1
|
Walker R, Harada K. Affective Exercise Experience in Childhood and Psychological Determinants of Exercise Among Japanese Older Adults. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-13. [PMID: 39012628 DOI: 10.1080/02701367.2024.2375290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/27/2024] [Indexed: 07/17/2024]
Abstract
Japan faces significant challenges associated with its super-aged society. Exercise and physical activity are recommended strategies to promote healthy aging and quality of life in older age. However, what determines exercise behavior among Japanese older adults is relatively unknown. The principle aim of this study was to explore exercise determinants and their relation to exercise behavior among Japanese older adults. Completed self-report questionnaires were received from 1,000 Japanese older adults aged between 65 and 74 years who resided in the Kansai area. A cross-sectional maximum likelihood path analysis was used to test the relationships between variables, where it was hypothesized that affective experiences in childhood had an indirect association with the exercise behavior of Japanese older adults through the seven psychological determinants of exercise. Demographic factors were also included in the model as potential influences of all factors. Knowledge held the largest significant direct association with exercise behavior (β = .539, p = <.001), particularly more intense forms of exercise such as resistance exercise (β = .725, p = <.001) and moderate to strenuous exercise (β = .420, p = <.001), whilst affective exercise experience in childhood (B = 3.749, p = <.001) and gender (B = 5.183, p = .003) held significant indirect associations. This paper emphasizes the importance of exercise-related knowledge among Japanese older adults and future research is warranted to further explore the role of positive affective exercise experiences in childhood and their influence on exercise behavior, especially amongst girls.
Collapse
|
2
|
Wall J, Xie H, Wang X. Temporal Interactions between Maintenance of Cerebral Cortex Thickness and Physical Activity from an Individual Person Micro-Longitudinal Perspective and Implications for Precision Medicine. J Pers Med 2024; 14:127. [PMID: 38392561 PMCID: PMC10890462 DOI: 10.3390/jpm14020127] [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: 11/28/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 02/24/2024] Open
Abstract
Maintenance of brain structure is essential for neurocognitive health. Precision medicine has interests in understanding how maintenance of an individual person's brain, including cerebral cortical structure, interacts with lifestyle factors like physical activity. Cortical structure, including cortical thickness, has recognized relationships with physical activity, but concepts of these relationships come from group, not individual, focused findings. Whether or how group-focused concepts apply to an individual person is fundamental to precision medicine interests but remains unclear. This issue was studied in a healthy man using concurrent micro-longitudinal tracking of magnetic resonance imaging-defined cortical thickness and accelerometer-defined steps/day over six months. These data permitted detailed examination of temporal relationships between thickness maintenance and physical activity at an individual level. Regression analyses revealed graded significant and trend-level temporal interactions between preceding activity vs. subsequent thickness maintenance and between preceding thickness maintenance vs. subsequent activity. Interactions were bidirectional, delayed/prolonged over days/weeks, positive, bilateral, directionally asymmetric, and limited in strength. These novel individual-focused findings in some ways are predicted, but in other ways remain unaddressed or undetected, by group-focused work. We suggest that individual-focused concepts of temporal interactions between maintenance of cortical structure and activity can provide needed new insight for personalized tailoring of physical activity, cortical, and neurocognitive health.
