Effects of physical exercise on working memory in older adults: a systematic and meta-analytic review

Exploring the effects of combining health qigong and dance on working memory in middle-aged and elderly women: A preliminary investigation

OBJECTIVE

Cognitive decline represents a critical clinical and public health issue that adversely affects the quality of life for older patients and their families. This concern was exacerbated by the reduced engagement in outdoor activities among seniors during the COVID-19 pandemic, presenting substantial challenges to aging societies. The objective of this study was to investigate the impact of health qigong combined with Tibetan dance on working memory in middle-aged and elderly women, and to determine its potential as a preventive strategy against cognitive disorders.

METHODS

A pilot study was conducted to compare the effects of a Health Qigong exercise intervention with those of everyday life and sports routines. The primary outcome measure was working memory assessed using a 2-Back working memory task research paradigm. Between July and September 2021, a total of 33 women were divided into four groups: two middle-aged groups (N = 18, with 8 women in the experimental group and 10 in the control group) and two elderly groups (N = 15, with 7 in the experimental group and 8 in the control group). Participants in the experimental groups underwent a 10-week intervention, consisting of three 60-min sessions per week. Each session included a warm-up, Health Qigong combined with Tibetan dance, and a cool-down. Throughout the study, all participants continued their daily routines. Response times and error rates were analyzed using a mixed-design repeated-measures analysis of variance.

RESULTS

A simple effects analysis revealed that Health Qigong combined with Tibetan dance significantly enhanced 2-Back response time and error rate in the middle-aged group. In contrast, the 2-Back error rate significantly increased in the elderly control group that did not receive the intervention (p < 0.05).

CONCLUSION

Health Qigong demonstrates beneficial effects on middle-aged and elderly women. Combining Health Qigong with dance may serve as a preventive measure against cognitive disorders. This pioneering study conducted during the COVID-19 pandemic, assesses the new possibility of Health Qigong and dance, with the objective to offer more diverse indoor exercise options for middle-aged and elderly women.

The effect of exercise on balance function in stroke patients: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

A growing body of studies has examined the effect of exercise on balance function in stroke patients, with conflicting findings. This study aimed to investigate the effect of exercise on balance function in stroke patients and to determine the optimal exercise prescription for stroke patients.

METHODS

We conducted an extensive search across various databases, including PubMed, Web of Science, EBSCO, Cochrane, and Scopus. The search was conducted until March 11th, 2024. Data were pooled using the weighted mean difference (WMD) and 95% confidence interval.

RESULTS

Twenty-nine studies fulfilled the inclusion criteria. Exercise significantly improved Berg balance scale (BBS, WMD, 5.24, P < 0.00001) and timed up and go test (TUG, WMD, - 2.91, P < 0.00001) in stroke patients. Subgroup analyses showed that aerobic exercise (WMD, 6.71, P = 0.003), exercise conducted ≥ 8 weeks (WMD, 6.43, P < 0.00001), > 3 times per week (WMD, 6.18, P < 0.00001), ≥ 60 min per session (WMD, 6.40, P < 0.0001), and ≥ 180 min per week (WMD, 7.49, P < 0.00001) were more effective in improving BBS.

CONCLUSIONS

Exercise improved balance function in stroke patients, and aerobic exercise might be the most effective intervention. To improve balance function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in a minimum of 8 weeks of exercise at least 3 times per week for more than 60 min per session, with a goal of 180 min per week being achieved by increasing the frequency of exercise.

Effect of information and communication technology-based smart care services for physical and cognitive functions in older adults living alone: A quasi-experimental study

BACKGROUND

As the global population ages and the number of older adults living alone increases, societies face the responsibility of building new support systems and providing novel forms of care to ensure the independence and happiness of sick or frail older individuals. This quasi-experimental study examined the association between information and communication technology-based smart care services and the physical and cognitive functions of older individuals living alone.

