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Stringhetta-Villar BP, Douradinho LG, Esperança TD, de Freitas RN, Cavalcante DP, Chaves-Neto AH, Dornelles RCM. The impact of resistance training on memory, gait and oxidative stress during periestropause in rats. Behav Brain Res 2024; 471:115124. [PMID: 38925510 DOI: 10.1016/j.bbr.2024.115124] [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: 03/12/2024] [Revised: 06/10/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
Aging, especially in female, is complex, involving various factors such as reproductive sensitivity, cognitive and functional decline, and an imbalance in the redox system. This study aims to assess the effectiveness of long-term resistance training as a non-pharmacological strategy to mitigate the impairment of recognition memory, hippocampal redox state, and ambulation in aging female Wistar rats during the periestropause period. Thirty Wistar rats aged 17 months, in periestropause, were distributed into non-trained (NT) and resistance training (RT; stair climbing 3 times per week for 4 months) groups. Before (17 months) and after (21 months) of the RT period, the rats underwent tests for ambulation, elevated plus maze (EPM), open field, and object recognition. Biochemical and histological analyses were conducted on the hippocampus of these animals. Analysis of the results revealed that at 21 months, females in the NT group (21Mo/NT) exhibited a decreased in length (p=0.0458) and an increased in past width (p<0.0479) compared to their measurements at 17 months. However, after 4 months of RT, the female rats aged 21 months (21Mo/RT group) experienced changes in gait components, showing an increase in length (p<0.0008) and a decrease in stride width. Regarding memory, the object recognition test indicated potential cognitive improvement in 21Mo/RT animals, with significant interaction between intervention and age across all three stages of the test (total exploration time, p=0.0001; Test 1, p=0.0003; Test 2, p=0.0014). This response was notable compared to animals in the 21Mo/NT group, which showed a decline in memory capacity (p<0.01). The data showed a significant difference in relation to the age of the animals (p<0.01). The hippocampal redox state markers showed reduced lipid oxidative (p=0.028), catalase (p=0.022), and superoxide dismutase (p=0.0067) in the RT group compared to the NT group. Hippocampal cells from the 21Mo/RT group showed increased citrate synthase enzyme activity (p<0.05) and Nissl body staining (p<0.05). The results of this study demonstrate that RT performed during the periestropause phase leads to significant improvements in functional abilities, cognitive performance, and neuroplasticity in aging female rats.
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Affiliation(s)
| | - Luana Galante Douradinho
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Thaina Daguane Esperança
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Rayara Nogueira de Freitas
- Programa de Pós-Graduação em Ciência Odontológica, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Debora Prazias Cavalcante
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Antonio Hernandes Chaves-Neto
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação em Ciência Odontológica, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Rita Cássia Menegati Dornelles
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
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Venegas-Sanabria LC, Cavero-Redondo I, Lorenzo-Garcia P, Sánchez-Vanegas G, Álvarez-Bueno C. Efficacy of Nonpharmacological Interventions in Cognitive Impairment: Systematic Review And Network Meta-Analysis. Am J Geriatr Psychiatry 2024:S1064-7481(24)00385-3. [PMID: 39034265 DOI: 10.1016/j.jagp.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION There is currently no known cure for cognitive impairment, which highlights the need to explore other ways of managing this condition. This topic has recently become an area of active research. However, the availability of nonpharmacological options poses a challenge when trying to determine the best treatment for improving cognitive function. METHODS We conducted a systematic review and a Bayesian network meta-analysis to compare the effects of nonpharmacological interventions on global cognition in patients with mild cognitive impairment and dementia. The nonpharmacological interventions were classified as aerobic exercise, strength exercise, multicomponent physical exercise, other physical exercises, tai chi, mind-body exercises, traditional cognitive rehabilitation, computer-based cognitive rehabilitation, occupational therapy, music therapy, physical-cognitive rehabilitation, and reminiscence therapy. RESULTS Physical-cognitive rehabilitation emerged as the most effective nonpharmacological intervention for enhancing global cognition in patients with unspecified cognitive impairment and dementia, whereas occupational therapy focused on dual-task interventions was found to be the most effective nonpharmacological intervention for mild cognitive impairment. CONCLUSION These results underscore the importance of adopting a dual approach to managing cognitive impairment, integrating both cognitive and physical rehabilitation within the same intervention.
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Affiliation(s)
- Luis Carlos Venegas-Sanabria
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain; Escuela de Medicina y Ciencias de la Salud (LCVS, GSV), Universidad del Rosario, Bogotá, Colombia; Hospital Universitario Mayor-Méderi (LCVS, GSV), Bogotá, Colombia.
| | - Iván Cavero-Redondo
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain; Rehabilitation in Health Research Center (CIRES) (ICR), Universidad de Las Américas, Santiago, Chile; Facultad de Enfermería de Cuenca (ICR), Cuenca, Spain
| | - Patricia Lorenzo-Garcia
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain
| | - Guillermo Sánchez-Vanegas
- Escuela de Medicina y Ciencias de la Salud (LCVS, GSV), Universidad del Rosario, Bogotá, Colombia; Hospital Universitario Mayor-Méderi (LCVS, GSV), Bogotá, Colombia
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain; Universidad Politécnica y Artística del Paraguay (CAB), Asunción, Paraguay
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Qaisar R, Iqbal MS, Karim A, Ahmad F. Resistance Exercise Reduces Sarcopenia by Repairing Leaky Gut in Patients with Alzheimer's Disease. Arch Med Res 2024; 55:103025. [PMID: 38879906 DOI: 10.1016/j.arcmed.2024.103025] [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: 10/06/2023] [Revised: 05/26/2024] [Accepted: 06/05/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Sarcopenia or age-associated muscle loss is common in patients with Alzheimer's disease (AD). We have previously demonstrated the contribution of a leaky gut to sarcopenia in AD. Here, we asked whether resistant exercise (RE) reduces the sarcopenia phenotype by repairing intestinal leakage in patients with AD. METHOD A prospective, single-center study of older adults, including healthy controls and patients with AD (n = 44-51/group), was conducted to measure plasma zonulin and claudin-3 (markers of intestinal leakage), handgrip strength (HGS), and short physical performance battery (SPPB) as a measure of functional capacity. Measurements in patients with AD were performed at baseline and after 12 weeks of RE. RESULTS At baseline, patients with AD had higher plasma zonulin and claudin-3 and lower HGS, gait speed, and SPPB scores than controls. RE reduced plasma zonulin and claudin-3 levels and improved HGS, SPPB scores, and gait speed. Regression analysis revealed robust relationships between changes in plasma zonulin and claudin-3 with HGS. Plasma zonulin was also positively associated with SPPB scores. In addition, RE downregulated plasma markers of inflammation and oxidative stress. However, the prevalence of sarcopenia based on low HGS and muscle atrophy or low SPPB was not affected by RE. CONCLUSION Taken together, disruption of the intestinal mucosal barrier may contribute to functional decline and sarcopenia in AD, which is incompletely recovered by RE. Circulating levels of zonulin and claudin-3 may be valuable in predicting sarcopenia and functional capacity in older adults with AD.
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Affiliation(s)
- Rizwan Qaisar
- Departmen of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; Cardiovascular Research Group, Research Institute of Medical and Health Science, University of Sharjah, Sharjah, United Arab Emirates.
| | - M Shahid Iqbal
- Department of Neurology and Stroke Medicine, Rehman Medical Institute, Peshawar, Pakistan
| | - Asima Karim
- Departmen of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Firdos Ahmad
- Departmen of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; Cardiovascular Research Group, Research Institute of Medical and Health Science, University of Sharjah, Sharjah, United Arab Emirates
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Wang Z, Xu X, Yang X, Wang SS, Zhou Y, Li Y. Effects of multicomponent exercise on cognitive function in persons with mild cognitive impairment: A systematic review and meta-analysis. Int J Nurs Stud 2024; 158:104843. [PMID: 39116586 DOI: 10.1016/j.ijnurstu.2024.104843] [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: 01/09/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Multicomponent exercise has the potential to improve cognitive function in people with mild cognitive impairment. However, the effects of multicomponent exercise on specific cognitive subdomains in mild cognitive impairment and the optimal combination of exercise components remain unclear. OBJECTIVE This systematic review aimed to (a) investigate the effects of multicomponent exercise on different cognitive subdomains in people with mild cognitive impairment and (b) investigate the effects of different combinations of multicomponent exercise on global cognition in people with mild cognitive impairment. DESIGN A systematic review and meta-analysis. METHODS Six electronic databases, including PubMed, Medline, EMBASE, Web of Science, Cochrane Library, and CINAHL were systematically searched from inception to January 1st, 2023. Randomized controlled trials assessing the effect of multicomponent exercise interventions on cognitive function in people with mild cognitive impairment were included. The risk of bias was assessed using the Cochrane collaborative bias assessment tool. A random-effects model was used to calculate standardized mean difference. Subgroup analyses, meta-regression, and sensitive analysis were performed. If a meta-analysis was not feasible, studies were synthesized narratively. RESULTS Twenty studies were identified for systematic review and meta-analysis. Multicomponent exercise significantly improved global cognition [SMD = 1.04; 95 % confidence interval (CI): 0.53, 1.55], cognitive flexibility (SMD = -1.04; 95 % CI: -1.81, -0.27), processing speed (SMD = 0.43; 95 % CI: 0.04, 0.82), verbal fluency (SMD = 0.38; 95 % CI: 0.13, 0.63), attention (SMD = -0.90; 95 % CI: -1.68, -0.12) and memory (SMD = 0.36; 95 % CI: 0.04, 0.69) in mild cognitive impairment. The multicomponent exercise including cardiovascular (exercise that promotes cardiovascular health, such as endurance training or aerobic exercise) and motor (exercises that improve physical abilities, such as balance, coordination, agility, flexibility, etc.) components positively affected global cognition in people with mild cognitive impairment (SMD = 1.06; 95 % CI: 0.55, 1.57). CONCLUSIONS The findings of this study suggest that multicomponent exercise has a positive impact on various cognitive domains, including global cognition, cognitive flexibility, processing speed, verbal fluency, attention and memory in mild cognitive impairment. Specifically, the combination of exercises including cardiovascular and motor components was found to be effective in improving global cognition. However, further research is needed to investigate the optimal frequency and intensity of the multicomponent exercise intervention, and more detail about exercise combinations of the motor component (not classified in this study) for individuals with mild cognitive impairment. REGISTRATION The protocol was registered on PROSPERO (CRD42023400302).
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Affiliation(s)
- Zihan Wang
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Xinyi Xu
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Xinxin Yang
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Shan Shan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Yi Zhou
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Yan Li
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China; Neuroscience Research Center, Hebei Medical University, Shijiazhuang, Hebei, China; Hebei Key Laboratory of Neurodegenerative Disease Mechanism, Shijiazhuang, Hebei, China.
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Krootnark K, Chaikeeree N, Saengsirisuwan V, Boonsinsukh R. Effects of low-intensity home-based exercise on cognition in older persons with mild cognitive impairment: a direct comparison of aerobic versus resistance exercises using a randomized controlled trial design. Front Med (Lausanne) 2024; 11:1392429. [PMID: 38975052 PMCID: PMC11224483 DOI: 10.3389/fmed.2024.1392429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Background It has been reported that both aerobic exercise and resistance exercise can improve cognitive function in older people with mild cognitive impairment (MCI), but it is unclear which type of exercise has a higher impact on cognitive function. Additionally, low-intensity exercise is considered safe for the elderly and can be done at home. This study aimed to compare the effects of 3-month low-intensity home-based exercises, aerobic versus resistance exercises, on cognitive function in people with MCI. Methods This study was a single-blind randomized controlled trial conducted in a suburban community. Ninety eligible participants aged 60-80 years were randomly assigned into aerobic exercise, resistance exercise or control group (30 in each group). The aerobic and resistance exercise groups underwent 3 months of low-intensity exercise at home (35 min/day, 5 days/week). The control group performed their usual daily activities. The Montreal Cognitive Assessment Thai version (MoCA), Trail Making Test Part A and B (TMT-A, TMT-B), Stroop Color and Word Test (SCWT), forward and backward Digit Span Test (DST-F, DST-B) and Stick Design Test (SDT) were administered before training, 3-month after training and 3-month follow-up. Results All participants completed a 3-month exercise program, but during the follow-up, data were gathered from 28, 27, and 26 participants in the aerobic, resistance, and control groups, respectively. Both aerobic and resistance groups showed significant improvements in all outcome measures during posttraining and follow-up, except SDT, while there was no cognitive improvement in control group at posttraining and follow-up. Compared to those in the control group, the aerobic group had significant improvements in MoCA, TMT-A, TMT-B, and SCWT, while resistance group had significant improvements in MoCA and TMT-B at posttraining and follow-up. There were no differences in any outcome measures between aerobic and resistance groups, except SCWT, which was significantly greater in the aerobic group than in the resistance group posttraining. Conclusion Low-intensity exercise, whether aerobic or resistance training, was effective at improving cognitive function in older people with MCI, and the effects were sustained at the 3-month follow-up.Clinical trial registration:thaiclinicaltrials.org, TCTR20231110003.
