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Li Z, Guo H, Liu X. What exercise strategies are best for people with cognitive impairment and dementia? A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 124:105450. [PMID: 38692156 DOI: 10.1016/j.archger.2024.105450] [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: 03/06/2024] [Revised: 04/03/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Explore the types of exercise that are appropriate for people with dementia, as well as the intensity and frequency of exercise training that is appropriate for older patients to carry out. METHODS Cochrane Library, PubMed, Embase, Web of Science, Scopus databases were searched by computer to collect RCT studies that met the inclusion criteria of this article. The search time limit was until January 2024. Two reviewers independently screened literature, extracted data, and assessed the quality and risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.4 and Stata 15.1 software. RESULTS The results of our study showed that physical exercise improved patients' cognitive ability and walking ability, with aerobic and multicomponent training showing the best improvement, and that the number of training sessions should not be too high, with the experimental group showing the best results when the total number of interventions was less than 30. CONCLUSION We recommend long-term exercise training for middle-aged and elderly patients with dementia or those who are predisposed to dementia. The type of training we recommend is multi-component training and aerobic training, and we recommend 2-3 sessions of exercise per week for about 60 min each.
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Affiliation(s)
- Zecheng Li
- College of Sports Science, Harbin Normal University, Harbin, China
| | - Hongpeng Guo
- College of Sports Science, Harbin Normal University, Harbin, China.
| | - Xuebin Liu
- College of Sports Science, Harbin Normal University, Harbin, China
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Xu Y, Zhang C, Pan B, Yuan Q, Zhang X. A portable and efficient dementia screening tool using eye tracking machine learning and virtual reality. NPJ Digit Med 2024; 7:219. [PMID: 39174736 PMCID: PMC11341897 DOI: 10.1038/s41746-024-01206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024] Open
Abstract
Dementia represents a significant global health challenge, with early screening during the preclinical stage being crucial for effective management. Traditional diagnostic biomarkers for Alzheimer's Disease, the most common form of dementia, are limited by cost and invasiveness. Mild cognitive impairment (MCI), a precursor to dementia, is currently identified through neuropsychological tests like the Montreal Cognitive Assessment (MoCA), which are not suitable for large-scale screening. Eye-tracking technology, capturing and quantifying eye movements related to cognitive behavior, has emerged as a promising tool for cognitive assessment. Subtle changes in eye movements could serve as early indicators of MCI. However, the interpretation of eye-tracking data is challenging. This study introduced a dementia screening tool, VR Eye-tracking Cognitive Assessment (VECA), using eye-tracking technology, machine learning, and virtual reality (VR) to offer a non-invasive, efficient alternative capable of large-scale deployment. VECA was conducted with 201 participants from Shenzhen Baoan Chronic Hospital, utilizing eye-tracking data captured via VR headsets to predict MoCA scores and classify cognitive impairment across different educational backgrounds. The support vector regression model employed demonstrated a high correlation (0.9) with MoCA scores, significantly outperforming baseline models. Furthermore, it established optimal cut-off scores for identifying cognitive impairment with notable sensitivity (88.5%) and specificity (83%). This study underscores VECA's potential as a portable, efficient tool for early dementia screening, highlighting the benefits of integrating eye-tracking technology, machine learning, and VR in cognitive health assessments.
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Affiliation(s)
- Ying Xu
- Shenzhen Bao'an Centre for Chronic Disease Control, Shenzhen, PR China
| | - Chi Zhang
- Shenzhen Yiwei Technology, Shenzhen, PR China
| | - Baobao Pan
- Shenzhen Yiwei Technology, Shenzhen, PR China
| | - Qing Yuan
- Shenzhen Bao'an Centre for Chronic Disease Control, Shenzhen, PR China.
| | - Xu Zhang
- National Engineering Laboratory for Big Data System Computing Technology, Shenzhen University, Shenzhen, PR China.
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Ye JY, Chen R, Chu H, Lin HC, Liu D, Jen HJ, Banda KJ, Kustanti CY, Chou KR. Dual-task training in older adults with cognitive impairment: A meta-analysis and trial sequential analysis of randomized controlled trials. Int J Nurs Stud 2024; 155:104776. [PMID: 38703695 DOI: 10.1016/j.ijnurstu.2024.104776] [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: 09/07/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To determine the effects of simultaneous dual-task training on cognitive function, physical function, and depression in older adults with mild cognitive impairment or dementia. METHODS Comprehensive database searches were conducted in PubMed, Embase, the Cochrane Library, CINAHL, Ovid-Medline, Web of Science, and Scopus up to December 2022. Randomized controlled trials were included to assess the efficacy of simultaneous dual-task training for older adults with mild cognitive impairment or dementia. The analysis utilized Comprehensive Meta-Analysis version 3.0, presenting Hedges' g and the corresponding 95 % confidence interval (CI) for the pooled effect size and, applying a random-effects model. The I2 and Cochran's Q tests were employed to evaluate heterogeneity. The Cochrane Risk of Bias 2.0 tool was employed to assess study quality. The Copenhagen Trial Unit (version 0.9.5.10 Beta) was employed for trial sequential analysis, providing a rigorous methodology for evaluating cumulative evidence from multiple studies. RESULTS Of the 1676 studies identified, 20 studies involving 1477 older adults with cognitive impairment were included. Dual-task training significantly enhanced global cognition (0.477, 95 % CI: 0.282 to 0.671), executive function (-0.310, 95 % CI: -0.586 to -0.035), working memory (0.714, 95 % CI: 0.072 to 1.355), gait (0.418, 95 % CI: 0.252 to 0.583), physical activity (0.586, 95 % CI: 0.012 to 1.16), and depression (-0.703, 95 % CI: -1.253 to -0.153). Trial sequential analyses revealed the robustness of this meta-analysis, which was based on a sufficient sample size from the included studies. Moreover, dual-task training demonstrated beneficial effects on global cognition, executive function, working memory, and gait. CONCLUSIONS Dual-task training improved cognition, physical function, and depression among older adults with cognitive impairment. Accordingly, dual-task training should be considered a clinical nonpharmacological intervention for older adults with mild cognitive impairment or dementia. Nevertheless, the trial sequential analysis results were consistent with those of the pairwise meta-analysis but only global cognition reached significance by crossing the trial sequential analysis boundary. Future studies with higher-quality designs and larger sample sizes are required to obtain more conclusive results regarding other outcomes. REGISTRATION PROSPERO CRD42023418598.
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Affiliation(s)
- Jia-You Ye
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan; Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Ju Jen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Kondwani Joseph Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Research Center for Neuroscience, Taipei Medical University, Taipei, Taiwan.
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Chang HW, Wu GH. Feasibility and effect of cognitive-based board game and multi-component exercise interventions on older adults with dementia. Medicine (Baltimore) 2024; 103:e38640. [PMID: 38941425 DOI: 10.1097/md.0000000000038640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Taiwan is an aging society, and the number of people with dementia is rapidly increasing. Due to a decline in cognitive and physical function, older adults with dementia not only gradually lose the ability to complete daily living tasks on their own, but are also at a higher risk of falls and injurious falls. It is important to develop interventions that combine cognitive and exercise training for older adults with dementia to promote or maintain their cognitive and physical functions and reduce their risk of falls. This study aimed to investigate the feasibility and effect of cognitive-based board games and multi-component exercise interventions on cognitive function, physical fitness, and fall risk in older adults with dementia. METHODS This was a quasi-experimental study with a single-group pretest and post-test design. The study participants were 41 community-dwelling older adults with mild to moderate dementia. They received cognitive-based board games and multi-component exercise interventions once a week for 12 weeks. The interventions included 1 hour of exercise training and 1 hour of cognitive training. Scores for the Taiwan version of the Montreal Cognitive Assessment (MoCA-T), physical fitness, and the St. Thomas Risk Assessment Tool for Falling Elderly Inpatients (STRATIFY) were measured as outcome indicators at baseline and after the 12-week period. RESULTS The overall MoCA-T score increased significantly (effect size = 0.402), with participants with mild dementia showing a greater increase (effect size = 0.522) than those with moderate dementia (effect size = 0.310). Participants' physical fitness performance improved. Female participants exhibited significant improvements in the 30-second chair stand test (effect size = 0.483) and 8-foot up-and-go test (effect size = 0.437). The fall risk score decreased by 0.05 points, the change was not significant. CONCLUSION The cognitive-based board game and multi-component exercise interventions used in this study are beneficial for improving cognitive function and physical fitness in older adults with dementia. These interventions are feasible and suitable for promotion among community-dwelling and institution-dwelling older adults with mild cognitive impairment or dementia to delay the decline in cognitive and physical function.
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Affiliation(s)
- Hui-Wen Chang
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Guey-Hau Wu
- National Taipei University of Nursing and Health Sciences, School of Nursing, Taipei, Taiwan
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Sun Z, Liu H, Yan M, Zeng H, Hu Y, Tian X, Mao D. The effect of multi-component exercise on cognition function in patients with diabetes: A systematic review and meta-analysis. PLoS One 2024; 19:e0304795. [PMID: 38900771 PMCID: PMC11189216 DOI: 10.1371/journal.pone.0304795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND This meta-analysis investigated the influence of exercise on cognitive function in people living with diabetes. METHODS Stringent criteria for literature inclusion and exclusion were defined. Searches were conducted across four English databases to gather randomized controlled trials investigating exercise interventions for cognitive function in people living with diabetes. Outcome indicators from 1193 subjects across 12 articles were analyzed using RevMan 5.4 software. RESULTS Exercise intervention demonstrated the ability to mitigate cognitive decline in people living with diabetes, with a combined effect size (standardized mean difference) of 0.91, 95% CI: 0.28, 1.54, P < 0.00001. The intervention effect showed significant modulation by intervention content (I2 = 95%), intervention duration (I2 = 95%), intervention frequency (I2 = 95%), and intervention cycle (I2 = 96%). Among these factors, multi-component exercise, sessions >40 minutes, exercise frequency >4 times per week, and sustained exercise for >6 months were paramount, all with P < 0.05. CONCLUSION Exercise intervention emerges as a viable strategy for delaying cognitive decline in people living with diabetes. Its efficacy is subject to modulation by various variables. Optimal intervention includes multi-component exercise, individual sessions lasting 40-60 minutes, exercising >4 times a week, and continuous exercise for over 6 months.
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Affiliation(s)
- Zhiyuan Sun
- Qufu Normal University, Qufu, Shandong, China
- Shandong Sport University, Jinan, Shandong, China
| | - Hualei Liu
- Shandong Sport University, Jinan, Shandong, China
| | - Min Yan
- Shandong Sport University, Jinan, Shandong, China
| | - Haiqing Zeng
- Shandong Sport University, Jinan, Shandong, China
| | - Yiping Hu
- Shandong Sport University, Jinan, Shandong, China
| | - Xuewen Tian
- Shandong Sport University, Jinan, Shandong, China
| | - Dewei Mao
- Qufu Normal University, Qufu, Shandong, China
- Shandong Sport University, Jinan, Shandong, China
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Nguyen ST, Guo J, Song S, Reyes-Dumeyer D, Sanchez D, Brickman AM, Manly JJ, Schupf N, Lantigua RA, Mayeux RP, Gu Y. Physical Activity Moderates the Relationship between Cardiovascular Disease Risk Burden and Cognition in Older Adults. Neuroepidemiology 2024:1-11. [PMID: 38531336 PMCID: PMC11424774 DOI: 10.1159/000536354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION Older individuals with a higher cardiovascular disease (CVD) burden have a higher risk for accelerated cognitive decline and dementia. Physical activity (PA) is an inexpensive and accessible preventive measure to CVD, cognitive impairment, and dementia. The current study examined (1) whether PA moderates the relationship between CVD burden and cognition and (2) whether the moderating effect of PA differs by race/ethnicity groups and by APOE-ɛ4 status. METHODS Our cross-sectional study included participants from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multiethnic, community-based, longitudinal study on aging and dementia among individuals aged 65 years and older who reside in northern Manhattan. All participants underwent an interview and a neuropsychological assessment for global cognition, memory, language, visuospatial, and speed functioning. RESULTS In 2,122 older individuals without dementia, having a higher CVD burden was associated with worse cognitive scores for global, language, speed, and visuospatial cognitive functions. PA mitigated the relationship between CVD burden and visuospatial function. Furthermore, PA mitigated the association of CVD burden with global cognition, language, and visuospatial functions in APOE-ɛ4 carriers but not in non-carriers. DISCUSSION/CONCLUSION Our study suggests that PA may mitigate the negative association between CVD and cognition, especially in APOE-ɛ4 carriers. The moderating effect of PA did not differ by race/ethnicity.
