Exercise and the psychological state of institutionalized elderly: a review

Leisure activities, apolipoprotein E e4 status, and the risk of dementia

BACKGROUND/PURPOSE

Leisure activities have been associated with a decreased risk of dementia. However, to date, no study has explored how apolipoprotein E (ApoE) e4 status or vascular risk factors modified the association between leisure activities and dementia risks.

METHODS

This case-control study recruited patients (age ≥ 60 years) with Alzheimer's disease (AD; n = 292) and vascular dementia (VaD; n = 144) and healthy controls (n = 506) from three teaching hospitals in Taiwan between 2007 and 2010. Information on patient's leisure activities were obtained through a questionnaire. Conditional logistic regression models were used to assess the association of leisure activities and ApoE e4 status with the risk of dementia.

RESULTS

High-frequency physical activity was associated with a decreased risk of AD [adjusted odds ratio (AOR) = 0.45], and the results become more evident among ApoE e4 carriers with AD (AOR = 0.30) and VaD (AOR = 0.26). Similar findings were observed for cognitive (AOR = 0.42) and social activities (AOR = 0.55) for AD. High-frequency physical, cognitive, and social activities were associated with a decreased risk of VaD (AOR = 0.29-0.60). Physical and social activities significantly interacted with each other on the risk of VaD (pinteraction = 0.04).

CONCLUSION

Physical activity consistently protects against AD and VaD. Significant interactions were identified across different types of leisure activities in lowering dementia risk.

Enriched environment and masticatory activity rehabilitation recover spatial memory decline in aged mice

Background

To measure the impact of masticatory reduction on learning and memory, previous studies have produced experimental masticatory reduction by modified diet or molar removal. Here we induced spatial learning impairment in mice by reducing masticatory activity and then tested the effect of a combination of environmental enrichment and masticatory rehabilitation in recovering spatial learning at adulthood and in later life. For 6 months (6M) or 18 months (18M), we fed three groups of mice from postnatal day 21 respectively with a hard diet (HD) of pellets; pellets followed by a powdered, soft diet (HD/SD, divided into equal periods); or pellets followed by powder, followed by pellets again (HD/SD/HD, divided into equal periods). To mimic sedentary or active lifestyles, half of the animals from each group were raised from weaning in standard cages (impoverished environment; IE) and the other half in enriched cages (enriched environment; EE). To evaluate spatial learning, we used the Morris water maze.

Results

IE6M-HD/SD mice showed lower learning rates compared with control (IE6M-HD) or masticatory rehabilitated (IE6MHD/SD/HD) animals. Similarly, EE-HD/SD mice independent of age showed lower performance than controls (EE-HD) or rehabilitated mice (EE-HD/SD/HD). However, combined rehabilitation and EE in aged mice improved learning rate up to control levels. Learning rates did not correlate with swim speed.

Conclusions

Reduction in masticatory activity imposed on mice previously fed a hard diet (HD/SD) impaired spatial learning in the Morris water maze. In adults, masticatory rehabilitation recovered spatial abilities in both sedentary and active mice, and rehabilitation of masticatory activity combined with EE recovered these losses in aged mice.

The effects on cognitive functions of a movement-based intervention in patients with Alzheimer's type dementia: a pilot study

OBJECTIVE

To explore the effect of a non-aerobic movement based activity on cognition in people with Alzheimer's type dementia (AD).

METHODS

The sample consisted of 27 patients fulfilling the AD ICD-10 diagnostic criteria. The patient sample was randomly divided into two groups: The Exercise Group received 6 weeks movement training and comprised 15 participants with a mean age of 70.5 years (SD: 8). Control Group participated in a standard care group, which served as a control intervention, and consisted of 12 patients with an average age of 75.7 years (SD: 6.90). Cognitive functions were assessed using six computerised tests from the CANTAB, pre and post training. Data were analysed using t-tests. The false discovery rate (FDR) for multiple comparisons as well as Cohen's d effect size was used to assess the significant effects.

RESULTS

Significant improvements in sustained attention, visual memory and a trend in working memory were found in the Exercise Group compared to Control Group after the 6 weeks training. In addition, after 6 weeks the Control Group deteriorated significantly in attention, while the AD patients who undertook the physical exercise showed a discrete improvement.