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Affiliation(s)
- Kitsana Krootnark
- Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Nithinun Chaikeeree
- Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | | | - Rumpa Boonsinsukh
- Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
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Akalp K, Ferreira JP, Soares CM, Ribeiro MJ, Teixeira AM. The effects of different types of exercises on cognition in older persons with mild cognitive impairment: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 126:105541. [PMID: 38981326 DOI: 10.1016/j.archger.2024.105541] [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: 02/28/2024] [Revised: 05/25/2024] [Accepted: 06/17/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE This systematic review with meta-analysis aims to analyze the effects of different types of exercise on cognition, neuroprotective and neuroinflammatory blood markers in older adults with mild cognitive impairment (MCI). METHODS Relevant studies were identified using PubMED, SPORTDiscuss, Web of Science, Scopus, and PsycInfo databases. Methodological quality assessment of the studies was done with modified Downs and Black checklist. Data obtained from the included studies was analyzed using Comprehensive Meta-Analysis 4.0 software and results were reported using the random effects method. RESULTS A total of twenty-three studies were identified. The findings were summarized as change in cognitive function after the exercise interventions in general and after each type of exercise. On average, the exercise intervention revealed an effect size (ES): 1.165; 0.741 to 1.589 (95% Confidence Interval (CI); p < 0.001); aerobic exercise ES: 1.442; 0.624 to 2.260 (95 %CI); p = 0.001; Multimodal ES: 0,856; 0.366 to 1.346 (95 % CI); p = 0.001 and resistance exercise ES: 1.229; 0.339 to 2.120 (95 % CI); p = 0.007. In addition, we observed significant small ES: -0.475; -0.817 to -0.134 (95 %CI); p = 0.006, I2= 0 %; τ2 = 0 of exercise effects on Tumor Necrosis Factor-α (TNF-α) and non-significant large ES:0.952; -0.238 to 2.142 (95 %CI); p = 0.117 on Brain Derived Neurotrophic Factor (BDNF) in persons with MCI. CONCLUSION The present study revealed the existence of a large positive effect of overall exercise intervention on cognitive function and a small effect on TNF-α in old people with MCI. Additionally, this study demonstrates that aerobic and resistance exercises had similar larger positive effects and were better than multimodal exercise on increasing cognition in older persons with MCI.
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Affiliation(s)
- Kaan Akalp
- University of Coimbra, Research Unit for Sport and Physical Activity(CIDAF -doi: 10.54499/UIDP/04213/2020), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal.
| | - José Pedro Ferreira
- University of Coimbra, Research Unit for Sport and Physical Activity(CIDAF -doi: 10.54499/UIDP/04213/2020), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
| | - Carlos M Soares
- University of Coimbra, Research Unit for Sport and Physical Activity(CIDAF -doi: 10.54499/UIDP/04213/2020), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal; University of Coimbra, Molecular Physical-Chemistry R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal; Higher Institute of Educational Sciences of Douro, ISCE Research Center (CI-ISCE), 4560-708 Penafiel, Portugal
| | - Maria José Ribeiro
- University of Coimbra, CIBIT-ICNAS, Coimbra, Portugal; University of Coimbra, Faculty of Medicine, Coimbra, Portugal
| | - Ana Maria Teixeira
- University of Coimbra, Research Unit for Sport and Physical Activity(CIDAF -doi: 10.54499/UIDP/04213/2020), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
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Liu H, Wang J, Xin X, Wang P, Jiang W, Meng T. The relationship and pathways between resting-state EEG, physical function, and cognitive function in older adults. BMC Geriatr 2024; 24:463. [PMID: 38802730 PMCID: PMC11129501 DOI: 10.1186/s12877-024-05041-x] [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: 12/03/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Based on resting-state electroencephalography (EEG) evidence, this study aimed to explore the relationship and pathways between EEG-mediated physical function and cognitive function in older adults with cognitive impairment. METHODS A total of 140 older adults with cognitive impairment were recruited, and data on their physical function, cognitive function, and EEG were collected. Pearson correlation analysis, one-way analysis of variance, linear regression analysis, and structural equation modeling analysis were conducted to explore the relationships and pathways among variables. RESULTS FP1 theta (effect size = 0.136, 95% CI: 0.025-0.251) and T4 alpha2 (effect size = 0.140, 95% CI: 0.057-0.249) were found to significantly mediate the relationship. The direct effect (effect size = 0.866, 95% CI: 0.574-1.158) and total effect (effect size = 1.142, 95% CI: 0.848-1.435) of SPPB on MoCA were both significant. CONCLUSION Higher physical function scores in older adults with cognitive impairment were associated with higher cognitive function scores. Left frontal theta and right temporal alpha2, as key observed indicators, may mediate the relationship between physical function and cognitive function. It is suggested to implement personalized exercise interventions based on the specific physical function of older adults, which may delay the occurrence and progression of cognitive impairment in older adults with cognitive impairment.
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Affiliation(s)
- Hairong Liu
- Physical Education Department of Shanghai International Studies University, Shanghai, China
| | - Jing Wang
- School of Sports and Health of Shanghai Lixin University of Accounting and Finance Shanghai, Shanghai, 201620, China
| | - Xin Xin
- Shanghai University of Sport, Shanghai, China
| | - Peng Wang
- Shanghai University of Sport, Shanghai, China
| | | | - Tao Meng
- School of Sports and Health of Shanghai Lixin University of Accounting and Finance Shanghai, Shanghai, 201620, China.
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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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Wan X, Zhang Y, Liu T, Li D, Yu H, Wen D. Exercise therapy of mild cognitive impairment: EEG could enhance efficiency. Front Aging Neurosci 2024; 16:1373273. [PMID: 38659707 PMCID: PMC11039927 DOI: 10.3389/fnagi.2024.1373273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/04/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Xianglong Wan
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
- Key Laboratory of Perception and Control of Intelligent Bionic Unmanned Systems, Ministry of Education, Institute of Artificial Intelligence, University of Science and Technology Beijing, Beijing, China
| | - Yifan Zhang
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
| | - Tiange Liu
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
- Key Laboratory of Perception and Control of Intelligent Bionic Unmanned Systems, Ministry of Education, Institute of Artificial Intelligence, University of Science and Technology Beijing, Beijing, China
| | - Danyang Li
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
- Department of Sports, University of Science and Technology Beijing, Beijing, China
| | - Hao Yu
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
- Department of Sports, University of Science and Technology Beijing, Beijing, China
| | - Dong Wen
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
- Key Laboratory of Perception and Control of Intelligent Bionic Unmanned Systems, Ministry of Education, Institute of Artificial Intelligence, University of Science and Technology Beijing, Beijing, China
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Deng J, Wang H, Fu T, Xu C, Zhu Q, Guo L, Zhu Y. Physical activity improves the visual-spatial working memory of individuals with mild cognitive impairment or Alzheimer's disease: a systematic review and network meta-analysis. Front Public Health 2024; 12:1365589. [PMID: 38605880 PMCID: PMC11007231 DOI: 10.3389/fpubh.2024.1365589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
Objective Our network meta-analysis aimed to ascertain the effect of physical activity on the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease as well as to propose tailored exercise interventions for each group. Methods Employing a frequentist approach, we performed a network meta-analysis to compare the effectiveness of different exercise interventions in improving the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease. Subsequently, we explored the moderating variables influencing the effectiveness of the exercise interventions through a subgroup analysis. Results We included 34 articles involving 3,074 participants in the meta-analysis, comprised of 1,537 participants from studies on mild cognitive impairment and 1,537 participants from studies on Alzheimer's disease. The articles included exhibited an average quality score of 6.6 (score studies) and 6.75 (reaction time [RT] studies), all passing the inconsistency test (p > 0.05). In the mild cognitive impairment literature, mind-body exercise emerged as the most effective exercise intervention (SMD = 0.61, 95% CI: 0.07-1.14). In Alzheimer's disease research, aerobic exercise was identified as the optimal exercise intervention (SMD = 0.39, 95% CI: 0.06-0.71). Conclusion The results of the subgroup analysis suggest that the most effective approach to enhancing the visual-spatial working memory of individuals with mild cognitive impairment entails exercising at a frequency of three or more times per week for over 60 min each time and at a moderate intensity for more than 3 months. Suitable exercise options include mind-body exercise, multicomponent exercise, resistance exercise, and aerobic exercise. For individuals with Alzheimer's disease, we recommend moderately intense exercise twice per week for over 90 min per session and for a duration of 3 months or longer, with exercise options encompassing aerobic exercise and resistance exercise.
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Affiliation(s)
- Jie Deng
- College of Physical Education, Southwest University, Chongqing, China
| | - Hong Wang
- College of Physical Education and Health Sciences, Chongqing Normal University, Chongqing, China
| | - Tingting Fu
- College of Physical Education, Southwest University, Chongqing, China
| | - Chong Xu
- Ministry of Sports and National Defense Education, Chongqing College of Electronic Engineering, Chongqing, China
| | - Qiqi Zhu
- College of Physical Education, Southwest University, Chongqing, China
| | - Liya Guo
- College of Physical Education, Southwest University, Chongqing, China
| | - Yu Zhu
- College of Physical Education, Southwest University, Chongqing, China
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11
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Zhang J, Yang C, Pan Y, Wang L. Effects of Multicomponent Exercise on Community-Dwelling Older Adults With Mild Cognitive Impairment. Res Gerontol Nurs 2024; 17:65-79. [PMID: 38285908 DOI: 10.3928/19404921-20240112-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
PURPOSE To explore the effects of a group-based multicomponent exercise program on general cognitive functioning, depression, and social functioning in community-dwelling older adults with mild cognitive impairment (MCI) and whether the effects can be maintained. METHOD Fifty older adults with MCI were conveniently recruited from two communities in the study area and randomly assigned to the intervention group or control group. The intervention group received three sessions of 60-minute, multicomponent exercise per week for 3 months, plus MCI-related health education. The control group only received MCI-related health education. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Beijing Version (MoCA-BJ) were used to assess general cognitive function. The Functional Activities Questionnaire (FAQ) and Geriatric Depression Scale (GDS-30) were used to evaluate participants' social function and depression, respectively. Participants' exercise intensity was assessed using the Category Ratio Scale. RESULTS After the 3-month intervention, there were significant improvements in general cognitive function (p = 0.046), attention (p = 0.009), delayed recall (p = 0.015), and social function (p = 0.011) in the intervention group compared with the control group. However, after 3-month postintervention follow up, no significant differences in MMSE, MoCA-BJ, GDS-30, and FAQ scores were noted between groups. CONCLUSION The 3-month multicomponent exercise program improved general cognitive function and social functioning in community-dwelling older adults with MCI. However, there was no evidence that these benefits lasted for another 3 months after stopping the exercise program. [Research in Gerontological Nursing, 17(2), 65-79.].
