
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Caroll-Ann Blanchette
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Kathia Saillant
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada
| | - Nadia Bouabdallaoui
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Josep Iglesies-Grau
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Marie Payer
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, H3W 1 W5, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, H3W 1 W5, Canada
| | - Sylvie Belleville
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, H2V 2S9, Canada
| | - Martin Juneau
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Paolo Vitali
- CIUSSS Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Mathieu Gayda
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Anil Nigam
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Louis Bherer
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada.
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada.
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de Souto Barreto P, Pothier K, Soriano G, Lussier M, Bherer L, Guyonnet S, Piau A, Ousset PJ, Vellas B. A Web-Based Multidomain Lifestyle Intervention for Older Adults: The eMIND Randomized Controlled Trial. J Prev Alzheimers Dis 2021; 8:142-150. [PMID: 33569560 PMCID: PMC7754697 DOI: 10.14283/jpad.2020.70] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Importance/Objective: To describe the feasibility and acceptability of a 6-month web-based multidomain lifestyle training intervention for community-dwelling older people and to test the effects of the intervention on both function- and lifestyle-related outcomes. DESIGN 6-month, parallel-group, randomized controlled trial (RCT). SETTING Toulouse area, South-West, France. PARTICIPANTS Community-dwelling men and women, ≥ 65 years-old, presenting subjective memory complaint, without dementia. INTERVENTION The web-based multidomain intervention group (MIG) received a tablet to access the multidomain platform and a wrist-worn accelerometer measuring step counts; the control group (CG) received only the wrist-worn accelerometer. The multidomain platform was composed of nutritional advices, personalized exercise training, and cognitive training. Main outcomes and measures: Feasibility, defined as the proportion of people connecting to ≥75% of the prescribed sessions, and acceptability, investigated through content analysis from recorded semi-structured interviews. Secondary outcomes included clinical (eg, cognitive function, mobility, health-related quality of life (HRQOL)) and lifestyle (eg, step count, food intake) measurements. RESULTS Among the 120 subjects (74.2 ±5.6 years-old; 57.5% women), 109 completed the study (n=54, MIG; n=55, CG). 58 MIG subjects connected to the multidomain platform at least once; among them, adherers of ≥75% of sessions varied across multidomain components: 37 people (63.8% of 58 participants) for cognitive training, 35 (60.3%) for nutrition, and three (5.2%) for exercise; these three persons adhered to all multidomain components. Participants considered study procedures and multidomain content in a positive way; the most cited weaknesses were related to exercise: too easy, repetitive, and slow progression. Compared to controls, the intervention had a positive effect on HRQOL; no significant effects were observed across the other clinical and lifestyle outcomes. CONCLUSIONS AND RELEVANCE Providing multidomain lifestyle training through a web-platform is feasible and well-accepted, but the training should be challenging enough and adequately progress according to participants' capabilities to increase adherence. Recommendations for a larger on-line multidomain lifestyle training RCT are provided.
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Affiliation(s)
- P de Souto Barreto
- Professor Philipe de Souto Barreto, Gérontopôle de Toulouse, Institut du Vieillissement, 37 Allées Jules Guesde, F-31000 Toulouse, France, Phone: (+33) 561 145 668, Fax: (+33) 561 145 640, e-mail:
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23
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Wollesen B, Fricke M, Jansen CP, Gordt K, Schwenk M, Muehlbauer T, Morawietz C, Kruse A, Gramann K. A three-armed cognitive-motor exercise intervention to increase spatial orientation and life-space mobility in nursing home residents: study protocol of a randomized controlled trial in the PROfit project. BMC Geriatr 2020; 20:437. [PMID: 33129261 PMCID: PMC7603752 DOI: 10.1186/s12877-020-01840-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/19/2020] [Indexed: 12/04/2022] Open
Abstract
Background In nursing home residents, the combination of decreasing mobility and declining cognitive abilities, including spatial orientation, often leads to reduced physical activity (PA) and life-space (LS) mobility. As a consequence of sedentary behavior, there is a lack of social interaction and cognitive stimulation, resulting in low quality of life. It has not yet been examined whether cognitive-motor training including spatial cognitive tasks is suitable to improve spatial orientation and, as a consequence, to enlarge LS mobility, and increase well-being and general cognitive-motor functioning. Therefore, the overall goal of this multicentric randomized controlled trial (RCT) is to compare the effect of three different intervention approaches including functional exercise and orientation tasks on PA, LS and spatial orientation in nursing home residents. Methods A three-arm single-blinded multicenter RCT with a wait-list control group will be conducted in a sample of 513 individuals (needed according to power analysis) in three different regions in Germany. In each nursing home, one of three different intervention approaches will be delivered to participating residents for 12 weeks, twice a week for 45 min each: The PROfit basic group will perform functional strength, balance, flexibility, and walking exercises always at the same location, whereas the PROfit plus group changes the location three times while performing similar/the same exercises as the PROfit basic group. The PROfit orientation group receives navigation tasks in addition to the relocation during the intervention. Physical and cognitive functioning as well as psychological measures will be assessed in all study groups at baseline. Participants will then be randomized into either the intervention group or the wait-list control group. After 12 weeks, and after 24 weeks the measures will be repeated. Discussion This study evaluates whether the three different interventions are feasible to reduce the decline of or even improve PA, LS, and spatial orientation in nursing home residents. By adding different training locations in PROfit plus, the program is expected to be superior to PROfit basic in increasing physical and cognitive parameters. Moreover, we expect the PROfit orientation intervention to be most effective in terms of PA, LS, and spatial orientation due to two mechanisms: (1) increased physical and cognitive activity will enhance cognitive-motor capacity and (2) the spatial training will help to build up cognitive strategies to compensate for age-related loss of spatial orientation abilities and related limitations. Trial registration The trial was prospectively registered at DRKS.de with registration number DRKS00021423 on April 16, 2020 and was granted permission by the Technical University Berlin local ethics committee (No. GR_14_20191217).
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Affiliation(s)
- Bettina Wollesen
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623, Berlin, Germany. .,Department of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany.
| | - Madeleine Fricke
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623, Berlin, Germany
| | - Carl-Philipp Jansen
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Katharina Gordt
- Institute of Sports and Sports Sciences, Heidelberg University, Im Neuenheimer Feld 720, 69120, Heidelberg, Germany
| | - Michael Schwenk
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany.,Institute of Sports and Sports Sciences, Heidelberg University, Im Neuenheimer Feld 720, 69120, Heidelberg, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141, Essen, Germany
| | - Christina Morawietz
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141, Essen, Germany
| | - Adele Kruse
- Department of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
| | - Klaus Gramann
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623, Berlin, Germany.,School of Software, University of Technology Sydney, Sydney, 2007, Australia
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