Collapse
Affiliation(s)
- John Wall
- Department of Neurosciences, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
| | - Hong Xie
- Department of Neurosciences, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
| | - Xin Wang
- Department of Neurosciences, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
- Department of Psychiatry, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
- Department of Radiology, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
| |
Collapse
|
3
|
Fritze S, Brandt GA, Benedyk A, Moldavski A, Geiger-Primo LS, Andoh J, Volkmer S, Braun U, Kubera KM, Wolf RC, von der Goltz C, Schwarz E, Meyer-Lindenberg A, Tost H, Hirjak D. Psychomotor slowing in schizophrenia is associated with cortical thinning of primary motor cortex: A three cohort structural magnetic resonance imaging study. Eur Neuropsychopharmacol 2023; 77:53-66. [PMID: 37717350 DOI: 10.1016/j.euroneuro.2023.08.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
Psychomotor slowing (PS) is characterized by slowed movements and lower activity levels. PS is frequently observed in schizophrenia (SZ) and distressing because it impairs performance of everyday tasks and social activities. Studying brain topography contributing to PS in SZ can help to understand the underlying neurobiological mechanisms as well as help to develop more effective treatments that specifically target affected brain areas. Here, we conducted structural magnetic resonance imaging (sMRI) of three independent cohorts of right-handed SZ patients (SZ#1: n = 72, SZ#2: n = 37, SZ#3: n = 25) and age, gender and education matched healthy controls (HC) (HC#1: n = 40, HC#2: n = 37, HC#3: n = 38). PS severity in the three SZ cohorts was determined using the Positive and Negative Syndrome Scale (PANSS) item #G7 (motor retardation) and Trail-Making-Test B (TMT-B). FreeSurfer v7.2 was used for automated parcellation and segmentation of cortical and subcortical regions. SZ#1 patients showed reduced cortical thickness in right precentral gyrus (M1; p = 0.04; Benjamini-Hochberg [BH] corr.). In SZ#1, cortical thinning in right M1 was associated with PANSS item #G7 (p = 0.04; BH corr.) and TMT-B performance (p = 0.002; BH corr.). In SZ#1, we found a significant correlation between PANSS item #G7 and TMT-B (p = 0.005, ρ=0.326). In conclusion, PANSS G#7 and TMT-B might have a surrogate value for predicting PS in SZ. Cortical thinning of M1 rather than alterations of subcortical structures may point towards cortical pathomechanism underlying PS in SZ.
Collapse
Affiliation(s)
- Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Geva A Brandt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anastasia Benedyk
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Alexander Moldavski
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Lena S Geiger-Primo
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Jamila Andoh
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sebastian Volkmer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | | | - Emanuel Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| |
Collapse
|
4
|
Delaire L, Courtay A, Humblot J, Aubertin-Leheudre M, Mourey F, Racine AN, Gilbert T, Niasse-Sy Z, Bonnefoy M. Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review. Nutrients 2023; 15:4100. [PMID: 37836384 PMCID: PMC10574358 DOI: 10.3390/nu15194100] [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: 07/31/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.
Collapse
Affiliation(s)
- Leo Delaire
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Aymeric Courtay
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Joannès Humblot
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Mylène Aubertin-Leheudre
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W5, Canada;
- Groupe de Recherche en Activité Physique Adaptée, Département des Sciences de l’Activité Physique, Université du Québec à Montréal (UQÀM), Montréal, QC H2L 2C4, Canada
| | - France Mourey
- Laboratoire CAPS (Cognition, Action, et Plasticité Sensorimotrice), Inserm U1093, UFR STAPS, Université de Bourgogne, Campus Universitaire, BP 27877, 21078 Dijon, France;
| | | | - Thomas Gilbert
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- RESHAPE Research on Healthcare Professionals and Performance, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Zeinabou Niasse-Sy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Marc Bonnefoy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Inserm U1060-CarMeN, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| |
Collapse
|
5
|
Eckert MA, Iuricich F, Harris KC, Hamlett ED, Vazey EM, Aston-Jones G. Locus coeruleus and dorsal cingulate morphology contributions to slowed processing speed. Neuropsychologia 2023; 179:108449. [PMID: 36528219 PMCID: PMC9906468 DOI: 10.1016/j.neuropsychologia.2022.108449] [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: 08/23/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022]
Abstract
Slowed information processing speed is a defining feature of cognitive aging. Nucleus locus coeruleus (LC) and medial prefrontal regions are targets for understanding slowed processing speed because these brain regions influence neural and behavioral response latencies through their roles in optimizing task performance. Although structural measures of medial prefrontal cortex have been consistently related to processing speed, it is unclear if 1) declines in LC structure underlie this association because of reciprocal connections between LC and medial prefrontal cortex, or 2) if LC declines provide a separate explanation for age-related changes in processing speed. LC and medial prefrontal structural measures were predicted to explain age-dependent individual differences in processing speed in a cross-sectional sample of 43 adults (19-79 years; 63% female). Higher turbo-spin echo LC contrast, based on a persistent homology measure, and greater dorsal cingulate cortical thickness were significantly and each uniquely related to faster processing speed. However, only dorsal cingulate cortical thickness appeared to statistically mediate age-related differences in processing speed. The results suggest that individual differences in cognitive processing speed can be attributed, in part, to structural variation in nucleus LC and medial prefrontal cortex, with the latter key to understanding why older adults exhibit slowed processing speed.