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12
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García-Llorente AM, Casimiro-Andújar AJ, Linhares DG, De Souza Vale RG, Marcos-Pardo PJ. Multidomain interventions for sarcopenia and cognitive flexibility in older adults for promoting healthy aging: a systematic review and meta-analysis of randomized controlled trials. Aging Clin Exp Res 2024; 36:47. [PMID: 38386173 PMCID: PMC10884056 DOI: 10.1007/s40520-024-02700-2] [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: 11/02/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
The global population is undergoing rapid aging, making physical activity a crucial element in preventing mortality and lowering the risk of Alzheimer's disease. Age-related declines in muscle mass and cognitive abilities significantly contribute to frailty and dependency. Thus, this study focuses on a meticulous analysis of the protective effects of multidomain interventions, an emerging resource combating age-related declines. It seeks to underscore their profound impact on cognitive flexibility and sarcopenia, highlighting their pivotal role in mitigating the adverse effects of aging. To identify relevant randomized controlled trials up to November 2023, we reviewed eight online academic databases, following PERSiST guidelines, PRISMA reporting system, and PICOs criteria. Meta-analyses on selected functional outcomes utilized a random-effects model, including the Timed Up and Go Test, Sit to Stand Test, Victoria Stroop Test, and Trail Making Test. Out of 2082 scrutinized articles, 17 were included in the systematic review, and 8 in the meta-analysis. Positive effects (p = 0.05, I2 = 57%; 95% CI - 0.63 to - 0.05) were observed in cognitive flexibility for certain interventions. Similarly, interventions addressing muscle strength demonstrated improvements in the Sit to Stand Test for the exercise group compared to the control group (p = 0.02, I2 = 0%; 95% CI - 0.63 to - 0.05). These findings underscore the importance of incorporating physical activity as a primary component of public health interventions for promoting healthy aging and reducing the burden of age-related diseases. Future interventions may explore more homogeneous approaches and evaluate the impact of thrice multidomain weekly sessions.
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Affiliation(s)
- A M García-Llorente
- SPORT Research Group (CTS-1024), Department of Education, CIBIS (Centro de Investigación Para el Bienestar y la Inclusión Social) Research Center, Area of Physical Education and Sport, University of Almería, Office 0.22, Building CITE III, Almería, Spain.
| | - A J Casimiro-Andújar
- SPORT Research Group (CTS-1024), Department of Education, CIBIS (Centro de Investigación Para el Bienestar y la Inclusión Social) Research Center, Area of Physical Education and Sport, University of Almería, Office 0.22, Building CITE III, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almeria, 04120, Almeria, Spain
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain
| | - D G Linhares
- Universidade do Estado de Rio de Janeiro, Rio de Janeiro, BR, Brazil
| | - R G De Souza Vale
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain
- Universidade do Estado de Rio de Janeiro, Rio de Janeiro, BR, Brazil
- Laboratorio de Ejercicio y Deporte, Instituto de Educación Física y Deportes, Universidad del Estado de Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil
| | - P J Marcos-Pardo
- SPORT Research Group (CTS-1024), Department of Education, CIBIS (Centro de Investigación Para el Bienestar y la Inclusión Social) Research Center, Area of Physical Education and Sport, University of Almería, Office 0.22, Building CITE III, Almería, Spain.
- Department of Education, Faculty of Education Sciences, University of Almeria, 04120, Almeria, Spain.
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain.
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13
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Zhu YH, Hu P, Luo YX, Yao XQ. Knowledge mapping of trends and hotspots in the field of exercise and cognition research over the past decade. Aging Clin Exp Res 2024; 36:19. [PMID: 38308660 PMCID: PMC10838253 DOI: 10.1007/s40520-023-02661-y] [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: 07/24/2023] [Accepted: 11/09/2023] [Indexed: 02/05/2024]
Abstract
Exercise elicits a wide range of physiological responses in mammalian tissues that enhance a broad range of functions, particularly in improving cognitive performance. However, the field lacks a comprehensive bibliometric analysis that clarifies its knowledge structure and research hotspots. This study aims to address this gap and map the research landscape regarding the role of exercise in cognitive function enhancement. Firstly, the frequencies and co-occurrence of keywords were analysed to identify six main clusters: aging, cognitive impairment, rehabilitation, obesity, fatigue, and hippocampus. Secondly, reference timeline co-citation analysis revealed that hippocampus and aging were the major bursts with high intensity and long attention span while children had recently emerged as a topical subject. Finally, the evolution of themes from 2012 to 2022 was analysed, and found that older adults had been the leading research theme for exercise affecting cognition. Childhood obesity was an emerging theme that attracted increasing research attention in recent years while the hippocampus research theme expanded rapidly during the decade but remained a niche topic with less relevance to others. This research identified and summarised research priorities and evolutionary trends in exercise to improve cognition by constructing knowledge networks through visual analysis. It provides researchers with a comprehensive insight into the current state of the field to facilitate further research.
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Affiliation(s)
- Ying-Hai Zhu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Hu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ya-Xi Luo
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Xiu-Qing Yao
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Municipality Clinical Research Center for Geriatric Medicine, Chongqing, China.
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14
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Lv S, Wang Q, Liu W, Zhang X, Cui M, Li X, Xu Y. Comparison of various exercise interventions on cognitive function in Alzheimer's patients: A network meta-analysis. Arch Gerontol Geriatr 2023; 115:105113. [PMID: 37418819 DOI: 10.1016/j.archger.2023.105113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/31/2023] [Accepted: 06/28/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE Exercise helps enhance cognitive function in Alzheimer's patients, although the most effective forms of exercise remain unknown. METHODS This network meta-analysis was registered in INPLASY (INPLASY202330066). According to predetermined criteria, this investigation comprised randomized controlled studies involving exercise therapies in people with Alzheimer's disease. The exercise intervention was ranked using surface under the cumulative ranking curve (SUCRA) and mean ranking, with the critical goal outcomes being overall cognition, executive function, and memory function. RESULTS Resistance exercise is the most likely strategy to be beneficial for slowing down overall cognitive function loss in Alzheimer's patients (72.4%). Additionally, multi-component exercise was the most effective way to improve executive function (30.4%). The only type of exercise that significantly affects memory function is resistance exercise. Memory is the cognitive function that is least responsive to exercise. CONCLUSION Resistance exercise may be an efficient intervention for overall cognitive function decline in patients with Alzheimer's and conjointly for their memory function. Multi-component exercise is more effective in improving executive function in patients with Alzheimer's disease.
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Affiliation(s)
- Shi Lv
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Qian Wang
- Postdoctoral Workstation, Department of Central Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Wenxin Liu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Xinlei Zhang
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Mengmeng Cui
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Xiubin Li
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China.
| | - Yuzhen Xu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China.
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15
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Setayesh S, Mohammad Rahimi GR. The impact of resistance training on brain-derived neurotrophic factor and depression among older adults aged 60 years or older: A systematic review and meta-analysis of randomized controlled trials. Geriatr Nurs 2023; 54:23-31. [PMID: 37703686 DOI: 10.1016/j.gerinurse.2023.08.022] [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: 07/27/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to investigate the impact of resistance training on brain-derived neurotrophic factor (BDNF) and depression among older adults aged 60 years or older. METHOD Four electronic databases were systematically searched. RESULTS A total of 11 randomized controlled trials, with a pooled sample of 868 participants, met our inclusion criteria. Meta-analysis demonstrated that resistance training significantly improved circulating BDNF levels (mean difference; MD: 0.73 ng/ml; 95% CI [0.04, 1.42]; p = 0.04). Additionally, resistance training was associated with significant improvements in depression (standardized mean difference; SMD: -0.38; 95% CI [- 0.62, -0.14]; p = 0.002). DISCUSSION These findings suggest that resistance training may be an effective intervention for improving BDNF levels and reducing depression symptoms in older adults. Further research is needed to confirm these findings and to investigate the underlying mechanisms.
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Affiliation(s)
- Shayan Setayesh
- Department of Exercise Physiology, Sanabad Golbahar Institute of Higher Education, Golbahar, Iran
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16
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Ramdeo KR, Fahnestock M, Gibala M, Selvaganapathy PR, Lee J, Nelson AJ. The Effects of Exercise on Synaptic Plasticity in Individuals With Mild Cognitive Impairment: Protocol for a Pilot Intervention Study. JMIR Res Protoc 2023; 12:e50030. [PMID: 37851488 PMCID: PMC10620638 DOI: 10.2196/50030] [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: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a syndrome preceding more severe impairment characterized by dementia. MCI affects an estimated 15% to 20% of people older than 65 years. Nonpharmacological interventions including exercise are recommended as part of overall MCI management based on the positive effects of exercise on cognitive performance. Interval training involves brief intermittent bouts of exercise interspersed with short recovery periods. This type of exercise promotes cognitive improvement and can be performed in individuals with MCI. Synaptic plasticity can be assessed in vivo by the neurophysiological response to repetitive transcranial magnetic stimulation (rTMS). A method to assess synaptic plasticity uses an intermittent theta burst stimulation (iTBS), which is a patterned form of rTMS. Individuals with MCI have decreased responses to iTBS, reflecting reduced synaptic plasticity. It is unknown whether interval training causes changes in synaptic plasticity in individuals living with MCI. OBJECTIVE This research will determine whether interval training performed using a cycle ergometer enhances synaptic plasticity in individuals with MCI. The three aims are to (1) quantify synaptic plasticity after interval training performed at a self-determined intensity in individuals with MCI; (2) determine whether changes in synaptic plasticity correlate with changes in serum brain-derived neurotrophic factor, osteocalcin, and cognition; and (3) assess participant compliance to the exercise schedule. METHODS 24 individuals diagnosed with MCI will be recruited for assignment to 1 of the 2 equally sized groups: exercise and no exercise. The exercise group will perform exercise 3 times per week for 4 weeks. Synaptic plasticity will be measured before and following the 4-week intervention. At these time points, synaptic plasticity will be measured as the response to single-pulse TMS, reflected as the percent change in the average amplitude of 20 motor-evoked potentials before and after an iTBS rTMS protocol, which is used to induce synaptic plasticity. In addition, individuals will complete a battery of cognitive assessments and provide a blood sample from the antecubital vein to determine serum brain-derived neurotrophic factor and osteocalcin. RESULTS The study began in September 2023. CONCLUSIONS The proposed research is the first to assess whether synaptic plasticity is enhanced after exercise training in individuals with MCI. If exercise does indeed modify synaptic plasticity, this will create a new avenue by which we can study and manipulate neural plasticity in these individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT05663918; https://clinicaltrials.gov/study/NCT05663918. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50030.
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Affiliation(s)
- Karishma R Ramdeo
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Margaret Fahnestock
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Martin Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | | | - Justin Lee
- Department of Geriatric Medicine, McMaster University, Hamilton, ON, Canada
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17
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Khasanova A, Henagan TM. Exercise Is Medicine: How Do We Implement It? Nutrients 2023; 15:3164. [PMID: 37513581 PMCID: PMC10385293 DOI: 10.3390/nu15143164] [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: 06/26/2023] [Revised: 07/08/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Exercise is well known to have beneficial effects on various disease states. In this paper, we broadly describe the fundamental concepts that are shared among various disease states, including obesity, type 2 diabetes (T2D), cardiovascular disease (CVD), heart failure (HF), cancer, and psychological well-being, and the beneficial effects of exercise training within these concepts. We highlight issues involved in implementing exercise recommendations and describe the potential impacts and challenges to medical professionals and patients. Problems are identified and discussed with respect to the future roles of professionals in the current built environment with its limited infrastructure to support current physical activity recommendations.
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Affiliation(s)
- Aliya Khasanova
- Department of Family Medicine, Baton Rouge General Family Health Center, Baton Rouge, LA 70806, USA
- Department of Family Medicine, Baton Rouge General Hospital, Baton Rouge, LA 70808, USA
| | - Tara M Henagan
- Department of Family Medicine, Baton Rouge General Family Health Center, Baton Rouge, LA 70806, USA
- Department of Family Medicine, Baton Rouge General Hospital, Baton Rouge, LA 70808, USA
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18
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Solis-Urra P, Molina-Hidalgo C, García-Rivero Y, Costa-Rodriguez C, Mora-Gonzalez J, Fernandez-Gamez B, Olvera-Rojas M, Coca-Pulido A, Toval A, Bellón D, Sclafani A, Martín-Fuentes I, Triviño-Ibañez EM, de Teresa C, Huang H, Grove G, Hillman CH, Kramer AF, Catena A, Ortega FB, Gómez-Río M, Erickson KI, Esteban-Cornejo I. Active Gains in brain Using Exercise During Aging (AGUEDA): protocol for a randomized controlled trial. Front Hum Neurosci 2023; 17:1168549. [PMID: 37284481 PMCID: PMC10239947 DOI: 10.3389/fnhum.2023.1168549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Alzheimer's disease is currently the leading cause of dementia and one of the most expensive, lethal and severe diseases worldwide. Age-related decline in executive function is widespread and plays a key role in subsequent dementia risk. Physical exercise has been proposed as one of the leading non-pharmaceutical approaches to improve executive function and ameliorate cognitive decline. This single-site, two-arm, single-blinded, randomized controlled trial (RCT) will include 90 cognitively normal older adults, aged 65-80 years old. Participants will be randomized to a 24-week resistance exercise program (3 sessions/week, 60 min/session, n = 45), or a wait-list control group (n = 45) which will be asked to maintain their usual lifestyle. All study outcomes will be assessed at baseline and at 24-weeks after the exercise program, with a subset of selected outcomes assessed at 12-weeks. The primary outcome will be indicated by the change in an executive function composite score assessed with a comprehensive neuropsychological battery and the National Institutes of Health Toolbox Cognition Battery. Secondary outcomes will include changes in brain structure and function and amyloid deposition, other cognitive outcomes, and changes in molecular biomarkers assessed in blood, saliva, and fecal samples, physical function, muscular strength, body composition, mental health, and psychosocial parameters. We expect that the resistance exercise program will have positive effects on executive function and related brain structure and function, and will help to understand the molecular, structural, functional, and psychosocial mechanisms involved.