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Affiliation(s)
- Sandra T Nguyen
- Department of Neurology, Columbia University, New York, New York, USA,
| | - Jing Guo
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
| | - Suhang Song
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Dolly Reyes-Dumeyer
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Danurys Sanchez
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Adam M Brickman
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Jennifer J Manly
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Nicole Schupf
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Rafael A Lantigua
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Department of Medicine, Columbia University, and the New York Presbyterian Hospital, New York, New York, USA
| | - Richard P Mayeux
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Yian Gu
- Department of Neurology, Columbia University, New York, New York, USA
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York, USA
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Sasaninezhad M, Moradi A, Farahimanesh S, Choobin MH, Almasi-Dooghaee M. Enhancing cognitive flexibility and working memory in individuals with mild cognitive impairment: Exploring the impact of virtual reality on daily life activities. Geriatr Nurs 2024; 56:32-39. [PMID: 38211369 DOI: 10.1016/j.gerinurse.2023.12.008] [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: 09/21/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Abstract
Mild Cognitive Impairment (MCI) serving as a transitional stage between normal aging and dementia. This study aimed to explore the impact of virtual reality (VR) on enhancing cognitive flexibility, working memory, and daily life activities. Forty participants diagnosed with MCI were randomly assigned to either an intervention group (N = 20) or a control group (N = 20). Evaluations were at baseline, post-training, and three months post-training using various cognitive assessment tools. Results showed that the VR-based cognitive rehabilitation significantly improved instrumental activities of daily living performance, visual and verbal working memory, and reduced anxiety and depression symptoms. While cognitive flexibility did not exhibit significant improvement, these findings highlight VR interventions as a potential avenue for improving cognitive and functional aspects, and alleviating psychological symptoms in individuals with MCI. Further research with larger sample sizes and extended follow-up periods is recommended to establish the long-term effectiveness of such interventions.
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Affiliation(s)
| | - Alireza Moradi
- Kharazmi University, Institute for Cognitive Science Studies, Tehran, Iran.
| | - Sharareh Farahimanesh
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Hasan Choobin
- Kharazmi University, Institute for Cognitive Science Studies, Tehran, Iran; Institute for Cognitive Science Studies, Tehran, Iran
| | - Mostafa Almasi-Dooghaee
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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García-Llorente AM, Casimiro-Andújar AJ, Linhares DG, De Souza Vale RG, Marcos-Pardo PJ. Multidomain interventions for sarcopenia and cognitive flexibility in older adults for promoting healthy aging: a systematic review and meta-analysis of randomized controlled trials. Aging Clin Exp Res 2024; 36:47. [PMID: 38386173 PMCID: PMC10884056 DOI: 10.1007/s40520-024-02700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
The global population is undergoing rapid aging, making physical activity a crucial element in preventing mortality and lowering the risk of Alzheimer's disease. Age-related declines in muscle mass and cognitive abilities significantly contribute to frailty and dependency. Thus, this study focuses on a meticulous analysis of the protective effects of multidomain interventions, an emerging resource combating age-related declines. It seeks to underscore their profound impact on cognitive flexibility and sarcopenia, highlighting their pivotal role in mitigating the adverse effects of aging. To identify relevant randomized controlled trials up to November 2023, we reviewed eight online academic databases, following PERSiST guidelines, PRISMA reporting system, and PICOs criteria. Meta-analyses on selected functional outcomes utilized a random-effects model, including the Timed Up and Go Test, Sit to Stand Test, Victoria Stroop Test, and Trail Making Test. Out of 2082 scrutinized articles, 17 were included in the systematic review, and 8 in the meta-analysis. Positive effects (p = 0.05, I2 = 57%; 95% CI - 0.63 to - 0.05) were observed in cognitive flexibility for certain interventions. Similarly, interventions addressing muscle strength demonstrated improvements in the Sit to Stand Test for the exercise group compared to the control group (p = 0.02, I2 = 0%; 95% CI - 0.63 to - 0.05). These findings underscore the importance of incorporating physical activity as a primary component of public health interventions for promoting healthy aging and reducing the burden of age-related diseases. Future interventions may explore more homogeneous approaches and evaluate the impact of thrice multidomain weekly sessions.
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Affiliation(s)
- A M García-Llorente
- SPORT Research Group (CTS-1024), Department of Education, CIBIS (Centro de Investigación Para el Bienestar y la Inclusión Social) Research Center, Area of Physical Education and Sport, University of Almería, Office 0.22, Building CITE III, Almería, Spain.
| | - A J Casimiro-Andújar
- SPORT Research Group (CTS-1024), Department of Education, CIBIS (Centro de Investigación Para el Bienestar y la Inclusión Social) Research Center, Area of Physical Education and Sport, University of Almería, Office 0.22, Building CITE III, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almeria, 04120, Almeria, Spain
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain
| | - D G Linhares
- Universidade do Estado de Rio de Janeiro, Rio de Janeiro, BR, Brazil
| | - R G De Souza Vale
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain
- Universidade do Estado de Rio de Janeiro, Rio de Janeiro, BR, Brazil
- Laboratorio de Ejercicio y Deporte, Instituto de Educación Física y Deportes, Universidad del Estado de Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil
| | - P J Marcos-Pardo
- SPORT Research Group (CTS-1024), Department of Education, CIBIS (Centro de Investigación Para el Bienestar y la Inclusión Social) Research Center, Area of Physical Education and Sport, University of Almería, Office 0.22, Building CITE III, Almería, Spain.
- Department of Education, Faculty of Education Sciences, University of Almeria, 04120, Almeria, Spain.
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain.
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Kawabata N, Iida T, Kunishige M, Fukuda H, Miyaguchi H, Harada T. Evaluating the impact of a darts game intervention on cognitive function in older adults with and without mild cognitive impairment: a pilot study. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1327494. [PMID: 38375367 PMCID: PMC10875000 DOI: 10.3389/fresc.2024.1327494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024]
Abstract
Introduction The current study investigated the relationship between the characteristics of a darts game, including the throwing motion toward a target, and mild cognitive impairment (MCI). To this end, we examined the associations between cognitive function and mental health, and the shift in center of gravity while throwing darts. In a preliminary investigation, a 1-month dart game intervention was conducted among older individuals living in the community. The participants were divided into the non-MCI and MCI groups, and the relationship between center of gravity movement during throwing and the presence of dementia was examined. Methods The intervention lasted for 1 month and was tested on healthy older individuals (aged ≥ 65 years) recruited from the community. The Japanese version of the Montreal Cognitive Assessment and the Trail Making Test was used to assess cognitive function. Mental health was evaluated using the Kessler Psychological Distress Scale and the Subjective Well-being Inventory. The center of pressure was analyzed to determine the center of gravity shift during dart throwing. Results The analysis of factors influencing the determination of the MCI score during the intervention revealed a tendency for the center of gravity shift to be associated as a protective factor in the non-MCI group, although this association did not reach statistical significance (odds ratio = 0.942, p = 0.084). In the MCI group, a significant effect of age was observed in the MCI score (odds ratio = 1.539, p = 0.007). Conclusion The current findings suggest that conducting center of gravity shift testing could potentially provide a helpful tool for predicting early decline in cognitive function.
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Affiliation(s)
- Nami Kawabata
- Program in Biological System Sciences, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Hiroshima, Japan
- Department of Rehabilitation/Occupational Therapist, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Tadayuki Iida
- Program in Biological System Sciences, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Hiroshima, Japan
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Japan
| | - Masafumi Kunishige
- Department of Occupational Therapy, Faculty of Health Science Technology, Bunkyo Gakuin University, Bunkyo, Japan
| | - Hiroshi Fukuda
- Graduate School of Information Sciences, Hiroshima City University, Hiroshima, Japan
| | - Hideki Miyaguchi
- Department of Human Behavior Science of Occupational Therapy, Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima City University, Hiroshima, Japan
| | - Toshihide Harada
- Program in Biological System Sciences, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Hiroshima, Japan
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Japan
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Ayed IB, Aouichaoui C, Ammar A, Naija S, Tabka O, Jahrami H, Trabelsi K, Trabelsi Y, El Massioui N, El Massioui F. Mid-Term and Long-Lasting Psycho-Cognitive Benefits of Bidomain Training Intervention in Elderly Individuals with Mild Cognitive Impairment. Eur J Investig Health Psychol Educ 2024; 14:284-298. [PMID: 38391486 PMCID: PMC10887966 DOI: 10.3390/ejihpe14020019] [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: 12/05/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background: This study investigated whether combining simultaneous physical and cognitive training yields superior cognitive outcomes compared with aerobic training alone in individuals with mild cognitive impairment (MCI) and whether these benefits persist after four weeks of detraining. Methods: Forty-four people with MCI (11 males and 33 females) aged 65 to 75 years were randomly assigned to an 8-week, twice-weekly program of either aerobic training (AT group, n = 15), aerobic training combined with cognitive games (ACT group, n = 15), or simply reading for controls (CG group, n = 14). Selective attention (Stroop), problem-solving (Hanoi Tower), and working memory (Digit Span) tasks were used to assess cognitive performances at baseline, in the 4th (W4) and 8th weeks (W8) of training, and after 4 weeks of rest (W12). Results: Both training interventions induced beneficial effects on all tested cognitive performance at W4 (except for the number of moves in the Hanoi tower task) and W8 (all p <0.001), with the ACT group exhibiting a more pronounced positive impact than the AT group (p < 0.05). This advantage was specifically observed at W8 in tasks such as the Stroop and Tower of Hanoi (% gain ≈40% vs. ≈30% for ACT and AT, respectively) and the digit span test (% gain ≈13% vs. ≈10% for ACT and AT, respectively). These cognitive improvements in both groups, with the greater ones in ACT, persisted even after four weeks of detraining, as evidenced by the absence of a significant difference between W8 and W12 (p > 0.05). Concerning neuropsychological assessments, comparable beneficial effects were recorded following both training regimens (all p < 0.05 from pre- to post-intervention). The control group did not show any significant improvement in most of the cognitive tasks. Conclusions: The greater mid-term and long-lasting effects of combined simultaneous physical-cognitive training underscores its potential as a cost-effective intervention for the prevention and management of cognitive decline. While these results are valuable in guiding optimal physical and mental activity recommendations for adults with MCI, further neurophysiological-based studies are essential to offer robust support and deepen our understanding of the mechanisms underlying these promising findings.