Collapse
Affiliation(s)
- Mark A Eckert
- Hearing Research Program, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, MSC 550, Charleston, S.C., 29425-5500, USA.
| | - Federico Iuricich
- Visual Computing Division, School of Computing, Clemson University, Clemson, S.C., 29634, USA
| | - Kelly C Harris
- Hearing Research Program, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, MSC 550, Charleston, S.C., 29425-5500, USA
| | - Eric D Hamlett
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, S.C., 29425-5500, USA
| | - Elena M Vazey
- Department of Biology, University of Massachusetts Amherst, Amherst, MA, 01003-9297, USA
| | - Gary Aston-Jones
- Brain Health Institute, Rutgers University/Rutgers Biomedical and Health Sciences, Piscataway, NJ, 08854, USA
| |
Collapse
|
6
|
A Systematic Study into the Effects of Long-Term Multicomponent Training on the Cognitive Abilities of Older Adults with Neurodegenerative Disorders. PSYCH 2022. [DOI: 10.3390/psych4040056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cognition includes all processes through which a person becomes aware of their situation, needs, goals, and necessary actions. Regular specialized cognitive and neuromotor simulation exercises have improved various cognitive processes, including memory, speed of reasoning, and problem-solving skills. This review focuses on understanding the efficacy of long-term multicomponent exercise interventions to mitigate and delay the effects on cognitive abilities in older adults with neurodegenerative disorders. The main criteria for final studies were randomised controlled trials with a minimum of a 24-week intervention. The Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, B-On, Sport Discus, Scielo, APA PsycINFO, Psychology and Behavioural Sciences, Academic Search Complete, Medline (PubMed), ERIC, and Google Scholar databases were checked. The search occurred between April 2022 and July 2022. A total of 19 studies were used in this review. The initial search identified 6.835 studies. In the first screening, a total of 6474 studies were excluded. After this, 361 studies were analysed by co-authors and did not meet the specific final criteria and were excluded. In total, 19 studies were included in the final analysis, and 14 papers met all requirements previously defined.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
The Development of the Psychological Determinants of Exercise Questionnaire for Japanese Older Adults: A Questionnaire Based Upon the Theoretical Domains Framework. J Aging Phys Act 2022; 30:857-871. [PMID: 35078152 DOI: 10.1123/japa.2021-0218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/19/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022]
Abstract
Japan has become a super-aged society. To overcome the negative implications of this, practitioners are increasingly using exercise-based interventions to reduce the requirement for long-term care among Japanese older adults. However, no comprehensive means of assessing the wide range of exercise behavioral determinants exists for this population. Thus, the principle aim of this study was to develop a questionnaire based upon the theoretical domains framework-a framework that has synthesized a wide range of behavior change theories. Completed responses were received from 1,000 Japanese older adults who resided in the Kansai area of Japan. Findings were suggestive of good reliability and validity for seven unique psychological determinants of exercise. This study was the first to provide a measurement tool related to a distinct range of psychological determinants of exercise among Japanese older adults.