METHODS

This study used a suite of smart technologies (artificial intelligence speaker, radar sensor, and personalized exercise App.) and interventions tailored to the initial physical functional scores of the participants. A total of 176 participants were recruited and assigned, with 88 participants in the intervention group and 88 in the control group. The short physical performance battery (SPPB), the digit span test (DST), and the Korean mini-mental state examination (K-MMSE) were used to assess participants before and after 12 weeks.

RESULTS

No significant differences in gender, age, or educational levels were observed between the intervention and control groups. After adjusting for baseline performance, analysis of covariance revealed that the intervention group exhibited better outcomes in the SPPB five-time chair stand score (adjusted score difference: 0.329; P = 0.044) and the backward DST (adjusted score difference: 0.472; P = 0.007), but had lower score of K-MMSE (adjusted score difference: -0.935; P = 0.021), indicating enhanced lower limb muscle strength and cognitive function in working memory.

CONCLUSION

ICT-based smart care services, combined with personalized exercise interventions, significantly support the physical and cognitive health of solitary older individuals. This approach highlights the potential of integrating smart technology and targeted physical activity to foster the well-being of the aging population living alone.

Effects of different types of leisure activities on working memory across the adult lifespan

The aim of the present study was to contrast the potential influence of five independent types of leisure activities (physical, mental, social, cultural, and passive) on working memory in a lifespan sample and in specific stages of adulthood (young, middle-aged, and older adults). A sample of 1652 healthy adults between 21 and 80 years of age participated in the study. Leisure activities were assessed through a lifestyle questionnaire created for the study. Working memory was measured in the verbal and spatial domains using a computerized n-back task that allowed us to reliably measure discrimination and reaction times. Across adulthood, mental (computer use and hobbies) and social leisure activities predicted greater verbal and spatial working memory discrimination; mental (reading) and social activities predicted faster verbal working memory; and mental (computer use) and physical activities predicted faster spatial working memory. In young adults, mental (computer use) and social activities were associated with greater verbal and spatial working memory performance. In middle-aged adults, physical and mental activities (computer use) were associated with greater working memory performance. In older adults, physical, mental (hobbies), and social activities were associated with greater working memory performance. Leisure activities can enhance working memory discrimination and speed independent of individuals' age.

Effects of different types of physical exercise on executive function of older adults: a scoping review

Objective

This scoping review examined the impact of physical exercise on executive function (EF) in older adults and investigated the moderating effects of exercise types.

Methods

We systematically searched four electronic databases for randomized controlled trials (RCTs) investigating the effects of exercise on EF, published until November 26, 2023. The proportions of positive and null/negative effects across all studies were calculated.

Results

In total, 91 studies were included in the analysis. Among these, 27 (29.7%) studies employed aerobic exercise interventions for older adults' EF, with 19 (70.4%) studies reporting positive effects. Additionally, 18 (19.8%) studies utilized strength exercise interventions for older adults' EF, with 15 (83.3%) studies demonstrating positive benefits. Furthermore, 32 (35.2%) studies employed coordination exercise interventions for older adults' EF, with 25 (78.1%) studies showing positive benefits. Similarly, 30 (33%) studies applied mixed exercise interventions for older adults' EF, with 25 (83.3%) studies indicating positive benefits.

Conclusion

Overall, all four types of physical exercise enhance EF in older adults, with mixed exercises being the most effective.

The Influence of Separate and Combined Exercise and Foreign Language Acquisition on Learning and Cognition

Aging contributes significantly to cognitive decline. Aerobic exercise (AE) has been shown to induce substantial neuroplasticity changes, enhancing cognitive and brain health. Likewise, recent research underscores the cognitive benefits of foreign language learning (FLL), indicating improvements in brain structure and function across age groups. However, the lack of a comprehensive paradigm integrating language learning with exercise limits research on combined effects in older adults. In order to address this gap, we devised a novel approach using a virtual world tourism scenario for auditory-based language learning combined with aerobic cycling. Our study examines the impact of simultaneous AE and FLL integration on cognitive and language learning outcomes compared to FLL alone. A total of 20 older adults were randomly assigned to AE + FLL and FLL-only groups. The results revealed significantly improved Spanish language learning outcomes in both combined and language learning-only groups. Additionally, significant cognitive function improvement was observed in the FLL group following short-term language learning.

