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Ding K, Song F, Qi W, Liu H, Sun M, Xia R. Effects of 12 weeks of head-down strong abdominal breathing on motor and cognitive performance during dual-tasking in patients with chronic obstructive pulmonary disease: Study protocol for a randomised controlled trial. Heliyon 2024; 10:e34255. [PMID: 39100443 PMCID: PMC11295862 DOI: 10.1016/j.heliyon.2024.e34255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/05/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
Objective Head-down training can affect behavioural and neurocognitive control while performing dual tasks (DT). Breathing training improves motor and cognitive performance in patients with chronic obstructive pulmonary disease (COPD). As a neurorehabilitation tool, functional near-infrared spectroscopy (fNIRS) has been demonstrated to be an effective method for detecting changes in brain activation during motor recovery, as well as monitoring patients' long-term progress during DT in motor and cognitive performance. However, no studies have examined the combined effect of head-down position and breathing exercises on motor and cognitive performance during DT. This study will employ a novel intervention involving head-down strong abdominal breathing training to investigate its effects on motor and cognitive performance during DT in patients with COPD aiming to inform future training modalities in the community and at home. Methods We will recruit participants from Anqing, China, through community announcements, bulletin board postings, WeChat, and offline visits and screen 72 patients with stable COPD, classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) I-II, by pulmonologists at the university hospital. All participants will be randomly assigned to the head-down strong abdominal breathing (tilt angle 0-30° on the inversion apparatus, respiratory rate 20-30 breaths/min), head-down training, and strong abdominal breathing training groups in a 1:1:1 ratio. The intervention will last 12 weeks, with sessions performed thrice weekly for 1 h. Results The primary outcomes will be motor-cognitive DT time, dual-task effects, correct responses to cognitive tasks, and gait characteristics assessed at baseline, 6 and 12 weeks of intervention. The patient's dorsolateral prefrontal cortex (PFC) will also be stimulated with fNIRS at wavelengths of 730 and 850 nm, with a sampling rate of 11 Hz, to record oxy-haemoglobin (oxy-Hb), deoxy-haemoglobin (deoxy-Hb), and total oxyhaemoglobin (total-Hb). Secondary outcomes will include pre- and post-intervention scales for dyspnoea, overall cognitive function, balance, and anxiety and depression. Conclusion Alterations in the PFC involved in attentional control, planning, and decision-making may partially explain cognitive and motor deficits (such as impaired balance and slower walking speed) in patients with COPD. This study may help to understand the effects of head-down strong abdominal breathing training on cognitive and motor performance under DT in patients with COPD and compare it with head-down training and breathing training alone. It may also help to determine whether it is a simple and effective form of exercise at home and in the community.
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Affiliation(s)
- Kexin Ding
- Institute of Physical Education, AnQing Normal University, No.1318, Jixian North Road, AnQing, Anhui, China
| | - Feiyun Song
- Institute of Physical Education, AnQing Normal University, No.1318, Jixian North Road, AnQing, Anhui, China
| | - Wei Qi
- Institute of Physical Education, AnQing Normal University, No.1318, Jixian North Road, AnQing, Anhui, China
| | - Hongrui Liu
- College of Urban and Environmental Science, Central China Normal University, No.152, Luoyu Road, Hongshan District, Wuhan, Hubei Province, China
| | - Mingyun Sun
- Institute of Physical Education, AnQing Normal University, No.1318, Jixian North Road, AnQing, Anhui, China
| | - Rui Xia
- Institute of Physical Education, Chaohu University, No.1, BanTang Road, Chaohu Economic Development Zone, Chaohu, Anhui, China
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Xu Z, Zheng X, Ding H, Zhang D, Cheung PMH, Yang Z, Tam KW, Zhou W, Chan DCC, Wang W, Wong SYS. The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e48355. [PMID: 39045858 PMCID: PMC11287235 DOI: 10.2196/48355] [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: 04/20/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/25/2024] Open
Abstract
Background Previous literature lacks summative information on the mental health benefits achieved from different forms of walking. Objective The aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety. Methods This was a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool. Results This review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD -0.591, 95% CI -0.778 to -0.403; I2=84.8%; τ2=0.3008; P<.001) and anxiety symptoms (RCTs: n=26; SMD -0.446, 95% CI -0.628 to -0.265; I2=81.1%; τ2=0.1530; P<.001) when compared with the inactive controls. Walking could significantly reduce depressive or anxiety symptoms in most subgroups, including different walking frequency, duration, location (indoor or outdoor), and format (group or individual) subgroups (all P values were <.05). Adult participants who were depressed (RCTs: n=5; SMD -1.863, 95% CI -2.764 to -0.962; I2=86.4%; τ2=0.8929) and those who were not depressed (RCTs: n=39; SMD -0.442, 95% CI -0.604 to -0.280; I2=77.5%; τ2=0.1742) could benefit from walking effects on their depressive symptoms, and participants who were depressed could benefit more (P=.002). In addition, there was no significant difference between walking and active controls in reducing depressive symptoms (RCTs: n=17; SMD -0.126, 95% CI -0.343 to 0.092; I2=58%; τ2=0.1058; P=.26) and anxiety symptoms (14 RCTs, SMD -0.053, 95% CI -0.311 to 0.206, I2=67.7%, τ2=0.1421; P=.69). Conclusions Various forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.