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Affiliation(s)
- Patricio Solis-Urra
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Faculty of Education and Social Sciences, Universidad Andrés Bello, Viña del Mar, Chile
| | - Cristina Molina-Hidalgo
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Yolanda García-Rivero
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
| | | | - Jose Mora-Gonzalez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Beatriz Fernandez-Gamez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Marcos Olvera-Rojas
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Andrea Coca-Pulido
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Angel Toval
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Darío Bellón
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Alessandro Sclafani
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Isabel Martín-Fuentes
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Eva María Triviño-Ibañez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
| | - Carlos de Teresa
- Andalusian Centre of Sports Medicine, Consejería de Turismo y Deporte, Granada, Spain
| | - Haiqing Huang
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - George Grove
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Charles H. Hillman
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, United States
- Department of Psychology, Northeastern University, Boston, MA, United States
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
| | - Arthur F. Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, United States
- Beckman Institute, University of Illinois, Urbana, IL, United States
| | - Andrés Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B. Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Gómez-Río
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Irene Esteban-Cornejo
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Karamacoska D, Butt A, Leung IHK, Childs RL, Metri NJ, Uruthiran V, Tan T, Sabag A, Steiner-Lim GZ. Brain function effects of exercise interventions for cognitive decline: a systematic review and meta-analysis. Front Neurosci 2023; 17:1127065. [PMID: 37260849 PMCID: PMC10228832 DOI: 10.3389/fnins.2023.1127065] [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: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Exercise is recognized as a modifiable lifestyle factor that can mitigate cognitive decline and dementia risk. While the benefits of exercise on cognitive aging have been reported on extensively, neuronal effects in adults experiencing cognitive decline have not been systematically synthesized. The aim of this systematic review was to assess the effects of exercise on cognition and brain function in people with cognitive decline associated with dementia risk. Method A systematic search was conducted for randomized controlled trials of ≥ 4 weeks exercise (aerobic, resistance, or mind-body) that assessed cognition and brain function using neuroimaging and neurophysiological measures in people with subjective or objective cognitive decline. Study characteristics and brain function effects were narratively synthesized, while domain-specific cognitive performance was subjected to meta-analysis. Study quality was also assessed. Results 5,204 records were identified and 12 unique trials met the eligibility criteria, representing 646 adults classified with cognitive frailty, mild or vascular cognitive impairment. Most interventions involved 40-minute sessions conducted 3 times/week. Exercise improved global cognition (g = -0.417, 95% CI, -0.694 to -0.140, p = 0.003, I2 = 43.56%), executive function (g = -0.391, 95% CI, -0.651 to -0.131, p = 0.003, I2 = 13.28%), but not processing speed or general short-term memory (both p >0.05). Across fMRI and ERP studies, significant neuronal adaptations were found with exercise cf. control throughout the brain and were linked with improved global cognition, memory, and executive function. Cerebral blood flow was also found to improve with 24 weeks of exercise, but was not linked with cognitive changes. Discussion The cognitive improvements associated with exercise are likely driven by increased metabolic activity, cerebrovascular mechanisms, and neuroplasticity throughout the brain. Our paper shows the promise in, and need for, high-quality trials integrating cognitive and brain function measures to elucidate the functional relationship between exercise and brain health in populations with a high risk of dementia. Systematic review registration PROSPERO, identifier: CRD42022291843.
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Affiliation(s)
- Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Ali Butt
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Isabella H. K. Leung
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Ryan L. Childs
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Vithya Uruthiran
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Tiffany Tan
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Genevieve Z. Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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20
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Ding Z, Leung PY, Lee TL, Chan AS. Effectiveness of lifestyle medicine on cognitive functions in mild cognitive impairments and dementia: A systematic review on randomized controlled trials. Ageing Res Rev 2023; 86:101886. [PMID: 36806378 DOI: 10.1016/j.arr.2023.101886] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
Mild cognitive impairment (MCI) and dementia are associated with lifestyle risk factors, making lifestyle medicine a potentially viable intervention for people with MCI and dementia. The present study aims to examine the effectiveness of lifestyle medicine on cognitive functions among people with MCI and dementia, by performing a systematic review and meta-analysis on randomized controlled trials (RCT). A systematic literature search was conducted to extract RCTs adopting lifestyle interventions of diet, exercise, and stress management or emotional well-being. Results showed that 65 studies were eligible. Exercise was the most promising lifestyle intervention that improved various cognitive functions among people with MCI and dementia, and was more effective in MCI than in dementia. Interventions on stress management or emotional well-being did not show a significant effect on people with MCI, and the evidence for people with dementia was insufficient to conclude. Similarly, due to the lack of RCTs on a healthy dietary pattern, the effectiveness of diet interventions was not examined. In conclusion, the exercise component of lifestyle medicine can be an effective and clinically significant intervention for protecting people with MCI and dementia against cognitive declines, especially when served as an early intervention at the stage of MCI.
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Affiliation(s)
- Zihan Ding
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Pui-Ying Leung
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsz-Lok Lee
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China.
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21
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Liu X, Wang G, Cao Y. Association of nonpharmacological interventions for cognitive function in older adults with mild cognitive impairment: a systematic review and network meta-analysis. Aging Clin Exp Res 2023; 35:463-478. [PMID: 36607554 DOI: 10.1007/s40520-022-02333-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Understanding the effectiveness of nonpharmacological interventions to improve cognitive function in older adults with MCI and identifying the best intervention may help inform ideas for future RCT studies and clinical decision-making. AIM The main focus of this study was to assess the comparative effectiveness of nonpharmacological interventions on cognitive function in older adults with MCI and to rank the interventions. METHODS RCT studies until September 2022 were searched from six databases, including PubMed, the Cochrane Library, Embase, Web of Science, PsycINFO and CINAHL. The risk of bias in eligible trials was evaluated using the Cochrane Risk of Bias tool. Both pairwise and network meta-analyses were used, and pooled effect sizes were reported using SMD and the corresponding 95% confidence intervals. RESULTS A total of 28 RCT studies were included in this study, pooling 18 categories of nonpharmacological interventions. MBE (mind-body exercise) (SMD (standard mean difference): 0.24, 95% CI: 0.08-0.41, P = 0.004), DTE (dual-task exercise) (SMD: 0.61, 95% CI: 0.09-1.13, P = 0.02), PE (physical exercise) (SMD: 0.58, 95% CI: 0.04-1.12, P = 0.03) may be effective in improving cognitive function in older adults with MCI. Acupressure + CT (cognitive training) was the top-ranked intervention among all interventions. No greater benefits of MA (mindful awareness) on cognitive function were found. CONCLUSIONS Overall, nonpharmacological interventions significantly improved cognitive function in older adults with MCI. Acupressure + CT(cognitive training) was the most effective intervention for managing cognitive impairment. Future studies with high quality and large sample size RCT studies are needed to confirm our results.
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Affiliation(s)
- Xueyan Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China
| | - Guangpeng Wang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China.
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22
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Ahn J, Kim M. Effects of exercise therapy on global cognitive function and, depression in older adults with mild cognitive impairment: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 106:104855. [PMID: 36436448 DOI: 10.1016/j.archger.2022.104855] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/10/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to identify the integrated effects of exercise therapy on global cognitive function and, depression in older adults with mild cognitive function (MCI) and to determine the optimal exercise methods. METHODS We searched international, and domestic databases from January 1, 2010, to May 31, 2022, and included 22 articles in the meta-analysis (global cognitive function 21 articles; depression 7articles). Meta-analysis of variance and meta-regression were performed with moderator analysis to explore the causes of heterogeneity RESULTS: The mean effects (standardized mean differences) were 0.65 (95% confidence interval [CI]: 0.39-0.91) for global cognitive function and -0.38 (95% CI: -0.63 to -0.12) for depression in older adults with MCI who received exercise therapy, and the effect was statistically significant. CONCLUSION Aerobic and resistance exercises were effective in improving global cognitive function, Whereas multicomponent and neuromotor exercises were not. Aerobic exercise was the most effective at improving cognitive function. Thus, exercise therapy is effective in reducing depression in older adults with MCI. The mean effect of global cognitive function increased with higher exercise frequency.
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Affiliation(s)
- Juhyun Ahn
- College of Nursing, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Myoungsuk Kim
- College of Nursing, Kangwon National University, Chuncheon 24341, Republic of Korea.
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23
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Yang J, Dong Y, Yan S, Yi L, Qiu J. Which Specific Exercise Models Are Most Effective on Global Cognition in Patients with Cognitive Impairment? A Network Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2790. [PMID: 36833483 PMCID: PMC9957167 DOI: 10.3390/ijerph20042790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/22/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
(1) Introduction: Physical exercise interventions can impart significant cognitive benefits to older adults suffering from cognitive impairment (CI). However, the efficacy of these interventions can vary widely, depending on the type, intensity, duration and frequency of exercise. (2) Aim: To systematically review the efficacy of exercise therapy on global cognition in patients with CI using a network meta-analysis (NMA). (3) Methods: The PubMed, Embase, Sport Discus (EBSCO) and Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on exercise for patients with CI from inception to 7 August 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The NMA was performed using the consistency model. (4) Results: A total of 29 RCTs comprising 2458 CI patients were included. The effects of different types of exercise on patients with CI were ranked as follows: multicomponent exercise (SMD = 0.84, 95% CI 0.31 to 1.36, p = 0.002), short duration (≤45 min) (SMD = 0.83, 95% CI 0.18 to 1.19, p = 0.001), vigorous intensity (SMD = 0.77, 95% CI 0.18 to 1.36, p = 0.011) and high frequency (5-7 times/week) (SMD = 1.28, 95% CI 0.41 to 2.14, p = 0.004). (5) Conclusion: These results suggested that multicomponent, short-duration, high-intensity, and high-frequency exercise may be the most effective type of exercise in improving global cognition in CI patients. However, more RCTs based on direct comparison of the effects of different exercise interventions are needed. (6) NMA registration identifier: CRD42022354978.
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Affiliation(s)
- Junchao Yang
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Yunfeng Dong
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Shuting Yan
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Longyan Yi
- China Institute of Sports and Health, Beijing Sport University, Beijing 100084, China
| | - Junqiang Qiu
- School of Sport Science, Beijing Sport University, Beijing 100084, China
- Beijing Sports Nutrition Engineering Research Center, Beijing 100084, China
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24
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Braz de Oliveira MP, Moreira Padovez RDFC, Serrão PRMDS, Gomes Dos Santos J, Silva DCPD, Andrade LPD. Is physical exercise effective at improving body structure & function and activity outcomes in individuals with Mild Cognitive Impairment? a systematic review with quality of evidence assessment. Disabil Rehabil 2023; 45:575-587. [PMID: 35195496 DOI: 10.1080/09638288.2022.2040609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the effect of physical exercise on body structure & function and activity outcomes in individuals with Mild Cognitive Impairment (MCI). METHODS Six databases were searched from inception until January 2021. Randomized controlled trials (RCTs) comparing physical exercise with a control group were included. RESULTS Fourteen RCTs were included. Three types of physical exercise were identified: aerobic (AE), resistance (RE), and multimodal (ME). Regarding body structure & function outcomes, evidence for RE was very low and with effect for improvement in upper limb muscle strength and very low and without effect for lower limbs. For improvement in postural balance, evidence was very low and with effect with AE and very low and without effect with RE and ME. Evidence for cardiorespiratory function was very low and without effect with AE and RE. Regarding activity outcomes, evidence was low and without effect for mobility with AE and very low and without effect with RE and ME. CONCLUSIONS Physical exercise promoted improvements in body structure & function outcomes in individuals with MCI. Resistance exercise improvement upper limb muscle strength and AE enhanced postural balance. In contrast, physical exercise did not promote a significant benefit in activity outcomes.Implications for rehabilitationResults of this systematic review have shown that physical exercise promoted improvements in body structure & function outcomes in individuals with Mild Cognitive Impairment (MCI).Resistance exercise with elastic bands for approximately 60 minutes twice a week for a total of three months improved upper limb muscle strength.Aerobic exercise with walking for approximately 60 minutes twice per week for a total of six months enhanced postural balance.Considering the potential benefits identified in this systematic review, physical exercise can be recommended for individuals with MCI.We also highlight the importance of the use of the International Classification of Functioning, Disability and Health for rehabilitation planning.
