The association of the 24-hour activity cycle profiles with cognition in older adults with mild cognitive impairment: A cross-sectional study

BACKGROUND

The relationship of cognition and the 24-hour activity cycles (24-HAC), encompassing physical activity, sedentary behaviour, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviours can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles.

METHODS

We conducted a cross-sectional analysis utilizing baseline data from three randomized controlled trials involving 253 community-dwelling older adults (55+ years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition.

RESULTS

Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n=108) engaged in all 24-HAC behaviours around the sample average. Profile 2 ("Active Chillers," n=64) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behaviour. Profile 3 ("Physical Activity Masters," n=56) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n=25) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p>0.05).

CONCLUSION

Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.

Aerobic exercise training effects on hippocampal volume in healthy older individuals: a meta-analysis of randomized controlled trials

We conducted a meta-analysis of randomized controlled trials investigating the effects of aerobic exercise training (AET) lasting ≥ 4 weeks on hippocampal volume and cardiorespiratory fitness (CRF) in cognitively unimpaired, healthy older individuals. Random-effects robust variance estimation models were used to test differences between AET and controls, while meta-regressions tested associations between CRF and hippocampal volume changes. We included eight studies (N = 554) delivering fully supervised AET for 3 to 12 months (M = 7.8, SD = 4.5) with an average AET volume of 129.85 min/week (SD = 45.5) at moderate-to-vigorous intensity. There were no significant effects of AET on hippocampal volume (SMD = 0.10, 95% CI - 0.01 to 0.21, p = 0.073), but AET moderately improved CRF (SMD = 0.30, 95% CI 0.12 to 0.48, p = 0.005). Improvement in CRF was not associated with changes in hippocampal volume (bSE = 0.05, SE = 0.51, p = 0.923). From the limited number of studies, AET does not seem to impact hippocampal volume in cognitively unimpaired, healthy older individuals. Notable methodological limitations across investigations might mask the lack of effects.

The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease

OBJECTIVE

To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke.

DESIGN

Systematic review and robust variance estimation meta-analysis with meta-regression.

DATA SOURCES

Systematic search of MEDLINE, Web of Science, and CINAHL databases.

RESULTS

Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes.

CONCLUSION

Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function.

Effects of exercise training on the cognitive function of older adults with different types of dementia: a systematic review and meta-analysis

OBJECTIVES

To assess the effect of exercise training on the cognitive function of older adults living with different types of dementia, as well as potential moderators of exercise efficacy.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Cochrane Central, PsycINFO, Embase, Medline and CINAHL.

ELIGIBILITY CRITERIA

Peer-reviewed, randomised controlled trials, in English (1990-present), which examined the effects of exercise training on the cognitive function of older adults living with dementia.

STUDY APPRAISAL AND SYNTHESIS

Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0 and Physiotherapy Evidence Database Scale). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test.

RESULTS

Twenty-eight studies (n=2158) were included in the qualitative review and 25 in the meta-analysis. For all-cause dementia, a small effect of exercise training on cognitive function was observed (g=0.19; 95% CI 0.05 to 0.33; p=0.009). Type of dementia and exercise training characteristics did not moderate the effects of exercise training on cognitive function (p>0.05). Adherence to the intervention moderated the cognitive outcome effect size such that greater mean adherence was associated with greater cognitive outcome effect sizes (b=0.02; SE=0.01; p=0.005).

CONCLUSION

Exercise training showed small benefits for the cognitive function of older adults living with all-cause dementia. More research and standardised reporting of exercise training characteristics can strengthen the evidence for what works best for which types of dementia.

PROSPERO REGISTRATION NUMBER

CRD42020198716.

Sources of Caregiving Burden in Middle-Aged and Older Latino Caregivers

OBJECTIVE

We aimed to identify sources of caregiver burden in middle-aged and older Latino caregivers of people with Alzheimer disease and related dementia (ADRD).

METHODS

Participants were recruited through an agreement with the Rush Alzheimer's Disease Center Clinic Data Repository. We conducted semistructured interviews with 16 middle-aged and older Latinos who were the primary caregiver for a family member diagnosed with ADRD. The interview guide consisted of questions and probes to capture participants' perceptions of family caregiving. Direct content analysis was performed.

RESULTS

Participants were aged 50 to 75 years (n = 16) and a majority female (n = 12). The sources of burden identified were (1) caregiver responsibilities, (2) caregiving-related health decline, (3) lack of support, (4) financial status, (5) vigilance, and (6) concerns about the future.

