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Yu F, Salisbury D, Pituch KA, Lin FV. Relations Between Cardiorespiratory Fitness and Cognition in Older Adults With Amnestic Mild Cognitive Impairment From the Aerobic Exercise and Cognitive Training (ACT) Trial: Sex Differences. Arch Rehabil Res Clin Transl 2024; 6:100341. [PMID: 39006107 PMCID: PMC11240017 DOI: 10.1016/j.arrct.2024.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Objective To examine the associations of cardiorespiratory fitness with executive function, episodic memory, and global cognition and sex differences in these associations in community-dwelling older adults with amnestic mild cognitive impairment. Design A cross-sectional study using baseline data from the aerobic exercise and cognitive training (ACT) trial. Setting The ACT trial conducted exercise testing in an exercise laboratory and data collections in a research facility. Participants ACT trial participants were recruited through referrals, registries, exhibits, flyers, media, and advertisements and screened for eligibility. To be eligible for this study, ACT enrollees needed complete data on all study variables. Among 146 ACT enrollees, 142 met eligibility for this study (N=142). Interventions None. Main Outcome Measures Cardiorespiratory fitness was measured as peak oxygen consumption (Vo2peak) with a peak cycle-ergometer test, executive function with the EXAMINER, episodic memory with the Brief Visuospatial Memory Test-Revised, and global cognition with Montreal Cognitive Assessment. Results The average age of the sample was 73.8±5.8 years with 16.9±2.9 years of education, with 87.3% White, 51.4% men, and 69.7% married. After controlling for covariates, Vo2peak was significantly related to executive function (b=.037, standard error [SE]=0.015, P=.0154, semipartial [sr] correlation coefficient=.239) and episodic memory (b=.590, SE=0.226, P=.0102, sr=.216), but not global cognition (b=.074, SE=0.055, P=.1837, sr=.125). For men, Vo2peak was significantly associated with executive function (b=.063, SE=0.024, P=.0099, r=.430) and episodic memory (b=1.088, SE=0.312, P=.0009, r=.382). Conclusions Our findings show that Vo2peak was associated with executive function and episodic memory in the overall sample and in men. Future studies can examine the longitudinal relations between cardiorespiratory fitness and cognition.
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Affiliation(s)
- Fang Yu
- University of Minnesota School of Nursing, Minneapolis, Minnesota, United States
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, Arizona, United States
| | - Dereck Salisbury
- University of Minnesota School of Nursing, Minneapolis, Minnesota, United States
| | - Keenan A. Pituch
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, Arizona, United States
| | - Feng Vankee Lin
- University of Rochester School of Nursing, Rochester, New York, United States
- Stanford University Department of Psychiatry and Behavioral Sciences, Stanford, California, United States
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Ben Ayed I, Ammar A, Aouichaoui C, Naija S, Ben Amor S, Glenn JM, Chtourou H, Jahrami H, Trabelsi K, Trabelsi Y, El Massioui F. Effectiveness of Simultaneous Combined Intervention for Enhancing Cognitive Function in Patients with Moderate Alzheimer's Disease. J Alzheimers Dis Rep 2024; 8:833-845. [PMID: 38910946 PMCID: PMC11191630 DOI: 10.3233/adr-249003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/01/2024] [Indexed: 06/25/2024] Open
Abstract
Background The evidence supporting the effectiveness of combined interventions in Alzheimer's disease (AD) patients remains inconclusive. Objective The aim of this study was to evaluate the mid- and long-term effectiveness of physical training, alone or combined with cognitive games, on cognitive performance in patients with moderate AD. Methods Seventy-nine AD patients (≈73% females, age of ≈70±1 years) were randomly divided into three groups: aerobic-based training (AT-group, n = 27), aerobic-based training plus cognitive games (ACT-group, n = 25), and a control group engaged in reading (CG, n = 26), two sessions per week. Cognitive performance was evaluated at the start, 4th week (W4), end of the 8th week (W8), and after a 4-week detraining period (W12), using problem-solving (Tower-of-Hanoi), selective attention (Stroop-test), and working memory (Digit-Span-test) assessments. Stress levels and quality of life were also evaluated.Results:: Aerobic and combined training induced a positive effect on all cognitive functions tested at W4 (except problem-solving) and W8 (all p < 0.001) with greater improvements in working-memory and problem-solving in ACT-group (p < 0.05). Depression levels also decreased significantly, and quality of life improved at W8 (p < 0.001) in both groups. After 4 weeks of detraining, the beneficial effect of AT and ACT was still observed. The CG did not show any significant improvements at all time points.Conclusions:: Physical and cognitive interventions appear effective for improving cognitive-functions, quality-of-life, and reducing depression in AD patients. Combined training emerges as a more effective strategy to mitigate AD progression. Further research is necessary to validate these results and explore their potential for preventing early cognitive decline.