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Affiliation(s)
- Ines Ben Ayed
- Research Laboratory, Exercise Physiology and Physiopathology: From Integrated to Molecular "Biology, Medicine and Health", LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse 4000, Tunisia
- Laboratory of Human and Artificial Cognition (EA 4004), Psychology UFR, University of Vincennes/Saint-Denis, 93200 Saint-Denis, France
- Research Laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Chirine Aouichaoui
- Research Laboratory, Exercise Physiology and Physiopathology: From Integrated to Molecular "Biology, Medicine and Health", LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse 4000, Tunisia
- High Institute of Sport and Physical Education of Ksar Saïd, University of Manouba, Mannouba 2010, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes-Gutenberg-University Mainz, 55122 Mainz, Germany
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax 3000, Tunisia
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3029, Tunisia
| | - Salma Naija
- Neurology Department, University Hospital Sahloul Sousse, Sousse 4052, Tunisia
| | - Oussama Tabka
- Research Laboratory, Exercise Physiology and Physiopathology: From Integrated to Molecular "Biology, Medicine and Health", LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse 4000, Tunisia
| | - Haitham Jahrami
- College of Medicine and Medical Science, Arabian Gulf University, Manama 293, Bahrain
| | - Khaled Trabelsi
- Research Laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3029, Tunisia
| | - Yassine Trabelsi
- Research Laboratory, Exercise Physiology and Physiopathology: From Integrated to Molecular "Biology, Medicine and Health", LR19ES09, Faculty of Medicine of Sousse, Sousse University, Sousse 4000, Tunisia
| | - Nicole El Massioui
- Laboratory of Human and Artificial Cognition (EA 4004), Psychology UFR, University of Vincennes/Saint-Denis, 93200 Saint-Denis, France
| | - Farid El Massioui
- Laboratory of Human and Artificial Cognition (EA 4004), Psychology UFR, University of Vincennes/Saint-Denis, 93200 Saint-Denis, France
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Hong XL, Cheng LJ, Feng RC, Goh J, Gyanwali B, Itoh S, Tam WSW, Wu XV. Effect of physio-cognitive dual-task training on cognition in pre-ageing and older adults with neurocognitive disorders: A meta-analysis and meta-regression of randomized controlled trial. Arch Gerontol Geriatr 2024; 116:105161. [PMID: 37619434 DOI: 10.1016/j.archger.2023.105161] [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: 06/09/2023] [Revised: 08/12/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
Declines in cognitive performance, such as those seen in neurocognitive disorders (NCDs) are often associated with ageing. Both physical activity and cognitive training are common interventional strategies that can mitigate the decline in cognitive and physical performance. This review aims to (1) to evaluate the effects of Physio-Cognitive Dual-task Training (PCDT) intervention on cognition, physical performance, activities of daily living (ADL) and health-related quality of life (HRQoL) in pre-ageing and older adults with neurocognitive disorders, (2) explore the effects of covariates on intervention outcomes. A systematic search was conducted in eight databases. Cochrane's Risk of Bias Tool version 1 and GRADE criteria were used to assess risk of bias and certainty of evidence, respectively. Meta-analysis and meta-regression analyses were conducted using R software. Twenty-six randomized controlled trials involving 1,949 pre-ageing and older adults with NCDs were included in the meta-analysis. PCDT interventions had small-to-medium effect size on all cognition outcomes (g = 0.40-0.52) and instrumental ADL (g == 0.42), and a large effect size on HRQoL (g = 0.72). The quality of evidence was rated moderate to low for the outcome measures in pre-ageing and older adults with NCDs. These findings highlight the importance of PCDT interventions in preventing and slowing down cognitive impairment in pre-ageing and older adults. Registration: PROSPERO Number (CRD42020213962).
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Affiliation(s)
- Xian Li Hong
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 12 Science Drive 2, 117549, Singapore
| | - Ruo Chen Feng
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore
| | - Jorming Goh
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 2 Medical Drive, MD9, National University of Singapore, 117593, Singapore; Centre for Healthy Longevity, National University Health System, 1E Kent Ridge Rd, 119228, Singapore
| | - Bibek Gyanwali
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 8 Medical Drive, 117596, Singapore
| | - Sakiko Itoh
- Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Department of Genome Informatics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka 565-0871, Japan
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, 117597, Singapore
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, 117597, Singapore; NUSMED Healthy Longevity Translational Research Programme, National University of Singapore, 28 Medical Drive, 117456, Singapore.
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12
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Kang B, Ma J, Jeong I, Yoon S, Kim JI, Heo SJ, Oh SS. Behavioral marker-based predictive modeling of functional status for older adults with subjective cognitive decline and mild cognitive impairment: Study protocol. Digit Health 2024; 10:20552076241269555. [PMID: 39193313 PMCID: PMC11348489 DOI: 10.1177/20552076241269555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 06/25/2024] [Indexed: 08/29/2024] Open
Abstract
Objective This study describes a research protocol for a behavioral marker-based predictive model that examines the functional status of older adults with subjective cognitive decline and mild cognitive impairment. Methods A total of 130 older adults aged ≥65 years with subjective cognitive decline or mild cognitive impairment will be recruited from the Dementia Relief Centers or the Community Service Centers. Data on behavioral and psychosocial markers (e.g. physical activity, mobility, sleep/wake patterns, social interaction, and mild behavioral impairment) will be collected using passive wearable actigraphy, in-person questionnaires, and smartphone-based ecological momentary assessments. Two follow-up assessments will be performed at 12 and 24 months after baseline. Mixed-effect machine learning models: MErf, MEgbm, MEmod, and MEctree, and standard machine learning models without random effects [random forest, gradient boosting machine] will be employed in our analyses to predict functional status over time. Results The results of this study will be fundamental for developing tailored digital interventions that apply deep learning techniques to behavioral data to predict, identify, and aid in the management of functional decline in older adults with subjective cognitive decline and mild cognitive impairment. These older adults are considered the optimal target population for preventive interventions and will benefit from such tailored strategies. Conclusions Our study will contribute to the development of self-care interventions that utilize behavioral data and machine learning techniques to provide automated analyses of the functional decline of older adults who are at risk for dementia.
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Affiliation(s)
- Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
| | - Jinkyoung Ma
- Department of Nursing, Yong-In Arts and Science University, Yongin, Republic of Korea
| | - Innhee Jeong
- Department of Nursing, Graduate School of Yonsei University, Seoul, Republic of Korea
- Navy Headquarter, Gyeryong, Republic of Korea
| | - Seolah Yoon
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- College of Nursing and Brain Korea 21 Four Project, Yonsei University, Seoul, Republic of Korea
| | - Jennifer Ivy Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Seok-jae Heo
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sarah Soyeon Oh
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
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13
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Liu XX, Huang PH, Wang YJ, Gao Y. Effects of Aerobic Exercise Combined With Attentional Bias Modification in the Care of Male Patients With a Methamphetamine Use Disorder. J Addict Nurs 2024; 35:E2-E14. [PMID: 38574107 DOI: 10.1097/jan.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
OBJECTIVE It remains unclear which individual or combined strategies are most beneficial for methamphetamine use disorders (MUDs). We compared the effects of aerobic exercise, attentional bias modification, and combined intervention on male patients with MUD. METHOD One hundred male patients with MUD were randomly assigned to combined intervention, aerobic exercise, attentional bias modification, or control groups (25 patients per group). The 8-week intervention protocol included three 60-minute sessions of aerobic exercises per week. Primary outcomes included high- and low-frequency heart rate variability, executive function, and cardiorespiratory fitness measured by customized software, computerized tests, and the Harvard step test, respectively. Secondary outcomes included psychiatric symptoms, drug craving, training acceptability, and persistence. RESULTS Participant characteristics were matched between groups at baseline. Executive function, heart rate variability, cardiorespiratory fitness, drug craving, and most psychiatric symptoms had significant time-group interactions at posttest (p < .05, η2 = .08-.28). Compared with the attentional bias modification and control groups, the combined intervention and aerobic exercise groups improved significantly in executive function, heart rate variability, cardiorespiratory fitness, and most secondary outcomes. In addition, high-frequency heart rate variability and cardiorespiratory fitness in the aerobic exercise group were significantly higher than those in the combined intervention group. CONCLUSIONS Combination strategies showed comparable efficacy to aerobic exercise alone in improving executive function, psychiatric symptoms, and drug craving and significantly exceeded other conditions. For heart rate variability and cardiorespiratory fitness, aerobic exercise alone was the most effective. For acceptability and persistence, combination strategies were preferred over single-domain training and health education intervention.
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14
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Baldimtsi E, Mouzakidis C, Karathanasi EM, Verykouki E, Hassandra M, Galanis E, Hatzigeorgiadis A, Goudas M, Zikas P, Evangelou G, Papagiannakis G, Bellis G, Kokkotis C, Tsatalas T, Giakas G, Theodorakis Y, Tsolaki M. Effects of Virtual Reality Physical and Cognitive Training Intervention On Cognitive Abilities of Elders with Mild Cognitive Impairment. J Alzheimers Dis Rep 2023; 7:1475-1490. [PMID: 38225966 PMCID: PMC10789285 DOI: 10.3233/adr-230099] [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: 08/03/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background Virtual reality (VR) technology has become increasingly used for assessment and intervention in the neuroscience field. Objective We aimed to investigate the effects of a VR Training System, named VRADA (VR Exercise App for Dementia and Alzheimer's Patients), on the cognitive functioning of older people with mild cognitive impairment (MCI). Methods In this intervention study, 122 older adults with MCI were randomly assigned to five groups (the VRADA group (n = 28), a bike group (n = 11), a physical exercise group (n = 24), a mixed group (physical and cognitive exercise) (n = 31), and a non-contact control group (n = 28). The VRADA group underwent 32 physical and cognitive training sessions, performed 2 or 3 times weekly for 12 weeks in the VR environment. All participants had detailed neuropsychological assessments before and after intervention. Results A series of linear regression models revealed that the VRADA group showed improvement or no deterioration in cognitive decline in global cognitive function (MMSE), verbal memory (Rey Auditory Verbal Learning Test and WAIS forward test), and executive functions, mental flexibility (Trail Making Test B). Conclusions This interventionstudy indicates that the VRADA system improves the cognitive function of elders with MCI.
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Affiliation(s)
- Eleni Baldimtsi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Christos Mouzakidis
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Maria Karathanasi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Verykouki
- School of Medicine, Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Agriculture, Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, Volos, Greece
| | - Mary Hassandra
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Evangelos Galanis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Marios Goudas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Paul Zikas
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - Giannis Evangelou
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - George Papagiannakis
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology – Hellas (FORTH), University of Crete, Heraklion, Crete, Greece
| | - George Bellis
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Christos Kokkotis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Themistoklis Tsatalas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Giannis Giakas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Yannis Theodorakis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Building A, Greece
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15
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Xue D, Li PWC, Yu DSF, Lin RSY. Combined exercise and cognitive interventions for adults with mild cognitive impairment and dementia: A systematic review and network meta-analysis. Int J Nurs Stud 2023; 147:104592. [PMID: 37769394 DOI: 10.1016/j.ijnurstu.2023.104592] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Exercise and cognitive interventions are beneficial for adults with preclinical and clinical dementia, but it is unclear whether the combination of these two components could generate synergistic benefits and what intervention designs would optimize this effect. OBJECTIVES This review aims to compare the effects of combined exercise and cognitive interventions on cognitive, psychological, functional outcomes, and health-related quality of life with the corresponding single approach and control groups in adults with mild cognitive impairment and dementia. It also aims to identify the optimal intervention design and factors affecting treatment effects. METHODS A comprehensive search was conducted in ten databases from inception to 23rd November 2022. The methodological quality of studies was evaluated by the Cochrane risk of bias tool. Pairwise meta-analyses were performed to assess the effects of combined interventions relative to the single type of intervention and control groups, with further subgroup analysis to explore the factors affecting treatment effects. Network meta-analyses were used to identify the optimal intervention components. RESULTS Twenty-nine randomized controlled trials involving 2910 participants were included. The results of pairwise meta-analyses indicated that combined interventions were superior to exercise in improving response inhibition, working memory, and delayed recall, but were not superior to cognitive interventions in all outcomes. Combined interventions were superior to active/passive controls in improving global cognition, response inhibition, immediate recall, delayed recall, category fluency, processing speed, and visuospatial ability. Influences of the clinical severity of dementia (mild cognitive impairment vs dementia), combination format (sequential vs simultaneous combination), mode of delivery (group-based vs individual-based vs mixed), training duration (short: ≤12 weeks vs medium: 13-24 weeks vs long: >24 weeks), and types of control (active vs passive control) were not detected. The network meta-analysis results indicated that the optimal intervention components varied across different outcomes, with multimodal exercise combining cognitive training demonstrated the greatest effects among all other combined or single component interventions in improving global cognition. CONCLUSIONS This review suggests the advantage of combined interventions over exercise with comparable effects when compared with cognitive interventions in the population with mild cognitive impairment and dementia. Full scale multi-arm randomized controlled trials to compare the effects of combined interventions with cognitive interventions are warranted.