Effects of exercise on post-stroke cognitive function: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

A growing body of research examining the effect of exercise on cognitive function in stroke patients, while findings of available studies were conflicting.

OBJECTIVES

We aimed to estimate the effect of exercise on cognitive function in stroke patients.

METHODS

For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane, and Scopus electronic databases, through 13 March 2023. The three-level restricted maximum likelihood random effects model was used to synthesize the data.

RESULTS

Twenty-five studies met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in stroke patients (Cohen's d = 0.37, 95% CI, 0.16 to 0.58, p < 0.01, I2  = 22.12%). Subgroup analysis showed that exercise significantly improved memory. In addition, aerobic exercise, exercise conducted 12 weeks or more, 3 times or more per week, less than 60 minutes per session, less than 180 minutes per week, and up to 12 months post-stroke increased cognitive function significantly.

CONCLUSIONS

Exercise improved cognitive function in stroke patients. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in aerobic exercise at least 3 times per week for 30-60 minutes, with a goal of 180 minutes per week being achieved by increasing the frequency of exercise. Exercise initiated within 12 months post-stroke and continued for 12 weeks or more is most beneficial for improving cognitive function.

The relationship of aerobic fitness with verbal and spatial working memory: An ERP study

Working memory (WM) plays an important role in daily life and is known to correlated with aerobic fitness. However, whether the relationship between aerobic fitness and WM is dependent on the stimulus modality or is associated with one or multiple subprocesses involved in WM remains unknown. Accordingly, this study utilized event-related potentials (ERPs) to comprehensively examine the encoding, preparation, and retrieval processes during verbal and spatial WM performance. Eighty-eight young adults aged 18-30years were recruited to participate in two laboratory visits on separate days. On day 1, aerobic fitness was assessed by maximum oxygen consumption (V˙O2max) during a treadmill-based graded exercise test. On day 2, participants completed verbal and spatial WM tasks while P2, contingent negative voltage (CNV), and P3 components of ERP were recorded during the encoding, preparatory, and retrieval stages of WM, respectively. Results of hierarchical regression analysis showed that V˙O2max was positively correlated with response accuracy during the high-demanding condition of spatial WM after controlling for age, sex, and self-reported physical activity. Additionally, a higher level of V˙O2max was associated with larger terminal CNV amplitude at the Cz electrode during the high-demanding condition of spatial WM. These findings suggest that aerobic fitness may have selective beneficial associations with the motor preparatory process and subsequent task performance requiring a greater amount of spatial information but not the encoding and retrieval stages nor the verbal modality of WM.

Self-reported physical activity and sleep quality is associated with working memory function in middle-aged and older adults during the COVID-19 pandemic

While previous work has shown a positive relationship between cognitive performance and lifestyle factors in younger adults, evidence for this relationship among middle-aged and older adults has been mixed. The current study aimed to further test the relationship among physical activity, sleep quality, and memory performance in middle-aged and older adults, and to test whether this relationship holds up during the COVID-19 pandemic. Our results showed that physical activity was associated with better sleep quality and better working memory performance, and better sleep quality was associated with better working memory and self-perceptions of everyday memory abilities. Additionally, we found that the effects of physical activity on working memory were partially mediated by sleep quality. While these effects were small and only correlational in nature, they lend further support to the notion that sleep quality and physical activity are beneficial to memory later in life, even during a global pandemic.