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Affiliation(s)
- Zijun Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaoxiang Zheng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Hanyue Ding
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Peter Man-Hin Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Zuyao Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Weiju Zhou
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dicken Cheong-Chun Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wenyue Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Kim D, Baek S, Kim S, Im S, Kim S. Analysis of breathing patterns to stabilize cardiovascular changes in physical stress environments : inspiration responds to rapid changes in blood pressure. Biomed Eng Lett 2024; 14:813-821. [PMID: 38946807 PMCID: PMC11208350 DOI: 10.1007/s13534-024-00379-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/24/2024] [Accepted: 03/30/2024] [Indexed: 07/02/2024] Open
Abstract
The thoracic nerves form a complex neural network that coordinates involuntary muscles such as breathing and the heart. Breathing has various patterns to maintain homeostasis in the human body. This study analyzes changes in the cardiovascular system and breathing patterns induced by stress caused by various mechanical movements performed in daily life and ultimately, the goal is to propose effective breathing patterns and breathing control methods to maintain cardiovascular homeostasis. The participants' age was 26.97 ± 3.93 years, height was 170.24 ± 8.61 cm, and weight was 65.69 ± 13.55 Kg, and there were 62 men and 38 women. Breathing and electrocardiogram were obtained using HiCard+, a biometric monitoring device. The measured electrocardiogram was analyzed for heartbeat interval, which indicates changes in the cardiovascular system, and standard deviation of normal to normal interval (SDNN) and root mean square of the successive differences (rMSSD), which indicate the activity of the autonomic and parasympathetic nervous systems. For respiration, time changes were analyzed as patterns by calculating inspiration and exhalation times. As a result of this study, rapid changes in blood pressure increased SDNN and rMSSD from 0.053 ± 0.06 and 0.056 ± 0.087 to 0.109 ± 0.114 and 0.125 ± 0.170 s, and induced an increase in spontaneous inspiratory time from 1.46 to 1.51 s (p < 0.05). Ultimately, we hope that the results of this study will be used as a breathing control training technique to prevent and manage rapid cardiovascular changes. Supplementary Information The online version contains supplementary material available at 10.1007/s13534-024-00379-y.
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Affiliation(s)
- Daechang Kim
- Department of Medical Biotechnology, Dongguk University, Bio Medi Campus, Ilsandonggu, Goyang si, Gyeonggi-do 10326 Korea
| | - Seungbin Baek
- Department of Medical Device Business, Dongguk University, 32, Dongguk ro, Ilsandonggu, Goyang si, Gyeonggi do 10326 Korea
| | - Seunghui Kim
- Department of Regulatory Science for Bio-Health Medical Device, Dongguk University, 32, Dongguk ro, Ilsandonggu, Goyang si, Gyeonggi do 10326 Korea
| | - Sanghee Im
- Department and Research Institute of Rehabilitation Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Sungmin Kim
- Department of Medical Biotechnology, Dongguk University, Bio Medi Campus, Ilsandonggu, Goyang si, Gyeonggi-do 10326 Korea
- Department of Medical Device Industry, Dongguk University, Seoul, 04620 Korea
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Chang L, Chen SC, Lin PY, Lin HP, Liao LL, Chao HC, Chen MC, Chen MC, Tsao YY. A Pilot Study to Explore the Improvements in Pulmonary and Cognitive Functions With a Kazoo Intervention Among Middle-Aged and Older Adults in a Rural Community. Gerontol Geriatr Med 2023; 9:23337214231212268. [PMID: 38026090 PMCID: PMC10647995 DOI: 10.1177/23337214231212268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Dementia is a leading cause of disability and dependence in older adults worldwide. The aim of this pilot study was to explore the effect of using a kazoo instrument to improve pulmonary function and cognitive reserve in middle-aged and older adults in rural areas. This quasi-experimental study was conducted at two community care stations selected using cluster sampling from a rural district in southern Taiwan. We enrolled 85 middle-aged and older adults who were randomly assigned into self-learner and in-class groups. Both groups received a 6-month kazoo program. Cognitive and pulmonary function were compared before and after the intervention between the two groups. Significantly improved pulmonary function with regards to forced vital capacity (p < .05) was found in the self-learner group, and significantly improved maximum expiratory flow 75% (p < .001) was found in both groups. Mini-Mental State Examination scores significantly improved in the self-learner group (p < .01), but there was no significant change in the in-class group. Our results suggest that community care stations could consider implementing wind instrument programs such as a kazoo to enhance pulmonary function and cognitive reserve in middle-aged and older adults residing in rural areas.
