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Siqueira VAAA, Shigematsu R, Sebastião E. Stepping towards health: a scoping review of square-stepping exercise protocols and outcomes in older adults. BMC Geriatr 2024; 24:590. [PMID: 38987666 PMCID: PMC11238358 DOI: 10.1186/s12877-024-05187-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Square-Stepping Exercise (SSE) is a type of physical-cognitive exercise. Such exercise has been used as an exercise approach in different studies with older adults. This scoping review provides an overview of the protocols and outcomes of studies employing the SSE in older adults. METHODS We searched in the PubMed, CINAHL, Scopus, CABI Global Health, and Web of Science databases for articles published between 2006 (first research article published on SSE) to December 2023 that met a robust inclusion criterion. The search yielded 424 articles, and after inclusion criteria being applied, 37 articles were included in the final analysis. RESULTS A total of 37 studies were included in the final analysis. Thirty-three out of the 37 studies focused on apparently healthy older adults, while four were conducted with older adults with neurological disease (i.e., multiple sclerosis, Parkinson's disease, and stroke). Most studies (n = 25) adopted an experiment (i.e., randomized controlled trial) or quasi-experimental approach, while 12 were classified as non-randomized (i.e., cross-sectional, mixed methods). The studies were conducted in different parts of the globe and adopted three major formats of intervention delivery, namely in-person, online, and home-based. Frequency, SSE session duration and intervention length significantly varied among studies, and reported outcomes were in the domains of physical and cognitive function. CONCLUSION This review comprehensively described the characteristics of 37 studies employing SSE in apparently healthy older adults and older adults with neurological diseases. The findings demonstrated that SSE has been used by researchers across the globe, adopting a variety of forms of delivery, and to particularly improve physical and cognitive function of different segments of the older adult population. The review further identified important gaps in research, including the restricted outcomes, and the lack of studies combining SSE with more traditional exercise modalities to address potential combinatory effects.
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Affiliation(s)
- Vitor A A A Siqueira
- Department of Health and Kinesiology, University of Illinois at Urbana- Champaign, Urbana, IL, USA
| | - Ryosuke Shigematsu
- Department of Health and Sports Sciences, Chukyo University, Toyota, Japan
| | - Emerson Sebastião
- Department of Health and Kinesiology, University of Illinois at Urbana- Champaign, Urbana, IL, USA.
- Department Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
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Rocha R, Fernandes SM, Santos IM. The Importance of Technology in the Combined Interventions of Cognitive Stimulation and Physical Activity in Cognitive Function in the Elderly: A Systematic Review. Healthcare (Basel) 2023; 11:2375. [PMID: 37685409 PMCID: PMC10486873 DOI: 10.3390/healthcare11172375] [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: 05/14/2023] [Revised: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Numerous studies have been developed in an attempt to understand which factors best predict improvements in cognitive function in the elderly such as exergaming. The aim of this study was to investigate and systematize literature on intervention programs that simultaneously include cognitive stimulation and physical activity, understand the importance of the use of new technology, including exergaming or computer programs, and understand their impact on cognitive function in older adults, giving indications about their contribution to healthy aging. METHODS A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified from electronic databases such as PubMed, Scopus, Web of Science, and Academic Search Complete. RESULTS Thirty-two articles, involving 2815 participants, were identified. All selected studies were randomized controlled studies. The studies were published between 2011 and 2020. All studies included a combination of cognitive and physical interventions. Many of the studies used technology to administer the cognitive stimulation program. CONCLUSIONS Most of the analyzed studies used exergaming in physical and cognitive interventions, demonstrating that this new form of intervention exerts lasting and stable benefits in cognition. However, we concluded that more studies are needed to compare interventions that use exergaming or computer programs with traditional interventions.