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Affiliation(s)
- Dandan Xue
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Rose S Y Lin
- University of Rochester School of Nursing, New York, USA.
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Chen IC, Chuang IC, Chang KC, Chang CH, Wu CY. Dual task measures in older adults with and without cognitive impairment: response to simultaneous cognitive-exercise training and minimal clinically important difference estimates. BMC Geriatr 2023; 23:663. [PMID: 37845603 PMCID: PMC10580601 DOI: 10.1186/s12877-023-04390-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. METHODS A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment < 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. RESULTS In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18-0.29; standardized response mean = 0.25-0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09-2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77-5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47-2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13-7.62. CONCLUSIONS Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. TRIAL REGISTRATION NCT04689776, 30/12/2020.
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Affiliation(s)
- I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan.
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Ku-Chou Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Hung Chang
- Program in Occupational Therapy, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Medicine, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Orthopedic Surgery, School of Medicine, Washington University , St. Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Tao M, Liu H, Cheng J, Yu C, Zhao L. Motor-Cognitive Interventions May Effectively Improve Cognitive Function in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial. Behav Sci (Basel) 2023; 13:737. [PMID: 37754015 PMCID: PMC10525591 DOI: 10.3390/bs13090737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/28/2023] Open
Abstract
Mild cognitive impairment (MCI) is a syndrome that occurs in the preclinical stage of Alzheimer's disease. Early intervention can be effective in preventing Alzheimer's disease, but further research is needed on intervention methods. To identify interventions that are more suitable for Chinese characteristics and to investigate the effects of motor-cognitive intervention on the cognitive functions of older adults with MCI, we screened 103 community-dwelling older adults with MCI aged 65 years and older in Qingdao, Shandong, China; divided them into an intervention group and a control group; and administered a motor-cognitive intervention to the intervention group for 12 weeks. The study used the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to assess the initial cognitive level of the MCI participants and detect the effects of the intervention. We found that the cognitive abilities of the intervention group were significantly improved at the end of the intervention, as well as at the end of the follow-up, compared with the control group. The results of the current study suggest that the motor-cognitive intervention we used may improve the cognition of older people with MCI in the Chinese community.
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Affiliation(s)
| | | | - Jinxuan Cheng
- Normal College, Qingdao University, Qingdao 266071, China; (M.T.); (H.L.); (C.Y.); (L.Z.)
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Brown CJ, Jeon S, Ng YT, Lee S, Fingerman KL, Charles ST. Switching it up: Activity diversity and cognitive functioning in later life. Psychol Aging 2023; 38:483-493. [PMID: 37535516 PMCID: PMC10528947 DOI: 10.1037/pag0000770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Participating in a broad and balanced range of daily activities (i.e., activity diversity) has been associated with better cognitive functioning in later life. One possible explanation for this finding is that high levels of activity diversity are merely a proxy for being more physically active, a factor robustly linked to cognitive health. The present study examined whether activity diversity has a unique association with cognitive functioning beyond physical movement. Community-dwelling older adults (N = 252, Mage = 73.55 years, SD = 6.39) completed a cognitive battery and then responded to ecological momentary assessments of their participation in 10 common activity types (e.g., reading, chores, social visits) every 3 hr for 5-6 days. They also wore accelerometers to track daily physical movement. Multiple regression models revealed that greater diversity in daily activities was related to higher cognitive functioning even after adjusting for physical movement and other covariates such as education level. This study further clarifies the unique relationship of activity diversity, beyond physical movement, with cognition. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Colette J Brown
- Department of Psychological Science, University of California, Irvine
| | - Sangha Jeon
- Department of Psychological Science, University of California, Irvine
| | - Yee To Ng
- Department of Physical Medicine and Rehabilitation, University of Michigan
| | - Soomi Lee
- Department of Human Development and Family Studies, Pennsylvania State University
| | - Karen L Fingerman
- Department of Human Development and Family Sciences, University of Texas at Austin
| | - Susan T Charles
- Department of Psychological Science, University of California, Irvine
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Kim Y, Kim S, Yang H. Effectiveness of an enhanced simultaneous cognitive-physical dual-task training based on fairy tales (ESCARF) in older adults with mild cognitive impairment. Geriatr Nurs 2023; 53:57-65. [PMID: 37454419 DOI: 10.1016/j.gerinurse.2023.07.002] [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: 05/03/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
The aim of this study was to provide a dual-task program that included cognitive and physical training to older adults with mild cognitive impairment (MCI) and evaluate its effects. A single-group pretest-posttest design was performed using 15 older adults with MCI. A 12-week enhanced simultaneous cognitive-physical dual-task training based on fairy tales (ESCARF) program was conducted from September 2019 to December 2019. Participants were assessed using the Korean version of the Montreal Cognitive Assessment, electroencephalography (EEG), muscle strength, flexibility, agility, memory self-efficacy questionnaire, physical self-efficacy scale, and quality of life before and after 6 and 12 weeks of the intervention. The ESCARF program significantly improved cognitive function, physical function, self-efficacy, and quality of life in older adults with MCI. These findings will provide insights into the development and implementation of customized cognitive interventions to prevent or delay the onset of cognitive decline in older adults with MCI.
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Affiliation(s)
- Younkyoung Kim
- College of Nursing, Chonnam National University, 160 Baekseo-Ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - Saeryun Kim
- College of Nursing, Chonnam National University, 160 Baekseo-Ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - Hyunju Yang
- College of Nursing, Chonnam National University, 160 Baekseo-Ro, Dong-gu, Gwangju 61469, Republic of Korea.
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20
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Parial LL, Kor PPK, Sumile EF, Leung AYM. Dual-Task Zumba Gold for Improving the Cognition of People With Mild Cognitive Impairment: A Pilot Randomized Controlled Trial. THE GERONTOLOGIST 2023; 63:1248-1261. [PMID: 35679826 DOI: 10.1093/geront/gnac081] [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: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Integrating mental activities with physical exercises (e.g., dual-tasking) may potentially improve cognition in older adults and people with mild cognitive impairment (MCI). This study investigated the preliminary efficacy of a new intervention called dual-task Zumba Gold (DTZ) on people with MCI to guide an adequately-powered full-scale trial. RESEARCH DESIGN AND METHODS This is a 2-arm pilot randomized controlled trial with 60 people with MCI assigned to a 12-week DTZ intervention or control group (health education). We hypothesized that DTZ would facilitate significant improvements in global cognition (primary outcome) and other psychological/physical measures at postintervention (T1) and 6-week follow-up (T2). Generalized estimating equations with an intention-to-treat approach were used to evaluate intervention effects. Postintervention qualitative interviews explored the participants' program perceptions. RESULTS Fifty-one participants completed the study, with no adverse events reported. DTZ participants showed significant improvements in global cognition (p < .001, d = 0.75-0.78), executive function (p < .001, d = 0.28-0.33), immediate recall (p < .001, d = 0.50-0.54), delayed recall (p = .003, d = 0.66-0.71), quality of life (p = .027, d = 0.59-0.63), and mobility (p = .005, d = 0.53-0.56) at T1 and T2. There were nonsignificant changes in working memory, depressive symptoms, blood pressure, body mass index, and waist circumference. Participants conveyed intervention acceptability, including challenges/barriers, enablers, and future recommendations. DISCUSSION AND IMPLICATIONS DTZ is a potentially feasible intervention for people with MCI that may improve cognition, quality of life, and mobility. A full-scale trial is recommended for confirmatory evaluation. CLINICAL TRIAL REGISTRATION NUMBER NCT04788238.
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Affiliation(s)
- Laurence Lloyd Parial
- Centre for Gerontological Nursing, School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
- College of Nursing, University of Santo Tomas, Manila, Philippines
| | - Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Earl Francis Sumile
- College of Nursing, University of the Philippines-Manila , Manila, Philippines
| | - Angela Yee Man Leung
- Centre for Gerontological Nursing, School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
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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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Kang W, Whelan E, Malvaso A. Understanding Cognitive Deficits in People with Arthritis. Healthcare (Basel) 2023; 11:healthcare11091337. [PMID: 37174879 PMCID: PMC10178460 DOI: 10.3390/healthcare11091337] [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: 02/09/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Cognitive deficits are commonly seen in people with arthritis. However, previous studies focused primarily on small-sized clinical samples. There is a need for cohort-based studies, which are characterized by high generalizability. In addition, these studies mainly focused on attention, memory, and executive function. However, cognition is not a single concept, but includes other cognitive domains, such as verbal fluency and arithmetic abilities. Thus, we aim to explore how arthritis can affect cognitive abilities, including episodic memory, semantic verbal fluency, fluid reasoning, and numerical ability by using a large cohort from the United Kingdom. The main findings were that people with arthritis have significantly lower immediate word recall (t(2257) = -6.40, p < 0.001, Cohen's d = -0.12, 95% C.I. = [-0.16, -0.08]), delayed word recall (t(2257) = -5.60, p < 0.001, Cohen's d = -0.11, 95% C.I. = [-0.14, -0.07]), semantic verbal fluency (t(2257) = -3.03, p < 0.01, Cohen's d = -0.06, 95% C.I. = [-0.10, -0.02]), fluid reasoning (t(2257) = -3.96, p < 0.001, Cohen's d = -0.07, 95% C.I. = [-0.11, -0.04]), and numerical ability (t(2257) = -3.85, p < 0.001, Cohen's d = -0.07, 95% C.I. = [-0.10, -0.03]) compared to what they would expect given their demographics. Interventions are needed to improve cognitive abilities in people with arthritis.
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Affiliation(s)
- Weixi Kang
- Imperial College London, London SW7 2BX, UK
| | - Edward Whelan
- Independent Researcher, 99MX QH Maynooth, County Kildare, Ireland
| | - Antonio Malvaso
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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23
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Liu X, Wang G, Cao Y. Association of nonpharmacological interventions for cognitive function in older adults with mild cognitive impairment: a systematic review and network meta-analysis. Aging Clin Exp Res 2023; 35:463-478. [PMID: 36607554 DOI: 10.1007/s40520-022-02333-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Understanding the effectiveness of nonpharmacological interventions to improve cognitive function in older adults with MCI and identifying the best intervention may help inform ideas for future RCT studies and clinical decision-making. AIM The main focus of this study was to assess the comparative effectiveness of nonpharmacological interventions on cognitive function in older adults with MCI and to rank the interventions. METHODS RCT studies until September 2022 were searched from six databases, including PubMed, the Cochrane Library, Embase, Web of Science, PsycINFO and CINAHL. The risk of bias in eligible trials was evaluated using the Cochrane Risk of Bias tool. Both pairwise and network meta-analyses were used, and pooled effect sizes were reported using SMD and the corresponding 95% confidence intervals. RESULTS A total of 28 RCT studies were included in this study, pooling 18 categories of nonpharmacological interventions. MBE (mind-body exercise) (SMD (standard mean difference): 0.24, 95% CI: 0.08-0.41, P = 0.004), DTE (dual-task exercise) (SMD: 0.61, 95% CI: 0.09-1.13, P = 0.02), PE (physical exercise) (SMD: 0.58, 95% CI: 0.04-1.12, P = 0.03) may be effective in improving cognitive function in older adults with MCI. Acupressure + CT (cognitive training) was the top-ranked intervention among all interventions. No greater benefits of MA (mindful awareness) on cognitive function were found. CONCLUSIONS Overall, nonpharmacological interventions significantly improved cognitive function in older adults with MCI. Acupressure + CT(cognitive training) was the most effective intervention for managing cognitive impairment. Future studies with high quality and large sample size RCT studies are needed to confirm our results.