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Affiliation(s)
- Ines Ben Ayed
- Research Laboratory, Exercise Physiology and Physiopathology: from Integrated to Molecular “Biology, Medicine and Health”, LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse, Tunisia
- Laboratory of Human and Artificial Cognition (EA 4004), Psychology UFR, University of Vin-cennes/Saint-Denis, Saint-Denis, France
- Research Laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Chirine Aouichaoui
- Research Laboratory, Exercise Physiology and Physiopathology: from Integrated to Molecular “Biology, Medicine and Health”, LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse, Tunisia
- High Institute of Sport and Physical Education of Ksar Saïd, University of Manouba, Cité Nasr, Tunisia
| | - Salma Naija
- Neurology Department, University Hospital Sahloul Sousse, Sousse, Tunisia
| | - Sana Ben Amor
- Neurology Department, University Hospital Sahloul Sousse, Sousse, Tunisia
| | - Jordan M. Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
| | - Haitham Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Khaled Trabelsi
- Research Laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Yassine Trabelsi
- Research Laboratory, Exercise Physiology and Physiopathology: from Integrated to Molecular “Biology, Medicine and Health”, LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse, Tunisia
| | - Farid El Massioui
- Laboratory of Human and Artificial Cognition (EA 4004), Psychology UFR, University of Vin-cennes/Saint-Denis, Saint-Denis, France
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Sharma AA, Mackensie Terry D, Popp JL, Szaflarski JP, Martin RC, Nenert R, Kaur M, Brokamp GA, Bolding M, Allendorfer JB. Neuromorphometric associations with mood, cognition, and self-reported exercise levels in epilepsy and healthy individuals. Epilepsy Behav Rep 2023; 25:100643. [PMID: 38264358 PMCID: PMC10803905 DOI: 10.1016/j.ebr.2023.100643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024] Open
Abstract
Regular physical activity may promote beneficial neuroplasticity, e.g., increased hippocampus volume. However, it is unclear whether self-reported physical exercise in leisure (PEL) levels are associated with the brain structure features demonstrated by exercise interventions. This pilot study investigated the relationship between PEL, mood, cognition, and neuromorphometry in patients with idiopathic generalized epilepsy (IGEs) compared to healthy controls (HCs). Seventeen IGEs and 19 age- and sex-matched HCs underwent magnetic resonance imaging (MRI) at 3T. The Baecke Questionnaire of Habitual Physical Activity, Profile of Mood States, and Montreal Cognitive Assessment (MoCA) assessed PEL, mood, and cognition, respectively. Structural MRI data were analyzed by voxel- and surface-based morphometry. IGEs had significantly lower PEL (p < 0.001), poorer mood (p = 0.029), and lower MoCA scores (p = 0.027) than HCs. These group differences were associated with reduced volume, decreased gyrification, and altered surface topology (IGEs < HCs) in frontal, temporal and cerebellar regions involved in executive function, memory retrieval, and emotional regulation, respectively. These preliminary results support the notion that increased PEL may promote neuroplasticity in IGEs, thus emphasizing the role of physical activity in promoting brain health in people with epilepsy.
