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Byun K, Hyodo K, Suwabe K, Fukuie T, Ha MS, Damrongthai C, Kuwamizu R, Koizumi H, Yassa MA, Soya H. Mild exercise improves executive function with increasing neural efficiency in the prefrontal cortex of older adults. GeroScience 2024; 46:309-325. [PMID: 37318716 PMCID: PMC10828372 DOI: 10.1007/s11357-023-00816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023] Open
Abstract
This study examined whether a 3-month mild-exercise intervention could improve executive function in healthy middle-aged and older adults in a randomized control trial. Ultimately, a total of 81 middle-aged and older adults were randomly assigned to either an exercise group or a control group. The exercise group received 3 months of mild cycle exercise intervention (3 sessions/week, 30-50 min/session). The control group was asked to behave as usual for the intervention period. Before and after the intervention, participants did color-word matching Stroop tasks (CWST), and Stroop interference (SI)-related reaction time (RT) was assessed as an indicator of executive function. During the CWST, prefrontal activation was monitored using functional near-infrared spectroscopy (fNIRS). SI-related oxy-Hb changes and SI-related neural efficiency (NE) scores were assessed to examine the underlying neural mechanism of the exercise intervention. Although the mild-exercise intervention significantly decreased SI-related RT, there were no significant effects of exercise intervention on SI-related oxy-Hb changes or SI-related NE scores in prefrontal subregions. Lastly, changes in the effects of mild exercise on NE with advancing age were examined. The 81 participants were divided into two subgroups (younger-aged subgroup [YA], older-aged subgroup [OA], based on median age [68 years.]). Interestingly, SI-related RT significantly decreased, and SI-related NE scores in all ROIs of the prefrontal cortex significantly increased only in the OA subgroup. These results reveal that a long-term intervention of very light-intensity exercise has a positive effect on executive function especially in older adults, possibly by increasing neural efficiency in the prefrontal cortex.
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Affiliation(s)
- Kyeongho Byun
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Division of Sport Science; Sport Science Institute & Health Promotion Center, College of Arts & Physical Education, Incheon National University, Yeonsu, Incheon, Republic of Korea
| | - Kazuki Hyodo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Hachioji, Tokyo, Japan
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kazuya Suwabe
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Faculty of Health and Sport Sciences, Ryutsu Keizai University, Ryugasaki, Ibaraki, Japan
| | - Takemune Fukuie
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Min-Seong Ha
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Sports Science, College of the Arts and Sports, University of Seoul, Dongdaemun, Seoul, Republic of Korea
| | - Chorphaka Damrongthai
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ryuta Kuwamizu
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hikaru Koizumi
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Michael A Yassa
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
| | - Hideaki Soya
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Pelosi C, Kauling RM, Cuypers JAAE, Utens EMWJ, van den Bosch AE, Kardys I, Bogers AJJC, Helbing WA, Roos-Hesselink JW, Legerstee JS. Executive functioning of patients with congenital heart disease: 45 years after surgery. Clin Res Cardiol 2023; 112:1417-1426. [PMID: 37031447 PMCID: PMC10562274 DOI: 10.1007/s00392-023-02187-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/28/2022] [Indexed: 04/10/2023]
Abstract
BACKGROUND Nowadays, more than 90% of patients with congenital heart disease (CHD) reach adulthood. However, long-term impact on neurodevelopment and executive functioning in adults with CHD are not completely understood. PURPOSE To investigate the self- and informant-reported executive functioning in adults with CHD operated in childhood. MATERIAL AND METHODS Longitudinal study of a cohort of patients (n = 194, median age: 49.9 [46.1-53.8]) who were operated in childhood (< 15 years old) between 1968 and 1980 (median follow-up time: 45 [40-53] years) for one of the following diagnoses: atrial septal defect (ASD), ventricular septal defect (VSD), pulmonary stenosis (PS), tetralogy of Fallot (ToF) or transposition of the great arteries (TGA). Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) questionnaire was used to assess self- and informant-reported executive functioning. RESULTS 40-53 years after surgery, the CHD group did show significantly better executive functioning compared to the norm data. No significant difference was found between mild CHD (ASD, VSD and PS) and moderate/severe CHD (ToF and TGA). Higher education, NYHA class 1 and better exercise capacity were associated with better self-reported executive functioning, whereas females or patients taking psychiatric or cardiac medications reported worse executive functioning. CONCLUSIONS Our findings suggest favorable outcomes (comparable to normative data) regarding executive functioning in adults with CHD, both self- and informant-reported. However, further study is warranted to explore more in detail the different cognitive domains of executive functioning in these patients.