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Affiliation(s)
- Xueyan Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China
| | - Guangpeng Wang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China.
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Xinran Z, Shumei Z, Xueying Z, Linan W, Ying G, Peng W, Yahong H, Longting M, Jing W. Construction of a predictive model for cognitive impairment risk in patients with advanced cancer. Int J Nurs Pract 2023:e13140. [PMID: 36759715 DOI: 10.1111/ijn.13140] [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: 07/14/2022] [Revised: 01/12/2023] [Accepted: 01/27/2023] [Indexed: 02/11/2023]
Abstract
AIMS The purpose of this study was to identify risk factors for cognitive impairment in advanced cancer patients and to develop predictive models based on these risk factors. BACKGROUND Cancer-related cognitive impairment seriously affects the quality of life of advanced cancer patients. However, neural network models of cognitive impairment in patients with advanced cancer have not yet been identified. DESIGN A cross-sectional design was used. METHODS This study collected 494 questionnaires between January and June 2022. Statistically significant clinical indicators were selected by univariate analysis, and the artificial neural network model and logistic regression model were used for multivariate analysis. The predicted value of the model was estimated using the area under the subject's working characteristic curve. RESULT The artificial neural network and the logistic regression models suggested that cancer course, anxiety and age were the major risk factors for cognitive impairment in advanced cancer patients. All the indexes of artificial neural network model constructed in this study are better than those of the logistic model. CONCLUSION The artificial neural network model can better predict the risk factors of cognitive impairment in patients with advanced cancer. Better prediction will enable nurses and other healthcare professionals to provide better targeted and timely support.
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Affiliation(s)
- Zhu Xinran
- Department of Nursing, Tianjin Medical University, Tianjin, China
| | - Zhuang Shumei
- Department of Nursing, Tianjin Medical University, Tianjin, China
| | - Zhou Xueying
- Department of Nursing, Tianjin Medical University, Tianjin, China
| | - Wang Linan
- Department of Nursing, Tianjin Medical University, Tianjin, China
| | - Guo Ying
- Tianjin First Central Hospital, Tianjin, China
| | - Wang Peng
- Tianjin Medical College, Tianjin, China
| | - Hou Yahong
- Chinese people'Armed Police Force, Tianjin, China
| | - Ma Longting
- Hematology Hospital, Chinese Academy of Medical Sciences, Tianjin, China
| | - Wang Jing
- Tianjin Central Obstetrics and Gynecology Hospital, Tianjin, China
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Uysal İ, Başar S, Aysel S, Kalafat D, Büyüksünnetçi AÖ. Aerobic exercise and dual-task training combination is the best combination for improving cognitive status, mobility and physical performance in older adults with mild cognitive impairment. Aging Clin Exp Res 2023; 35:271-281. [PMID: 36550323 DOI: 10.1007/s40520-022-02321-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
AIM The aim of the present study was to investigate the effects of different exercise combinations on cognitive status, muscle strength of lower extremities, mobility, physical performance, mood and quality of life in older adults with mild cognitive impairment (MCI). METHODS A total of 48 older adults with MCI were randomly assigned to four groups: (1) aerobic plus lower extremity strengthening exercises (AG), (2) dual-task training plus lower extremity strengthening exercises (DG), (3) aerobic exercise, dual-task training and lower extremity strengthening exercises (ADG), (4) solely lower extremity strengthening exercises (CG). Patients' cognitive status, lower extremity muscle strength, balance, mobility, activities-specific balance confidence, functional exercise capacity, physical performance, mood and quality of life were evaluated. RESULTS In all three intervention groups, there was a significant improvement in cognitive status, balance, mobility, activities-specific balance confidence, physical performance, mood and quality of life (p < 0.05). The most remarkable change was observed in the ADG on cognitive status, mobility and physical performance parameters (p < 0.05). In addition, the most significant improvement in balance parameters was recorded both in the DG and ADG (p < 0.05). Besides, the highest increase in functional exercise capacity was detected both in the AG and ADG (p < 0.05). On the other hand, both exercise combinations were superior to the control group in terms of improving mood and quality of life (p < 0.05). CONCLUSION The trial results proved that aerobic exercise and dual-task training is the best combination for improving cognitive status, mobility and physical performance in older adults with MCI.
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Affiliation(s)
- İsmail Uysal
- Fethiye Vocational School of Health Services, Department of Elderly Care, Muğla Sıtkı Koçman University, 48330, Fethiye, Muğla, Turkey.
| | - Selda Başar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
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SMARTfit Dual-Task Exercise Improves Cognition and Physical Function in Older Adults With Mild Cognitive Impairment: Results of a Community-Based Pilot Study. J Aging Phys Act 2023:1-12. [PMID: 36716745 DOI: 10.1123/japa.2022-0040] [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: 03/01/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 02/01/2023]
Abstract
Mild cognitive impairment is an intermediate state between the cognitive decline often experienced in normal aging and dementia that affects 15% of Americans over 65 years of age. Our communities have an opportunity to support the development and adoption of evidence-based programs to help older adults preserve cognition and physical function. In partnership with a local urban YMCA in an underserved, predominantly minority neighborhood, we tested the appeal and therapeutic benefits of SMARTfit training among older adults with mild cognitive impairment. The participants reported a positive training experience. After 12 weeks of dual-task training, Trail-Making Test and Stroop Color-Word Interference Test scores improved, as did scores on the Short Physical Performance Battery. Results of our SMARTfit dual-task training intervention are encouraging. Larger randomized controlled trials must further investigate the development, implementation, and therapeutic impacts of SMARTfit dual-task training on cognitive and physical function in aging.
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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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28
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Chuang IC, Chiau HY, Liao WW, Wu YR, Chang CH, Wu CY. Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial. Digit Health 2023; 9:20552076231203633. [PMID: 37744745 PMCID: PMC10515553 DOI: 10.1177/20552076231203633] [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: 02/18/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment. Methods A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale. Results Significant interaction effects between group and time were found in WMS-spatial span (p = 0.04) and WMS-word lists (p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG (p = 0.039), PHY (p = 0.010) and SEQ groups (p = 0.017). For WMS-word lists, the SEQ group improve more than COG (p = 0.013), PHY (p = 0.030) and SIMUL (p = 0.019) groups. No significant differences were found in IADL performance among four groups (p = 0.645). Conclusions Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.
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Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan
| | - Hui-Yan Chiau
- Institute of Cognitive Neuroscience, National Central University, Taoyuan
| | - Wan-Wen Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei City
| | - Yih-Ru Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan
- College of Medicine, Chang Gung University, Taoyuan
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University in St Louis School of Medicine, St Louis, MO, USA
- Department of Medicine, Washington University in St Louis School of Medicine, St Louis, MO, USA
- Department of Orthopaedic Surgery, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Healthy Aging Research Center, Chang Gung University, Taoyuan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan
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Ahn S, Chung JW, Crane MK, Bassett DR, Anderson JG. The Effects of Multi-Domain Interventions on Cognition: A Systematic Review. West J Nurs Res 2022; 44:1134-1154. [PMID: 34261376 DOI: 10.1177/01939459211032272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This review aimed to evaluate the effects of multi-domain interventions on cognition among individuals without dementia. Multi-domain interventions refer to those combining any single preventive measure such as physical activity, cognitive training, and/or nutrition to prevent dementia. Seventeen studies were included (n = 10,056 total participants; mean age = 73 years), eight of which were rated as strong in quality while the other nine showed moderate quality. The standardized mean difference (SMD; d) was used to calculate the effect size for each included study. Multi-domain interventions consisting of physical activity, cognitive training, cardioprotective nutrition, and/or cardiovascular health education exerted beneficial effects on global cognition, episodic memory, and/or executive function with very small to moderate effect sizes (0.16-0.77). Nurses may consider combining these components to potentially stave off dementia. Future research is warranted to identify the optimal multi-domain intervention components that can induce clinically significant beneficial effects on cognition.
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Affiliation(s)
- Sangwoo Ahn
- College of Nursing, University of Tennessee, Knoxville, TN, USA
| | - Jae Woo Chung
- Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - David R Bassett
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - Joel G Anderson
- College of Nursing, University of Tennessee, Knoxville, TN, USA
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Kim H, Jung J, Lee S. Therapeutic Application of Virtual Reality in the Rehabilitation of Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. VISION (BASEL, SWITZERLAND) 2022; 6:vision6040068. [PMID: 36412649 PMCID: PMC9680273 DOI: 10.3390/vision6040068] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022]
Abstract
This review aimed to quantify the effect of therapeutic application of virtual reality (VR) on cognitive function in individuals with mild cognitive impairment (MCI). We searched for randomized controlled trials involving VR in the interventions provided to individuals with MCI. After searching four international electronic databases, we analyzed six studies involving 279 individuals with MCI. RevMan 5.4 was used for quality assessment and quantitative analysis. Therapeutic application of VR in individuals with MCI resulted in a significant improvement in cognitive function (mean difference = -1.46; 95% confidence interval: -2.53 to -0.39; heterogeneity: χ2 = 970.56, df = 18, I2 = 98%; and overall effect: Z = 2.67, p = 0.008). However, there was no significant improvement in the subcategories such as global cognition, working memory, executive function, memory function, and attention. In conclusion, feedback stimulation through VR has a potential value in improving cognitive function in individuals with MCI. However, on the basis of the results of the subcategories, a personalized VR program is required for the individual subcategories of cognitive function.
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Affiliation(s)
- Hyunjoong Kim
- Seogwangju Chung Yeon Rehabilitation Hospital, Gwangju 72070, Republic of Korea
- Department of Physical Therapy, Gwangju Health University, Gwangju 62287, Republic of Korea
| | - Jihye Jung
- Institute of SMART Rehabilitation, Sahmyook University, Seoul 01795, Republic of Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea
- Correspondence:
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Wang R, Zhang H, Li H, Ren H, Sun T, Xu L, Liu Y, Hou X. The influence of exercise interventions on cognitive functions in patients with amnestic mild cognitive impairment: A systematic review and meta-analysis. Front Public Health 2022; 10:1046841. [PMID: 36457329 PMCID: PMC9706097 DOI: 10.3389/fpubh.2022.1046841] [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: 09/17/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Patients with amnestic mild cognitive impairment (aMCI) are more likely to develop dementia compared to patients with non-aMCI (naMCI). Among the mixed samples of aMCI and naMCI, exercise interventions are effective for patients with MCI to improve cognitive functions. However, the influence of exercise interventions on patients with aMCI is still unclear. Objective The objective of this systematic review and meta-analysis is to evaluate the influence of exercise interventions on cognitive functions in patients with aMCI. Methods Four literature databases (PubMed, Web of Science, EBSCO, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) were searched from their inception to August 31, 2022. Based on the preliminary search of seven databases and their cited references, a total of 2,290 records were identified. Finally, 10 studies with a total of 28 data points involving 575 participants with aMCI were included in this meta-analysis. If the measurements of outcomes were different among studies, the effect size was synthesized using the standardized mean difference (SMD) with a 95% confidence interval (CI). If the measurements were the same, the weight mean difference (WMD) with a 95% CI was used to integrate the effect size. Data synthesis The results showed that exercise interventions had no significant effects on improving several specific domains of cognitive functions including working memory (WMD = -0.05; 95% CI = -0.74 to 0.63; p = 0.88; I 2 = 78%) and attention (SMD = 0.20; 95% CI = -0.31 to 0.72; p = 0.44; I 2 = 60%). Additionally, exercise interventions had a significant effect on global cognitive function (SMD = 0.70; 95% CI = 0.50-0.90; p < 0.00001; I 2 = 29%) and some specific cognitive domains including immediate recall (SMD = 0.55; 95% CI = 0.28-0.81; p < 0.0001; I 2 = 0%), delayed recall (SMD = 0.66; 95% CI = 0.45-0.87; p < 0.00001; I 2 = 37%), and executive function (SMD = 0.38; 95% CI = 0.16-0.60; p= 0.0006; I 2 = 4%). Furthermore, subgroup analysis based on the intervention forms indicated that multi-component interventions (SMD = 0.44; 95% CI = 0.11-0.77; p = 0.009; I 2 = 0%) appeared to be less effective than the single-component intervention (SMD = 0.85; 95% CI = 0.60-1.10; p < 0.00001; I 2 = 10%) in terms of boosting global cognitive function. Conclusion This meta-analysis suggests that the exercise can help patients with aMCI improve global cognitive function. And exercise interventions have positive influence on enhancing several specific cognitive domains such as immediate recall, delayed recall, and executive function.Systematic review registration: http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022354235.