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Affiliation(s)
- Luna Chang
- National Tainan Junior College of Nursing, Tainan, Taiwan. R.O.C
| | - Shu-Chuan Chen
- National Tainan Junior College of Nursing, Tainan, Taiwan. R.O.C
| | - Po-Yu Lin
- National Cheng Kung University Hospital, Tainan, Taiwan. R.O.C
| | - Hsiu-Pi Lin
- Chia Nan University of Pharmacy & Science, Tainan, Taiwan. R.O.C
| | - Li-Ling Liao
- Kaohsiung Medical University, Kaohsiung, Taiwan. R.O.C
| | - Hui-Chen Chao
- National Tainan Junior College of Nursing, Tainan, Taiwan. R.O.C
| | - Mei-Chun Chen
- National Tainan Junior College of Nursing, Tainan, Taiwan. R.O.C
| | - Mei-Chun Chen
- National Tainan Junior College of Nursing, Tainan, Taiwan. R.O.C
| | - Yi-Ying Tsao
- National Tainan Junior College of Nursing, Tainan, Taiwan. R.O.C
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Cheng YY, Lin SY, Hsu CY, Fu PK. Respiratory Muscle Training Can Improve Cognition, Lung Function, and Diaphragmatic Thickness Fraction in Male and Non-Obese Patients with Chronic Obstructive Pulmonary Disease: A Prospective Study. J Pers Med 2022; 12:jpm12030475. [PMID: 35330474 PMCID: PMC8955729 DOI: 10.3390/jpm12030475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/05/2022] [Accepted: 03/13/2022] [Indexed: 12/25/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) are frequently comorbid with mild cognitive impairment (MCI). Whether respiratory muscle training (RMT) is helpful for patients with COPD comorbid MCI remains unclear. Inspiratory muscle training (IMT) with or without expiratory muscle training (EMT) was performed. Patients were randomly assigned to the full training group (EMT + IMT) or the simple training group (IMT only). A total of 49 patients completed the eight-week course of RMT training. RMT significantly improved the maximal inspiratory pressure (MIP), the diaphragmatic thickness fraction and excursion, lung function, scores in the COPD assessment test (CAT), modified Medical Research Council (mMRC) scale scores, and MMSE. The between-group difference in the full training and single training group was not significant. Subgroup analysis classified by the forced expiratory volume in one second (FEV1) level of patients showed no significant differences in MIP, lung function, cognitive function, and walking distance. However, a significant increase in diaphragmatic thickness was found in patients with FEV1 ≥ 30%. We suggest that patients with COPD should start RMT earlier in their disease course to improve physical activity.