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Affiliation(s)
- Rute Rocha
- Centro Social e Paroquial de S. Mamede do Coronado, Aveiro University, 3810-193 Aveiro, Portugal
| | | | - Isabel M. Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal;
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Zhang Q, Zhu M, Huang L, Zhu M, Liu X, Zhou P, Meng T. A Study on the Effect of Traditional Chinese Exercise Combined With Rhythm Training on the Intervention of Older Adults With Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen 2023; 38:15333175231190626. [PMID: 37489602 PMCID: PMC10624104 DOI: 10.1177/15333175231190626] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
BACKGROUND To examine the effect of combination exercise program on cognitive function of older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions. METHODS Subjects were 42 older adults (ages, 60-80 years) with MCI. The subjects were randomly classified to traditional Chinese exercise combined with rhythm training group (TCE + RTG, n = 14), walking group (WG, n = 14), and control group (CG, n = 14), according to their level of MMSE scores. These groups exercised for 60 minutes at 1 session, 3 sessions a week for 12 weeks. The intervention program was conducted under multitask conditions to stimulate attention and memory, and the control group attended 3 education classes. Measurements were administered before, after the 6-week, and after the 12-week intervention period; Measurements: The Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), Activities of Daily Living Scale (ADL), and the 17-item Hamilton Depression Scale (HAMD-17), along with the brain-derived neurotrophic factor (BDNF). A repeated-measures analysis of variance was used to examine differences among the 3 groups and between the 3 testing times (pre-test vs middle-test vs post-test). RESULTS (1) The TCE + RTG showed significant improvement in the MMSE, MoCA, SDMT, and ADL scale test results (P < .01) and HAMD-17 scale test results (P < .05). The WG also showed significant improvement in the MMSE, MoCA, and HAMD-17 scale test results (P < .05) and the ADL scale test results (P < .01). While there was no significant change in the CG after the intervention. (2) The TCE + RTG and WG showed positive improvement in peripheral blood BDNF levels, while the CG showed a decrease in these test results. There were significant differences between the TCE + RTG and CG before and after the intervention. CONCLUSION The results suggested that a TCE + RT is beneficial for improving memory and maintaining general cognitive function and peripheral blood BDNF levels in older adults with MCI. Peripheral blood BDNF levels may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of TCE + RT on cognitive function in older adults with MCI. Trial Registration: ChiCTR2200058545, Registered 10 April 2022.
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Affiliation(s)
- Qiang Zhang
- Graduate School, Capital University of Physical Education and Sports, Beijing, China
| | - Menglong Zhu
- Encephalopathy Center, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China
| | - Lili Huang
- Chinese Wushu Academy, Beijing Sport University, Beijing, China
| | - Miao Zhu
- Graduate School, Capital University of Physical Education and Sports, Beijing, China
| | - Xiaolei Liu
- Chinese Traditional Regimen Exercise Intervention Research Center, Beijing Sport University, Beijing, China
| | - Ping Zhou
- School of Art, Beijing Sport University, Beijing, China
| | - Tao Meng
- School of Wushu and Performance, Capital University of Physical Education and Sports, Beijing, China
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Multi-Component Interventions in Older Adults Having Subjective Cognitive Decline (SCD)-A Review Article. Geriatrics (Basel) 2022; 8:geriatrics8010004. [PMID: 36648909 PMCID: PMC9844291 DOI: 10.3390/geriatrics8010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/11/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Subjective cognitive decline (SCD) is one of those significant concerns faced by older individuals. Though it is predominantly self-reported, it is not an event that should be overlooked, considering its significant association with cognitive disorders like Alzheimer's disease, mild cognitive impairment, and so on. This makes it imperative to find ways to manage the event to enhance the cognitive performance of older adults and/or suppress the rate at which cognitive decline results in impairment. While multiple interventions have been used for SCD, multi-component non-pharmacological interventions are beginning to gain more attention among researchers. This is due to how such interventions have effectively contributed to improved cognitive performance across different outcome domains. Against this backdrop, this literature review has been conducted to explore the different multi-component non-pharmacological interventions utilized in managing SCD. Papers from databases such as PubMed, Scopus, and EBSCO were retrieved, with relevant data being extracted on the subject matter to address the objective of this review.