Collapse
|
9
|
Yu F, Mathiason MA, Han S, Gunter JL, Jones D, Botha H, Jack C. Mechanistic Effects of Aerobic Exercise in Alzheimer's Disease: Imaging Findings From the Pilot FIT-AD Trial. Front Aging Neurosci 2021; 13:703691. [PMID: 34690736 PMCID: PMC8530186 DOI: 10.3389/fnagi.2021.703691] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Despite strong evidence from animal models of Alzheimer's disease (AD) supporting aerobic exercise as a disease-modifying treatment for AD, human mechanistic studies are limited with mixed findings. The objective of this pilot randomized controlled trial was to examine the effects of 6-month aerobic exercise on hippocampal volume, temporal meta-regions of interest (ROI) cortical thickness, white matter hyperintensity (WMH) volume, and network failure quotient (NFQ), measured with MRI, in community-dwelling older adults with AD dementia. Additionally, the relationships between 6- and 12-month changes in MRI biomarkers and the AD Assessment Scale-Cognition (ADAS-Cog) were examined. Sixty participants were randomized, but one was excluded because baseline MRI failed quality control: 38 randomized to cycling and 21 to stretching. The intervention was moderate-intensity cycling for 20-50 mins, three times a week for 6 months. Control was low-intensity stretching. The study outcomes include hippocampal volume, temporal meta-ROI cortical thickness, WMH volume, and NFQ. Outcomes were measured at baseline, 6 months, and 12 months. The sample averaged 77.3 ± 6.3 years old with 15.6 ± 2.9 years of education and 53% men. Both groups experienced significant declines over 6 months in hippocampal volume (2.64% in cycling vs. 2.89% in stretching) and temporal meta-ROI cortical thickness (0.94 vs. 1.54%), and over 12 months in hippocampal volume (4.47 vs. 3.84%) and temporal meta-ROI cortical thickness (2.27 vs. 1.79%). These declines did not differ between groups. WMH volume increased significantly with the cycling group increasing less (10.9%) than stretching (24.5%) over 6 months (f = 4.47, p = 0.04) and over 12 months (12.1 vs. 27.6%, f = 5.88, p = 0.02). NFQ did not change significantly over time. Pairwise correlational analyses showed a significant negative correlation between 6-month changes in hippocampal volume and ADAS-Cog (r = -0.34, p < 0.05). To conclude, aerobic exercise may reduce the decline in hippocampal volume and temporal meta-ROI cortical thickness during the intervention period, but the effect sizes are likely to be very small and dose-dependent and reverse once the intervention stops. Aerobic exercise is effective on slowing down WMH progression but has no effect on NFQ. Hippocampal atrophy was associated with cognitive decline during the intervention period. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01954550.
Collapse
Affiliation(s)
- Fang Yu
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ, United States
- University of Minnesota School of Nursing, Minneapolis, MN, United States
| | | | - SeungYong Han
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ, United States
| | | | - David Jones
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| | - Hugo Botha
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| | - Clifford Jack
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| |
Collapse
|
10
|
Kim Y, Chae M, Yang H. Simultaneous cognitive-physical dual task training based on fairy tales in older adults with mild cognitive impairment: A pilot study. Geriatr Nurs 2021; 42:1156-1163. [PMID: 34419868 DOI: 10.1016/j.gerinurse.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 12/29/2022]
Abstract
In this study, we aimed to develop a simultaneous cognitive-physical dual-task training program based on familiar cultural backgrounds using fairy tales and to explore its feasibility and preliminary effects, including effects on neurophysiological, cognitive, and physical functions. A single-group pretest-posttest design (n = 9) was employed to evaluate the effects of the cognitive-physical intervention performed for 60-90 min once a week for 12 weeks. The findings showed that perceived memory and physical self-efficacy, muscle strength, and cognitive function were significantly increased after the intervention. Although the relative beta band power measured using electroencephalography showed a tendency to increase in eight brain domains after the 12-week intervention, the changes were not significant. Findings suggested that the intervention was feasible and provided beneficial effects on cognitive and physical functions in older adults with mild cognitive impairment. Future research on larger sample sizes using randomized controlled trials is needed to determine the effectiveness of such interventions on neurophysiological functions.