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Affiliation(s)
- Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402010, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Shih-Yi Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung 407219, Taiwan;
| | - Pin-Kuei Fu
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402010, Taiwan
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- Integrated Care Center of Interstitial Lung Disease, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- College of Human Science and Social Innovation, Hungkuang University, Taichung 433304, Taiwan
- Correspondence: ; Tel.: +886-937-701-592
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Zhidong C, Wang X, Yin J, Song D, Chen Z. Effects of physical exercise on working memory in older adults: a systematic and meta-analytic review. Eur Rev Aging Phys Act 2021; 18:18. [PMID: 34535084 PMCID: PMC8447686 DOI: 10.1186/s11556-021-00272-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background This systematic and meta-analytic review aimed to investigate the effects of physical exercise on the working memory of older adults, and to identify the moderators of these effects. Methods We searched six electronic databases for randomized controlled trials on the effects of physical exercise on working memory that were published before or on May 15, 2020. The PEDro scale was used to evaluate the methodological quality of the included studies. Stata 14.0 software was used to perform the meta-analysis, subgroup analysis, and publication bias testing. Results A total of 28 studies and 2156 participants were included. The methodological quality of the included studies was fair to excellent, and there was no publication bias. Overall, we found that physical exercise had a significant effect on working memory in older adults (standardized mean difference = 0.30, p < 0.0001). The effects of physical exercise on working memory were moderated by exercise frequency, intensity, type, duration, cognitive status, and control subgroup (active/passive), but not by intervention period or age of participant. Conclusion Physical exercise can effectively improve the working memory of older adults. The recommended physical exercise is multi-component exercise or mind–body exercise of moderate intensity for 45–60 min 3 times a week, for more than 6 months. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00272-y.
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Affiliation(s)
- Cai Zhidong
- Shanghai University of Sport, School of Physical Education and Training, Shanghai, 200438, China
| | - Xing Wang
- Shanghai University of Sport, School of Physical Education and Training, Shanghai, 200438, China
| | - Jilin Yin
- Physical Education Department, Beibu Gulf University, Qinzhou, 535011, China
| | - Dehai Song
- Institute of P. E Yancheng Teachers University, Yancheng, 224002, Jiangsu Province, China
| | - Zhitong Chen
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, 2800 Wenxiang Road, Shanghai, 201620, China.
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Krzysztofik M. Utilisation of Post-Activation Performance Enhancement in Elderly Adults. J Clin Med 2021; 10:jcm10112483. [PMID: 34199706 PMCID: PMC8200027 DOI: 10.3390/jcm10112483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 01/27/2023] Open
Abstract
With age, many physiological changes occur in the human body, leading to a decline in biological functions, and those related to the locomotor system are some of the most visible. Hence, there is a particular need to provide simple and safe exercises for the comprehensive development of physical fitness among elderly adults. The latest recommendations for the elderly suggest that the main goal of training should be to increase muscle power. The post-activation performance enhancement effect underpinning complex training might be an approach that will allow for the development of both muscle strength and velocity of movement, which will result in an increase in muscle power and improve the ability to perform daily activities and decrease injury risk. This article briefly introduces a complex training model adapted to the elderly with its potential benefits and proposes a direction for further studies.
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Affiliation(s)
- Michał Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
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Chen FT, Etnier JL, Chan KH, Chiu PK, Hung TM, Chang YK. Effects of Exercise Training Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis. Sports Med 2020; 50:1451-1467. [PMID: 32447717 PMCID: PMC7376513 DOI: 10.1007/s40279-020-01292-x] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic exercise training has been shown be to positively associated with executive function (EF) in older adults. However, whether the exercise training effect on EF is affected by moderators including the specific sub-domain of EF, exercise prescription variables, and sample characteristics remains unknown. OBJECTIVES This systematic and meta-analytic review of randomized controlled trials (RCTs) investigated the effects of exercise training on EF in older adults and explored potential moderators underlying the effects of exercise training on EF. METHODS In accordance with the PRISMA guidelines, the electronic databases MEDLINE (PubMed) and EMBASE (Scopus) were searched from January 2003 to November 2019. All studies identified for inclusion were peer-reviewed and published in English. To be included, studies had to report findings from older (> 55 years old), cognitively normal adults or adults with mild cognitive impairment (MCI) randomized to an exercise training or a control group. The risk of bias in each study was appraised using the Cochrane risk-of-bias tool. Fixed-effects models were used to compare the effects of exercise training and control conditions on EF assessed at baseline and post-intervention. In addition, subgroup analyses were performed for three moderators (i.e., the specific sub-domain of EF, exercise prescription