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Benefits of Two 24-Week Interactive Cognitive-Motor Programs on Body Composition, Lower-Body Strength, and Processing Speed in Community Dwellings at Risk of Falling: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127117. [PMID: 35742365 PMCID: PMC9222305 DOI: 10.3390/ijerph19127117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/05/2023]
Abstract
This 24-week randomized controlled trial study evaluated the effects of two interactive cognitive−motor programs on body composition, lower-body strength, and processing speed in community dwellings at risk of falling. Forty-eight participants (75.0 ± 5.4 years) were allocated into EG1 (psychomotor intervention program), EG2 (combined program (psychomotor intervention + whole-body vibration)), and a control group. EG programs induced significant improvements in bone mass, lower-body strength, and processing speed (p < 0.05), with similar treatment effects on lower-body strength and processing speed and higher bone mineral content and density within EG2. The fall rate decreased in EG1 (44.2%) and EG2 (63%) (p < 0.05). After the 12-week no-intervention follow-up, improvements in lower-body strength were reversed in both EGs, but those in processing speed were maintained, mainly in EG2 (p < 0.05). In conclusion, both programs were accepted and well tolerated. The combined program led to additional benefits in bone mass. Both programs positively impacted physical and cognitive risk factors for falls and injuries. They induced similar improvements in lower-body strength and processing speed, decreasing the fall rate. These findings suggest that both programs are successful for fall and injury prevention in the studied population.
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Square-Stepping Exercise Program Effects on Fall-Related Fitness and BDNF Levels in Older Adults in Korea: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127033. [PMID: 35742280 PMCID: PMC9222997 DOI: 10.3390/ijerph19127033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 01/27/2023]
Abstract
The risk of dementia increases with age. To mitigate this risk, we examined the effect of a square-stepping exercise (SSE) program on fall-related fitness and brain-derived neurotrophic factor (BDNF) levels. Twenty older adults in Korea were randomly assigned to either the experimental or control group (each group n = 10). Participants performed SSE for 70 min per session, twice a week, for 12 weeks with a certified instructor. The average age of the participants was 74.80 ± 6.763 years in the exercise group and 72.50 ± 6.519 years in the control group. The experiment group showed significant improvement (p < 0.01) in the lower muscle strength post-intervention. The paired t-test revealed a significant improvement (p < 0.01) in the experimental group and a significant difference in the interaction effect (p < 0.01) in the BDNF levels. There was a significant improvement (p < 0.05) in the BDNF levels in the experimental group and a significant decrease (p < 0.05) in the control group. The SSE program had a positive effect on fall-related fitness and BDNF levels.
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Mai Ba H, Kim J. The Effects of Combined Physical and Cognitive Interventions on Direct and Indirect Fall Outcomes for the Elderly with Mild Cognitive Impairment: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10050862. [PMID: 35628001 PMCID: PMC9140643 DOI: 10.3390/healthcare10050862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 01/04/2023] Open
Abstract
This review was intended to determine the effectiveness of physical and cognitive training (PCT) on falls and fall-related factors and cognitive function among community-dwelling elderly people with mild cognitive impairment (MCI). A systematic literature search was performed of the MEDLINE, CINAHL, Web of Sciences, Scopus, ProQuest, Embase, and Google Scholar databases for articles published from 2010 to 2020. The studies that combined PCT to assess their impacts on fall outcomes both directly and indirectly were included. Study quality was assessed using the standardized JBI Critical Appraisal Tool for RCTs. The standardized data extraction tool from JBI-MAStARI was used to extract data of included studies. Seven RCTs involving 740 participants were included. The overall fall incidence did not significantly decrease after the interventions. However, PCT significantly impacted the cognitive function and physical activities of elderly people with MCI, particularly improving their balancing ability, gait speed, muscular strength, and executive functions. This study indicated that combining PCT improves balance ability, gait speed, and executive functioning in the elderly with MCI, which may help to minimize fall occurrence.