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Affiliation(s)
- Ayushe A. Sharma
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - D. Mackensie Terry
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Johanna L. Popp
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Jerzy P. Szaflarski
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), Department of Neurobiology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), Department of Neurosurgery, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
| | - Roy C. Martin
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
| | - Rodolphe Nenert
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Manmeet Kaur
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
| | - Gabrielle A. Brokamp
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Mark Bolding
- University of Alabama at Birmingham (UAB), Department of Radiology, Birmingham, AL, USA
| | - Jane B. Allendorfer
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), Department of Neurobiology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Center for Exercise Medicine, Birmingham, AL, USA
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Maeneja R, Silva CR, Ferreira IS, Abreu AM. Aerobic physical exercise versus dual-task cognitive walking in cognitive rehabilitation of people with stroke: a randomized clinical trial. Front Psychol 2023; 14:1258262. [PMID: 37901076 PMCID: PMC10611528 DOI: 10.3389/fpsyg.2023.1258262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Stroke is a neurological deficit caused by an acute focal injury to the central nervous system due to vascular injury that can result in loss of neurological function, lasting brain damage, long-term disability and, in some cases, death. The literature reports that aerobic physical exercise, as well as dual-task cognitive walking, are used for the cognitive recovery of people with stroke. We aimed to assess whether aerobic physical exercise influences post-stroke cognitive recovery, namely performance on selective and sustained attention. We tested the hypothesis that post-stroke aerobic physical exercise leads to more significant gains than post-stroke dual-task cognitive walking. Methods We used a Randomized Clinical Trial, single-blind, parallel group, to verify the existence of differences between two groups. A total of 34 patients with subacute to chronic stroke were divided into two groups to train three times a week for 12 weeks: the aerobic physical exercise (PE) group engaged in 20 min on a treadmill, 20 min on a stationary bicycle and 5 min on a desk bike pedal exerciser per session; the dual-task (DT) gait exercise group walked for 45 min while simultaneously performing cognitive tasks per session. All participants were assessed on cognitive functioning with the Mini-Mental State Examination (MMSE) and d2 Test of Attention before acute interventions and post interventions. We have also applied a Visual Analog Scale to monitor the participants' perceived difficulty, pre-, post-acute, and post-chronic interventions. Participants also responded to a Borg Scale of perceived exertion following the acute and the final session of chronic training. Results A mixed model ANOVA revealed a significant interaction effect with a large effect size for most of the cognitive variables under study. The variables associated with the d2 Test of Attention showed significant differences between the groups, mainly from T0 to T2. Also for MMSE, an ANOVA revealed a significant interaction effect with significant improvements from T0 to T2. Our results strongly suggest that aerobic physical exercise is more beneficial than dual-task cognitive-gait exercise since in the PE group, cognitive attention scores increase, and cognitive impairment and perception of exertion decrease, compared to the DT group. Conclusion These findings support that PE provides more significant benefits for patients post-stroke when compared to DT.
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Affiliation(s)
- Reinaldo Maeneja
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Ciências da Saúde e Desporto, Universidade Save, Maxixe, Mozambique
| | - Cláudia R. Silva
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Escola Superior de Saúde de Alcoitão, Alcabideche, Portugal
| | - Inês S. Ferreira
- Faculty of Health Sciences, Universidade Europeia, Lisbon, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculdade de Psicologia e de Ciências da Educação (FPCE), Universidade de Coimbra, Coimbra, Portugal
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), Faculdade de Psicologia e de Ciências da Educação (FPCE), Universidade de Coimbra, Coimbra, Portugal
| | - Ana Maria Abreu
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal
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Tao M, Liu H, Cheng J, Yu C, Zhao L. Motor-Cognitive Interventions May Effectively Improve Cognitive Function in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial. Behav Sci (Basel) 2023; 13:737. [PMID: 37754015 PMCID: PMC10525591 DOI: 10.3390/bs13090737] [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: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/28/2023] Open
Abstract
Mild cognitive impairment (MCI) is a syndrome that occurs in the preclinical stage of Alzheimer's disease. Early intervention can be effective in preventing Alzheimer's disease, but further research is needed on intervention methods. To identify interventions that are more suitable for Chinese characteristics and to investigate the effects of motor-cognitive intervention on the cognitive functions of older adults with MCI, we screened 103 community-dwelling older adults with MCI aged 65 years and older in Qingdao, Shandong, China; divided them into an intervention group and a control group; and administered a motor-cognitive intervention to the intervention group for 12 weeks. The study used the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to assess the initial cognitive level of the MCI participants and detect the effects of the intervention. We found that the cognitive abilities of the intervention group were significantly improved at the end of the intervention, as well as at the end of the follow-up, compared with the control group. The results of the current study suggest that the motor-cognitive intervention we used may improve the cognition of older people with MCI in the Chinese community.
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Affiliation(s)
| | | | - Jinxuan Cheng
- Normal College, Qingdao University, Qingdao 266071, China; (M.T.); (H.L.); (C.Y.); (L.Z.)