Grip strength, working memory, and emotion perception in middle-aged males

This study examined the association between grip strength and emotional working memory in middle-aged adults. Seventy-six males aged 40-60years (mean=48.5years, SD=5.4) participated in this cross-sectional study. They completed a muscular fitness assessment using a maximum grip strength test and emotional n-back tasks under two emotion conditions (fearful and neutral facial pictures) and two working memory loads (1-back and 2-back tasks). Hierarchical regression analyses indicated that greater muscular fitness was associated with superior working memory performance in the fearful condition in both the 1-back and 2-back tasks, after controlling for confounders. Greater muscular fitness was also associated with superior working memory performance in the neutral condition when the working memory load was high (2-back task) but not low (1-back task). These findings suggest a positive association between muscular fitness and emotional working memory and highlight the importance of maintaining muscular fitness for physical and cognitive-emotional well-being in middle-aged adults.

Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases

Rehabilitation improves symptoms, quality of life, and survival in patients with chronic respiratory or cardiovascular disease. We evaluated smartphone application-based rehabilitation programs for patients with chronic respiratory or cardiovascular diseases. This was a single-center prospective single arm study. Participants underwent smartphone application-based pulmonary or cardiac rehabilitation for 12 weeks. A total of 93 participants were recruited, and 75 visited after rehabilitation. Their median age was 67.0 (interquartile range, 60.0-70.8) years, and 60 (80.0%) were men. For patients with chronic respiratory disease (n = 41), VO2peak (median 13.7 to 15.4 ml/kg/min, P = 0.049), chronic obstructive pulmonary disease assessment test (median 14 to 6, P < 0.001), Euro-QoL 5-Dimension 5-Level (EQ-5D-5L) index (median 0.795 to 0.862, P = 0.001), and Health-related Quality of Life Instrument with 8 Items (HINT-8) index (median 0.784 to 0.855, P < 0.001) were significantly improved. For patients with chronic cardiovascular disease (n = 34), VO2peak (median 21.8 to 23.3, P = 0.007), EQ-5D-5L index (median 0.871 to 1.000, P = 0.037), and HINT-8 index (median 0.890 to 0.903, P < 0.001) were significantly improved. The smartphone application-based rehabilitation program improved exercise capacity and quality of life in patients with chronic respiratory or cardiovascular disease.Trial registration: https://clinicaltrials.gov/ct2/show/NCT05383950 (20/05/2022).

Cpt1a silencing in AgRP neurons improves cognitive and physical capacity and promotes healthy aging in male mice

Orexigenic neurons expressing agouti-related protein (AgRP) and neuropeptide Y in the arcuate nucleus (ARC) of the hypothalamus are activated in response to dynamic variations in the metabolic state, including exercise. We previously observed that carnitine palmitoyltransferase 1a (CPT1A), a rate-limiting enzyme of mitochondrial fatty acid oxidation, is a key factor in AgRP neurons, modulating whole-body energy balance and fluid homeostasis. However, the effect of CPT1A in AgRP neurons in aged mice and during exercise has not been explored yet. We have evaluated the physical and cognitive capacity of adult and aged mutant male mice lacking Cpt1a in AgRP neurons (Cpt1a KO). Adult Cpt1a KO male mice exhibited enhanced endurance performance, motor coordination, locomotion, and exploration compared with control mice. No changes were observed in anxiety-related behavior, cognition, and muscle strength. Adult Cpt1a KO mice showed a reduction in gastrocnemius and tibialis anterior muscle mass. The cross-sectional area (CSA) of these muscles were smaller than those of control mice displaying a myofiber remodeling from type II to type I fibers. In aged mice, changes in myofiber remodeling were maintained in Cpt1a KO mice, avoiding loss of physical capacity during aging progression. Additionally, aged Cpt1a KO mice revealed better cognitive skills, reduced inflammation, and oxidative stress in the hypothalamus and hippocampus. In conclusion, CPT1A in AgRP neurons appears to modulate health and protects against aging. Future studies are required to clarify whether CPT1A is a potential antiaging candidate for treating diseases affecting memory and physical activity.

The Impact of an Outdoor Motor-Cognitive Exercise Programme on the Health Outcomes of Older Adults in Community Settings: A Pilot and Feasibility Study

Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor-cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor-cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, ηp2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults.