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Affiliation(s)
- Hai Mai Ba
- Faculty of Nursing, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam; or
| | - Jiyun Kim
- School of Nursing, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4226
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Wang YH, Liu YH, Yang YR, Wang RY. Effects of square-stepping exercise on motor and cognitive function in older adults - A systematic review and meta-analysis. Geriatr Nurs 2021; 42:1583-1593. [PMID: 34773911 DOI: 10.1016/j.gerinurse.2021.10.022] [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: 08/03/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To document the effects of square-stepping exercise (SSE) on motor and cognitive function in older adults. METHODS Five online databases were searched in May 2021. Controlled studies published from 2006 to May 2021 were included. The experimental group received SSE alone or SSE combined with other exercise(s), whereas the control group received no training or other exercise(s). Motor and cognitive outcomes included balance, fall risk, agility, endurance, gait speed, flexibility, muscle strength, reaction time, global cognitive function, memory, and executive function. RESULTS Ten articles with a total of 920 participants were included. Static balance (p=0.0009), dynamic balance (p=0.0008), fall risk (p<0.00001), and agility (p=0.02) improved more in the intervention group than in the control group. However, SSE did not seem to exert beneficial effects on cognitive function. CONCLUSION In older adults, SSE provided beneficial effects on motor function, including static and dynamic balance, risk of falls, and agility. However, positive effects on cognitive function were not observed and require further investigation.
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Affiliation(s)
- Yin-Hsiang Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yun-Hsien Liu
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
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Brioschi Guevara A, Bieler M, Altomare D, Berthier M, Csajka C, Dautricourt S, Démonet JF, Dodich A, Frisoni GB, Miniussi C, Molinuevo JL, Ribaldi F, Scheltens P, Chételat G. Protocols for cognitive enhancement. A user manual for Brain Health Services-part 5 of 6. Alzheimers Res Ther 2021; 13:172. [PMID: 34635149 PMCID: PMC8507160 DOI: 10.1186/s13195-021-00844-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022]
Abstract
Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques.We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence.CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory.We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs ("smart drugs", acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment.Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.
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Affiliation(s)
- Andrea Brioschi Guevara
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Melanie Bieler
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Marcelo Berthier
- Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
| | - Chantal Csajka
- Center for Research and Innovation in clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Jean-François Démonet
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alessandra Dodich
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gael Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
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Sharma S, Balaji GK, Sahana A, Karthikbabu S. Effects of Cognitive Versus Mind-Motor Training on Cognition and Functional Skills in the Community-Dwelling Older Adults. Indian J Psychol Med 2021; 43:300-305. [PMID: 34385722 PMCID: PMC8327871 DOI: 10.1177/0253717620957517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There is a decline in cognitive and functional skills in older adults. The objective of this study was to compare the effects of cognitive and mind-motor training (MMT) on cognition and functional skills in a community-dwelling sample of older adults. METHODS In this observer-blinded randomized clinical trial, 40 older adults with medical stability, ability to comprehend and respond to simple verbal instructions, no diagnosed psychological disorders, absence of severe visual and hearing problems, the capacity to walk independently, and a score of more than 46 in Berg Balance Scale were included. They were randomly allocated into cognitive or MMT groups. Cognitive training (CT) was practiced with activities for memory and attention, using paper-pencil tasks. MMT was practiced using a simple, indoor based square-stepping exercise. They practiced one-hour of training per day, three days a week, for eight weeks. RESULTS General linear model analysis showed that the time by groups was not statistically significant. The mean (standard deviation) scores in General Practitioner Assessment of Cognition Scale and Hindi Mental State Examination improved significantly (P < 0.001) following MMT [1.75 (1.29); 2.4 (1.34)] and CT [1.5 (1.36); 2.7 (0.99)]. The functional skills measured using Lawton Instrumental Activities of Daily Living Scale revealed beneficial changes for both the groups. None of the outcomes were statistically significant between the groups (P > 0.05). CONCLUSION Both cognitive and MMTs showed similar practice effects on cognition and functional skills in community-dwelling older adults.