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Affiliation(s)
- Rong Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hanyue Zhang
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China.,School of Physical Education, Northeast Normal University, Changchun, China
| | - Hongjuan Li
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hong Ren
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Tingting Sun
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Liya Xu
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Yang Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, China
| | - Xiao Hou
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
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Yang JG, Thapa N, Park HJ, Bae S, Park KW, Park JH, Park H. Virtual Reality and Exercise Training Enhance Brain, Cognitive, and Physical Health in Older Adults with Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13300. [PMID: 36293881 PMCID: PMC9602597 DOI: 10.3390/ijerph192013300] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED We investigated the effectiveness of virtual-reality-based cognitive training (VRCT) and exercise on the brain, cognitive, physical and activity of older adults with mild cognitive impairment (MCI). METHODS This study included 99 participants (70.8 ± 5.4) with MCI in the VRCT, exercise, and control groups. The VRCT consisted of a series of games targeting different brain functions such as executive function, memory, and attention. Twenty-four sessions of VRCT (three days/week) were performed, and each session was 100 min long. Exercise intervention consisted of aerobic and resistance trainings performed in 24 sessions for 60 min (2 times/week for 12 weeks). Global cognitive function was measured using the Mini-Mental State Examination (MMSE) test. Resting-state electroencephalography (EEG) of the neural oscillatory activity in different frequency bands was performed. Physical function was measured using handgrip strength (HGS) and gait speed. RESULTS After the intervention period, VRCT significantly improved the MMSE scores (p < 0.05), and the exercise group had significantly improved HGS and MMSE scores (p < 0.05) compared to baseline. One-way analysis of variance (ANOVA) of resting-state EEG showed a decreased theta/beta power ratio (TBR) (p < 0.05) in the central region of the brain in the exercise group compared to the control group. Although not statistically significant, the VRCT group also showed a decreased TBR compared to the control group. The analysis of covariance (ANCOVA) test showed a significant decrease in theta band power in the VRCT group compared to the exercise group and a decrease in delta/alpha ratio in the exercise group compared to the VRCT group. CONCLUSION Our findings suggest that VRCT and exercise training enhances brain, cognitive, and physical health in older adults with MCI. Further studies with a larger population sample to identify the effect of VRCT in combination with exercise training are required to yield peak benefits for patients with MCI.
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Affiliation(s)
- Ja-Gyeong Yang
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Ngeemasara Thapa
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Hye-Jin Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Seongryu Bae
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
| | - Kyung Won Park
- Department of Neurology, College of Medicine, Dong-A University, Busan 49201, Korea
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Korea
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Gao Z, Liu C, Yang L, Mei X, Wei X, Kuang J, Zhou K, Xu M. Longitudinal Association Between Depressive Symptoms and Cognitive Function Among Older Adults: A Latent Growth Curve Modeling Approach. Int J Public Health 2022; 67:1605124. [PMID: 36213141 PMCID: PMC9537360 DOI: 10.3389/ijph.2022.1605124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: Although the evidence from numerous longitudinal studies has indicated a remarkable change in cognitive function (CF) and depressive symptoms (DS) over time, the parallel latent growth curve model (LGCM) has seldom been used to simultaneously investigate the relationship between their change trajectories. This study aimed to examine whether a change in DS was associated with CF over time using an LGCM. Methods: Data were collected from the Chinese Longitudinal Healthy Longevity Survey's 2011, 2014, and 2018 waves. A parallel LGCM examined the association between CF and DS. Results: The multivariate conditioned model's goodness of fit supported the validity of the longitudinal model (Tucker-Lewis index [TLI] = 0.90, comparative fit index [CFI] = 0.96, root mean square error of approximation [RMSEA] = 0.04). The results showed that the CF intercept was positively to the DS slope (β = 0.42, p = 0.004). The CF and DS slopes were significantly linked (β = -0.65, p = 0.002). Conclusion: The findings expand the knowledge about CF's effect on DS in older adults.
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Affiliation(s)
- Zihan Gao
- School of Nursing, Qingdao University, Qingdao, China
| | - Cuiping Liu
- School of Nursing, Qingdao University, Qingdao, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, China
| | - Xinyi Mei
- School of Nursing, Wuhan University of Science and Technology, Wuhan, China
| | - Xiao Wei
- School of Nursing, Qingdao University, Qingdao, China
| | - Jinke Kuang
- School of Nursing, Qingdao University, Qingdao, China
| | - Kexin Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Mengfan Xu
- School of Nursing, Qingdao University, Qingdao, China
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Spatial Olfactory Memory and Spatial Olfactory Navigation, Assessed with a Variant of Corsi Test, Is Modulated by Gender and Sporty Activity. Brain Sci 2022; 12:brainsci12081108. [PMID: 36009170 PMCID: PMC9406228 DOI: 10.3390/brainsci12081108] [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: 05/29/2022] [Revised: 08/13/2022] [Accepted: 08/17/2022] [Indexed: 11/27/2022] Open
Abstract
Many studies have focused on navigation, spatial skills, and the olfactory system in comparative models, including those concerning the relationship between them and physical activity. Although the results are often in contrast with each other, it is assumed that physical activity can affect cognition in different ways—both indirectly and through a certain influence on some brain structures. In contrast, there is little research that focuses on the relationship between spatial abilities and olfactory abilities in humans. This research aimed to evaluate and compare the performance in working memory tasks of athletes and non-athletes who require good visual–spatial navigation, olfactory–spatial navigation, and olfactory–semantic skills. The study involved 236 participants (83 athletes) between the ages of 18 and 40. All subjects were matched by age or sex. The standard Corsi Block Tapping Test (CBTT) was administrated to investigate the visual-spatial memory. Olfactory–spatial navigation and olfactory–semantic skills were assessed with two modified versions of CBTT: Olfactory CBTT (OCBTT) and Semantic–Olfactory CBTT (SOCBTT) respectively. The results show differences between the CORSI conditions in direction of a poor performance for athletes. A gender effect in favor of men was also found, particularly in the classic version of the CBTT. Both groups performed better in the classic version of the CBTT than OCBTT and SOCBTT. The mean of SOCBTT results is markedly lower, perhaps due to the different information processing systems needed to perform this kind of task. It is possible to explain how sports practice can affect tasks that require spatial skills and olfactory perception differently, thus supporting new hypotheses and opening new scientific horizons.
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Rondão CADM, Mota MPG, Esteves D. Development of a Combined Exercise and Cognitive Stimulation Intervention for People with Mild Cognitive Impairment-Designing the MEMO_MOVE PROGRAM. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10221. [PMID: 36011852 PMCID: PMC9408716 DOI: 10.3390/ijerph191610221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Dementia patients are at high risk for the decline of both physical and cognitive capacities, resulting in an increased risk of the loss of autonomy. Exercise is regarded as a non-pharmacological therapy for dementia, considering the potential benefits of preventing cognitive decline and improving physical fitness. In this paper, we aim to describe the different design stages for an exercise program combined with cognitive stimulation for a population with mild cognitive impairment, i.e., the MEMO_MOVE program. METHODS The intervention design followed the Medical Research Council's guidelines for complex interventions and was structured according to the six steps in quality intervention development (6SQuID). The intervention was described considering the Template for Intervention Description and Replication (TIDieR). In order to establish the intervention characteristics, a literature review was conducted to collate and analyze previous work, which provided a summary the type of exercise that should be implemented among this population. RESULTS The MEMO_MOVE program was structured and described, regarding (i) inclusion of a cognitive stimulation component; (ii) the kind of cognitive stimulation; and (iii) the type of exercise, duration, frequency, intensity, and program length. CONCLUSIONS A systematic step-by-step process design was followed to create a specific intervention to promote physical fitness and cognitive stimulation in individuals with mild dementia.
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Affiliation(s)
| | - Maria Paula Gonçalves Mota
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sports, University of Trás os Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Dulce Esteves
- Department of Sports, University of Beira Interior, 6201-001 Covilhã, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
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Han K, Tang Z, Bai Z, Su W, Zhang H. Effects of combined cognitive and physical intervention on enhancing cognition in older adults with and without mild cognitive impairment: A systematic review and meta-analysis. Front Aging Neurosci 2022; 14:878025. [PMID: 35928994 PMCID: PMC9343961 DOI: 10.3389/fnagi.2022.878025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/28/2022] [Indexed: 12/11/2022] Open
Abstract
Background Combined cognitive and physical intervention is commonly used as a non-pharmacological therapy to improve cognitive function in older adults, but it is uncertain whether combined intervention can produce stronger cognitive gains than either single cognitive or sham intervention. To address this uncertainty, we performed a systematic review and meta-analysis to evaluate the effects of combined intervention on cognition in older adults with and without mild cognitive impairment (MCI). Methods We systematically searched eight databases for relevant articles published from inception to November 1, 2021. Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) were used to compare the effects of the combined intervention with a single cognitive or sham intervention on cognition in older adults with and without MCI aged ≥ 50 years. We also searched Google Scholar, references of the included articles, and relevant reviews. Two independent reviewers performed the article screening, data extraction, and bias assessment. GRADEpro was used to rate the strength of evidence, and RevMan software was used to perform the meta-analysis. Results Seventeen studies were included in the analysis, comprising eight studies of cognitively healthy older adults and nine studies of older adults with MCI. The meta-analysis showed that the combined intervention significantly improved most cognitive functions and depression (SMD = 0.99, 95% CI 0.54-1.43, p < 0.0001) in older adults compared to the control groups, but the intervention effects varied by cognition domains. However, there was no statistically significant difference in the maintenance between the combined and sham interventions (SMD = 1.34, 95% CI -0.58-3.27, p = 0.17). The subgroup analysis also showed that there was no statistical difference in the combined intervention to improve global cognition, memory, attention, and executive function between cognitive healthy older adults and older adults with MCI. Conclusions Combined intervention improves cognitive functions in older adults with and without MCI, especially in global cognition, memory, and executive function. However, there was no statistical difference in the efficacy of the combined intervention to improve cognition between cognitive healthy older adults and older adults with MCI. Moreover, the maintenance of the combined intervention remains unclear due to the limited follow-up data and high heterogeneity. In the future, more stringent study designs with more follow-ups are needed further to explore the effects of combined intervention in older adults. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42021292490.