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Affiliation(s)
- C Pelosi
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - R M Kauling
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - J A A E Cuypers
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - E M W J Utens
- Academic Center for Child Psychiatry Levvel, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - I Kardys
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - A J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - W A Helbing
- Division of Cardiology, Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Predictive Accuracy of Inpatient Cognitive Screening for Correctly Classifying Mild Cognitive Impairment at 4 Months Using A Full Neurocognitive Battery in Acute Coronary Syndrome. J Cardiopulm Rehabil Prev 2023; 43:74-75. [PMID: 36576424 DOI: 10.1097/hcr.0000000000000760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Taylor JL, Barnes JN, Johnson BD. The Utility of High Intensity Interval Training to Improve Cognitive Aging in Heart Disease Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16926. [PMID: 36554807 PMCID: PMC9778921 DOI: 10.3390/ijerph192416926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Adults with cardiovascular disease and heart failure are at higher risk of cognitive decline. Cerebral hypoperfusion appears to be a significant contributor, which can result from vascular dysfunction and impairment of cerebral blood flow regulation. In contrast, higher cardiorespiratory fitness shows protection against brain atrophy, reductions in cerebral blood flow, and cognitive decline. Given that high intensity interval training (HIIT) has been shown to be a potent stimulus for improving cardiorespiratory fitness and peripheral vascular function, its utility for improving cognitive aging is an important area of research. This article will review the physiology related to cerebral blood flow regulation and cognitive decline in adults with cardiovascular disease and heart failure, and how HIIT may provide a more optimal stimulus for improving cognitive aging in this population.
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Affiliation(s)
- Jenna L. Taylor
- Human Integrative and Environmental Physiology Laboratory, Mayo Clinic, Rochester, MN 55902, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Jill N. Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Bruce D. Johnson
- Human Integrative and Environmental Physiology Laboratory, Mayo Clinic, Rochester, MN 55902, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA
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Effect of Respiratory Training Combined with Core Muscle Training on the Overall Motor Function and Activities of Daily Living of Patients with Early and Midterm Stroke. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:2830711. [PMID: 35035821 PMCID: PMC8759847 DOI: 10.1155/2022/2830711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
Abstract
Stroke is a cerebral ischemic or hemorrhagic disease with sudden onset and rapid progress. To analyze the effect of respiratory training combined with core muscle training on the overall motor function and activities of daily living of patients with early and midterm stroke, 90 cases with early and midterm stroke admitted to the neurological department of our hospital from April 2018 to April 2019 were chosen as the research objects. According to the odd or even hospitalization numbers, they were equally divided into the study group and the reference group. Both groups received basic drug treatment. On this basis, the reference group was given routine rehabilitation training, while the study group was given respiratory training combined with core muscle training. The clinical indexes of both groups before and after intervention were evaluated to analyze the effect of different training methods on the rehabilitation of patients with early and midterm stroke. There was no significant difference in gender ratio, average age, average BMI, average course of disease, stroke types, MAS grading, location of limb dysfunction, and combined disease between the two groups (P < 0.05). The total clinical effective rate of the study group after intervention was obviously higher than that of the reference group (P < 0.05). The MoCA scores of both groups after intervention were obviously higher than those before intervention, and the score of the study group after intervention was obviously higher than that of the reference group. The scores of limb motor function, activities of daily living, and balance function at T2, T3, and T4 in the study group were obviously higher than those in the reference group (P < 0.001). At 4 and 8 weeks after intervention, the 10 m MWS of the study group was obviously higher than that of the reference group (P < 0.001), while the TUGT was obviously lower (P < 0.001). Respiratory training combined with core muscle training can obviously improve the activities of daily living, cognitive function, and limb motor function of patients with early and midterm stroke, which is worth popularizing and using.