Pilot study of a high-intensity interval training program in older adults: Safety, feasibility, functional fitness and cognitive effects

Exercise can boost physical and cognitive health in older adults. However, there are a lack of accessible exercise programs that foster adherence among older adults. In this study, we aimed to establish the safety and feasibility of APEX, a new exercise program designed to optimize fitness and cognitive gains for older adults, in addition to evaluating its acute physiological effects, and assessing its possible effects on functional fitness and cognition among healthy older adults. APEX utilizes a multimodal progressive high-intensity interval training (HIIT) design, with high-intensity intervals focused on enhancing cardiovascular fitness and muscle strength, and recovery intervals that incorporate balance and mobility exercises. The APEX training was tested in healthy older adults (n=4) over the course of four weeks. Ultimately, APEX was found to be safe and feasible, with no adverse events and high adherence. Participants met heart rate targets for all of the high-intensity exercises, and all intervals had a significant difference in heart rates between high-intensity and recovery periods in linear effects models (p<0.001). Improvements in functional fitness were observed in aerobic endurance, lower body strength, and balance. The intervention was also associated with positive trends in the cognitive domains of information processing, working memory, executive control, and attention. APEX offers a promising alternative to traditional cardiovascular exercise modalities for older adults with additional benefits for functional fitness and cognition. These results encourage further testing of the APEX program in older adults and different clinical populations.

Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older - an umbrella review

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults ≥ 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acute exercise. Variation across studies due to heterogeneity was considered very high.Conclusions Mind-body exercise has moderate positive effects on the cognitive function of people aged 55 or older. To promote healthy aging, mind-body exercise should be used over a prolonged period to complement other types of exercise. Results of this review should be used to inform the development of guidelines to promote healthy aging.Trial registration PROSPERO (CDR 42022312955).

Aerobic Fitness as an Important Moderator Risk Factor for Loneliness in Physically Trained Older People: An Explanatory Case Study Using Machine Learning

BACKGROUND

Loneliness in older people seems to have emerged as an increasingly prevalent social problem.

OBJECTIVE

To apply a machine learning (ML) algorithm to the task of understanding the influence of sociodemographic variables, physical fitness, physical activity levels (PAL), and sedentary behavior (SB) on the loneliness feelings of physically trained older people.

MATERIALS AND METHODS

The UCLA loneliness scale was used to evaluate loneliness, the Functional Fitness Test Battery was used to evaluate the correlation of sociodemographic variables, physical fitness, PAL, and SB in the loneliness feelings scores of 23 trained older people (19 women and 4 men). For this purpose, a naive Bayes ML algorithm was applied.

RESULTS

After analysis, we inferred that aerobic fitness (AF), hand grip strength (HG), and upper limb strength (ULS) comprised the most relevant variables panel to cause high participant loneliness with 100% accuracy and F-1 score.

CONCLUSIONS

The naive Bayes algorithm with leave-one-out cross-validation (LOOCV) predicted loneliness in trained older with a high precision. In addition, AF was the most potent variable in reducing loneliness risk.

An umbrella review of randomized control trials on the effects of physical exercise on cognition

Extensive research links regular physical exercise to an overall enhancement of cognitive function across the lifespan. Here we assess the causal evidence supporting this relationship in the healthy population, using an umbrella review of meta-analyses limited to randomized controlled trials (RCTs). Despite most of the 24 reviewed meta-analyses reporting a positive overall effect, our assessment reveals evidence of low statistical power in the primary RCTs, selective inclusion of studies, publication bias and large variation in combinations of pre-processing and analytic decisions. In addition, our meta-analysis of all the primary RCTs included in the revised meta-analyses shows small exercise-related benefits (d = 0.22, 95% confidence interval 0.16 to 0.28) that became substantially smaller after accounting for key moderators (that is, active control and baseline differences; d = 0.13, 95% confidence interval 0.07 to 0.20), and negligible after correcting for publication bias (d = 0.05, 95% confidence interval -0.09 to 0.14). These findings suggest caution in claims and recommendations linking regular physical exercise to cognitive benefits in the healthy human population until more reliable causal evidence accumulates.