variables, and sample characteristics). RESULTS Thirty-three RCTs were included. Overall, exercise training was associated with a significant small improvement in EF [Q(106) = 260.09, Hedges' g = 0.21; p < 0.01]. The EF sub-domain moderator was not significant [Q(2) = 4.33, p > 0.05], showing that the EF improvement in response to exercise is evident for measures of inhibition, updating, and shifting. Regarding exercise prescription variables, results were significantly moderated by frequency of exercise training [Q(1) = 10.86, p < 0.05], revealing that effect sizes (ESs) were larger for moderate frequency (g = 0.31) as compared to low frequency exercise (g = 0.15). The results also showed type of exercise training moderated the ESs [Q(4) = 26.18, p < 0.05], revealing that ESs were largest for other forms of exercise (g = 0.44), followed by Tai Chi and yoga (g = 0.38), resistance exercise (g = 0.22), aerobic exercise (g = 0.14), and combined exercise (g = 0.10). In addition, The results showed moderated length of training the ESs [Q(2) = 16.64, p < 0.05], revealing that ESs were largest for short length (g = 0.32), followed by mid length (g = 0.26) and long length (g = 0.09). No significant difference in effects was observed as a function of exercise intensity [Q(1) = 2.87 p > 0.05] and session time [Q(2) = 0.21, p > 0.05]. Regarding sample characteristics, the results were significantly moderated by age [Q(2) = 20.64, p < 0.05], with significant benefits for young-old (55-65 years old) (g = 0.30) and mid-old (66-75 years old) (g = 0.25), but no effect on EF for old-old (more than 75 years old). The results were also significantly moderated by physical fitness levels [Q(1) = 10.80, p < 0.05], revealing that ESs were larger for sedentary participants (g = 0.33) as compared to physically fit participants (g = 0.16). In addition, results were also significantly moderated by cognitive status [Q(1) = 11.44, p < 0.05], revealing that ESs were larger for participants with cognitively normal (g = 0.26) as compared to those with mild cognitive impairment (g = 0.08). No significant differences in effects were observed as a function of sex [Q(2) = 5.38, p > 0.05]. CONCLUSIONS Exercise training showed a small beneficial effect on EF in older adults and the magnitude of the effect was different across some moderators.
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Affiliation(s)
- Feng-Tzu Chen
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Jennifer L Etnier
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Kuei-Hui Chan
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan, ROC
| | - Ping-Kun Chiu
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan, ROC
| | - Tsung-Ming Hung
- Department of Physical Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei, Taiwan, ROC
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei, Taiwan, ROC.
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan, ROC.
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9
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Gasquoine PG, Chen PY. Effect of physical exercise on popular measures of executive function in older, nonclinical, participants of randomized controlled trials: A meta-analytic review. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:203-211. [DOI: 10.1080/23279095.2020.1732980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Philip Gerard Gasquoine
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Po-Yi Chen
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, USA
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10
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Cheung YT, Brinkman TM, Li C, Mzayek Y, Srivastava D, Ness KK, Patel SK, Howell RM, Oeffinger KC, Robison LL, Armstrong GT, Krull KR. Chronic Health Conditions and Neurocognitive Function in Aging Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 2019; 110:411-419. [PMID: 29088360 DOI: 10.1093/jnci/djx224] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/20/2017] [Indexed: 11/12/2022] Open
Abstract
Background Neurocognitive impairment in survivors of childhood cancer may be associated with direct neurotoxicity, as well as indirect effects of systemic health complications. We evaluated associations among treatment exposures, chronic health conditions, and neurocognitive outcomes in adult survivors of childhood cancer. Methods Participants included 5507 adult survivors of childhood cancer (47.1% male; mean [SD] age = 31.8 [7.6] years at evaluation; 23.1 [4.5] years postdiagnosis) in the Childhood Cancer Survivor Study who completed a self-report measure of neurocognitive function. Cardiac, pulmonary, and endocrine chronic health conditions were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03). Structural equation modeling was used to examine a priori hypothesized causal pathways among cancer treatment, subsequent chronic health conditions, and neurocognitive outcomes. Multivariable models were used to estimate relative risk for associations of treatments and chronic conditions on neurocognitive function. All statistical tests were two-sided. Results One-third of survivors with a grade 2 or higher chronic condition reported impairments in task efficiency and memory. In addition to direct effects of cranial radiation, path analyses and multivariable models demonstrated direct effects of cardiopulmonary (β = 0.10, P = .002; relative risk [RR] = 1.27, 95% confidence interval [CI] = 1.12 to 1.44) and endocrine (β = 0.07, P = .04; RR = 1.14, 95% CI = 1.02 to 1.28) conditions on impaired task efficiency. We identified similar effects of cardiopulmonary condition on memory (P = .01) and emotional regulation (P = .01). Thoracic radiation was associated with impaired task efficiency (P = .01) and emotional regulation (P = .01) through endocrine morbidity. Conclusions Non-neurotoxic exposures, such as thoracic radiation, can adversely impact survivors' neurocognitive function through chronic conditions. Management of chronic diseases may mitigate neurocognitive outcomes among aging survivors of childhood cancer.