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Affiliation(s)
- Marcos Paulo Braz de Oliveira
- Physical Therapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos, Brasil
| | | | | | - Julimara Gomes Dos Santos
- Department of Physical Education, Federal Institute of Education, Science and Technology of Mato Grosso, Advanced Campus Diamantino, Diamantino, Brazil
| | | | - Larissa Pires de Andrade
- Physical Therapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos, Brasil
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Zhu Q, Deng J, Yao M, Xu C, Liu D, Guo L, Zhu Y. Effects of physical activity on visuospatial working memory in healthy individuals: A systematic review and meta-analysis. Front Psychol 2023; 14:1103003. [PMID: 36874874 PMCID: PMC9974834 DOI: 10.3389/fpsyg.2023.1103003] [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: 11/19/2022] [Accepted: 01/25/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction Physical activity interventions improve cognitive performance, especially visuospatial working memory (VSWM). However, evidence on the effects of these interventions in children, adolescents, and older adults remains scant. This meta-analysis aimed to identify the effects of physical activity on VSWM improvement in healthy individuals and the best exercise intervention program to improve VSWM capacity. Methods We searched for randomized controlled trials (RCTs) of exercise interventions targeting VSWM in healthy individuals from Web of Science, MEDLINE, BIOSIS Previews, PubMed, China National Knowledge Infrastructure, and Wanfang Data (Chinese) databases, from inception to August 20, 2022. Results Among 21 articles (1,595 healthy participants), the heterogeneity test statistic was I2 = 32.3%, p = 0.053. The mean quality scores of the included articles were 6.9 points (reaction time [RT] studies) and 7.5 points (Score studies). Moreover, 28 RCTs were included (10 RT studies and 18 Score studies), and the subgroup analysis found significant effects for elderly participants, children, interventions involving a higher level of cognitive engagement, low and moderate exercise intensity, chronic exercise, exercise duration ≥60 min, and exercise period ≥90 days. Physical activity had a small but significant positive impact on VSWM in healthy individuals. Current evidence confirms the effects of physical activity on VSWM capacity only in children and seniors but not in young adults. Other age groups, including adolescents and middle-aged adults, have not been studied. Prescription of interventions involving high-level cognitive engagement, low and moderate exercise intensity, chronic exercise, exercise for >30 min per session, and exercise for more than 3 months is recommended for children and seniors. Discussion Future RCTs would be to fill the gap in studies on adolescents and middle-aged adults, and report detailed exercise intervention programs about different age groups.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022354737). INPLASY (https://doi.org/10.37766/inplasy2022.8.0053).
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Affiliation(s)
- Qiqi Zhu
- College of Physical Education, Southwest University, Chongqing, China
| | - Jie Deng
- College of Physical Education, Southwest University, Chongqing, China
| | - Meixi Yao
- Physical Education College, Zhengzhou University, Henan, China
| | - Chong Xu
- Ministry of Sports and National Defense Education, Chongqing College of Electronic Engineering, Chongqing, China
| | - Demin Liu
- College of Physical Education, Southwest University, Chongqing, China
| | - Liya Guo
- College of Physical Education, Southwest University, Chongqing, China
| | - Yu Zhu
- College of Physical Education, Southwest University, Chongqing, China
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26
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Cunha PM, Nunes JP, Werneck AO, Ribeiro AS, da Silva Machado DG, Kassiano W, Costa BDV, Cyrino LT, Antunes M, Kunevaliki G, Tomeleri CM, Fernandes RR, Junior PS, Teixeira DC, Venturini D, Barbosa DS, Qian YU, Herold F, Zou L, Mayhew JL, Stubbs B, Cyrino ES. Effect of Resistance Exercise Orders on Health Parameters in Trained Older Women: A Randomized Crossover Trial. Med Sci Sports Exerc 2023; 55:119-132. [PMID: 36044330 DOI: 10.1249/mss.0000000000003030] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to compare the effects of four resistance exercise orders on muscular strength, body composition, functional fitness, cardiovascular risk factors, and mental health parameters in trained older women. METHODS The intervention lasted 63 wk. Sixty-one physically independent women (>60 yr) after completing a 12-wk resistance training (RT) preconditioning phase were randomized into four different exercise orders groups to perform 12 wk of RT: multijoint to single-joint and upper- to lower-body, single-joint to multijoint and upper- to lower-body, multijoint to single-joint and lower- to upper-body, and single-joint to multijoint and lower- to upper-body. This was followed by a 12-wk detraining period and another 12-wk RT in which exercise orders were crossed over between MJ-SJ and SJ-MJ conditions. Body composition (dual-energy x-ray absorptiometry), muscular strength (one-repetition maximum tests), functional fitness (gait speed, walking agility, 30-s chair stand, and 6-min walk tests), cardiovascular risk factors (glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, advanced oxidation protein product, total radical-trapping antioxidant parameter, and nitric oxide), depressive (Geriatric Depression Scale) and anxiety symptoms (Beck Anxiety Inventory), and cognitive performance (Montreal Cognitive Assessment, Trail Making, verbal fluency, and Stroop test) were analyzed. RESULTS After the final training period, all groups presented significant improvements ( P < 0.05) in almost all analyzed variables (muscular strength, body composition, functional tests, blood biomarkers, and mental health parameters), without significant difference among exercise orders. CONCLUSIONS Our results suggest that RT exercise orders in which MJ, SJ, upper, or lower-body exercises are performed first have similar effects on health parameters in trained older women.
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Affiliation(s)
| | - João Pedro Nunes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - André O Werneck
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, SP, BRAZIL
| | | | | | - Witalo Kassiano
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Bruna D V Costa
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Letícia T Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Melissa Antunes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Gabriel Kunevaliki
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Crisieli M Tomeleri
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Rodrigo R Fernandes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Paulo Sugihara Junior
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Denilson C Teixeira
- Study and Research Group on Human Aging and Physical Activity, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
| | - Danielle Venturini
- Clinical Analyses Laboratory, State University of Londrina, Londrina, PR, BRAZIL
| | - Décio S Barbosa
- Clinical Analyses Laboratory, State University of Londrina, Londrina, PR, BRAZIL
| | - Y U Qian
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, CHINA
| | | | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, CHINA
| | - Jerry L Mayhew
- Exercise Science Program, Truman State University. Kirksville, MO
| | | | - Edilson Serpeloni Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, BRAZIL
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27
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Azevedo CV, Hashiguchi D, Campos HC, Figueiredo EV, Otaviano SFSD, Penitente AR, Arida RM, Longo BM. The effects of resistance exercise on cognitive function, amyloidogenesis, and neuroinflammation in Alzheimer's disease. Front Neurosci 2023; 17:1131214. [PMID: 36937673 PMCID: PMC10017453 DOI: 10.3389/fnins.2023.1131214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
With the increasing prevalence of Alzheimer's disease (AD) and difficulties in finding effective treatments, it is essential to discover alternative therapies through new approaches. In this regard, non-pharmacological therapies, such as physical exercise, have been proposed and explored for the treatment of AD. Recent studies have suggested that resistance exercise (RE) is an effective strategy for promoting benefits in memory and cognitive function, producing neuroprotective and anti-inflammatory effects, and reducing amyloid load and plaques, thereby reducing the risk, and alleviating the neurodegeneration process of AD and other types of dementia in the elderly. In addition, RE is the exercise recommended by the World Health Organization for the elderly due to its benefits in improving muscle strength and balance, and increasing autonomy and functional capacity, favoring improvements in the quality of life of the elderly population, who is more likely to develop AD and other types of dementia. In this mini-review, we discuss the impact of RE on humans affected by MCI and AD, and animal models of AD, and summarize the main findings regarding the effects of RE program on memory and cognitive functions, neurotrophic factors, Aβ deposition and plaque formation, as well as on neuroinflammation. Overall, the present review provides clinical and preclinical evidence that RE plays a role in alleviating AD symptoms and may help to understand the therapeutic potential of RE, thereby continuing the advances in AD therapies.
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Affiliation(s)
| | - Debora Hashiguchi
- Department of Physiology, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto do Cérebro, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil
| | | | | | | | - Arlete Rita Penitente
- Department of Physiology, Universidade Federal de São Paulo, São Paulo, Brazil
- Escola de Medicina, Departamento de Ginecologia Obstetrícia e Propedêutica da, Universidade Federal de Ouro Preto (UFOP), Minas Gerais, Brazil
| | - Ricardo Mario Arida
- Department of Physiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Beatriz Monteiro Longo
- Department of Physiology, Universidade Federal de São Paulo, São Paulo, Brazil
- *Correspondence: Beatriz Monteiro Longo,
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Lin M, Ma C, Zhu J, Gao J, Huang L, Huang J, Liu Z, Tao J, Chen L. Effects of exercise interventions on executive function in old adults with mild cognitive impairment: A systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev 2022; 82:101776. [PMID: 36332758 DOI: 10.1016/j.arr.2022.101776] [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: 10/21/2021] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
AIMS To assess the effect of exercise interventions on subdomains of executive function (EF) in older adults with mild cognitive impairment (MCI). METHODS Nine electronic databases were comprehensively searched from their inception to February 2021. Randomized controlled trials examining the effect of exercise training on EF in MCI were included. RESULTS Twenty-four eligible articles involving 2278 participants were identified. The results showed that exercise interventions had positive benefits on working memory, switching and inhibition in MCI. Subgroup analysis based on exercise prescriptions revealed that both aerobatic exercise and mind-body exercise had similar positive effect size on working memory. However, only mind-body exercise had significant effect on switching. Exercise training with moderate frequency (3-4 times/week) had larger effect size than low frequency (1-2 times/week) and only moderate frequency had positive benefits on switching. Both short (4-12 weeks), medium (13-24 weeks) and long (more than 24 weeks) exercise duration significantly ameliorate working memory and switching, however with short duration having slight larger effect sizes than medium and long. CONCLUSION Exercise significantly improves three subdomains of EF in MCI, especially mind-body exercise. Exercise training sticking to at least 4 weeks with 3-4 times a week tends to have larger effect size.