Feasibility of a pilot dyadic randomized controlled trial testing the effects of three behavioral interventions on older adults' cognitive, physical and everyday function

Introduction: Maintaining functional abilities is critical for optimizing older adults' well-being and independence. This randomized controlled trial (RCT) pilot examined the feasibility of testing the effects of three commercially available interventions on function-related outcomes in older adults. Methods: Pairs of community-dwelling older adults (N=55, Mage=71.4) were randomized to a 10-week intervention (cognitive-COG, physical-EX, combined exergame-EXCOG, or control-CON). Cognitive, physical, and everyday function were assessed at baseline, immediately post-intervention, and 6-months post-intervention. Feasibility was evaluated using recruitment, enrollment, training adherence, and retention metrics. Variability and patterns of change in functional outcomes were examined descriptively. Results: A total of 208 individuals were screened, with 26% subsequently randomized. Across training arms, 95% of training sessions were completed and 89% of participants were retained at immediate post-test. Variability in functional outcomes and patterns of change differed across study arms. Discussion: Results support a fully powered RCT, with several modifications to the pilot study design, to investigate short- and long-term training impacts.

Effects of physical activity interventions on executive function in older adults with dementia: A meta-analysis of randomized controlled trials

BACKGROUND

To date quantitative meta-analysis with large samples to investigate the effects and potential moderators of physical activity (PA) on executive function (EF) in older adults with dementia is insufficient. Therefore, we conducted this meta-analysis.

DESIGN

Meta-analysis of randomized controlled trials (RCTs).

PARTICIPANTS

Old people with Alzheimer's disease (AD) or related dementia of varying types and severity as the primary diagnosis.

METHODS

PubMed, Web of Science, the Cochrane Library and Embase databases were searched for relevant studies published from 01 January, 2010 to 01 March, 2022. The results of executive function were reported in all RCTs. Random-effects meta-analysis was used to calculate the size of effects. Subgroup analyses of three moderators (including the specific sub-domains of EF, exercise prescription variables, and sample characteristics) were performed.

RESULTS

Eighteen RCTs were included with a combined sample size of 1366. Overall, PA interventions improved overall EF (standardized mean difference [SMD]=0.23, 95% confidence interval [CI] 0.05 to 0.41, p<0.05). The EF sub-domain "planning" was significant moderator (SMD=0.31, 95%CI 0.11 to 1.51, p<0.01), but inhibitory control, working memory and cognitive flexibility were not significant. Regarding exercise prescription variables, type of resistance training; moderate intensity; total duration ≤24 weeks and short (once or twice a week) frequency improved overall EF performance. Session length may be a moderator. Regarding sample characteristics, old-old, AD and both dementia and AD had significant benefits.

CONCLUSIONS AND IMPLICATIONS

EF in older adults with AD or related dementia benefited from physical activity, and the benefit was affected by the type, intensity, total duration, frequency of exercise. Physical activity can be an alternative intervention in aging patients with dementia, to improve EF performance or prevent or EF decline.

The effect of exercise on cognitive function in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

A growing body of research examining the effect of exercise on cognitive function in people with multiple sclerosis (MS), while findings of available studies were conflicting. We aimed to explore the effect of exercise on cognitive function in MS patients.

METHODS

For this systematic review and meta-analysis, we searched PubMed, Web of Science, EBSCO, Cochrane, and Scopus electronic databases, through July 18, 2022. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature.