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Affiliation(s)
- Shruti Sharma
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | | | - Sahana A
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | - Suruliraj Karthikbabu
- Dept. of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, Karnataka, India
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Effects of Combined Physical Activity and Cognitive Training on Cognitive Function in Older Adults with Subjective Cognitive Decline: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021. [DOI: 10.1155/2021/8882961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Subjective cognitive decline (SCD) is recognized as the earliest prodromal stage of Alzheimer’s disease (AD). Emerging studies explored the effects of combined physical activity and cognitive training interventions on cognitive ability, psychological well-being, and emotion of older adults with SCD, but the results are now still controversial. Objective. This study systematically evaluated the enhancement effects of the combined physical-cognitive interventions on memory self-efficacy, objective cognitive function, psychological well-being, and emotion of older adults with SCD. Methods. Data sources PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang degree and conference papers database, Chinese Science and Technology Periodical (VIP) databases from their inception to 28 February 2020, the Cochrane Central Register of Controlled Trials (Cochrane Library, 2020, Issue 3), and the reference lists of all retrieved articles were searched. Data analysis and bias risk evaluation were conducted in 2020. Two reviewers (SG and YY) independently evaluated the risk of bias of the included studies using the RoB 2 tool. Results. Eleven RCTs involving 1713 participants with SCD (age 68.0 ± 6.1) were included for review and meta-analysis. The interventions in the included studies were physical activity combined with cognitive training. Multiple-modality exercise with mind-motor training, supervised strategy-based memory training sequentially after stationary cycling, Dejian Mind-Body intervention, and physical activity and cognitive stimulation were also practiced. Conclusions. Compared to the active or nonactive control groups, the combined interventions are effective in improving objective cognitive function in SCD which may show the potential value of combined physical-cognitive interventions in improving objective cognitive ability and preventing the conversion of SCD to MCI or AD and no adverse effects. However, owing to the limitations of the included studies, these findings should be interpreted cautiously.
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Kraiwong R, Vongsirinavarat M, Rueankam M, Sumalrot T. Effects of physical-cognitive training on physical and psychological functions among older adults with type 2 diabetes and balance impairment: a randomized controlled trial. J Exerc Rehabil 2021; 17:120-130. [PMID: 34012938 PMCID: PMC8103183 DOI: 10.12965/jer.2142106.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/25/2021] [Indexed: 12/02/2022] Open
Abstract
Risks of falls among older adults are multifactorial in nature. A combined training program might be beneficial on fall-related outcomes. This study aimed to explore the effects of group-based physical-cognitive trainings on physical and psychological outcomes among older adults with type 2 diabetes mellitus (T2DM) and balance impairment. Fall incidence were also determined. Thirty-seven older adults with T2DM and balance impairment were randomly assigned to control and intervention groups. The intervention program comprised of 24 training sessions of 45–60 min exercise for 8 weeks. The exercise consisted of warm-up, aerobic exercise by nine square stepping, resistance exercise combined with cognitive training and cool down. All participants were assessed at baseline, 4 and 8 weeks after intervention, and 1-year follow-up. Both groups reported similar rates of falls. Global cognition, depressive symptoms, and fear of falling did not differ between groups at any time. The Timed Up & Go (TUG) test, alternate stepping test (AST), knee extensors, ankle plantarflexors, and dorsiflexors strength differed at 4 weeks. TUG, AST, hip abductors, knee flexors, ankle plantarflexors, and dorsiflexors strength differed at 8 weeks. The activity of daily living (ADL), TUG test (P=0.002) and AST, hip extensors and abductors, knee extensors and flexors, ankle plantarflexors and dorsiflexors were different at 1-year follow-up. The group-based physical-cognitive training could benefit older adults with T2DM in terms of maintaining ADL. The intervention could reduce fall risk factors by improving balance and lower limb muscle strength among older adults with T2DM and balance impairment.