Collapse
Affiliation(s)
- Younkyoung Kim
- Chonnam National University, College of Nursing, Gwangju, Republic of Korea
| | - Myeongjeong Chae
- Kwangju Women's University, Department of Nursing, Gwangju, Republic of Korea
| | - Hyunju Yang
- Chonnam National University, College of Nursing, Gwangju, Republic of Korea.
| |
Collapse
|
11
|
Merchant RA, Chan YH, Hui RJY, Tsoi CT, Kwek SC, Tan WM, Lim JY, Sandrasageran S, Wong BLL, Chen MZ, Ng SE, Morley JE. Motoric cognitive risk syndrome, physio-cognitive decline syndrome, cognitive frailty and reversibility with dual-task exercise. Exp Gerontol 2021; 150:111362. [PMID: 33887381 DOI: 10.1016/j.exger.2021.111362] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/28/2021] [Accepted: 04/17/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Cognitive frailty (CF) is associated with dementia and disability. It was initially proposed in 2013 by the International Institute of Nutrition and Aging and the International Geriatrics Association. Over the years, there have been many emerging definitions e.g., Motoric Cognitive Risk Syndrome (MCR), Physio-cognitive Decline Syndrome (PCDS), reversible CF and potentially reversible CF. OBJECTIVE Our objective was to determine the demographics including physical, functional, and psychosocial factors for the four CF definitions amongst community-dwelling older adults. In addition, the effect of dual-task exercise on the reversibility of different definitions of CF was also studied. METHODS Participants were community-dwelling older adults aged ≥60 years recruited between August 2017 and December 2019. Older adults screened to be frail, prefrail or have cognitive impairment were invited to participate in dual-task exercise program called HAPPY (Healthy Ageing Promotion Program for You). Improvement in cognition, frailty, and physical performance after a 3-month dual-task exercise intervention program was compared with controls. RESULTS The prevalence of CF depending on definition ranged from 8.8% to 28.7% with minimal overlap. The cognitive scores were significantly lower in all the groups predominantly affecting non-memory domains except for reversible CF. Frailty was three to seven times more prevalent in CF. MCR group had higher prevalence of functional limitation, pain and depression. All four groups had significant increase in global cognition scores especially in the attention domain where the control group declined, and reduction in the prevalence of frailty post intervention. MCR and reversible CF were significantly associated with increased odds of cognitive improvement after 3 months of intervention compared with control. CONCLUSION CF is a novel concept and regardless of the definitions, is a target for reversing frailty, functional limitation and cognitive impairment through dual-task exercise. Long-term prospective studies are needed to evaluate the effectiveness of dual-task interventions in delaying the conversion to dementia and reduction of disability.
Collapse
Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Richard Jor Yeong Hui
- National University Polyclinics, National University Health System, Singapore, Singapore
| | - Chris Tung Tsoi
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - Sing Cheer Kwek
- National University Polyclinics, National University Health System, Singapore, Singapore
| | - Weng Mooi Tan
- Integrated Health Division, MOH Office for Healthcare Transformation, Singapore
| | - Jia Yi Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Surein Sandrasageran
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - Beatrix Ling Ling Wong
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - Shu Ee Ng
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO, USA
| |
Collapse
|
12
|
Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, Aubertin-Leheudre M, Bernabei R, Cadore EL, Cesari M, Chen LK, de Souto Barreto P, Duque G, Ferrucci L, Fielding RA, García-Hermoso A, Gutiérrez-Robledo LM, Harridge SDR, Kirk B, Kritchevsky S, Landi F, Lazarus N, Martin FC, Marzetti E, Pahor M, Ramírez-Vélez R, Rodriguez-Mañas L, Rolland Y, Ruiz JG, Theou O, Villareal DT, Waters DL, Won Won C, Woo J, Vellas B, Fiatarone Singh M. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging 2021; 25:824-853. [PMID: 34409961 DOI: 10.1007/s12603-021-1665-8] [Citation(s) in RCA: 388] [Impact Index Per Article: 129.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.
Collapse
Affiliation(s)
- M Izquierdo
- Mikel Izquierdo, PhD, Department of Health Sciences, Public University of Navarra, Av. De Barañain s/n 31008 Pamplona (Navarra) Spain, Tel + 34 948 417876
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|