CONCLUSIONS

The influence of gender roles seemed to play a role in caregivers' perceptions of sources of burden, especially on caregiver responsibilities and perceptions of lack of support. Latinos cultural values such as familismo and marianismo likely reinforced gender disparities in family caregiving.

A Walking Intervention Supplemented With Mobile Health Technology in Low-Active Urban African American Women With Asthma: Proof-of-Concept Study

Background

Physical inactivity is associated with worse asthma outcomes. African American women experience disparities in both physical inactivity and asthma relative to their white counterparts. We conducted a modified evidence-based walking intervention supplemented with mobile health (mHealth) technologies to increase physical activity (PA).

Objective

This study aimed to assess the preliminary feasibility of a 7-week walking intervention modified for African American women with asthma.

Methods

African American women with suboptimally controlled asthma were identified from a health system serving low-income minorities. At a baseline data collection visit, participants performed spirometry and incremental shuttle walk test, completed questionnaires, and were given an accelerometer to wear for 1 week. The intervention comprised an informational study manual and 3 in-person group sessions over 7 weeks, led by a nurse interventionist, in a community setting. The supplemental mHealth tools included a wearable activity tracker device (Fitbit Charge HR) and one-way text messages related to PA and asthma 3 times per week. A secure Web-based research platform, iCardia, was used to obtain Fitbit data in real time (wear time, moderate-to-vigorous physical activity [MVPA] and sedentary time) and send text messages. The feasibility of the intervention was assessed in the domains of recruitment capability, acceptability (adherence, retention, engagement, text messaging, acceptability, complaints, and concerns), and preliminary outcome effects on PA behavior (change in steps, duration, and intensity).

Results

We approached 22 women, of whom 10 were eligible; 7 consented, enrolled and completed the study. Group session attendance was 71% (5/7), 86% (6/7), and 86% (6/7), respectively, across the 3 sessions. All participants completed evaluations at each group session. The women reported being satisfied or very satisfied with the program (eg, location, time, and materials). None of them had concerns about using, charging, or syncing the Fitbit device and app. Participants wore their Fitbit device for at least 10 hours per day in 44 out of the 49 intervention days. There was an increase in Fitbit-measured MVPA from week 1 (19 min/week, SD 14 min/week) to the last week of intervention (22 min/week, SD 12 min/week; Cohen d=0.24, 95% CI 0.1 to 6.4). A slight decrease in step count was observed from week 1 (8926 steps/day, SD 2156 steps/day) to the last week of intervention (8517 steps/day, SD 1612 steps/day; Cohen d=−0.21, 95% CI −876.9 to 58.9).

Conclusions

The initial feasibility results of a 7-week community-based walking intervention tailored for African American women with asthma and supplemented with mHealth tools are promising. Modifications to recruitment, retention, and the intervention itself are needed. These findings support the need to conduct a further modified pilot trial to collect additional data on feasibility and estimate the efficacy of the intervention on asthma and PA outcomes.

Actividad física y TDAH: evidencia sobre el desarrollo, efectos neurocognitivos a corto y largo plazo y sus aplicaciones

PROBLEMA: El trastorno por Déficit de Atención e Hiperactividad (TDAH) está caracterizado por retrasos en el desarrollo neurobiológico. La actividad física (AF) puede influir en varios de los mecanismos neurocognitivos que también son afectados por el TDAH, por lo tanto, puede considerarse parte del tratamiento y manejo del TDAH. Esta revisión sobre TDAH resumirá estudios que evaluaron AF, aptitud física y coordinación motora. CRITERIOS DE INCLUSIÓN/EXCLUSIÓN: Fueron incluidos artículos sobre AF en la niñez en el espectro de TDAH. RESULTADOS: Estudios transversales: los niños con TDAH  presentan niveles de AF más altos que aquellos niños aparentemente saludables. La niñez coincide con oportunidades para participar en juego libre, pero esta ventaja es reducida durante la adolescencia, en la cual la AF es estructurada y menos inclusiva. Durante la adultez, las personas con TDAH están más propensas a ser obesas y a no adoptar las recomendaciones de estilos de vida saludables. Estudios longitudinales: AF durante etapas tempranas predice la severidad de los síntomas del TDAH en etapas subsecuentes. Otros estudios: la AF moderada de corta duración brinda beneficios neurocognitivos. Los resultados sobre intervenciones de varias semanas difieren según la variable de interés y el grupo con el cual es comparada la intervención. CONCLUSIÓN/IMPLICACIONES: Las intervenciones de AF que retan las habilidades cognitivas y destrezas de movimientos  brindan beneficios a los niños con TDAH. Además, estimulan a niños, niñas y adolescentes a participar en AF estructurada, a cumplir con la recomendación de AF y a incluir AF de corta duración como parte de las rutinas diarias.