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Affiliation(s)
- Ratchanok Kraiwong
- Department of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Mantana Vongsirinavarat
- Department of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Maliwan Rueankam
- Department of Occupational Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Thanayot Sumalrot
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Gavelin HM, Dong C, Minkov R, Bahar-Fuchs A, Ellis KA, Lautenschlager NT, Mellow ML, Wade AT, Smith AE, Finke C, Krohn S, Lampit A. Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials. Ageing Res Rev 2021; 66:101232. [PMID: 33249177 DOI: 10.1016/j.arr.2020.101232] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 02/06/2023]
Abstract
Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k = 41, Hedges' g = 0.22, 95 % CI 0.14 to 0.30) and physical function (k = 32, g = 0.25, 95 % CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.
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14
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Jardim NYV, Bento-Torres NVO, Costa VO, Carvalho JPR, Pontes HTS, Tomás AM, Sosthenes MCK, Erickson KI, Bento-Torres J, Diniz CWP. Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults. Front Aging Neurosci 2021; 13:589299. [PMID: 33679369 PMCID: PMC7928356 DOI: 10.3389/fnagi.2021.589299] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/20/2021] [Indexed: 12/04/2022] Open
Abstract
Background It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults. Methods This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures. Results Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance. Conclusion We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults. Clinical Trial Registration Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.
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Affiliation(s)
- Naina Yuki Vieira Jardim
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Natáli Valim Oliver Bento-Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Physical Therapy and Occupational Therapy Program, Federal University of Pará, Belém, Brazil
| | - Victor Oliveira Costa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Josilayne Patricia Ramos Carvalho
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Physical Therapy and Occupational Therapy Program, Federal University of Pará, Belém, Brazil
| | - Helen Tatiane Santos Pontes
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Alessandra Mendonça Tomás
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Marcia Consentino Kronka Sosthenes
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - João Bento-Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Physical Therapy and Occupational Therapy Program, Federal University of Pará, Belém, Brazil
| | - Cristovam Wanderley Picanço Diniz
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
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Boa Sorte Silva NC, Nagamatsu LS, Gill DP, Owen AM, Petrella RJ. Memory Function and Brain Functional Connectivity Adaptations Following Multiple-Modality Exercise and Mind-Motor Training in Older Adults at Risk of Dementia: An Exploratory Sub-Study. Front Aging Neurosci 2020; 12:22. [PMID: 32158386 PMCID: PMC7052336 DOI: 10.3389/fnagi.2020.00022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/21/2020] [Indexed: 01/07/2023] Open
Abstract
Background Multiple-modality exercise improves brain function. However, whether task-based brain functional connectivity (FC) following exercise suggests adaptations in preferential brain regions is unclear. The objective of this study was to explore memory function and task-related FC changes following multiple-modality exercise and mind-motor training in older adults with subjective cognitive complaints. Methods We performed secondary analysis of memory function data in older adults [n = 127, mean age 67.5 (7.3) years, 71% women] randomized to an exercise intervention comprised of 45 min of multiple-modality exercise with additional 15 min of mind-motor training (M4 group, n = 63) or an active control group (M2 group, n = 64). In total, both groups exercised for 60 min/day, 3 days/week, for 24 weeks. We then conducted exploratory analyses of functional magnetic resonance imaging (fMRI) data collected from a sample of participants from the M4 group [n = 9, mean age 67.8 (8.8) years, 8 women] who completed baseline and follow-up task-based fMRI assessment. Four computer-based memory tasks from the Cambridge Brain Sciences cognitive battery (i.e. Monkey Ladder, Spatial Span, Digit Span, Paired Associates) were employed, and participants underwent 5 min of continuous fMRI data collection while completing the tasks. Behavioral data were analyzed using linear mixed models for repeated measures and paired-samples t-test. All fMRI data were analyzed using group-level independent component analysis and dual regression procedures, correcting for voxel-wise comparisons. Results Our findings indicated that the M4 group showed greater improvements in the