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Tam JW, Khurshid K, Sprague B, Clark DO, Xu H, Moser LR, Miller DK, Considine R, Callahan CM, Garringer HJ, Rexroth D, Unverzagt FW. Design and baseline characteristics of the Cognitive and Aerobic Resilience for the Brain (CARB) study. Contemp Clin Trials 2023; 131:107249. [PMID: 37268243 PMCID: PMC10527227 DOI: 10.1016/j.cct.2023.107249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/15/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Treatments that delay progression of cognitive impairment in older adults are of great public health significance. This manuscript outlines the protocol, recruitment, baseline characteristics, and retention for a randomized controlled trial of cognitive and aerobic physical training to improve cognition in individuals with subjective cognitive dysfunction, the "Cognitive and Aerobic Resilience for the Brain" (CARB) study. METHODS Community-dwelling, older adults with self-reported memory loss were randomly assigned to receive either computer-based cognitive training, aerobic physical training, combined cognitive and physical training, or education control. Treatment was delivered 2- to 3-times per week in 45- to 90-min sessions for 12 weeks by trained facilitators videoconferencing into subject's home. Outcome assessments of were taken at the baseline, immediately following training, and 3-months after training. RESULTS 191 subjects were randomized into the trial (mean age, 75.5 years; 68% female; 20% non-white; mean education, 15.1 years; 30% with 1+ APOE e4 allele). The sample was generally obese, hypertensive, and many were diabetic, while cognition, self-reported mood, and activities of daily living were in the normal range. There was excellent retention throughout the trial. Interventions were completed at high rates, participants found the treatments acceptable and enjoyable, and outcome assessments were completed at high rates. CONCLUSIONS This study was designed to determine the feasibility of recruiting, intervening, and documenting response to treatment in a population at risk for progressive cognitive decline. Older adults with self-reported memory loss were enrolled in high numbers and were well engaged with the intervention and outcome assessments.
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Affiliation(s)
- Joyce W Tam
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Kiran Khurshid
- Department of Neurology, Indiana University School of Medicine, United States of America
| | - Briana Sprague
- Department of Medicine, Indiana University School of Medicine, United States of America; Indiana University Center for Aging Research at Regenstrief Institute, United States of America
| | - Daniel O Clark
- Department of Medicine, Indiana University School of Medicine, United States of America; Indiana University Center for Aging Research at Regenstrief Institute, United States of America
| | - Huiping Xu
- Department of Biostatistics, Indiana University School of Medicine, United States of America
| | - Lyndsi R Moser
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Douglas K Miller
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, United States of America
| | - Robert Considine
- Department of Medicine, Indiana University School of Medicine, United States of America
| | | | - Holly J Garringer
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, United States of America
| | - Daniel Rexroth
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Frederick W Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, United States of America.
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Hong SY, Jeong WM, Rhyu HS. Effects of multimodal cognitive exercise program on cognitive function, bone density, blood lipid, fitness, and depression in old women with mild cognitive impairment. J Exerc Rehabil 2023; 19:27-34. [PMID: 36910679 PMCID: PMC9993012 DOI: 10.12965/jer.2244514.257] [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: 11/08/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
The purpose of this study is to verify the effects of participation in 12-week multimodal cognitive exercise program on cognitive function, bone mineral density, blood lipids, senior functional fitness, and depression of the old women with mild cognitive impairment and osteopenia. As a result, the exercise group showed significant effects in cognitive function, depression, bone mineral density, blood lipid, lower extremity flexibility, upper extremity flexibility, dynamic balance, and body endurance. Such results prove that multimodal cognitive exercise program is an effective interventional exercise program for improving cognitive function in the old women with mild cognitive impairment.
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Affiliation(s)
- Seo-Youn Hong
- Department of Physical Education, Seoul National University of Education, Seoul, Korea
| | | | - Hyun-Seung Rhyu
- Department of Physical Education, Jungwon University, Goesan, Korea
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A Systematic Study into the Effects of Long-Term Multicomponent Training on the Cognitive Abilities of Older Adults with Neurodegenerative Disorders. PSYCH 2022. [DOI: 10.3390/psych4040056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cognition includes all processes through which a person becomes aware of their situation, needs, goals, and necessary actions. Regular specialized cognitive and neuromotor simulation exercises have improved various cognitive processes, including memory, speed of reasoning, and problem-solving skills. This review focuses on understanding the efficacy of long-term multicomponent exercise interventions to mitigate and delay the effects on cognitive abilities in older adults with neurodegenerative disorders. The main criteria for final studies were randomised controlled trials with a minimum of a 24-week intervention. The Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, B-On, Sport Discus, Scielo, APA PsycINFO, Psychology and Behavioural Sciences, Academic Search Complete, Medline (PubMed), ERIC, and Google Scholar databases were checked. The search occurred between April 2022 and July 2022. A total of 19 studies were used in this review. The initial search identified 6.835 studies. In the first screening, a total of 6474 studies were excluded. After this, 361 studies were analysed by co-authors and did not meet the specific final criteria and were excluded. In total, 19 studies were included in the final analysis, and 14 papers met all requirements previously defined.