PHYSICAL ACTIVITY AND ADHD: EVIDENCE ON DEVELOPMENTAL TRAJECTORIES, TRANSIENT AND DURABLE NEUROCOGNITIVE EFFECTS, AND REAL-WORLD APPLICATIONS

THE PROBLEM: Attention-Deficit/Hyperactivity Disorder (ADHD), the most common childhood mental health disorder in the United States, is the behavioral manifestation of neurodevelopmental delays. Physical activity (PA) is broadly accessible, culturally acceptable, and influences many of the same neurocognitive systems delayed in ADHD. These factors make PA a potential tool in treatment and management plans. This selective qualitative review synthesizes findings from studies investigating PA, fitness, and motor coordination in ADHD. INCLUSION AND EXCLUSION CRITERIA: Studies of PA [and related constructs] in youth on the spectrum for ADHD. MAIN RESULTS: Cross-sectional studies suggest children with ADHD evidence similar or higher PA levels than typically developing peers in childhood—a period when most PA is free play—but any advantages dissipate by adolescence, as PA programs become increasingly structured and selective. In adulthood, individuals with ADHD are more likely to be obese and less likely to meet healthy lifestyle guidelines. Longitudinal studies suggest that PA at earlier life stages predicts symptom severity in subsequent stages. Acute bout experiments suggest transient benefits on neurocognitive function following moderate-intensity activity of limited duration. Multi-week intervention studies have tested diverse formats with results that differ based upon the chosen outcome and comparison group utilized. CONCLUSION AND PRACTICAL APPLICATIONS: Existing research suggests youth with ADHD may benefit most from PA interventions that challenge cognition and fundamental movement skills in childhood, empower youth to participate in structured programs and meet PA guidelines in adolescence, and strategically time PA bouts to maximize focus during difficult periods of daily routines.

Análise do nível de satisfação e perfeccionismo de atletas profissionais de futsal do Estado do Paraná

O estudo teve como objetivo investigar os níveis de satisfação e perfeccionismo de atletas de equipes de futsal da região norte e noroeste do Paraná. Participaram da pesquisa 58 esportistas adultos do gênero masculino. Como instrumentos foram utilizados o Questionário de Satisfação do Atleta e a Escala Multidimensional de Perfeccionismo. Para a análise dos dados, foram utilizados os testes Kolmogorov-Smirnov, o alfa de Cronbach, Anova de Medidas Repetidas, o Post Hoc de Bonferroni e o teste exato de Fisher, adotando p < 0,05. Os resultados evidenciaram que os atletas em geral demonstraram níveis moderados de satisfação atlética e não apresentaram características de perfeccionismo; não houve associação entre a tendência de perfeccionismo ajustado e desajustado com a satisfação dos atletas; não houve correlação entre as características do perfeccionismo e a satisfação dos atletas. Concluiu-se que o perfeccionismo não é um fator interveniente no nível de satisfação dos atletas das equipes de futsal da região norte e noroeste do Paraná.

Estado de fluxo em praticantes de escalada e skate downhill

Este estudo teve como objetivo investigar a prevalência do estado de fluxo em praticantes de escalada e skate downhill. Foram sujeitos 37 praticantes. Como instrumentos foram utilizadas a Escala de Motivação para o Esporte (SMS) e a Ficha de Percepção de Capacidade de Realização da Tarefa. A coleta foi realizada nos locais de prática das atividades. Para análise dos dados foram utilizados Shapiro-Wilk, Mann-Whitney e Anova one-way. Os resultados demonstraram: 4,54% dos praticantes de escalada e 13,33% de skate downhill atingiram os elementos do estado de fluxo; a maioria dos praticantes situou-se entre a fase de fluxo estados de ansiedade ou relaxamento e exaltação ou controle; o tempo de prática contribuiu para atingir metas e estado de fluxo. Concluiu-se: o estado de Fluxo teve baixa incidência nos praticantes, havendo interferência da falta de equilíbrio entre percepção das metas, habilidades e desafios nas atividades de aventura.