Paired Associates tasks compared to the M2 group at 24 weeks [mean difference: 0.47, 95% confidence interval (CI): 0.08 to 0.86, p = 0.019]. For our fMRI analysis, dual regression revealed significant decrease in FC co-activation in the right precentral/postcentral gyri after the exercise program during the Spatial Span task (corrected p = 0.008), although there was no change in the behavioral task performance. Only trends for changes in FC were found for the other tasks (all corrected p < 0.09). In addition, for the Paired Associates task, there was a trend for increased co-activation in the right temporal lobe (Brodmann Area = 38, corrected p = 0.07), and left middle frontal temporal gyrus (corrected p = 0.06). Post hoc analysis exploring voxel FC within each group spatial map confirmed FC activation trends observed from dual regression. Conclusion Our findings suggest that multiple modality exercise with mind-motor training resulted in greater improvements in memory compared to an active control group. There were divergent FC adaptations including significant decreased co-activation in the precentral/postcentral gyri during the Spatial Span task. Borderline significant changes during the Paired Associates tasks in FC provided insight into the potential of our intervention to promote improvements in visuospatial memory and impart FC adaptations in brain regions relevant to Alzheimer's disease risk. Clinical Trial Registration The trial was registered in ClinicalTrials.gov in April 2014, Identifier: NCT02136368.
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Affiliation(s)
- Narlon C Boa Sorte Silva
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lindsay S Nagamatsu
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Dawn P Gill
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Adrian M Owen
- The Brain and Mind Institute, Department of Physiology and Pharmacology, and Psychology, Western University, London, ON, Canada
| | - Robert J Petrella
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.,Canadian Centre for Activity and Aging, Western University, London, ON, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Hsieh SW, Hsiao SF, Liaw LJ, Huang LC, Yang YH. Effects of multiple training modalities in the elderly with subjective memory complaints: A pilot study. Medicine (Baltimore) 2019; 98:e16506. [PMID: 31335722 PMCID: PMC6709103 DOI: 10.1097/md.0000000000016506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study investigated the effects of multiple training modalities (MTM) on senior fitness and neuropsychiatric function in the elderly with subjective memory complaints (SMC). METHODS This study was conducted in 24 elderly subjects with Clinical Dementia Rating (CDR) score of 0 and instrument of ascertainment of dementia 8 (AD8) score of <2. The participants were classified into SMC (n = 7) and non-SMC (n = 17).All were assigned to receive multiple training modalities (1 hour for each training: physical fitness activities, calligraphy or drawing, and meditation) twice a week over a 16-week period.A series of senior fitness test, and neuropsychiatric tests, namely the Traditional Chinese version Mini-Mental Status Examination (MMSE), Cognitive Assessment Screening Instrument (CASI), and the Center for Epidemiologic Studies Depression Scale (CESD), were conducted before and after the intervention. We compared the differences of pre/posttest-MTM and SMC/non-SMC in senior fitness and the neuropsychological tests. RESULTS There was no significant difference between SMC and non-SMC groups in demographic characteristics. MTM showed significant improvement in senior fitness and CESD, but not in CASI and MMSE. Significant change in recent memory subscale of CASI was only observed in SMC group, whereas improvement of partial senior fitness and CESD were observed in both groups. CONCLUSION MTM had effects in enhancing senior fitness and improving depressive syndromes in the elderly. MTM contributed to greater improvement in recent memory function in the SMC group than in the non-SMC group.
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Affiliation(s)
- Sun-Wung Hsieh
- Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University
- Neuroscience Research Center, Kaohsiung Medical University
| | - Shih-Fen Hsiao
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University
- Department of Rehabilitation Medicine, Kaohsiung Medical University Hospital
| | - Lih-Jiun Liaw
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University
- Department of Rehabilitation Medicine, Kaohsiung Medical University Hospital
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University
- Neuroscience Research Center, Kaohsiung Medical University
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University
- Neuroscience Research Center, Kaohsiung Medical University
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital
- Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung
- Chinese Mentality Protection Association, Taiwan
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