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Goldstein DW, Hajduk AM, Song X, Tsang S, Geda M, Dodson JA, Forman DE, Krumholz H, Chaudhry SI. Factors Associated With Cardiac Rehabilitation Participation in Older Adults After Myocardial Infarction: THE SILVER-AMI STUDY. J Cardiopulm Rehabil Prev 2022; 42:109-114. [PMID: 34799530 PMCID: PMC8881286 DOI: 10.1097/hcr.0000000000000627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Cardiac rehabilitation (CR) is a key aspect of secondary prevention following acute myocardial infarction (AMI). While there is growing evidence of unique benefits of CR in older adults, it remains underutilized. We aimed to examine specific demographic, clinical, and functional factors associated with utilization of CR among older adults hospitalized with AMI. METHODS Our project used data from the SILVER-AMI study, a nationwide prospective cohort study of patients age ≥75 yr hospitalized with AMI and followed them up for 6 mo after discharge. Extensive baseline data were collected on demographics, clinical and psychosocial factors, and functional and sensory impairments. The utilization of CR was collected by a survey at 6 mo. Backward selection was employed in a multivariable-adjusted logistic regression model to identify independent predictors of CR use. RESULTS Of the 2003 participants included in this analysis, 779 (39%) reported participating in CR within 6 mo of discharge. Older age, longer length of hospitalization, having ≤12 yr of education, visual impairment, cognitive impairment, and living alone were associated with decreased likelihood of CR participation; receipt of diagnostic and interventional procedures (ie, cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft) was associated with increased likelihood of CR participation. CONCLUSIONS Demographic and clinical factors, as well as select functional and sensory impairments common in aging, were associated with CR participation at 6 mo post-discharge in older AMI patients. These results highlight opportunities to increase CR usage among older adults and identify those at risk for not participating.
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Affiliation(s)
- David W Goldstein
- Department of Internal Medicine, Massachusetts General Hospital, Boston (Dr Goldstein); Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Drs Hajduk, Krumholz, and Chaudhry and Mss Tsang and Geda); Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, Connecticut (Ms Song); Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York (Dr Dodson); Geriatric Cardiology Section, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Forman), and Section of Health Policy and Management, Yale School of Public Health, New Haven, and Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, Connecticut (Dr Krumholz)
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Taylor J. Exercise and the brain in cardiovascular disease: A narrative review. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_50_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Gaalema DE, Mahoney K, Ballon JS. Cognition and Exercise: GENERAL OVERVIEW AND IMPLICATIONS FOR CARDIAC REHABILITATION. J Cardiopulm Rehabil Prev 2021; 41:400-406. [PMID: 34561368 PMCID: PMC8563446 DOI: 10.1097/hcr.0000000000000644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Performance of endurance exercise is associated with a broad range of cognitive benefits, with notable improvements shown across a wide variety of populations including healthy populations as well as those with impaired cognition. By examining the effects of exercise in general populations, as well in populations where cognitive deficits are pronounced, and critical to self-care, we can learn more about using exercise to ameliorate cognitive issues and apply that knowledge to other patient populations, such as those eligible for cardiac rehabilitation (CR). Cognitive challenges are a concern within CR, as management of a chronic disease is cognitively taxing, and, as expected, deficits in cognition predict worse outcomes, including lower attendance at CR. Some subsets of patients within CR may be particularly at high risk for cognitive challenges including those with heart failure with low ejection fraction, recent coronary bypass surgery, multiple chronic conditions, and patients of lower socioeconomic status. Attendance at CR is associated with cognitive gains, likely through the progressive exercise component, with larger amounts of exercise over longer periods having greater benefits. Programs should identify at-risk patients, who could gain the most from completing CR, and provide additional support to keep those patients engaged. While engaged in CR, patients should be encouraged to exercise, at least at moderate intensity, and transitioned to a long-term exercise regimen. Overall, CR programs are well-positioned to support these patients and make significant contributions to their long-term well-being.
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Affiliation(s)
- Diann E Gaalema
- University of Vermont, Burlington (Dr Gaalema and Ms Mahoney); and Stanford University, Stanford, California (Dr Ballon)
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Cardiovascular and Pulmonary Research: The Year (2020) in Review. Cardiopulm Phys Ther J 2021. [DOI: 10.1097/cpt.0000000000000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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