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Abstract
PURPOSE OF REVIEW We review recent work on applications of non-pharmacologic strategies to promote cognitive health in older adulthood and discuss potential network mechanisms, limitations, and considerations for improving intervention uptake and efficacy. RECENT FINDINGS In healthy older adults and patients with mild cognitive impairment, cognitive training produces global and domain-specific cognitive gains, though effect sizes tend to be modest and transfer is variable. Non-invasive brain stimulation has shown moderate success in enhancing cognitive function, though the optimum approach, parameters, and cortical targets require further investigation. Physical activity improves cognitive functions in late life, with emerging trials highlighting key intervention components that may maximize treatment outcomes. Multimodal interventions may be superior to single-component interventions in conferring cognitive gains, although interpretation is limited by modest sample sizes and variability in training components and parameters. Across modalities, individual differences in patient characteristics predict therapeutic response. These interventions may advance cognitive health by modulating functional networks that support core cognitive abilities including the default mode, executive control, and salience networks. Effectiveness of cognitive enhancement strategies may be increased with clinician-led coaching, booster sessions, gamification, integration of multiple intervention modalities, and concrete applications to everyday functioning. Future trials involving rigorous comparisons of training components, parameters, and delivery formats will be essential in establishing the precise approaches needed to maximize cognitive outcomes. Novel studies using patient-level clinical and neuroimaging features to predict individual differences in training gains may inform the development of personalized intervention prescriptions to optimize cognitive health in late life.
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Sun X, Wang L, Shen X, Huang C, Wei Z, Su L, Wang S, Liu X, Zhen X. Correlates of Adherence of Multimodal Non-pharmacological Interventions in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study. Front Psychiatry 2022; 13:833767. [PMID: 35747098 PMCID: PMC9210931 DOI: 10.3389/fpsyt.2022.833767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-pharmacological interventions are promising for delaying cognitive decline in older adults with mild cognitive impairment (MCI). Although some studies have demonstrated adherence rates and factors influencing participation in single modality non-pharmacological interventions, little is known about the level and correlates of adherence to multimodal non-pharmacological interventions (MNPIs) in older adults with MCI. Objective This study aimed to explore the adherence level and the correlates of adherence to MNPIs in older adults with MCI. Methods A cross-sectional design was employed. Community-dwelling older adults aged 60 years and over were recruited from senior community centers and healthcare centers in Huzhou from March 2019 to December 2020. Data were collected by a general information questionnaire and the adherence scale of cognitive dysfunction management (AS-CDM) in older adults with MCI. Hierarchical regression analyses were applied to explore the correlates of adherence to MNPIs. Results A total of 216 completed questionnaires were finally analyzed. Of these, 68.52% were female, and 45.4% of the participants had no less than 6 years of education. The overall mean score for adherence was 117.58 (SD = 10.51) out of 160, equivalent to 73.49 in the hundred-mark system, indicating a medium-level adherence to MNPIs in older adults with MCI. Of the five dimensions of adherence (AS-CDM), self-efficacy scored the highest, and the lowest was perceived barriers. The univariate analysis showed that the factors associated with the adherence to MNPIs were: regular physical exercise, meat-vegetable balance, absence of multimorbidity, high level of education, living alone, and living in urban (p < 0.05). In the hierarchical regression analysis, the final model explained 18.8% of variance in overall adherence (p < 0.01), which high school (Beta = 0.161, p < 0.05), college and above more (Beta = 0.171, p < 0.05), meat-vegetarian balance (Beta = 0.228, p < 0.05), regular physical exercise (Beta = 0.234, p < 0.05), and presence of multimorbidity (Beta = -0.128, p < 0.05) significantly contributed to adherence. In addition, nearly 80% of older adults with MCI preferred MNPIs. Conclusion Early assessment and management of adherence to MNPIs were essential in older adults with MCI. Furthermore, the findings shed light on several critical areas of intervention to improve adherence to MNPIs in older adults with MCI. Clinical Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=35363, ChiCTR1900020950 (Registered on January 23, 2019).