RESULTS

Twenty-one studies with a total of 23 experimental groups and 21 control groups met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in MS patients, while the effect size was small (Cohen's d = 0.20, 95% CI 0.06-0.34, p < 0.001, I² = 39.31%). Subgroup analysis showed that exercise significantly improved memory (Cohen's d = 0.17, 95% CI 0.02-0.33, p = 0.03, I² = 7.59%). In addition, multicomponent training, exercise conducted 8 weeks and 10 weeks, up to 60 min per session, 3 times or more per week, 180 min or more per week increased cognitive function significantly. Furthermore, a worse basal MS status (defined by the Expanded Disability Status Scale) and an older age were associated with greater improvement in cognitive function.

CONCLUSION

MS patients are recommended to participate in at least three multicomponent training sessions per week, with each session lasting up to 60 min, and the exercise goal of 180 min per week can be achieved by increasing the frequency of exercise. Exercise lasting 8 or 10 weeks is best for cognitive function improvement. Additionally, a worse basal MS status, or the older the age, the greater effect on cognitive function.

Does the combination of exercise and cognitive training improve working memory in older adults? A systematic review and meta-analysis

Background

Cognitive functioning is dependent on working memory and a decline in working memory is the main cause of cognitive aging. Many studies have suggested that physical exercise or cognitive intervention can effectively improve working memory in the elderly. However, it is still unknown whether a combination of exercise and cognitive training (CECT) is more effective than either intervention alone. The present systematic review and meta-analysis were undertaken to evaluate the effect of CECT on working memory in the elderly.

Methods

The review was registered in the International Prospective Systematic Review (PROSPERO, CRD42021290138). Systematic searches were conducted on Web of Science, Elsevier Science, PubMed and Google Scholar. The data were extracted according to the PICOS framework. Comprehensive meta-analysis (CMA) software was used to perform the meta-analysis, moderator analysis and publication bias testing.

Results

The current meta-analysis included 21 randomized controlled trials (RCT). Results showed that CECT had a significantly greater impact on working memory in older adults compared to no intervention groups (SMD = 0.29, 95% CI [0.14-0.44], p < 0.01), with no significant difference between CECT and exercise (SMD = 0.16, 95% CI [-0.04-0.35], p = 0.12) or cognitive intervention alone (SMD = 0.08, 95% CI [-0.13-0.30], p = 0.44). Furthermore, the positive effect of CECT was moderated by intervention frequency and cognitive state.

Conclusions

The CECT can effectively improve working memory of older adults, but the effect of CECT compared to single intervention needs to be further explored.

The Molecular Effects of Environmental Enrichment on Alzheimer's Disease

Environmental enrichment (EE) is an environmental paradigm encompassing sensory, cognitive, and physical stimulation at a heightened level. Previous studies have reported the beneficial effects of EE in the brain, particularly in the hippocampus. EE improves cognitive function as well as ameliorates depressive and anxiety-like behaviors, making it a potentially effective neuroprotective strategy against neurodegenerative diseases such as Alzheimer's disease (AD). Here, we summarize the current evidence for EE as a neuroprotective strategy as well as the potential molecular pathways that can explain the effects of EE from a biochemical perspective using animal models. The effectiveness of EE in enhancing brain activity against neurodegeneration is explored with a view to differences present in early and late life EE exposure, with its potential application in human being discussed. We discuss EE as one of the non pharmacological approaches in preventing or delaying the onset of AD for future research.

The Effect of Aerobic Exercise on Cognitive Function in People with Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