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Affiliation(s)
- Miaoran Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Chuyi Ma
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Jingfang Zhu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Jiahui Gao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Li Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| | - Zhizhen Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
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29
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Wang R, Zhang H, Li H, Ren H, Sun T, Xu L, Liu Y, Hou X. The influence of exercise interventions on cognitive functions in patients with amnestic mild cognitive impairment: A systematic review and meta-analysis. Front Public Health 2022; 10:1046841. [PMID: 36457329 PMCID: PMC9706097 DOI: 10.3389/fpubh.2022.1046841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Patients with amnestic mild cognitive impairment (aMCI) are more likely to develop dementia compared to patients with non-aMCI (naMCI). Among the mixed samples of aMCI and naMCI, exercise interventions are effective for patients with MCI to improve cognitive functions. However, the influence of exercise interventions on patients with aMCI is still unclear. Objective The objective of this systematic review and meta-analysis is to evaluate the influence of exercise interventions on cognitive functions in patients with aMCI. Methods Four literature databases (PubMed, Web of Science, EBSCO, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) were searched from their inception to August 31, 2022. Based on the preliminary search of seven databases and their cited references, a total of 2,290 records were identified. Finally, 10 studies with a total of 28 data points involving 575 participants with aMCI were included in this meta-analysis. If the measurements of outcomes were different among studies, the effect size was synthesized using the standardized mean difference (SMD) with a 95% confidence interval (CI). If the measurements were the same, the weight mean difference (WMD) with a 95% CI was used to integrate the effect size. Data synthesis The results showed that exercise interventions had no significant effects on improving several specific domains of cognitive functions including working memory (WMD = -0.05; 95% CI = -0.74 to 0.63; p = 0.88; I 2 = 78%) and attention (SMD = 0.20; 95% CI = -0.31 to 0.72; p = 0.44; I 2 = 60%). Additionally, exercise interventions had a significant effect on global cognitive function (SMD = 0.70; 95% CI = 0.50-0.90; p < 0.00001; I 2 = 29%) and some specific cognitive domains including immediate recall (SMD = 0.55; 95% CI = 0.28-0.81; p < 0.0001; I 2 = 0%), delayed recall (SMD = 0.66; 95% CI = 0.45-0.87; p < 0.00001; I 2 = 37%), and executive function (SMD = 0.38; 95% CI = 0.16-0.60; p= 0.0006; I 2 = 4%). Furthermore, subgroup analysis based on the intervention forms indicated that multi-component interventions (SMD = 0.44; 95% CI = 0.11-0.77; p = 0.009; I 2 = 0%) appeared to be less effective than the single-component intervention (SMD = 0.85; 95% CI = 0.60-1.10; p < 0.00001; I 2 = 10%) in terms of boosting global cognitive function. Conclusion This meta-analysis suggests that the exercise can help patients with aMCI improve global cognitive function. And exercise interventions have positive influence on enhancing several specific cognitive domains such as immediate recall, delayed recall, and executive function.Systematic review registration: http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022354235.
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Affiliation(s)
- Rong Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hanyue Zhang
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China.,School of Physical Education, Northeast Normal University, Changchun, China
| | - Hongjuan Li
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hong Ren
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Tingting Sun
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Liya Xu
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Yang Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, China
| | - Xiao Hou
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
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Yang JG, Thapa N, Park HJ, Bae S, Park KW, Park JH, Park H. Virtual Reality and Exercise Training Enhance Brain, Cognitive, and Physical Health in Older Adults with Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13300. [PMID: 36293881 PMCID: PMC9602597 DOI: 10.3390/ijerph192013300] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED We investigated the effectiveness of virtual-reality-based cognitive training (VRCT) and exercise on the brain, cognitive, physical and activity of older adults with mild cognitive impairment (MCI). METHODS This study included 99 participants (70.8 ± 5.4) with MCI in the VRCT, exercise, and control groups. The VRCT consisted of a series of games targeting different brain functions such as executive function, memory, and attention. Twenty-four sessions of VRCT (three days/week) were performed, and each session was 100 min long. Exercise intervention consisted of aerobic and resistance trainings performed in 24 sessions for 60 min (2 times/week for 12 weeks). Global cognitive function was measured using the Mini-Mental State Examination (MMSE) test. Resting-state electroencephalography (EEG) of the neural oscillatory activity in different frequency bands was performed. Physical function was measured using handgrip strength (HGS) and gait speed. RESULTS After the intervention period, VRCT significantly improved the MMSE scores (p < 0.05), and the exercise group had significantly improved HGS and MMSE scores (p < 0.05) compared to baseline. One-way analysis of variance (ANOVA) of resting-state EEG showed a decreased theta/beta power ratio (TBR) (p < 0.05) in the central region of the brain in the exercise group compared to the control group. Although not statistically significant, the VRCT group also showed a decreased TBR compared to the control group. The analysis of covariance (ANCOVA) test showed a significant decrease in theta band power in the VRCT group compared to the exercise group and a decrease in delta/alpha ratio in the exercise group compared to the VRCT group. CONCLUSION Our findings suggest that VRCT and exercise training enhances brain, cognitive, and physical health in older adults with MCI. Further studies with a larger population sample to identify the effect of VRCT in combination with exercise training are required to yield peak benefits for patients with MCI.
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Affiliation(s)
- Ja-Gyeong Yang
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Ngeemasara Thapa
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Hye-Jin Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Seongryu Bae
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Kyung Won Park
- Department of Neurology, College of Medicine, Dong-A University, Busan 49201, Korea
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
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Li H, Su W, Dang H, Han K, Lu H, Yue S, Zhang H. Exercise Training for Mild Cognitive Impairment Adults Older Than 60: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2022; 88:1263-1278. [PMID: 35811527 PMCID: PMC9484098 DOI: 10.3233/jad-220243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: The prevalence of mild cognitive impairment (MCI) continues to increase due to population aging. Exercise has been a supporting health strategy that may elicit beneficial effects on cognitive function and prevent dementia. Objective: This study aimed to examine the effects of aerobic, resistance, and multimodal exercise training on cognition in adults aged > 60 years with MCI. Methods: We searched the Cochrane Library, PubMed, and Embase databases and ClinicalTrials.gov (https://clinicaltrials.gov) up to November 2021, with no language restrictions. We included all published randomized controlled trials (RCTs) comparing the effect of exercise programs on cognitive function with any other active intervention or no intervention in participants with MCI aged > 60 years. Results: Twelve RCTs were included in this review. Meta-analysis results revealed significant improvements in resistance training on measures of executive function (p < 0.05) and attention (p < 0.05); no significant differences were observed between aerobic exercise and controls on any of the cognitive comparisons. Conclusion: Exercise training had a small beneficial effect on executive function and attention in older adults with MCI. Larger studies are required to examine the effects of exercise and the possible moderators.
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Affiliation(s)
- Hui Li
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,China Rehabilitation Research Center, Beijing, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Wenlong Su
- China Rehabilitation Research Center, Beijing, China
| | - Hui Dang
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,China Rehabilitation Research Center, Beijing, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Kaiyue Han
- China Rehabilitation Research Center, Beijing, China
| | - Haitao Lu
- China Rehabilitation Research Center, Beijing, China
| | - Shouwei Yue
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hao Zhang
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,China Rehabilitation Research Center, Beijing, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
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Mai Ba H, Kim J. The Effects of Combined Physical and Cognitive Interventions on Direct and Indirect Fall Outcomes for the Elderly with Mild Cognitive Impairment: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10050862. [PMID: 35628001 PMCID: PMC9140643 DOI: 10.3390/healthcare10050862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 01/04/2023] Open
Abstract
This review was intended to determine the effectiveness of physical and cognitive training (PCT) on falls and fall-related factors and cognitive function among community-dwelling elderly people with mild cognitive impairment (MCI). A systematic literature search was performed of the MEDLINE, CINAHL, Web of Sciences, Scopus, ProQuest, Embase, and Google Scholar databases for articles published from 2010 to 2020. The studies that combined PCT to assess their impacts on fall outcomes both directly and indirectly were included. Study quality was assessed using the standardized JBI Critical Appraisal Tool for RCTs. The standardized data extraction tool from JBI-MAStARI was used to extract data of included studies. Seven RCTs involving 740 participants were included. The overall fall incidence did not significantly decrease after the interventions. However, PCT significantly impacted the cognitive function and physical activities of elderly people with MCI, particularly improving their balancing ability, gait speed, muscular strength, and executive functions. This study indicated that combining PCT improves balance ability, gait speed, and executive functioning in the elderly with MCI, which may help to minimize fall occurrence.
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Affiliation(s)
- Hai Mai Ba
- Faculty of Nursing, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam; or
| | - Jiyun Kim
- School of Nursing, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4226
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Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. Ageing Res Rev 2022; 76:101591. [PMID: 35182742 DOI: 10.1016/j.arr.2022.101591] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine the dose-response relationship between overall and specific types of exercise with cognitive function in older adults. DESIGN Systematic Review and Bayesian Model-Based Network Meta-Analysis. DATA SOURCES Systematic search of MEDLINE, Web of Science, Scopus, PsycINFO and SPORTDiscus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomized controlled trials of exercise interventions in participants aged 50 years or over, and that reported on at least one global cognition outcome. RESULTS The search returned 1998 records, of which 44 studies (4793 participants; 102 different effect sizes) were included in this review with meta-analysis. There was a non-linear, dose-response association between overall exercise and cognition. We found no minimal threshold for the beneficial effect of exercise on cognition. The estimated minimal exercise dose associated with clinically relevant changes in cognition was 724 METs-min per week, and doses beyond 1200 METs-min per week provided less clear benefits. We also found that the dose-response association was exercise type dependent, and our results show that clinically important effects may occur at lower doses for many types of exercise. Our findings also highlighted the superior effects of resistance exercises over other modalities. CONCLUSIONS If provided with the most potent modalities, older adults can get clinical meaningful benefits with lower doses than the WHO guidelines. Findings support the WHO recommendations to emphasise resistance training as a critical component of interventions for older adults.
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Huang X, Zhao X, Li B, Cai Y, Zhang S, Wan Q, Yu F. Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:212-223. [PMID: 34004389 PMCID: PMC9068743 DOI: 10.1016/j.jshs.2021.05.003] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Exercise is a promising nonpharmacological therapy for cognitive dysfunction, but it is unclear which type of exercise is most effective. The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment (MCI) or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment. METHODS We searched PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia. Primary outcomes included global cognition, executive cognition, and memory cognition. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, and quality of life. Pairwise analyses and network meta-analyses were performed using a random effects model. RESULTS A total of 73 articles from 71 trials with 5606 participants were included. All types of exercise were effective in increasing or maintaining global cognition, and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition (standard mean difference (SMD) = 1.05, 95% confidence interval (95%CI): 0.56-1.54), executive function (SMD = 0.85, 95%CI: 0.21-1.49), and memory function (SMD = 0.32, 95%CI: 0.01-0.63) in patients with cognitive dysfunction. Subgroup analyses for patients with MCI revealed different effects, and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition (SMD = 0.99, 95%CI: 0.44-1.54) and executive function (SMD = 0.72, 95%CI: 0.06-1.38). However, only resistance exercise showed significant effects on memory function for patients with MCI (SMD = 0.35, 95%CI: 0.01-0.69). Exercise interventions also showed various effects on the secondary outcomes. CONCLUSION Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive decline in patients with cognitive dysfunction, especially in patients with dementia. Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.
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Affiliation(s)
- Xiuxiu Huang
- School of Nursing, Peking University, Beijing 100191, China
| | - Xiaoyan Zhao
- School of Nursing, Peking University, Beijing 100191, China
| | - Bei Li
- School of Nursing, Peking University, Beijing 100191, China
| | - Ying Cai
- School of Nursing, Peking University, Beijing 100191, China
| | - Shifang Zhang
- School of Nursing, Peking University, Beijing 100191, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing 100191, China.
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
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Coelho-Junior H, Marzetti E, Calvani R, Picca A, Arai H, Uchida M. Resistance training improves cognitive function in older adults with different cognitive status: a systematic review and Meta-analysis. Aging Ment Health 2022; 26:213-224. [PMID: 33325273 DOI: 10.1080/13607863.2020.1857691] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The present study investigated the impact of resistance training (RT) on cognitive function in older adults with different cognitive status by conducting a systematic review and meta-analysis of intervention studies. We performed a literature search with no restriction on publication year in MEDLINE, Embase, CINAHL, SPORTDiscus, and AgeLine from inception up to August 2020. Experimental studies investigating the impact of RT on the cognitive function of cognitively healthy (CH) and cognitively impaired (CI) older adults (≥60 years) were included for analysis. Eighteen studies were included in the final analysis, of which ten studies investigated CH community-dwelling older adult, seven studies investigated CI older adults, and one study investigated both. RT significantly improved overall cognitive function in both CH (SMD = 0.54; 95% CI = 0.00 to 1.08, P = 0.047) and CI (SMD = 0.60; 95% CI = 0.21 to 1.16, P = 0.005) older adults. However, short-term memory was only improved in CH older adults (MD = -0.20; 95% CI = -0.25 to -0.15, P < 0.00001). In conclusion, RT improved overall cognitive function in CH and CI older adults, whereas short-term memory, assessed by the digit span of the WAIS III, was only significantly improved in CH older adults.