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Affiliation(s)
- Xue Sun
- School of Medicine, Huzhou University, Huzhou, China
| | - Lina Wang
- School of Medicine, Huzhou University, Huzhou, China
| | - Xinhua Shen
- Department of Neurosis and Psychosomatic Diseases, Third People's Hospital of Huzhou, Huzhou, China
| | - Cheng Huang
- School of Medicine, Huzhou University, Huzhou, China
| | - Zhuqin Wei
- School of Medicine, Huzhou University, Huzhou, China
| | - Liming Su
- School of Medicine, Huzhou University, Huzhou, China
| | - Simeng Wang
- School of Medicine, Huzhou University, Huzhou, China
| | - Xiaoshen Liu
- Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueting Zhen
- School of Medicine, Tongxiang City Health School, Jiaxing, China
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Kępka A, Ochocińska A, Borzym-Kluczyk M, Chojnowska S, Skorupa E, Przychodzeń M, Waszkiewicz N. Healthy Food Pyramid as Well as Physical and Mental Activity in the Prevention of Alzheimer’s Disease. Nutrients 2022; 14:nu14081534. [PMID: 35458096 PMCID: PMC9028231 DOI: 10.3390/nu14081534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/05/2023] Open
Abstract
The ageing of the population is resulting in neurodegenerative diseases, including Alzheimer’s disease (AD), which are an increasing social, economic and medical problem. Diet and physical activity are now considered as important modifiable factors that help prevent or delay the development of AD and other dementia-related diseases. The pyramid of healthy nutrition and lifestyle is a way of presenting the principles, the implementation of which gives a chance for proper development and a long healthy life. The basis of the pyramid, in the first place, is physical activity. Our review of the literature in the PubMed database supports the hypothesis that complementary factors, such as proper diet, physical exercise and mental activity, have a positive impact on the prevention of neurodegenerative diseases. The nutritional recommendations for healthy adults primarily include the consumption of vegetables, fruits, cereals, legumes, vegetable oils and fishes. Therefore, the introduction of Mediterranean and Asian diets may reduce the risk of the neurodegenerative diseases associated with dementia, whereas dairy products and meat—the main sources of L-carnitine—should be consumed in moderate amounts. The aim of our work is to provide up-to-date knowledge about the appropriate dietary model and healthy lifestyle elements and their impact on good health and the long life of people.
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Affiliation(s)
- Alina Kępka
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute of Warsaw, 04-730 Warsaw, Poland;
- Correspondence: (A.K.); (A.O.); Tel.: +48-22-815-73-01 (A.O.)
| | - Agnieszka Ochocińska
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute of Warsaw, 04-730 Warsaw, Poland;
- Correspondence: (A.K.); (A.O.); Tel.: +48-22-815-73-01 (A.O.)
| | - Małgorzata Borzym-Kluczyk
- Department of Pharmaceutical Biochemistry, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Sylwia Chojnowska
- Faculty of Health Sciences, Lomza State University of Applied Sciences, 18-400 Lomza, Poland;
| | - Ewa Skorupa
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute of Warsaw, 04-730 Warsaw, Poland;
| | - Małgorzata Przychodzeń
- Department of Psychogeriatry, Independent Public Psychiatric Health Care Institution in Choroszcz, 16-070 Choroszcz, Poland;
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 15-089 Bialystok, Poland;
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Salisbury D, Plocher T, Yu F. Efficacy of simultaneous aerobic exercise and cognitive training in subjective cognitive decline: study protocol for randomized controlled trial of the Exergames Study. Trials 2021; 22:14. [PMID: 33407727 PMCID: PMC7788690 DOI: 10.1186/s13063-020-04950-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) is an early manifestation of Alzheimer's disease (AD) and offers a therapeutic window where interventions have strong potential to prevent or delay the progression of AD. Aerobic exercise and cognitive training represent two promising interventions for AD prevention, but their synergistic effect has yet to be assessed in persons with SCD. METHODS/DESIGN The purpose of this single-blinded, 3-parallel group randomized controlled trial is to test the synergistic efficacy of an exergame intervention (simultaneous moderate-intensity aerobic cycling and cognitive training) on cognition and aerobic fitness in community-dwelling older adults with SCD. The Exergames Study will randomize 96 participants on a 2:1:1 allocation ratio to 3-month exergame, cycling only, or attention control (stretching). Primary outcomes include global cognition and aerobic fitness, which will be assessed at baseline and after 3 months. The specific aims of the Exergames Study are to (1) determine the efficacy of the exergame in older adults with SCD and (2) assess the distraction effect of exergame on aerobic fitness. Data will be analyzed using ANOVA following intention-to-treat. DISCUSSION This study will test the synergistic effects of exergame on cognition and aerobic fitness. It has the potential to advance prevention research for AD by providing effect-size estimates for future trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04311736 . Registered on 17 March 2020.