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Affiliation(s)
- Yin Ting Cheung
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Tara M Brinkman
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.,Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Chenghong Li
- Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Yasmin Mzayek
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Deokumar Srivastava
- Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Kirsten K Ness
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Sunita K Patel
- Departments of Population Sciences and Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA
| | - Rebecca M Howell
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Leslie L Robison
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Gregory T Armstrong
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Kevin R Krull
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.,Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
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11
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Sanders LMJ, Hortobágyi T, la Bastide-van Gemert S, van der Zee EA, van Heuvelen MJG. Dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis. PLoS One 2019; 14:e0210036. [PMID: 30629631 PMCID: PMC6328108 DOI: 10.1371/journal.pone.0210036] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/14/2018] [Indexed: 01/09/2023] Open
Abstract
This systematic review and meta-analysis examined the dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairments. We included single-modality randomized controlled aerobic, anaerobic, multicomponent or psychomotor exercise trials that quantified training frequency, session and program duration and specified intensity quantitatively or qualitatively. We defined total exercise duration in minutes as the product of program duration, session duration, and frequency. For each study, we grouped test-specific Hedges' d (n = 163) and Cohen's d (n = 23) effect sizes in the domains Global cognition, Executive function and Memory. We used multilevel mixed-effects models to investigate dose-related predictors of exercise effects. In healthy older adults (n = 23 studies), there was a small positive effect of exercise on executive function (d = 0.27) and memory (d = 0.24), but dose-parameters did not predict the magnitude of effect sizes. In older adults with cognitive impairments (n = 13 studies), exercise had a moderate positive effect on global cognition (d = 0.37). For older adults with cognitive impairments, we found evidence for exercise programs with a short session duration and high frequency to predict higher effect sizes (d = 0.43-0.50). In healthy older adults, dose-parameters did not predict the magnitude of exercise effects on cognition. For older adults with cognitive impairments, exercise programs with shorter session duration and higher frequency may generate the best cognitive results. Studies are needed in which different exercise doses are directly compared among randomized subjects or conditions.
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Affiliation(s)
- Lianne M. J. Sanders
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sacha la Bastide-van Gemert
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Eddy A. van der Zee
- Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, The Netherlands
| | - Marieke J. G. van Heuvelen
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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12
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McFall GP, McDermott KL, Dixon RA. Modifiable Risk Factors Discriminate Memory Trajectories in Non-Demented Aging: Precision Factors and Targets for Promoting Healthier Brain Aging and Preventing Dementia. J Alzheimers Dis 2019; 70:S101-S118. [PMID: 30775975 PMCID: PMC6700610 DOI: 10.3233/jad-180571] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Non-demented cognitive aging trajectories are characterized by vast level and slope differences and a spectrum of outcomes, including dementia. OBJECTIVE The goal of AD risk management (and its corollary, promoting healthy brain aging) is aided by two converging objectives: 1) classifying dynamic distributions of non-demented cognitive trajectories, and 2) identifying modifiable risk-elevating and risk-reducing factors that discriminate stable or normal trajectory patterns from declining or pre-impairment patterns. METHOD Using latent class growth analysis we classified three episodic memory aging trajectories for n = 882 older adults (baseline Mage=71.6, SD=8.9, range = 53-95, female=66%): Stable (SMA; above average level, sustained slope), Normal (NMA; average level, moderately declining slope), and Declining (DMA; below average level, substantially declining slope). Using random forest analyses, we simultaneously assessed 17 risk/protective factors from non-modifiable demographic, functional, psychological, and lifestyle domains. Within two age strata (Young-Old, Old-Old), three pairwise prediction analyses identified important discriminating factors. RESULTS Prediction analyses revealed that different modifiable risk predictors, both shared and unique across age strata, discriminated SMA (i.e., education, depressive symptoms, living status, body mass index, heart rate, social activity) and DMA (i.e., lifestyle activities [cognitive, self-maintenance, social], grip strength, heart rate, gait) groups. CONCLUSION Memory trajectory analyses produced empirical classes varying in level and slope. Prediction analyses revealed different predictors of SMA and DMA that also varied by age strata. Precision approaches for promoting healthier memory aging-and delaying memory impairment-may identify modifiable factors that constitute specific targets for intervention in the differential context of age and non-demented trajectory patterns.