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Affiliation(s)
- Helio Coelho-Junior
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy.,Universidade Estadual de Campinas - Campus Cidade Universitaria Zeferino Vaz, Campinas, Brazil
| | - Emanuele Marzetti
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Calvani
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Picca
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Marco Uchida
- Universidade Estadual de Campinas - Campus Cidade Universitaria Zeferino Vaz, Campinas, Brazil
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Huang X, Zhao X, Cai Y, Wan Q. The cerebral changes induced by exercise interventions in people with mild cognitive impairment and Alzheimer's disease: A systematic review. Arch Gerontol Geriatr 2022; 98:104547. [DOI: 10.1016/j.archger.2021.104547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/14/2021] [Accepted: 10/02/2021] [Indexed: 11/28/2022]
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An Overview on Cognitive Function Enhancement through Physical Exercises. Brain Sci 2021; 11:brainsci11101289. [PMID: 34679354 PMCID: PMC8534220 DOI: 10.3390/brainsci11101289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/12/2021] [Accepted: 09/18/2021] [Indexed: 11/18/2022] Open
Abstract
This review is extensively focused on the enhancement of cognitive functions while performing physical exercises categorized into cardiovascular exercises, resistance training, martial arts, racquet sports, dancing and mind-body exercises. Imaging modalities, viz. functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), have been included in this review. This review indicates that differences are present in cognitive functioning while changing the type of physical activity performed. This study concludes that employing fNIRS helps overcome certain limitations of fMRI. Further, the effects of physical activity on a diverse variety of the population, from active children to the old people, are discussed.
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Zhidong C, Wang X, Yin J, Song D, Chen Z. Effects of physical exercise on working memory in older adults: a systematic and meta-analytic review. Eur Rev Aging Phys Act 2021; 18:18. [PMID: 34535084 PMCID: PMC8447686 DOI: 10.1186/s11556-021-00272-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background This systematic and meta-analytic review aimed to investigate the effects of physical exercise on the working memory of older adults, and to identify the moderators of these effects. Methods We searched six electronic databases for randomized controlled trials on the effects of physical exercise on working memory that were published before or on May 15, 2020. The PEDro scale was used to evaluate the methodological quality of the included studies. Stata 14.0 software was used to perform the meta-analysis, subgroup analysis, and publication bias testing. Results A total of 28 studies and 2156 participants were included. The methodological quality of the included studies was fair to excellent, and there was no publication bias. Overall, we found that physical exercise had a significant effect on working memory in older adults (standardized mean difference = 0.30, p < 0.0001). The effects of physical exercise on working memory were moderated by exercise frequency, intensity, type, duration, cognitive status, and control subgroup (active/passive), but not by intervention period or age of participant. Conclusion Physical exercise can effectively improve the working memory of older adults. The recommended physical exercise is multi-component exercise or mind–body exercise of moderate intensity for 45–60 min 3 times a week, for more than 6 months. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00272-y.
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Affiliation(s)
- Cai Zhidong
- Shanghai University of Sport, School of Physical Education and Training, Shanghai, 200438, China
| | - Xing Wang
- Shanghai University of Sport, School of Physical Education and Training, Shanghai, 200438, China
| | - Jilin Yin
- Physical Education Department, Beibu Gulf University, Qinzhou, 535011, China
| | - Dehai Song
- Institute of P. E Yancheng Teachers University, Yancheng, 224002, Jiangsu Province, China
| | - Zhitong Chen
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, 2800 Wenxiang Road, Shanghai, 201620, China.
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Coelho-Júnior HJ, Uchida MC, Picca A, Bernabei R, Landi F, Calvani R, Cesari M, Marzetti E. Evidence-based recommendations for resistance and power training to prevent frailty in community-dwellers. Aging Clin Exp Res 2021; 33:2069-2086. [PMID: 33587271 DOI: 10.1007/s40520-021-01802-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial health care costs are associated with frailty. These features have led to the recognition of frailty as a public health problem. The identification of strategies for the management of frailty has, therefore, become a topic of extensive instigation. In this context, resistance (RT) and power training (PT) have received considerable attention, and experts in the field have recently suggested that both training modalities may improve frailty-related parameters. However, most studies have only included robust people and investigated frailty as a secondary outcome, so that current literature only allows RT and PT preventive programs against frailty to be designed. Here, we provide evidence-based critical recommendations for the prescription of RT and PT programs against incident frailty in community-dwellers.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil.
- Rehabilitation Unit, Lar Mãe Mariana Nursing Home, Poá, Brazil.
| | - Marco Carlos Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil
| | - Anna Picca
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Roberto Bernabei
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | | | - Riccardo Calvani
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20122, Milan, Italy
- Geriatric Unit, IRCCS Istutiti Clinici Scientifici Maugeri, 20138, Milan, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy.
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Coelho-Júnior HJ, Uchida MC. Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults. Front Med (Lausanne) 2021; 8:702436. [PMID: 34381802 PMCID: PMC8350041 DOI: 10.3389/fmed.2021.702436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/22/2021] [Indexed: 12/19/2022] Open
Abstract
Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people. Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity. Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate. Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT. Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
| | - Marco Carlos Uchida
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
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Kwag E, Stuckenschneider T, Schneider S, Abeln V. The effect of a psychomotor intervention on electroencephalography and neuropsychological performances in older adults with and without mild cognitive impairment. Psychogeriatrics 2021; 21:528-539. [PMID: 33960574 DOI: 10.1111/psyg.12702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/31/2021] [Accepted: 04/09/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this pilot study was to examine the acute effect of a psychomotor intervention (PMI) on auditory-verbal memory, emotional state, and electrocortical activity recorded by electroencephalography on subjectively healthy older adults (sHE) and older adults diagnosed with mild cognitive impairment (MCIs). METHODS Eleven MCIs and 11 sHE underwent a single 45-min PMI. Resting state electroencephalography, the Rey Auditory-Verbal Learning Test, MoodMeter®, and the Positive and Negative Affect Schedule were compared between groups and pre- and post-PMI. RESULTS Electroencephalography current source density and activity within the theta frequency band were higher in MCIs than in sHE at baseline, and brain frequency had a tendency to decrease in MCIs after training. Both groups showed improvement on the auditory-verbal memory test. Only among MCIs were there increases in perceived physical state and psychological strain and an improvement in negative affect. CONCLUSIONS Our findings suggest that acute psychomotor activity may be more effective for MCIs than for sHE. It supports the notion that PMI does have functional influences on the central nervous level and therefore might prevent and treat cognitive, psychological, and psychiatric symptoms of people with mild cognitive impairment.
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Affiliation(s)
- Eunyoung Kwag
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | - Tim Stuckenschneider
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Vera Abeln
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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Wu J, Wang X, Ye M, Wang L, Zheng G. Effect of regular resistance training on memory in older adults: A systematic review. Exp Gerontol 2021; 150:111396. [PMID: 33964318 DOI: 10.1016/j.exger.2021.111396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to evaluate the effect of regular resistance training on memory in older adults. METHODS Eight databases (PubMed, Cochrane Library, EMBASE, Web of Science, SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP) and Wanfang) were searched from their inception to March 24, 2021. The data included in the study were analysed according to the Cochrane handbook using Review Manager 5.3 software. RESULTS Eighteen eligible randomized controlled trials (RCTs) with a total of 1365 older adults were identified that met the inclusion criteria for the systematic review. Compared with no specific exercise or a low intensity exercise control, regular resistance training significantly improved working memory (standardized mean difference (SMD): 0.27, 95% confidence interval (CI): 0.11, 0.42, P < 0.001), immediate memory (SMD: 0.27, 95% CI: 0.01, 0.54, P = 0.04), and short-term memory (SMD: 0.68, 95% CI: 0.23,1.14, P = 0.003) but had no significant impact on verbal memory (SMD: 0.15, 95% CI: -0.40, 0.71, P = 0.59) or delayed memory (SMD: 0.01, 95% CI: -0.39, 0.42, P = 0.18). CONCLUSIONS Regular resistance training has a positive beneficial effect on working memory, immediate memory and short-term memory in older adults. However, due to the limitations of the included studies, these findings should be interpreted cautiously.
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Affiliation(s)
- Jiawei Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiaoqian Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mingzhu Ye
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lecong Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Guohua Zheng
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China.
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Pedroso RV, Lima-Silva AE, Tarachuque PE, Fraga FJ, Stein AM. THE EFFICACY OF PHYSICAL EXERCISE ON CORTICAL ACTIVITY MODULATION IN MILD COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW. Arch Phys Med Rehabil 2021; 102:2393-2401. [PMID: 33932357 DOI: 10.1016/j.apmr.2021.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/28/2021] [Accepted: 03/23/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the effects of physical exercise on cortical activity measured via EEG in individuals with Mild Cognitive Impairment (MCI). DATA SOURCES Pubmed, Web of Science, PsycINFO, Scielo databases were searched, using: "physical exercise"; "physical activity"; "physical therapy"; "exercise"; "training"; "electroencephalogram"; "electroencephalography"; "EEG"; "mild cognitive impairment"; "cognitive dysfunction"; "MCI". PRISMA statement was followed and the PEDro scale was used to assess the risk of bias of each study. STUDY SELECTION Original articles, sample including individuals with MCI, physical exercise intervention, use of EEG to measure cortical activity. DATA EXTRACTION Sample characteristics, physical exercise protocol characteristics, results related to effects of physical exercise on parameters derived from EEG signals and on other cognitive assessments, strengths, limitations and conclusions of the studies were selected by two investigators. DATA SYNTHESIS 365 articles were identified in electronic databases. After the selection stage, seven studies were included. Although there was a large spectrum of type of exercise (aerobic, resistance, multimodal, exergames and combined exercise with cognitive training), all exercise protocols altered cortical activity in MCI patients. An exercise session (acute response) causes power reduction of delta band and increases complexity and P300 amplitude in resting-state EEG. After an intervention with an exercise program (chronic response), there was a reduction in the power of delta and theta bands and an increase in beta and alpha bands, as well an increase in complexity in resting-state EEG. CONCLUSIONS Physical exercise seems to play a role in cortical activity in MCI patients, suggesting neural plasticity in such individuals.
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Affiliation(s)
- Renata Valle Pedroso
- Department of Gerontology, Federal University of São Carlos (UFSCar), São Carlos, São Paulo.
| | | | | | - Francisco José Fraga
- Engineering, Modelling and Applied Social Sciences Center (CECS), Federal University of ABC (UFABC), Santo André, São Paulo, Brazil
| | - Angelica Miki Stein
- The Human Performance Research Group Technological Federal University of Paraná, Curitiba, Paraná
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Lee S, Cho EJ, Kwak HB. Personalized Healthcare for Dementia. Healthcare (Basel) 2021; 9:healthcare9020128. [PMID: 33525656 PMCID: PMC7910906 DOI: 10.3390/healthcare9020128] [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: 12/23/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 01/07/2023] Open
Abstract
Dementia is one of the most common health problems affecting older adults, and the population with dementia is growing. Dementia refers to a comprehensive syndrome rather than a specific disease and is characterized by the loss of cognitive abilities. Many factors are related to dementia, such as aging, genetic profile, systemic vascular disease, unhealthy diet, and physical inactivity. As the causes and types of dementia are diverse, personalized healthcare is required. In this review, we first summarize various diagnostic approaches associated with dementia. Particularly, clinical diagnosis methods, biomarkers, neuroimaging, and digital biomarkers based on advances in data science and wearable devices are comprehensively reviewed. We then discuss three effective approaches to treating dementia, including engineering design, exercise, and diet. In the engineering design section, recent advances in monitoring and drug delivery systems for dementia are introduced. Additionally, we describe the effects of exercise on the treatment of dementia, especially focusing on the effects of aerobic and resistance training on cognitive function, and the effects of diets such as the Mediterranean diet and ketogenic diet on dementia.
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Affiliation(s)
- Seunghyeon Lee
- Program in Biomedical Science and Engineering, Inha University, Incheon 22212, Korea; (S.L.); (E.-J.C.)
- Department of Chemical Engineering, Inha University, Incheon 22212, Korea
| | - Eun-Jeong Cho
- Program in Biomedical Science and Engineering, Inha University, Incheon 22212, Korea; (S.L.); (E.-J.C.)
| | - Hyo-Bum Kwak
- Program in Biomedical Science and Engineering, Inha University, Incheon 22212, Korea; (S.L.); (E.-J.C.)