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Affiliation(s)
- Kaiyue Han
- School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Zhiqing Tang
- School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Zirong Bai
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Wenlong Su
- School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | - Hao Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
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Barisch-Fritz B, Bezold J, Scharpf A, Trautwein S, Krell-Roesch J, Woll A. ICT-Based Individualized Training of Institutionalized Individuals With Dementia. Evaluation of Usability and Trends Toward the Effectiveness of the InCoPE-App. Front Physiol 2022; 13:921105. [PMID: 35874545 PMCID: PMC9304760 DOI: 10.3389/fphys.2022.921105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/27/2022] [Indexed: 01/10/2023] Open
Abstract
Physical activity interventions can alleviate the course of disease for individuals with dementia (IWD) who have been extraordinarily affected by the COVID-19 pandemic. Information and Communication Technology (ICT) provides new opportunities not only to mitigate negative effects of the pandemic but also to sustainably improve everyday life of IWD in nursing homes. The aim of the present study was to evaluate the ICT-based InCoPE-App, which was used to assess physical and cognitive performance and deliver individualized exercise for IWD, with regard to 1) user experience of nursing assistants, and 2) trends toward the effectiveness of the intervention on physical and cognitive performance of IWD. An 18-week individualized multidomain intervention (2 × 60 min/session) was delivered to an intervention group (IG; n = 10, mean age 88.4 ± 5.6, 70% female) by nursing assistants (n = 10, mean age 56.1 ± 10.4, 90% female) using the InCoPE-App. A control group (CG; n = 3, mean age 87.3 ± 3.5, 100% female) received conventional treatment. User experience was assessed among nursing assistants by different questionnaires, i.e., PSSUQ and ISONORM 9241/110-S for usability, and AttrakDiff2 for pragmatic (PQ), hedonic quality-identity and stimulation (HQI and HQS), and attractiveness (ATT). Trends toward the effectiveness of the intervention were assessed using MMSE (global cognitive function), FICSIT-4 (balance), 6MWT and TUG (mobility), and m30CST (function of lower limbs). Usability of the InCoPE-App was rated as high by nursing assistants (mean ± SD; overall PSSUQ 2.11 ± 0.75; overall ISONORM 9241/110-S 1.90 ± 0.88; ATT 1.86 ± 1.01; PQ 1.79 ± 1.03; HQI 1.8 ± 0.79; and HQS 1.37 ± 0.69). Dropout was high in the total sample (36.7%). Trends toward the effectiveness were observed within IG in nine IWD who showed positive or neutral trends in at least two physical performance outcomes. Seven participants had positive or neutral trends in the FICSIT-4, seven participants in m30CST, and four and seven participants in 6MWT and TUG, respectively. In conclusion, the InCoPE-App has good nursing assistant-rated usability, whereas training effects and intervention adherence were rather low most likely due to COVID-19 restrictions. Single-subject research revealed more positive than negative trends in IG of IWD. Further research is needed to evaluate feasibility, suitability, and effectiveness of the InCoPE-App.
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Affiliation(s)
- Bettina Barisch-Fritz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Gait Speed and Sleep Duration Is Associated with Increased Risk of MCI in Older Community-Dwelling Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137625. [PMID: 35805289 PMCID: PMC9266270 DOI: 10.3390/ijerph19137625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 12/29/2022]
Abstract
This study aimed to examine the linear and nonlinear associations between sleep duration and gait speed and the risk of developing mild cognitive impairment (MCI) in community-dwelling older adults. Participants were 233 older adults who met the study inclusion criteria. The MCI diagnosis was based on medical evaluations through a clinical interview conducted by a dementia specialist. Self-reported sleep duration was evaluated using the Pittsburgh Sleep Quality Index. The usual gait speed was calculated from the time taken to walk along a 4 m walkway. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (95% CI) of developing MCI in relation to sleep duration and gait speed. Generalized additive models were used to examine the dose−response relationships between sleep duration, gait speed, and the risk of developing MCI. Slower gait speed (OR: 1.84, 95%; CI: 1.00−3.13) and poor sleep duration (OR: 1.76, 95%; CI: 1.00−3.35) were associated with the risk of developing MCI, compared with their optimal status. In addition, the combination of poor sleep and slower gait was associated with a higher risk of developing MCI than optimal sleep duration and gait speed (OR: 3.13, 95%; CI: 1.93−5.14). Furthermore, gait speed and sleep duration were non-linearly associated with the risk of developing MCI. These results highlight the complex interplay and synergism between sleep duration and gait abilities on the risk of developing MCI in older adults. In addition, our results suggest that slower gait speed (<1.0 m/s) and short (<330 min) and long (>480 min) sleep duration may be linked to MCI risks through underlying pathways.
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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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Eubank JM, Oberlin DJ, Alto A, Sahyoun NR, Asongwed E, Monroe-Lord L, Harrison EA. Effects of Lifestyle Factors on Cognition in Minority Population of Older Adults: A Review. Front Nutr 2022; 9:841070. [PMID: 35369047 PMCID: PMC8966895 DOI: 10.3389/fnut.2022.841070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
The onset of dementia and Alzheimer's disease (AD) is projected to expand over the next several decades in the United States as the population ages. However, the cognitive health burden is not equally distributed among the population, as Hispanics and African Americans are at higher risk of AD when compared with Non-Hispanic Whites. There is some evidence to indicate that cognitive decline may be associated with lifestyle factors and that interventions in these domains may prevent or delay this decline. These lifestyle factors include social engagement, physical activity, both aerobic and strength training, dietary intake, sleep and stress. This review summarizes, in general, what is known about the relationship between risk factors and cognition and, in particular what is known about this relationship in minority populations. The results show that the relationship between these risk factors and cognitive decline is stronger for some of the factors such as physical activity and dietary intake and weaker for the other factors depending on what is measured and in what populations. It does appear, however, that the studies in minority populations is limited and warrants more targeted research and interventions.
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Affiliation(s)
- Jacob M. Eubank
- Lehman College, City University of New York, New York, NY, United States
- *Correspondence: Jacob M. Eubank ; orcid.org/0000-0003-1806-9308
| | - Douglas J. Oberlin
- Lehman College, City University of New York, New York, NY, United States
| | - Andrew Alto
- Lehman College, City University of New York, New York, NY, United States
| | - Nadine R. Sahyoun
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD, United States
| | - Elmira Asongwed
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
| | - Lillie Monroe-Lord
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
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Mix-and-Match or Mismatch? Exploring the Perspectives of Older Adults About Zumba Dance and Its Potential Utilization for Dual-Task Training. J Aging Phys Act 2022; 30:893-905. [PMID: 35196649 DOI: 10.1123/japa.2021-0293] [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: 07/29/2021] [Revised: 12/23/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022]
Abstract
Despite the popularity of Zumba dancing, research is scarce about its impact on older adults. Meanwhile, the integration of cognitive tasks with physical exercises, also known as dual tasking, is an evolving strategy to facilitate activities for older adults. This study investigated the perceptions of persons aged ≥55 years on Zumba and its potential to be incorporated into a dual-task program. We conducted a descriptive-qualitative study involving 44 Filipino older adults. Using content analysis, four themes were identified: moving toward match or mismatch, balancing benefits with burdens, dual tasking as innovative yet potentially challenging, and overcoming barriers with enablers. Although Zumba was perceived as an inclusive and beneficial activity, individual and contextual limitations could hinder its suitability. Moreover, dual tasking in Zumba was considered an innovative approach, although challenges should be addressed to promote its feasibility. Several strategies could enable the design and implementation of age-appropriate Zumba and dual-tasking programs for older adults.
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Wang S, Liu HY, Cheng YC, Su CH. Exercise Dosage in Reducing the Risk of Dementia Development: Mode, Duration, and Intensity-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413331. [PMID: 34948942 PMCID: PMC8703896 DOI: 10.3390/ijerph182413331] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022]
Abstract
Senile dementia, also known as dementia, is the mental deterioration which is associated with aging. It is characterized by a decrease in cognitive abilities, inability to concentrate, and especially the loss of higher cerebral cortex function, including memory, judgment, abstract thinking, and other loss of personality, even behavior changes. As a matter of fact, dementia is the deterioration of mental and intellectual functions caused by brain diseases in adults when they are mature, which affects the comprehensive performance of life and work ability. Most dementia cases are caused by Alzheimer’s disease (AD) and multiple infarct dementia (vascular dementia, multi-infarct dementia). Alzheimer’s disease is characterized by atrophy, shedding, and degenerative alterations in brain cells, and its occurrence is linked to age. The fraction of the population with dementia is smaller before the age of 65, and it increases after the age of 65. Since women live longer than men, the proportion of women with Alzheimer’s disease is higher. Multiple infarct dementia is caused by a cerebral infarction, which disrupts blood supply in multiple locations and impairs cerebral cortex function. Researchers worldwide are investigating ways to prevent Alzheimer’s disease; however, currently, there are no definitive answers for Alzheimer’s prevention. Even so, research has shown that we can take steps to reduce the risk of developing it. Prospective studies have found that even light to moderate physical activity can lower the risk of dementia and Alzheimer’s disease. Exercise has been proposed as a potential lifestyle intervention to help reduce the occurrence of dementia and Alzheimer’s disease. Various workout modes will be introduced based on various physical conditions. In general, frequent exercise for 6–8 weeks lessens the risk of dementia development.
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Affiliation(s)
- Sukai Wang
- College of Physical Education, Huaqiao University, Quanzhou 362021, China;
| | - Hong-Yu Liu
- Department of Exercise and Health Promotion, Chinese Culture University, Taipei 111369, Taiwan; (H.-Y.L.); (Y.-C.C.)
| | - Yi-Chen Cheng
- Department of Exercise and Health Promotion, Chinese Culture University, Taipei 111369, Taiwan; (H.-Y.L.); (Y.-C.C.)
| | - Chun-Hsien Su
- College of Kinesiology and Health, Chinese Culture University, Taipei 111369, Taiwan
- Correspondence: ; Tel.: +886-975159678
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Sun J, Zeng H, Pan L, Wang X, Liu M. Acupressure and Cognitive Training Can Improve Cognitive Functions of Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Front Psychol 2021; 12:726083. [PMID: 34867607 PMCID: PMC8635488 DOI: 10.3389/fpsyg.2021.726083] [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: 06/16/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Given the limited effectiveness of pharmacological treatments in mitigating cognitive decline in individuals with mild cognitive impairment (MCI), there is a pressing need for developing effective non-pharmacological intervention programs to counteract MCI-related cognitive decline. Acupressure and cognitive training are safe and cost-effective; however, evidence of the effect of acupressure or the combined effect of acupressure and cognitive training on cognitive functions of older adults with MCI is limited. Objective: To evaluate both the individual and combined effects of acupressure and cognitive training on cognitive functions of older adults with MCI. Methods: One hundred and eighty older adults with MCI were recruited and randomly assigned to combined acupressure and cognitive training group (n = 45), acupressure group (n = 45), cognitive training group (n = 45), or control group (n = 45). Participants in the experimental groups received self-administered and group-based training sessions, while those in the control group received routine community education. The intervention lasted for 6 months. The cognitive functions of all the participants were assessed at multiple stages, including pre-intervention, at the end of the third and sixth months. Results: One hundred and fifty-one participants completed the study, and all participants analyzed in intervention groups completed at least 85% of all practice sessions recommended. Repeated measures analysis of variance of the scores of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at different time points among the four groups revealed that the group effect, time effect, and interaction effect were all significant (p < 0.01). Pairwise comparisons with Bonferroni correction showed that the scores of MMSE and MoCA in acupressure group, cognitive training group, and combined group were significantly raised compared with control group (p < 0.01). Compared with acupressure or cognitive training groups, the scores of MMSE and MoCA in combined group were significantly higher (p < 0.05). The scores of MMSE and MoCA in acupressure group had no significant differences with those in cognitive training group (p > 0.05). Conclusion: Acupressure and cognitive training both could improve the cognitive functions of older adults with MCI, and when used together, the effects were enhanced. Clinical Trial Registration: This study was registered in the Chinese Clinical Trial Registry (No.ChiCTR2100049955).