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Affiliation(s)
- Dereck Salisbury
- University of Minnesota School of Nursing, 5-160 WDH 1331, 308 Harvard St SE, Minneapolis, MN 55455 USA
| | | | - Fang Yu
- University of Minnesota School of Nursing, 5-160 WDH 1331, 308 Harvard St SE, Minneapolis, MN 55455 USA
- Arizona State University, Health North Suite 301, 550 North 3rd Street, Mail Code 3020, Phoenix, AZ 85004 USA
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Yu F, Vock DM, Zhang L, Salisbury D, Nelson NW, Chow LS, Smith G, Barclay TR, Dysken M, Wyman JF. Cognitive Effects of Aerobic Exercise in Alzheimer's Disease: A Pilot Randomized Controlled Trial. J Alzheimers Dis 2021; 80:233-244. [PMID: 33523004 PMCID: PMC8075384 DOI: 10.3233/jad-201100] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Aerobic exercise has shown inconsistent cognitive effects in older adults with Alzheimer's disease (AD) dementia. OBJECTIVE To examine the immediate and longitudinal effects of 6-month cycling on cognition in older adults with AD dementia. METHODS This randomized controlled trial randomized 96 participants (64 to cycling and 32 to stretching for six months) and followed them for another six months. The intervention was supervised, moderate-intensity cycling for 20-50 minutes, 3 times a week for six months. The control was light-intensity stretching. Cognition was assessed at baseline, 3, 6, 9, and 12 months using the AD Assessment Scale-Cognition (ADAS-Cog). Discrete cognitive domains were measured using the AD Uniform Data Set battery. RESULTS The participants were 77.4±6.8 years old with 15.6±2.9 years of education, and 55% were male. The 6-month change in ADAS-Cog was 1.0±4.6 (cycling) and 0.1±4.1 (stretching), which were both significantly less than the natural 3.2±6.3-point increase observed naturally with disease progression. The 12-month change was 2.4±5.2 (cycling) and 2.2±5.7 (control). ADAS-Cog did not differ between groups at 6 (p = 0.386) and 12 months (p = 0.856). There were no differences in the 12-month rate of change in ADAS-Cog (0.192 versus 0.197, p = 0.967), memory (-0.012 versus -0.019, p = 0.373), executive function (-0.020 versus -0.012, p = 0.383), attention (-0.035 versus -0.033, p = 0.908), or language (-0.028 versus -0.026, p = 0.756). CONCLUSION Exercise may reduce decline in global cognition in older adults with mild-to-moderate AD dementia. Aerobic exercise did not show superior cognitive effects to stretching in our pilot trial, possibly due to the lack of power.
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Affiliation(s)
- Fang Yu
- University of Minnesota Division of Biostatistics, Minneapolis, MN, USA
| | - David M. Vock
- University of Minnesota Division of Biostatistics, Minneapolis, MN, USA
| | - Lin Zhang
- University of Minnesota Division of Biostatistics, Minneapolis, MN, USA
| | | | | | - Lisa S. Chow
- University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Glenn Smith
- University of Florida Department of Clinical and Health Psychology, Gainesville, FL, USA
| | | | - Maurice Dysken
- University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Jean F. Wyman
- University of Minnesota School of Nursing, Minneapolis, MN, USA
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14
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Lin Y, Wang C, Chang Y, Wang J. Effects of the biopsychosocial functional activity program on cognitive function for community older adults with
mild cognitive impairment
: A cluster‐randomized controlled trial. Nurs Health Sci 2020; 22:1065-1075. [DOI: 10.1111/nhs.12772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/03/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Yen‐Chun Lin
- Department of Nursing Chang Jung Christian University Tainan Taiwan
| | - Chi‐Jane Wang
- Department of Nursing College of Medicine, National Cheng Kung University Tainan Taiwan
| | - Yin‐Fan Chang
- Department of Family Medicine National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan Taiwan
| | - Jing‐Jy Wang
- Department of Nursing College of Medicine, National Cheng Kung University Tainan Taiwan
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15
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The Mobile Physical Activity and Cognitive Training App for Older Adults: A Pilot Study. Comput Inform Nurs 2020; 38:537-542. [PMID: 33170814 DOI: 10.1097/cin.0000000000000697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Kotov SV, Isakova EV, Zaitseva EV, Egorova YV. [Multimodal stimulation in the neurorehabilitation of patients with poststroke cognitive impairment]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:125-130. [PMID: 32621478 DOI: 10.17116/jnevro2020120051125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Loss of functional activity after a stroke is a leading cause of disability in adults worldwide. Particular attention is currently being paid to post-stroke cognitive impairment. Approaches based on multimodal exposure are increasingly being used when planning rehabilitation programs, which makes it possible to comprehensively cover the entire spectrum of existing neurological disorders in patients and enables to achieve a more effective recovery of functional activity after a stroke.