CONCLUSIONS

The present study shows that a short course of non-aerobic movement based exercise is already effective at least in some aspects of cognitive functioning in patients with AD. Although the present study is a pilot study with small samples, nevertheless, the results are promising for the further investigation and development of non-aerobic movement programmes.

Socio-demographic and health-related factors associated with cognitive impairment in the elderly in Taiwan

Background

Cognitive impairment is an age-related condition as the rate of cognitive decline rapidly increases with aging. It is especially important to better understand factors involving in cognitive decline for the countries where the older population is growing rapidly. The aim of this study was to examine the association between socio-demographic and health-related factors and cognitive impairment in the elderly in Taiwan.

Methods

We analysed data from 2119 persons aged 65 years and over who participated in the 2005 National Health Interview Survey. Cognitive impairment was defined as having the score of the Mini Mental State Examination lower than 24. The χ² test and multiple logistic regression models were used to evaluate the association between cognitive impairment and variables of socio-demography, chronic diseases, geriatric conditions, lifestyle, and dietary factors.

Results

The prevalence of cognitive impairment was 22.2%. Results of multivariate analysis indicated that low education, being single, low social support, lower lipid level, history of stroke, physical inactivity, non-coffee drinking and poor physical function were associated with a higher risk of cognitive impairment.

Conclusion

Most of the characteristics in relation to cognitive impairment identified in our analysis are potentially modifiable. These results suggest that improving lifestyle behaviours such as regular exercise and increased social participation could help prevent or decrease the risk of cognitive impairment. Further investigations using longitudinal data are needed to clarify our findings.

Physical activity and executive functions in the elderly with mild cognitive impairment

The primary goal of the present study was to examine whether in the elderly with mild cognitive impairment (MCI), the effect of physical activity measured directly following treatment, was reflected in an improvement in cognitive functioning in general or in executive functions (EF) in particular. Secondly, this study aimed to compare the effectiveness of two types of intervention, with varying intensities: walking and hand/face exercises. Forty-three frail, advanced elderly subjects (mean age: 86) with MCI were randomly divided into three groups, namely, a walking group (n=15), a group performing hand and face exercises (n=13), and a control group (n=15). All subjects received individual treatment for 30 minutes a day, three times a week, for a period of six weeks. A neuropsychological test battery, administered directly after cessation of treatment, assessed cognitive functioning. The results show that although a (nearly) significant improvement in tasks appealing to EF was observed in both the walking group and the hand/face group compared to the control group, the results should be interpreted with caution. Firm conclusions about the effectiveness of mild physical activity on EF in the oldest old can only be drawn after studies with larger number of subjects.

Mood Alterations in Mindful Versus Aerobic Exercise Modes

The results of most recent studies have generally indicated an improvement in mood after participation in aerobic exercise. However, only a few researchers have compared mindful modes of exercise with aerobic exercise to examine the effect of 1 single session of exercise on mood. In the present study, the authors assessed state anxiety, depressive mood, and subjective well-being prior to and following 1 class of 1 of 4 exercise modes: yoga, Feldenkrais (awareness through movement), aerobic dance, and swimming; a computer class served as a control. Participants were 147 female general curriculum and physical education teachers (mean age = 40.15, SD = 0.2) voluntarily enrolled in a 1-year enrichment program at a physical education college. Analyses of variance for repeated measures revealed mood improvement following Feldenkrais, swimming, and yoga but not following aerobic dance and computer lessons. Mindful low-exertion activities as well as aerobic activities enhanced mood in 1 single session of exercise. The authors suggest that more studies assessing the mood-enhancing benefits of mindful activities such as Feldenkrais and yoga are needed.

On a happier note: validation of musical exercise for older persons in long-term care settings

This paper describes a quasi-experimental study of a musical exercise intervention to improve the physical, cognitive, behavioral status and life satisfaction of older residents in a long-term care facility in the United Kingdom. Twenty long-term care residents from three different units (n=60) were recruited and assigned to one of three groups: a control (C) group (no intervention), an occupational therapy (OT) group (comparison group) and a music exercise group (intervention group). Assessments of physical and cognitive status were made pre-intervention and repeated at the end of the 10-week exercise program and again 10 weeks after the completion of the program. The results show that both OT and exercise participation is associated with improvement in physical and cognitive function. However, the exercise group showed significant improvement in more areas than the OT group. The functional benefits from OT and exercise were not sustainable after these activities ceased and showed significant decline 10 weeks after the end of the programs.