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Affiliation(s)
- Jingxian Sun
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hui Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Lu Pan
- Second Xiangya Hospital, Central South University, Changsha, China
| | | | - Mengjiao Liu
- Second Xiangya Hospital, Central South University, Changsha, China
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Bowen ME, Gaynor B, Phillips LJ. Changes in Physical and Cognitive Function Predict Sedentary Behavior in Older Adults With Mild Cognitive Impairment. Res Gerontol Nurs 2021; 14:285-291. [PMID: 34807787 DOI: 10.3928/19404921-20211021-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current longitudinal study examined the influence of cognitive and lower extremity function on sedentary behavior continuously over 6 months in community-dwelling older adults with mild cognitive impairment (MCI). Multilevel models examined Montreal Cognitive Assessment (MoCA) change scores and the Short Physical Performance Battery (SPPB) on percent time in sedentary behavior among 17 older adults with MCI (50 to 74 observations for analysis). Sedentary behavior was measured daily and averaged monthly using wrist-worn actigraphy. Each 1-unit decrease in MoCA score was associated with an increase of 2 percentage points in sedentary behavior (p ≤ 0.01). In addition, each 1-unit decrease in chair stand score (lower extremity strength) was associated with an increase of 5 percentage points in sedentary behavior (p ≤ 0.01). Older adults experiencing cognitive decline and concurrent changes in lower extremity strength had the sharpest increase in sedentary behavior. Findings suggest lower body strengthening interventions may reduce sedentary behavior time and subsequently preserve physical functioning in this vulnerable population. [Research in Gerontological Nursing, 14(6), 285-291.].
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Effects of Aerobic Exercise Combined with Attentional Bias Training on Cognitive Function and Psychiatric Symptoms of Individuals with Methamphetamine Dependency: a Randomized Controlled Trial. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00686-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Chow G, Gan JKE, Chan JKY, Wu XV, Klainin-Yobas P. Effectiveness of psychosocial interventions among older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1986-1997. [PMID: 33200623 DOI: 10.1080/13607863.2020.1839861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This review aimed to examine available evidence concerning the effectiveness of psychosocial interventions in improving memory, executive function, depression and activities of daily living (ADL) in older adults with MCI. METHODS Eight electronic databases were used to conduct a comprehensive literature search for published and unpublished studies. A primary outcome was cognitive function, including memory and executive function. Secondary outcomes were depression and ADL. Two researchers independently appraised quality of included studies and extracted data. Meta-analysis, heterogeneity test, subgroup analysis and sensitivity analyses were performed. RESULTS Ten studies (out of 1,265 records) were included in this review. Psychosocial interventions contributed to a significant improvement in memory, not executive function, depression and ADL. Subgroup analyses suggested that interventions with a longer duration, more therapeutic sessions, and individual format had larger effect sizes. Strategies found to enhance memory entailed behavior modification and activation, memory training, visual imagery, storytelling, memory aids, journaling, and exercise. CONCLUSION Healthcare providers may offer psychosocial interventions to client with MCI in clinical settings. Higher quality trials should be conducted to increase solid evidence in this domain.
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Affiliation(s)
- Gigi Chow
- Khoo Teck Puat Hospital, Singapore, Singapore
| | | | | | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
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Binarelli G, Joly F, Tron L, Lefevre Arbogast S, Lange M. Management of Cancer-Related Cognitive Impairment: A Systematic Review of Computerized Cognitive Stimulation and Computerized Physical Activity. Cancers (Basel) 2021; 13:5161. [PMID: 34680310 PMCID: PMC8534081 DOI: 10.3390/cancers13205161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 01/27/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI) occurs frequently in patients living with cancer, with consequences on quality of life. Recently, research on the management of these difficulties has focused on computerized cognitive stimulation and computerized physical activity programs. This systematic review presents the state of knowledge about interventions based on computerized-cognitive stimulation and/or physical activity to reduce CRCI. The review followed the PRISMA guidelines. A search was conducted in PUBMED and Web of Science databases. Risk of bias analysis was conducted using the Rob2 tool and the quality of evidence was conducted following the GRADE approach. A total of 3776 articles were initially identified and 20 of them met the inclusion criteria. Among them, sixteen investigated computerized-cognitive stimulation and four computerized-physical activity. Most of the studies were randomized controlled trials and assessed the efficacy of a home-based intervention on objective cognition in adults with cancer. Overall, cognitive improvement was found in 11/16 computerized-cognitive stimulation studies and 2/4 computerized-physical activity studies. Cognitive stimulation or physical activity improved especially cognitive complaints, memory, and attention. These results suggest the efficacy of both computerized-cognitive stimulation and physical activity. However, we report a high risk of bias for the majority of studies and a low level of quality of evidence. Therefore, further investigations are needed to confirm the efficacy of these interventions and to investigate the possible added benefit on cognition of a combined computerized-cognitive/physical intervention.
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Affiliation(s)
- Giulia Binarelli
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Laure Tron
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Sophie Lefevre Arbogast
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
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Yang QH, Lyu X, Lin QR, Wang ZW, Tang L, Zhao Y, Lyu QY. Effects of a multicomponent intervention to slow mild cognitive impairment progression: A randomized controlled trial. Int J Nurs Stud 2021; 125:104110. [PMID: 34736073 DOI: 10.1016/j.ijnurstu.2021.104110] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Mild cognitive impairment affects 36% of people aged ≥65 years in China, around 50% of whom will develop dementia within 3 years. Early intervention can slow disease progression and delay the onset of dementia; however, whether a multicomponent intervention can decelerate the progression of mild cognitive impairment remains unknown. OBJECTIVE To evaluate the effects of a multicomponent intervention to slow mild cognitive impairment progression in Chinese patients. DESIGN Randomized controlled trial. SETTING(S) AND PARTICIPANTS This study was conducted in two large regional communities in Guangzhou, China. Patients aged ≥ 65 years diagnosed with mild cognitive impairment were included. METHODS A total of 112 eligible participants were assigned to receive either a 6-month multicomponent intervention or usual care from September 2019 until January 2021. Data were collected at the beginning of the study and at 1, 3, and 6 months thereafter. The primary outcomes were cognitive function, comprehensive physical capacity, depression, and quality of life. Analysis followed the intention-to-treat principle. A generalized estimating equation was used to determine intervention effects. RESULTS At baseline, clinical characteristics did not differ significantly between groups. Significant interaction effects between time and group were detected (p < 0.001), indicating that the scores of five outcomes (cognitive function, short physical performance battery, timed up and go test, quality of life, and depression) of intervention and control groups changed differently over time. Participants in the intervention group were found to have a significantly greater improvement in cognitive function, physical function, quality of life, and fewer depression symptoms compared with the control group at baseline and follow-up periods. CONCLUSIONS This study demonstrates the beneficial effects of a multicomponent intervention on cognitive function, physical function, depression symptoms, and quality of life in people with mild cognitive impairment in the East Asia region. The effectiveness and feasibility of this intervention program suggest that its application should be promoted in community settings to delay the progression of disease in people with mild cognitive impairment. Registration number:ChiCTR1900026042 Tweetable abstract: The multicomponent intervention improves cognitive/physical function, depression, and quality of life, slowing cognitive impairment progression.
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Affiliation(s)
| | - Xia Lyu
- Nursing Department, Shenzhen People's Hospital, Shenzhen, China
| | - Qing-Ran Lin
- Nursing Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zi-Wen Wang
- School of Nursing, Jinan University, Guangzhou, China
| | - Li Tang
- School of Nursing, Jinan University, Guangzhou, China
| | - Yu Zhao
- School of Nursing, Jinan University, Guangzhou, China
| | - Qi-Yuan Lyu
- School of Nursing, Jinan University, Guangzhou, China.
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Pilot testing of Dual-task Zumba Gold (DTZ) for community-dwelling people with mild cognitive impairment: A mixed-methods study. Geriatr Nurs 2021; 42:1397-1407. [PMID: 34624697 DOI: 10.1016/j.gerinurse.2021.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/09/2023]
Abstract
Dual-tasking (e.g., enrichment of physical activities with mental exercises) is an innovative strategy to enhance older adults' cognition. Meanwhile, Zumba is a popular dance program, but research is limited about its utility on older people or those with mild cognitive impairment (MCI). This study assessed the feasibility of a new intervention called dual-task Zumba Gold (DTZ) for people with MCI. A mixed-methods feasibility study involving ten people aged ≥55 years with MCI was conducted from December 2020 to March 2021. Nine participants completed the study (90%) with high intervention acceptability. Program adherence (90.3%) and implementation fidelity (92.2%) were high. Participants also expressed the program's benefits, challenges, and facilitators. Moreover, pilot test results suggested improvements in global cognition (Z=-2.680; p=0.007), quality of life (Z=-2.688; p=0.008), and mobility (Z=-2.333; p=0.020). Hence, DTZ is feasible and acceptable for people with MCI, offering potential multidomain effects. Future randomized controlled studies should confirm these outcomes.
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50
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Binarelli G, Lange M, Dos Santos M, Grellard JM, Lelaidier A, Tron L, Lefevre Arbogast S, Clarisse B, Joly F. Multimodal Web-Based Intervention for Cancer-Related Cognitive Impairment in Breast Cancer Patients: Cog-Stim Feasibility Study Protocol. Cancers (Basel) 2021; 13:cancers13194868. [PMID: 34638354 PMCID: PMC8508392 DOI: 10.3390/cancers13194868] [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: 07/09/2021] [Revised: 09/02/2021] [Accepted: 09/23/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Cognitive difficulties and their impact on patients’ quality of life are frequently reported by patients treated for breast cancer, who ask for support to improve these difficulties. Cognitive stimulation and physical activity resulted as beneficial for cognitive difficulties, but they are challenging to generalize in hospitals. To overcome this limitation, home-based computerized interventions have been proposed. In this study, the feasibility of a combined intervention of web-based cognitive stimulation and physical activity among breast cancer patients undergoing radiotherapy will be investigated. The overall goal is to develop interventions for cognitive difficulties adapted to supportive care units. Abstract Cancer-related cognitive impairment (CRCI) is a frequent side-effect of cancer treatment, with important consequences on patients’ quality of life. Cognitive stimulation and physical activity are the most efficient in improving cognitive impairment, but they are challenging to generalize in hospitals’ routine and to patients’ needs and schedules. Moreover, the added value of a combination of these interventions needs to be more investigated. The Cog-Stim study is an interventional study investigating the feasibility of a web-based multimodal intervention (combining cognitive stimulation and physical activity for the improvement of cognitive complaints among breast-cancer patients currently treated with radiotherapy (n = 20). Patients will take part in a 12-week program, proposing two sessions per week of web-based cognitive stimulation (20 min/session with HappyNeuron®) and two sessions per week of web-based physical activity (30 min/session with Mooven® platform). Cognitive complaints (FACT-Cog) and objective cognitive functioning (CNS Vital Signs®), anxiety, depression (HADS), sleep disorders (ISI) and fatigue (FACIT-Fatigue) will be assessed before and after the intervention. The primary endpoint is the adherence rate to the intervention program. Patients’ satisfaction, reasons for non-attrition and non-adherence to the program will also be assessed. The overall goal of this study is to collect information to develop web-based interventions for cognitive difficulties in supportive care units.
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Affiliation(s)
- Giulia Binarelli
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France;
- Correspondence: ; Tel.: +33-2-31-45-86-09; Fax: +33-2-31-45-50-97
| | - Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France;
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Mélanie Dos Santos
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France;
| | - Jean-Michel Grellard
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
| | - Anaïs Lelaidier
- Northwest Data Center (CTD-CNO), Ligue Nationale Contre le Cancer and French National Cancer Institute (INCa), 14000 Caen, France;
| | - Laure Tron
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France;
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Sophie Lefevre Arbogast
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France;
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Benedicte Clarisse
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.); (J.-M.G.); (S.L.A.); (B.C.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France;
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
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