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Affiliation(s)
- S V Kotov
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
| | - E V Isakova
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
| | - E V Zaitseva
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
| | - Yu V Egorova
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
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17
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The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9051312. [PMID: 32370159 PMCID: PMC7290566 DOI: 10.3390/jcm9051312] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 02/03/2023] Open
Abstract
The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning.
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Li D, Mielke MM, Bell WR, Reilly C, Zhang L, Lin FV, Yu F. Blood biomarkers as surrogate endpoints of treatment responses to aerobic exercise and cognitive training (ACT) in amnestic mild cognitive impairment: the blood biomarkers study protocol of a randomized controlled trial (the ACT Trial). Trials 2020; 21:19. [PMID: 31907024 PMCID: PMC6943901 DOI: 10.1186/s13063-019-3798-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/11/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is an epidemic with tremendous public health impacts because there are currently no disease-modifying therapeutics. Randomized controlled trials (RCTs) for prevention of AD dementia often use clinical endpoints that take years to manifest (e.g., cognition) or surrogate endpoints that are costly or invasive (e.g., magnetic resonance imaging [MRI]). Blood biomarkers represent a clinically applicable alternative surrogate endpoint for RCTs that would be both cost-effective and minimally invasive, but little is known about their value as surrogate endpoints for treatment responses in the prevention of AD dementia. METHODS The objective of this study is to investigate blood neuropathological, neurodegenerative, and neurotrophic biomarkers as surrogate endpoints for treatment responses to three interventions in older adults with amnestic mild cognitive impairment (aMCI, a prodromal stage of AD): aerobic exercise, cognitive training, and combined aerobic exercise and cognitive training (ACT). We chose these three sets of biomarkers for their unique mechanistic associations with AD pathology, neurodegeneration and neurogenesis. This study is built on the ACT Trial (1R01AG055469), a single-blinded, multi-site, 2 × 2 factorial phase II RCT that examines the synergistic effects of a 6-month ACT intervention on cognition and MRI biomarkers (AD-signature cortical thickness and hippocampal volume) (n = 128). In this ACT Trial blood biomarkers study, we will enroll 120 ACT Trial participants with aMCI and measure blood biomarkers at baseline and at 3, 6, 12, and 18 months. The goals are to (1) determine the effect of interventions on blood biomarkers over 6 months, (2) evaluate blood biomarkers as surrogate endpoints for predicting cognitive responses to interventions over 18 months, and (3, exploratory) examine blood biomarkers as surrogate endpoints for predicting brain MRI biomarker responses to interventions over 18 months. DISCUSSION This study aims to identify new blood biomarkers that can track cognitive decline or AD-related brain atrophy among patients with aMCI subjected to a regimen of aerobic exercise and cognitive training. Findings from this study will drive the further use of blood biomarkers in developing effective prevention and treatment strategies for AD dementia. TRIAL REGISTRATION ClinicalTrials.gov, NCT03313895. Registered on 18 October 2017.
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Affiliation(s)
- Danni Li
- Department of Lab Medicine and Pathology, University of Minnesota, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
| | - Michelle M. Mielke
- Department of Neurology and Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN 55902 USA
| | - W. Robert Bell
- Department of Lab Medicine and Pathology, University of Minnesota, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
| | - Cavan Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Lin Zhang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Feng Vankee Lin
- University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642 USA
| | - Fang Yu
- School of Nursing, University of Minnesota, 5-140 WDH, 308 Harvard St SE, Minneapolis, MN 55455 USA
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