- Correspondence: ; Tel.: +82-32-860-8183
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Preventing dementia? Interventional approaches in mild cognitive impairment. Neurosci Biobehav Rev 2021; 122:143-164. [PMID: 33440197 DOI: 10.1016/j.neubiorev.2020.12.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/13/2020] [Accepted: 12/19/2020] [Indexed: 12/19/2022]
Abstract
Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.
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Faieta JM, Devos H, Vaduvathiriyan P, York MK, Erickson KI, Hirsch MA, Downer BG, van Wegen EEH, Wong DC, Philippou E, Negm A, Ahmadnezhad P, Krishnan S, Kahya M, Sood P, Heyn PC. Exercise interventions for older adults with Alzheimer's disease: a systematic review and meta-analysis protocol. Syst Rev 2021; 10:6. [PMID: 33397453 PMCID: PMC7779651 DOI: 10.1186/s13643-020-01555-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/06/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The growing societal and economic impact of Alzheimer's disease (AD) is further compounded by the present lack of disease-modifying interventions. Non-pharmacological intervention approaches, such as exercise, have the potential to be powerful approaches to improve or mitigate the symptoms of AD without added side effects or financial burden associated with drug therapies. Various forms and regiments of exercise (i.e., strength, aerobic, multicomponent) have been reported in the literature; however, conflicting evidence obscures clear interpretation of the value and impact of exercise as an intervention for older adults with AD. The primary objective of this review will be to evaluate the effects of exercise interventions for older adults with AD. In addition, this review will evaluate the evidence quality and synthesize the exercise training prescriptions for proper clinical practice guidelines and recommendations. METHODS This systematic review and meta-analysis will be carried out by an interdisciplinary collective representing clinical and research stakeholders with diverse expertise related to neurodegenerative diseases and rehabilitation medicine. Literature sources will include the following: Embase, PsychINFO, OVID Medline, and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily. Inclusion criteria are participants with late onset AD and structured exercise interventions with prescribed duration, frequency, and intensity. The primary outcome of this study will center on improved or sustained cognitive functioning. Secondary outcomes will include institutionalization-related outcomes, ability in activities of daily living, mood and emotional well-being, quality of life, morbidity, and mortality. Analysis procedures to include measurement of bias, data synthesis, sensitivity analysis, and assessment of heterogeneity are described in this protocol. DISCUSSION This review is anticipated to yield clinically meaningful insight on the specific value of exercise for older adults with AD. Improved understanding of diverse exercise intervention approaches and their specific impact on various health- and function-related outcomes is expected to guide clinicians to more frequently and accurately prescribe meaningful interventions for those affected by AD. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020175016 .
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Affiliation(s)
- Julie M Faieta
- Department of Rehabilitation, Université Laval, Quebec, Canada. .,Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Québec, Canada.
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, USA
| | | | | | | | - Mark A Hirsch
- Physical Medicine and Rehabilitation, Carolinas Medical Center/Carolinas Rehabilitation, Charlotte, USA
| | - Brian G Downer
- Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, USA
| | - Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam Neurosciences, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Diana C Wong
- Occupational Therapy, Rehabilitation Department, New York University, New York, USA
| | - Elena Philippou
- Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ahmed Negm
- Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Pedram Ahmadnezhad
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, USA
| | - Shilpa Krishnan
- Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, USA
| | - Melike Kahya
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, USA
| | - Pallavi Sood
- Rehabilitation Science, University of Florida, Gainesville, USA
| | - Patricia C Heyn
- Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, USA
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Duan H, Li P, Wang Z, Chen H, Wang T, Wu W, Liu X. Effect of 12-week pulmonary rehabilitation on cognitive function in patients with stable chronic obstructive pulmonary disease: study protocol for a single-center randomised controlled trial. BMJ Open 2020; 10:e037307. [PMID: 33067278 PMCID: PMC7569932 DOI: 10.1136/bmjopen-2020-037307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/23/2020] [Accepted: 09/06/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Cognitive impairment, an important complication in patients with chronic obstructive pulmonary disease (COPD), seriously affects self-management of the disease and quality of life (QoL). As an exercise-based intervention programme, pulmonary rehabilitation (PR)-especially aerobic exercise (mainly mind-body exercise) and resistance exercise (RE)-has been proposed for its potential effectiveness in improving cognitive function. However, there is still a lack of strong evidence for PR's effectiveness. In this study, we expect to clarify the effects of pulmonary-based Qigong exercise and elastic band-based RE on cognitive function in patients with COPD and to fill in the relevant evidence blanks. METHODS AND ANALYSIS This study is a single-centre randomised controlled trial with assessor and data analyst blinding. We will recruit 108 participants with stable COPD starting on 23 December 2019, and randomly allocate them into the pulmonary-based Qigong exercise group, elastic band-based RE group, pulmonary-based Qigong exercise and elastic band-based RE combined group, or control group at a 1:1:1:1 ratio. Participants in intervention groups will perform 30 min of exercise two times per day, 5 days a week, for 12 weeks. The primary outcome will be the global cognitive function as assessed by the Montreal Cognitive Assessment and auditory event-related potential P300. Secondary outcomes will include the specific cognitive domains-attention, memory, executive function, verbal fluency and mental-processing speed; psychological functions and QoL. Exploratory outcomes will include grey matter volume and levels of inflammatory mediators. Outcomes will be measured before and after the interventions. ETHICS AND DISSEMINATION Ethics approval has been granted by the Ethics Committee of Yue-Yang Integrative Medicine Hospital, an affiliate of Shanghai University of Traditional Chinese Medicine, Shanghai, China (Grant No. 2019-141). Written informed consent will be obtained from each participant before any procedures are performed. The findings will be published in peer-reviewed journals and presented at academic conferences. TRIAL REGISTRATION NUMBER ChiCTR1900026869; pre-results.
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Affiliation(s)
- Hongxia Duan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peijun Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Zhenwei Wang
- Department of Respiratory Medicine, Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, China
| | - Haixia Chen
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Ting Wang
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Weibing Wu
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Whitty E, Mansour H, Aguirre E, Palomo M, Charlesworth G, Ramjee S, Poppe M, Brodaty H, Kales HC, Morgan-Trimmer S, Nyman SR, Lang I, Walters K, Petersen I, Wenborn J, Minihane AM, Ritchie K, Huntley J, Walker Z, Cooper C. Efficacy of lifestyle and psychosocial interventions in reducing cognitive decline in older people: Systematic review. Ageing Res Rev 2020; 62:101113. [PMID: 32534025 DOI: 10.1016/j.arr.2020.101113] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/20/2020] [Accepted: 06/08/2020] [Indexed: 01/06/2023]
Abstract
It is unclear what non-pharmacological interventions to prevent cognitive decline should comprise. We systematically reviewed lifestyle and psychosocial interventions that aimed to reduce cognitive decline in healthy people aged 50+, and people of any age with Subjective Cognitive Decline or Mild Cognitive Impairment. We narratively synthesised evidence, prioritising results from studies rated as at lower Risk of Bias (ROB) and assigning Centre for Evidence Based Medicine grades. We included 64 papers, describing: psychosocial (n = 12), multi-domain (n = 10), exercise (n = 36), and dietary (n = 6) interventions. We found Grade A evidence that over 4+ months: aerobic exercise twice weekly had a moderate effect on global cognition in people with/ without MCI; and interventions that integrate cognitive and motor challenges (e.g. dance, dumb bell training) had small to moderate effects on memory or global cognition in people with MCI. We found Grade B evidence that 4+ months of creative art or story-telling groups in people with MCI; 6 months of resistance training in people with MCI and a two-year, dietary, exercise, cognitive training and social intervention in people with or without MCI had small, positive effects on global cognition. Effects for some intervention remained up to a year beyond facilitated sessions.
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De la Rosa A, Olaso-Gonzalez G, Arc-Chagnaud C, Millan F, Salvador-Pascual A, García-Lucerga C, Blasco-Lafarga C, Garcia-Dominguez E, Carretero A, Correas AG, Viña J, Gomez-Cabrera MC. Physical exercise in the prevention and treatment of Alzheimer's disease. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:394-404. [PMID: 32780691 PMCID: PMC7498620 DOI: 10.1016/j.jshs.2020.01.004] [Citation(s) in RCA: 227] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/26/2019] [Accepted: 12/12/2019] [Indexed: 05/02/2023]
Abstract
Dementia is one of the greatest global challenges for health and social care in the 21st century. Alzheimer's disease (AD), the most common type of dementia, is by no means an inevitable consequence of growing old. Several lifestyle factors may increase, or reduce, an individual's risk of developing AD. Much has been written over the ages about the benefits of exercise and physical activity. Among the risk factors associated with AD is a low level of physical activity. The relationship between physical and mental health was established several years ago. In this review, we discuss the role of exercise (aerobic and resistance) training as a therapeutic strategy for the treatment and prevention of AD. Older adults who exercise are more likely to maintain cognition. We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies. We will pay especial attention to the potential role of exercise in the modulation of amyloid β turnover, inflammation, synthesis and release of neurotrophins, and improvements in cerebral blood flow. Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide. Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations.
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Affiliation(s)
- Adrian De la Rosa
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | - Gloria Olaso-Gonzalez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | - Coralie Arc-Chagnaud
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain; INRA, UMR866 Muscle dynamics and metabolism, University of Montpellier, F-34060, Montpellier, France
| | - Fernando Millan
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | - Andrea Salvador-Pascual
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | | | | | - Esther Garcia-Dominguez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | - Aitor Carretero
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | - Angela G Correas
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain
| | - Jose Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain.
| | - Mari Carmen Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, and CIBERFES, Insitute of Health Research-INCLIVA, Valencia 46010, Spain.
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Zhou XL, Wang LN, Wang J, Zhou L, Shen XH. Effects of exercise interventions for specific cognitive domains in old adults with mild cognitive impairment: A meta-analysis and subgroup analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e20105. [PMID: 32756073 PMCID: PMC7402775 DOI: 10.1097/md.0000000000020105] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To conduct a meta-analysis and subgroup analysis investigating the effects of exercise on mild cognitive impairment (MCI) patients across specific cognitive domain outcomes. We also analyzed and identified the level of influence of exercise interventions on specific cognitive domains. METHODS MEDLINE, EMBASE, Cochrane Library, Web of Science, CNKI, the Wan Fang Database, and CBM were searched from inception to April 2018. Randomized controlled trials of exercise interventions in MCI patients older than 55 years, with an outcome measure of cognitive function were included. RESULTS Eleven studies with sufficient data met the inclusion criteria for the meta-analysis. Exercise interventions significantly improved general function (g mini-mental state examination Montreal cognitive assessment = 0.32, 95% the 95% confidence interval (CI) 0.1 to 0.54, P = .005 and g Alzheimer disease assessment scale-cognition = -0.45, 95% CI -0.82 to -0.08, P = .02); executive functions (g digit span forward test, digit span backward test, digit span forward test -B, stroop test-A, stroop test-B = 0.66, 95% CI 0.17 to 1.15, P = .008); memory (g Wechsler memory scale immediate recall and Wechsler memory scale delayed recall = 0.37, 95% CI 0.15 to 0.60, P = .001); language ability (g category verbal fluency test and letter verbal fluency test = 0.55, 95% CI 0.22 to 0.89, P = .001); and visuospatial ability (g block design score = 0.38, 95% CI 0.03 to 0.72, P = .03). However, the improvement exercise conferred on the trail-making test part B-A was not statistically significant (g trail-making test part B-A = -0.25, 95% CI -0.88 to 0.39, P = .45). The preliminary ranking of the effect on the overall effect was as follows: Z language ability > Z executive functions > memory > Z visuospatial ability. CONCLUSION Exercise improves performance in the 5 cognitive domains. Across cognitive domains, language ability was the domain most affected by exercise. Besides, the kind of ranking (Z value) provides a new perspective for community health care workers to prescribe targeted exercise interventions for MCI patients.PROSPERO registration number: CRD42018093902.
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Affiliation(s)
- Xiang-Lian Zhou
- School of Nursing, Medical College of Huzhou University, Zhejiang Province
| | - Li-Na Wang
- School of Nursing, Medical College of Huzhou University, Zhejiang Province
| | - Jie Wang
- School of Nursing, Medical College of Huzhou University, Zhejiang Province
| | - Ling Zhou
- Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai City
| | - Xin-Hua Shen
- Department of psychosomatic diseases, Huzhou Third People's Hospital, Zhejiang Province, China
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