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Affiliation(s)
- G. Peggy McFall
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Kirstie L. McDermott
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Roger A. Dixon
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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13
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McDermott KL, McFall GP, Andrews SJ, Anstey KJ, Dixon RA. Memory Resilience to Alzheimer's Genetic Risk: Sex Effects in Predictor Profiles. J Gerontol B Psychol Sci Soc Sci 2017; 72:937-946. [PMID: 28025282 DOI: 10.1093/geronb/gbw161] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 11/12/2016] [Indexed: 02/05/2023] Open
Abstract
Objectives Apolipoprotein E (APOE) ɛ4 and Clusterin (CLU) C alleles are risk factors for Alzheimer's disease (AD) and episodic memory (EM) decline. Memory resilience occurs when genetically at-risk adults perform at high and sustained levels. We investigated whether (a) memory resilience to AD genetic risk is predicted by biological and other risk markers and (b) the prediction profiles vary by sex and AD risk variant. Method Using a longitudinal sample of nondemented adults (n = 642, aged 53-95) we focused on memory resilience (over 9 years) to 2 AD risk variants (APOE, CLU). Growth mixture models classified resilience. Random forest analysis, stratified by sex, tested the predictive importance of 22 nongenetic risk factors from 5 domains (n = 24-112). Results For both sexes, younger age, higher education, stronger grip, and everyday novel cognitive activity predicted memory resilience. For women, 9 factors from functional, health, mobility, and lifestyle domains were also predictive. For men, only fewer depressive symptoms was an additional important predictor. The prediction profiles were similar for APOE and CLU. Discussion Although several factors predicted resilience in both sexes, a greater number applied only to women. Sex-specific mechanisms and intervention targets are implied.
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Affiliation(s)
| | - G Peggy McFall
- Neuroscience and Mental Health Institute.,Department of Psychology, University of Alberta, Edmonton, Canada
| | - Shea J Andrews
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia
| | - Roger A Dixon
- Neuroscience and Mental Health Institute.,Department of Psychology, University of Alberta, Edmonton, Canada
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14
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Cheng KS, Chang YF, Han RPS, Lee PF. Enhanced conflict monitoring via a short-duration, video-assisted deep breathing in healthy young adults: an event-related potential approach through the Go/NoGo paradigm. PeerJ 2017; 5:e3857. [PMID: 29018605 PMCID: PMC5633029 DOI: 10.7717/peerj.3857] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/06/2017] [Indexed: 12/20/2022] Open
Abstract
Objectives Practitioners of mindfulness are reported to have greater cognitive control especially in conflict monitoring, response inhibition and sustained attention. However, due to the various existing methods in each mindfulness practices and also, the high commitment factor, a barrier still exists for an individual to pick up the practices. Therefore, the effect of short duration deep breathing on the cognitive control is investigated here. Methods Short duration guided deep breathing videos consisting of 5, 7 and 9 min respectively were created and used on subjects training. The effect on cognitive control was assessed using a Go/NoGo task along with event-related potential (ERP) measurements at Fz, Cz, and Pz. Results From the study, the significant outcome showed at the follow-up session in which participants engaged for 5 min deep breathing group showed a profound NoGo N2 amplitude increment as compared to the control group, indicating an enhanced conflict monitoring ability. An inverse relationship between the NoGo N2 amplitude and the breathing duration is observed as well at the follow-up session. Conclusion These results indicated the possibility of performing short duration deep breathing guided by a video to achieve an enhanced conflict monitoring as an alternative to other mindfulness practices and 5 min is found to be the optimum practice duration. Significant This study is the first to establish a relationship between deep breathing and conflict monitoring through ERP. The study population of young adults taken from the same environment reduces the variance in ERP results due to age and environment. Limitation A larger sample size would provide a greater statistical power. A longer duration of deep breathing should be investigated to further clarify the relationship between the practice duration and the NoGo N2 amplitude. The result can be split by gender and analyzed separately due to the different brain structure of males and females.
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Affiliation(s)
- Kok Suen Cheng
- Department of Mechatronics & Biomedical Engineering, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - Yun Fah Chang
- Department of Mathematical & Actuarial Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - Ray P S Han
- College of Engineering, Peking University, Beijing, China
| | - Poh Foong Lee
- Department of Mechatronics & Biomedical Engineering, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
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