A growing body of research has examined the effect of aerobic exercise on cognitive function in people with Alzheimer's Disease (AD), but the findings of the available studies were conflicting. The aim of this study was to explore the effect of aerobic exercise on cognitive function in AD patients. Searches were performed in PubMed, Web of Science, and EBSCO databases from the inception of indexing until 12 November 2021. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1942 search records initially identified, 15 randomized controlled trials (RCTs) were considered eligible for systematic review and meta-analysis. Included studies involved 503 participants in 16 exercise groups (mean age: 69.2-84 years) and 406 participants (mean age: 68.9-84 years) in 15 control groups. There was a significant effect of aerobic exercise on increasing mini-mental state examination (MMSE) score in AD patients [weighted mean difference (WMD), 1.50 (95% CI, 0.55 to 2.45), p = 0.002]. Subgroup analyses showed that interventions conducted 30 min per session [WMD, 2.52 (95% CI, 0.84 to 4.20), p = 0.003], less than 150 min per week [WMD, 2.10 (95% CI, 0.84 to 3.37), p = 0.001], and up to three times per week [WMD, 1.68 (95% CI, 0.46 to 2.89), p = 0.007] increased MMSE score significantly. In addition, a worse basal cognitive status was associated with greater improvement in MMSE score. Our analysis indicated that aerobic exercise, especially conducted 30 min per session, less than 150 min per week, and up to three times per week, contributed to improving cognitive function in AD patients. Additionally, a worse basal cognitive status contributed to more significant improvements in cognitive function.

Effects of Sport-Based Exercise Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis

Exercise programs of moderate-to-vigorous intensity have been shown to improve the cognitive performance of older people. However, the specific effects of sports-based exercise programs on cognitive performance, particularly executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sports-based exercise programs on executive functions in older adults using a systematic review and meta-analysis of the scientific literature. A systematic review was conducted between 1 March and 1 July 2022, to look for published scientific evidence that analyzed different sports programs that may have affected executive function in healthy older adults. Longitudinal studies, which assessed the effects of sports interventions on healthy older adults, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of nine studies with a total of 398 subjects met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibition, and cognitive flexibility. The DerSimonian and Laird random-effects model was performed using the Comprehensive Meta-Analysis software to facilitate the analysis of the studies. Statistical significance was set at p ≤ 0.05. In terms of working memory, a small but positive significant effect was noted for the intervention group compared to the control group (effect size (ES) = 0.35, 95% confidence interval (CI) = 0.04-0.67; p = 0.029; I² = 36.7%); in terms of inhibition, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.20, 95% CI = -0.42-0.84; p = 0.517; I² = 78.8%); and in terms of cognitive flexibility, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.39, 95% CI = -0.11-0.89; p = 0.131; I² = 75.5%). Our findings suggest that healthy older adults should be encouraged to participate in sports to improve their working memory; however, more studies are required in this area to reach more robust conclusions. This systematic review was registered with the International Prospective Register of Systematic Reviews (registration number: CRD42022284788).

Effects of Sport-Based Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis Protocol

Background: Moderate-to-vigorous intensity exercise programs have proven to exert positive effects on the cognitive performance of older people. However, the specific effects sport-based exercise programs have on cognitive performance, upon executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sport-based exercise programs on executive functions in older adults, through a systematic review protocol of the scientific literature, with a meta-analysis. Methods: The search was performed in the Web of Science, PubMed, Scopus, and EBSCO electronic databases by combining keywords and different medical subject headings (MeSH) to identify and evaluate the relevant studies from inception up until June 2022. This study considers longitudinal studies with at least one experimental group and pre- and post-intervention measurements involving healthy older adults of 60 years of age or older. Studies have to consider one or more measures of executive function, including dimensions of working memory, inhibition, and cognitive flexibility, in order to meet the eligibility criteria for inclusion in this report. The Physiotherapy Evidence Database (PEDro) scale was used for methodological quality assessment studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses and report effect sizes (ES, i.e., Hedges’ g) with 95% confidence intervals (95% CIs), and a statistical significance set at p ≤ 0.05. The ES values were calculated for executive function globally and for each dimension of executive function (e.g., working memory, inhibition, cognitive flexibility) in the experimental and control/comparator groups using the mean and standard deviation values before and after the intervention period. Conclusions: Our systematic review aims to clarify the effects of sport-based exercise programs on executive functions in older adults. The results may help practitioners and stakeholders to provide better evidence-based decisions regarding sport-based exercise program implementation for older adults, and to help them to optimize cognitive functions during the aging process. Ethical permission is not required for this study. Systematic review registration: this systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022284788).